RELATIONSHIP WITH YOUR PARTNER & SEX POSTPARTUM

Relationship Issues

Having a baby, while associated with immense joy and euphoria, is a major life change for both you and your partner, and can affect you both individually and as a couple. Although it can bring couples much closer than before, postpartum can be challenging for your relationship with your partner, even if it was wonderful before and during pregnancy. And all the more so if there are ongoing difficulties and unresolved issues between you. 

Your partner may be going through a variety of personal emotions, such as:

• Recovering from the intensity of labor and birth

• Questioning their performance and ability to provide sufficient support for you and the new baby

• Fatigue from lack of sleep and doing a lot of extra work around the house

• Struggling with an increased sense of responsibility and finances 

• Anxiety over you and your baby’s well being

• Balancing outside pressures from work 

• Taking care of their own health needs

• Conflict regarding new role as a parent, especially if they had issues with their own parents

• Guilt about not being able to completely fulfill professional responsibilities or meet your physical and emotional needs

It is a time for healing and integration for your partner as well, and they may also feel overwhelmed, stressed and exhausted. Although you need lots of care and support, your partner may also. Tensions can escalate, so be mindful of doing what it takes to minimize or diffuse them. It is important each day to spend even just a few minutes alone to talk, laugh, hug, have a good cry if needed, and let each other know you appreciate and love each other. Individual or couples counseling by a holistic qualified therapist or life coach may be needed down the road, and have helped many adjust to this major life change in healthy transformative ways. 

Postpartum Sex

It is normal to have a decreased interest in sex for several months after having a baby, but once you are ready there are ways to navigate the journey and reclaim your sensual sexual relationship. It is safe to resume sexual intercourse when the vaginal bleeding has stopped, after the perineal area has healed, and after your 5-7 week postpartum checkup is normal.  

Suggestions to make your postpartum sex life better are to:

• Communicate your temporary limitations to your partner. Be honest and tell them how you are feeling.

• Include your partner in the postpartum experience since they often feel left out.

• Until you feel comfortable having intercourse, just cuddle, kiss and spend some sensual, affectionate time together doing recreational activities you enjoy. Focus on the pleasure of being together. 

• Practice mula bandha exercises several times per day to strengthen your pelvic floor (see instructions here).

• When ready to try intercourse, plan a date together with your partner when you expect the baby to be sleeping. Be prepared for occasional interruptions and keep your sense of humor. Remind them to be gentle as it may still be tender inside.

• Use extra lubricant. Explore the various natural scented and unscented sensual massage oils and see which one you like best.  

• Experiment with different positions. Try being on top, or a pillow under your buttocks with you on the bottom for comfort.

• Take Maca powder or capsules to support a healthy stress response, balance hormones and enhance your sex drive

Seek help if the sexual problems between you and your spouse run deeper than this, if you have worsening pain during sex, or if your discomfort or lack of sexual desire or feelings do not resolve over the next few months. Remember that if you are interested in preventing another pregnancy at this time, or if you feel that you cannot handle having another baby so soon after this one, do not resume intercourse until you have discussed contraceptive options with your practitioner. Whether or not you are breastfeeding, you can become pregnant as early as five weeks postpartum.

 As always, if you need more personalized support and guidance, schedule a chat with me so I can advise you about the best supplements, remedies and dosages specific to your situation.

Need more help from me?

Check out my insider’s Guide to the joys and challenges of recovering from birth in these modern times created by a seasoned holistic nurse midwife who has seen everything! Learn simple tricks of the trade to make the journey to motherhood more holistically healthy and fulfilling.
You will have direct access to me through my Guides to Pregnancy, Birth & Postpartum - bundled together or sold separately, now 50% off!! And Postpartum I can help you:

• Help yourself recover postpartum healthfully and with easeful joy

• Get the support and guidance you need to answer all of your questions to create a postpartum experience you love and treasure forever

• Understand holistic modalities on common postpartum issues

• Get the support and tools you need for stress reduction

• Answer questions and make informed decisions

BUY NOW!

Give yourself this gift a lifetime to have the Pregnancy, Birth and Postpartum experience of your dreams, you will treasure forever.
As always, if you need more personalized support and guidance, schedule a chat with me so I can advise you about the best supplements, remedies and dosages specific to your situation.

For more in depth discussion and holistic modalities for common ailments, check out my Natural Birth Secrets book 2nd edition, available in print, kindle and ebook.

