I think people need to talk about it more because it’s almost like the fourth trimester, it’s part of pregnancy.
Serena Williams
Postpartum: The Fourth Trimester
While the big birth moment gets most of the recognition, it is SO crucial not to underestimate postpartum or forget to plan for it. Regardless of the path your birth takes, in the postpartum period you will be healing physically as well as undergoing incredible changes emotionally and hormonally. Don’t forget to dedicate time and planning to what your early days and weeks will look like, and where you will get your support from.
We spent so much time planning for labour and delivery. But no one prepares you for your body or heart after you leave the hospital.
- @postpartumtogether
So let’s change that. Let’s consider both the moments before AND after your birth. Let’s set you up for success so that you feel held and confident during your postpartum journey as well.
Baby’s Coming: What do you really need? One of my favourite postpartum handouts challenges you to think beyond sleepers and diapers to the things that will really make a difference during those early weeks at home. While I’m not suggesting you ignore stocking up on diapers, I do encourage you to ALSO focus on the following postpartum considerations.
Make a Plan.
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Sleep.
Yes baby needs sleep, but just as importantly, so do you and your partner. Make a plan for not only where baby will sleep (in their own room, in your room, in their own sleep space, cosleeping), but also how you will ensure that your sleep needs are met. This may look like sharing nighttime parenting duties, prioritizing naps during the day, or bringing someone in from outside to enable you both to sleep. I know, I know. It’s so annoying to hear someone say “sleep when the baby sleeps” but it’s such a persistent phrase for a reason. In those early weeks, sleep trumps all. Offload any other responsibilities that you can in order to get enough sleep so you can roll with the other punches. And I promise - it’s a lot easier to have this conversation pre-baby than when you’re both already exhausted and a little emotionally fragile. One option? Have one parent get an ‘early bedtime’ and the other get a ‘sleepin’, offering both of you an extended stretch without having to wake for babe.
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Food.
Even if you’re not breastfeeding, your body still needs nutritional support to recover postpartum and thrive in early postpartum. While the increase in delivery apps sure makes this easier, best case scenario also provides you with easy access to healthy basics and easy grab options. Brainstorm together what meals and snacks you may want postpartum and how you will make that happen. I’m a huge fan of feeding the freezer - choose a few days throughout pregnancy to make staples and fill your freezer - muffins, protein bites, and cookies go great alongside lasagnas, prepped taco meat, chili, soups and egg bites. This is also a great task to hand off to family members who want to help but aren’t quite sure how. I would personally prioritize options that are easy to eat (one hand grab for the win!) or would be appetizing at multiple times of day. Another option is to source out meal delivery options that you can start postpartum.
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Household Help.
This portion will look different depending on your own needs. Take a look at the things you do on a regular basis, and plan out for those things that may be more difficult with a babe in arms. Do you have a pet that will need snuggles or walks? A litter box or yard the needs to be pooper scooped? Do you have a plan for getting our your garbage bins or picking up groceries. While you’re not incapable of doing these things during most postpartums, it can take a huge load off just to have one less thing to worry about. Other often forgotten tasks that friends or family members may be able to help with - laundry, entertainment or transportation for other children, or even just rides for yourself to and from appointments or shopping. Simple tasks like picking up groceries feel a lot less daunting when you’ve got another set of hands along.
Support and Resources.
The absolutely worst time to try to research something? When you’re already in the thick of it and feeling like you’re drowning. Do yourself a favour and create a resources list ahead of time that you can refer back to if you’re feeling overwhelmed or in need of support. Here’s a few ideas to start you out.
Postpartum Doula.
A postpartum doula provides in home support during the early days and weeks to ensure you feel nurtured. She will help take care of not just baby, but you. These are just a few of my favourites.
Parent and Baby Groups.
Sometimes all you need is to get out of the house and be around other people who understand what you’re going through. In the early days and weeks this will be more for you, but as they get older, interaction with others is super important for baby’s development as well - and you get to fill your social cup at the same time.
Therapy.
No matter how well you prepare, and how fantastic your personal support circle is, sometimes it needs to be a bit bigger. There is only strength in reaching out for additional support if you think you could use a hand.
Now that you’ve had a chance to start thinking about planning for postpartum, I wanted to suggest heading over to Dr Kristen’s website to grab her Postpartum Planning workbook. It is an incredible collection of things to consider, presented in a way that makes you feel empowered, not overwhelmed. Work your way through her suggestions, and reach out if you had any questions, or needed more resources.
Infant Feeding
Most parents plan to breastfeed their baby. That doesn’t mean that ALL parents will, or that the process will go as planned. I am a huge supporter of breastfeeding and breastfed all three of my own babies, but let me also tell you WHOLEHEARTEDLY that while breastfeeding may be the best biological option for your baby, that does not mean it is always the best choice for each family. And in the end - the choice needs to be right for your family, not anyone elses. There are a myriad of reasons that a family may choose either not to initiate breastfeeding, to switch to formula and/or bottles after starting breastfeeding, or to choose a combination of the two. If you choose to share those reasons with me, I am honoured. Regardless, I will support your feeding decisions as being the best for your family - because you said so.
With that out of the way, let’s look first at some infant feeding information that is going to be applicable no matter what method of feeding you are choosing.
Signs that baby is getting enough milk
The best practice for most newborn feeding is to feed on demand, which means paying attentions to babe’s hunger cues. Watch your baby, not the clock or the amount in the bottle, and pay attention to their cues. Early hunger cues may be turning their head from side to side, sticking their tongue out, puckering their lips, and sticking fists in their mouths. Crying tends to be a later sign of hunger, and if left that long, it may be harder to get baby calm enough to feed properly. In the early weeks if you can, it is best to limit pacifiers as these may lead to baby not feeding as often. Don’t worry if you can’t (I couldn’t), but make sure that you’re paying extra close mind to the other signs below.