Natural Birth Secrets: An Insider's Guide...How to Give Birth Holistically, Healthfully and Safely, & Love the Experience! 2nd edition eBook

$12.99

INITIAL POSTPARTUM CARE AT HOME: YOUR COMPREHENSIVE GUIDE - PART TWO

POSTPARTUM CARE AT HOME: YOUR COMPREHENSIVE GUIDE TO THE FIRST FEW WEEKS - PART TWO

Do see last month’s blog for Postpartum Care at Home: Your Comprehensive Guide to the First Few Weeks - Part One.

Dealing With Postpartum Exhaustion

Welcome to motherhood!  Caring for a newborn and recovering from childbirth is no small task.  Fatigue can easily lead to exhaustion, infection, irritability and depression if you do not listen to your body’s signals for increased rest during this time. 

The best way to minimize fatigue is to spend the first two to four weeks after birth (longer after cesarean) caring only for yourself and your baby, while someone else (like your partner, a close relative or friend) tends to the other needs of the household. No need to feel guilty for doing nothing other than resting, taking care of you and your baby during this time. This is your sole job right now, with nothing else on your plate. 

Many of the suggestions for fatigue in pregnancy still apply, but other suggestions specific for postpartum to prevent exhaustion include:

• Eat well, at least three whole food varied healthy meals and snacks, without skipping meals

• Drink at least 8-10 glasses (64 ounces) of water daily

• Take recommended supplements, to ensure you are getting all the nourishment not you need for yourself and your baby while you breastfeed and recover, that is not supplied by diet alone. 

• If you are anemic or had excessive blood loss after birth, be sure to take herbal iron at least for the first 6-8 weeks postpartum, until you feel back to yourself and your labs including iron stores are normal. 

• Try to plan so that for the next 2, ideally 4 weeks, someone other than you is doing errands, cleaning, preparing meals for you and your family, and tending to the older siblings.

• Consider hired help (such as a mother’s helper or postpartum doula, a cleaning lady and even a personal chef or healthy meal delivery) if you do not feel you have enough support, or after your support leaves. This can be put on your online baby gift registry and is much more essential than stuffed animals, toys and an oversupply of newborn clothes Baby will soon grow out of.

• Be honest and direct about communicating your needs. Don’t be afraid to delegate responsibilities to others.

• Gratefully accept offers to help. Remember this is not just a much needed time to heal from the birth, but it is also a sacred time to get to know your baby and learn to breastfeed. As long as you are well supported, allow yourself to enjoy this special time and bask in the loving support of others.

• Rest, sleep and lounge as much as possible during at least the first month postpartum. Nap when Baby naps and ask a friend or relative to take the older kids for even an hour or two each day so you can do this. When you have a choice between folding the laundry or doing the dishes and napping, choose napping. Do not give into the temptation to do any housework, errands, childcare or cooking, as these tasks can be delegated to others during this time while you are recuperating. This is not a time to be supermom. Allowing yourself this extra time to rest now, will help you stay well physically and emotionally for you and your family, and will help you feel back to yourself sooner.

• Be strict with visitors. Don’t be shy about suggesting when it’s best for them to visit or excusing yourself if you feel tired. Ideally, put a sign on your front door saying something like,

“New moms and babies need lots of rest and help. We are resting now, please do not disturb. But, we would love a short quiet visit between {insert baby’s most awake hours}. If you would like to stay longer, please bring or cook a meal, play with our older children, or do some housework like the dishes or laundry.”

• Ask your partner to tend to the baby at night after you breastfeed for burping, diaper changing, settling, or holding skin to skin. Once breastfeeding is well established, your partner can also give the baby a bottle of expressed breast milk for one of the night feedings.

• Keep night feedings dark, quiet and boring so that baby will eventually learn to sleep longer periods of time during the night.

• If you can’t fall asleep at night, try these suggestions for insomnia, and make sure to take 1-2 daily naps or rest periods when the baby sleeps. Remember to silence your phone. Better yet, keep it out of the bedroom.

• Limit caffeine and avoid it after 4:00 P.M.

• Limit time on computer and iphone, and avoid it after dark.

• Get daily fresh air and sun exposure during the non-peak hours. 

• Treat yourself to a nice deep tissue massage focused especially on areas of aching muscles, or ask your partner to do it. A soothing simple combination for massage oil includes 3½ ounces Almond oil, ½ ounce Arnica oil, 15-30 drops of your favorite uplifting essential oils like Rosemary, Evergreen (Pine), Peppermint, Spearmint, Rose, Geranium, Ylang Ylang, Orange, Lemon, Citrus blend, Lavender or Jasmine. Shake well before each use, and store in a cool dark place in a glass bottle (this Almond oil comes with an extra 4 ounce travel bottle). A few drops of Vitamin E oil can be added to preserve it.

• After the first few weeks, an occasional weekend in a nice hotel with your partner and baby can be a really nice restorative rest and treat. And so worth the expense, as the hotel staff will clean your room and cook your meals!

• Practice regular yoga and light stretching any time. There are many ways to do it with your baby, or you may benefit more from having some space to do it alone, leaving Baby with pumped breast milk and a trusted sitter. Gradually get back into exercise in the morning or early afternoon after the first several weeks, and increase as tolerated after your bleeding stops and you feel up to it. 

• Do daily 10-20 minutes of conscious connected breathwork that provides you with natural energy and increases vitality. 

• Heed to signs of not getting enough rest, which include:

  • Ongoing exhaustion

  • Feeling run down and achy

  • Excess or prolonged bleeding

  • Inflamed clogged milk ducts

  • Frequent infections and colds

  • Excess emotional irritability 

Report to your practitioner if you cannot sleep, are too exhausted to cope, or your fatigue worsens or does not ease up by six weeks after Baby is born.

Excessive Sweating, Peeing and Shaking

A normal increase in perspiration and trips to the bathroom are common as your body rids itself of additional fluids that developed during pregnancy, and IV fluids if given during labor. Intense shaking right after birth is also common due to the hormonal fluctuations, temperature and body changes after the huge work your body just did to give birth. This is a normal stress response to release the intense energy that was involved.

Suggestions are:

• Ask your partner to hold you when shaking, but do encourage and embrace the shakes, without trying to stop your body from doing what it needs to do in order to reset.

• Take Rescue Remedy to support your normal stress response, if you feel you need it.

• If you are cold, wear absorbent all-cotton clothing and warm socks, dress in layers and cover yourself with warm blankets.

• For sweating and chills not related to infection:

  • Sleep on a large towel or terry cloth sheets.

  • Drink Ginger tea alternating with Cinnamon tea. It is best homemade, by adding a pinch of freshly ground ginger or a stick of Cinnamon to 1 cup boiling water and brewing covered for 15-20 minutes. Or a steep a stick of cinnamon in the water for a few minutes. Strain into a glass mason jar, add honey and or pure nut milk to taste.

  • For severe sweating, get an acupuncture treatment to balance your Qi and promote healing. 

Report to your practitioner persistent sweating that lasts several weeks, chills, muscle aches, and temperature over 100.4 after the first few days.

Dealing with Feeling Fat

This is one of the most common postpartum complaints. Women often struggle with body image issues postpartum, and feel fat. Typically, only about 12 pounds are lost with delivery, another 5 pounds are lost during the first week, and an additional few pounds are lost by the 6 week check-up. It can take several months for the fat stored around your hips and buttocks for breastfeeding and nourishing you during the pregnancy and postpartum, to be used up. So, it is good to remember that the calories used for breastfeeding will help you lose this extra pregnancy weight.  

The rest of the weight gained during pregnancy will have to be lost through a healthful diet and exercise program. Also, it takes at least 6 weeks for the uterus to return to a non-pregnant size, and it takes time and abdominal exercises to tone up the muscles and overlying skin that was stretched. It takes at least several months to return to your pre-pregnant size. 

Remember, breast milk production requires even greater caloric intake than pregnancy, as you are the primary provider of nourishment to your rapidly growing baby. So, this is definitely not an appropriate time to diet, as it deprives you and your baby of essential nutrients. If you gained excessive weight in pregnancy or were overweight before pregnancy, eating varied, whole food of high quality, and avoiding processed foods high in unhealthy fats, refined carbohydrates and sugars, and regular exercise when ready, is usually sufficient.

To summarize:

• Drink 64 ounces filtered, spring or well water daily between meals, at least 20-30 minutes before or 2 hours after eating.

• Eat a balanced, nourishing and varied diet high in:

  • Fresh organic fruit and vegetables

  • Organic tofu and tempeh

  • Beans 

  • Nuts, nut butters, and seeds

  • Organic pastured whole eggs

  • Organic free range, grass fed chicken and turkey, beef, lamb, and wild game

  • Wild Alaskan salmon and other fresh water fish from non polluted waters

  • Organic whole raw dairy-goat or sheep is best

  • Limited whole grains (sprouted is ideal)

  • Organic cold expeller pressed extra virgin olive oil, coconut oil, ghee or goat butter 

• Avoid foods that are heavily processed and loaded with unhealthy refined vegetable oils and partially hydrogenated fat, sugars, refined flours and starches.