Diaper Counts
In the first week you can typically expect baby to have the same number of wet/dirty diapers as the day they are on. Day 1 you should expect to see at least one wet and one poopy diaper. The poop will be black and sticky meconium (I highly recommend some vaseline on their bottom so it’s easier to get off). Day 2 will see at least two pees and two poops, which will start to turn more dark green. By Day 3 baby should have at least three pees and three poops, the the poop will transition more away from meconium, becoming a more brown/green or even yellowish colour. This pattern continues until approximately day 6 when you will notice the diapers level off. From this point, we should expect to see approximately six or more wet diapers, and around three of them should have some level of poop (note that these do not need to be huge poops to be considered, newborns are very efficient!). If you are breastfeeding, the poop after the first week will often be a light yellow, mustard like consistency, may change with what you eat, and may contain little curds or seed looking bits. If you are formula feeding it will tend to be more consistent, and typically thicker or pastier. Many blogs and well meaning friends and relatives will tell you that it’s normal for breastfed babies to go a few days in between pooping, but recent research suggests this isn’t necessarily ‘normal’ so keep an eye on baby’s temperment and other behaviors and bring it up with your lactation consultant or nutritionist if you have any concerns.
Weight Gain
Alongside those diaper counts above, monitoring weight gain is going to give you your most accurate confirmation that baby is getting enough milk. To start with though, I want you to keep in mind that their birth weight may be overinflated depending on if and how much IV fluids you received during labour. It is normal for newborns to lose approximately 5-7% of their birth weight in the first few days after birth. After this, they should start to gain again, and most babies are expected to be at their birth weight by approximately two weeks old. If your baby loses more than 8% of their birth weight, your midwife or pediatrician will likely recommend watching closely, and if they creep closer to 10%, supplementation will almost certainly be recommended. This can be additional breastmilk or formula, and could take many forms, so make sure to ask questions if you’re not comfortable with the initial suggestions.
After Feed Behavior
While the above two measures should be given more weight, also be sure to keep an eye on how baby seems after and in between feeds. While growth spurts are very very normal, generally speaking baby should seem content and calm at the end of a feed. Their hands will often loosen and open, and they may get drowsy. In between feeds they should seem reasonably calm and able to be settled. If you notice that baby seems just as fussy after a feed as before, or if they’re wanting to feed again very soon after what seemed like a good feed, make sure you’re keeping an eye on their diapers and weight gain. Otherwise, remind yourself that a content baby is usually a well fed one.
Bottle Feeding
As mentioned, most babies should be fed ‘on demand’, which means paying attention to their cues and offering milk accordingly. With formula or bottle fed infants, this tends to settle in around every 2-3 hours, stretching to 3-4 once they’re older and their stomachs have grown. Newborns may take 1.5-3oz per feeding, but remember to watch your baby, not the measurement. If they’re still seeming dissatisfied, offer more milk. If they lose interest, it’s ok to stop, providing their weight gain has been ok. In the same vein, if baby seems hungry before the 2-3 hour mark, listen to them! As always, if your pediatrician has suggested a different feeding schedule, follow that.
Paced Bottle Feeding
First of all, there is no one best bottle. Let’s get that out of the way before we begin. While there are stronger recommendations for breastfed infants, with the intention to decrease the chance of latch confusion, every baby is going to have a preference for a different bottle. For this reason, I recommend even if you plan to bottle feed, purchase only a few of your preferred bottle type to start - if babe likes it, fantastic, you can grab more. If not, you haven’t spent a years car payments on bottles that will never be used again.
So now that you’ve got a great bottle… how to bottle feed? If you’re like me, you grew up watching babies fed in the crook of a parent’s arm, bottle tilted to the sky, keep going until it’s empty. Seems easy enough, right? While it can be, and some babies do great with this method still, the current recommendation is for paced bottle feeding. This allows baby control over milk flow, allowing them to choose how much and how fast they drink, decreasing choking, gas and overfeeding.
For paced bottle feeding you will hold baby semi-upright or sidelying, and position the bottle straight so that the nipple has milk but is not overflowing. Remember to still take breaks to burp and allow babe to decide if they are still hungry.
While we’re discussing best practices for bottle feeding, I want to share this clip as well. Many people think of ‘good latch’ as being only something to worry about when you’re feeding at the breast, but it’s important for bottle fed babies too. Ensuring that baby is getting a good deep latch means less gas, better milk transfer, and less chance of a tuckered out baby before they’ve finished their feed.
Breastfeeding
Breastfeeding is one of those things that people often feel like should just ‘come naturally’, so they don’t prepare prenatally, and then feel badly when they struggle postpartum. Two things can be true. Breastfeeding is ‘natural’ — AND it can also be HARD!
Familiarizing yourself with breastfeeding basics ahead of time can make the transition at birth a lot easier. Thankfully, Lynette at Untied Latch has offered her Expecting To Breastfeed course complimentary for all Winnipeg Birth doula clients.
Click through the link above to enroll.
Click on “Did you receive a coupon of promo code?”
Type in your promo code: JENINE23
Congratulations, you have your course! Reach out if you have any questions, and come back here when you’re ready to continue on.
Lynette has done such a fantastic deep dive into all things breastfeeding that I don’t want to overwhelm you with a whole bunch more details. If you managed to make it all the way through Expecting to Breastfeed though, you should consider yourself well prepared and know that we will tackle any other issues as they come up. A overpreparer like me? Don’t worry, I’ll provide you with a few handouts for additional reading IF you feel called to.