• Begin regular exercise like brisk walking or dancing as soon as you are able and the bleeding stops. Aim for 30 minutes 4-5 times per week. Pilates is a great way to strengthen your muscles, and especially tone up your core. Yoga will tone your core as well, in addition to increasing total body flexibility and strength, and helping you calm and grounding feelings. Ideally, take a local class like mommy and me yoga or postpartum yoga and Pilates. There are also plenty of online classes until you can manage to get out to an actual class. Light walking, gentle yoga stretching, side lying leg lifts, pelvic floor muscle strengthening, and gentle abdominal toning exercises can be done after the first few weeks. Gradually increase time and intensity as you are able. Listen to your body, though. There is no need to rush or push yourself during this time of needed rest, healing and recovery.

• Historically and in plenty of cultures around the world, a fuller figure is more glorified, respected and honored, and being too thin is not considered healthy or attractive. While obesity is unhealthy and it is important to have a healthy weight and body image, there are many variations in normal weight and body characteristics. Ditch the pervasive media pictures of thin models. They are not realistic, they wreck havoc with body image and often result in you feeling unnecessarily bad about yourself. If you need to, look at the #BodyPositive images of mothers on social media. Be mindful of unhealthy thoughts from modern, western cultural stereotypes that imply “thin is most beautiful” and “looking fat is ugly.” Try to replace them with more true affirmations of pride and gratitude for your body having just grown and birthed your baby. Maintain acceptance and love for your unique body type which is forever changing. Know that you are more than just a body, but a beautiful eternal soul with your own special gifts, attributes and purpose far bigger than that of your body. Even though you are a postpartum woman who has just birthed her baby, you are also physically radiant, lovely, magnificent and have a deeper sort of beauty and wisdom.

Postpartum Depression and Anxiety

Intense emotions, mild depression, anxiety and mood swings are common in the first few weeks after having a baby, as are postpartum struggles. This is especially true if you are overtired and exhausted, without help or support from others, and/or have other stresses, personal issues or other problems. You may find that you are at times down, irritable, easily upset, extremely sensitive, cry without apparent reason, overwhelmed, tense, anxious, and unable to concentrate or remember things.  

Natural remedies to lessen the emotional ups and downs, and help you cope include many that are mentioned in my posts for managing stress and emotions in pregnancy. 

Suggestions specific for postpartum include:

• Minimize fatigue with the tips from the exhaustion section above. A - adequate sleep is crucial.

• Eat a healthy well-balanced diet as described above, but many feel best completely off gluten, dairy, soy and all forms of cane sugar. Consider eating an organic Paleo diet, an ancestral whole or real food way of eating high in pastured organic animal protein and healthy fat, plenty of fruits, veggies, nuts and seeds, with free use of herbs, spices and healthier sugars like raw honey. Try it for a month. You will be amazed how much better you feel physically and emotionally.

• For general health and physical and emotional well-being, make sure to take the supplements here that include a whole food multivitamin, omega threes, probiotics, Vitamin D, plus those specific for symptoms of anxiety and depression:

  • Calcium, 250-500mg 2-3 times daily

  • Magnesium, 200-400mg 2-3 times daily

  • Vitamin B complex, 20-50 mg once daily with methylated folate and 

  • Vitamin B12 sublingual (under the tongue) in the form of methyl, hydroxo or adenosyl cobalamin), 1000-5000 mcg daily to 2-3 times weekly depending on symptom severity and blood levels

  • Curumin (Tumeric), 500 1-3 times daily to reduce inflammation linked to depression, anxiety and other mental health challenges

  • Evening Primrose oil, 500-1300 mg daily

  • Continue your iron supplement if prescribed during pregnancy until you stop bleeding

• Take your encapsulated placenta pills as directed (see supplement section).

• Spend extra time breastfeeding and cuddling with your baby, skin to skin.

• Share your feelings with a close friend, relative, transformational life coach or integrative health professional. An occasional good cry does wonders, as does a good hug, and a good laugh. 

• Write and feel free to share your birth story. Include the details, the lessons you learned about yourself and others, your strengths you have discovered, how you and your partner have grown, and qualities you found that exceeded your expectations.

• Commiserate with other mothers by taking a postpartum yoga or exercise class, or joining a mothering, breastfeeding or parenting class or support group.

• Every day, remember to protect your emotional well-being by doing things that cheer you up and avoiding things that upset you.

• Each morning, shower, brush your hair, put on your usual make-up, and get dressed, even if it is just changing PJs or sweat pants and shirt. After the first two weeks, get dressed in clothes. 

• As soon as you are able and the bleeding stops, begin a regular exercise program such as brisk walking, hiking, low-impact aerobics, more active yoga, dancing or swimming for 30 minutes 4-5 times per week.

• Get out of the house and get some fresh air at least once daily, even for just a little walk in the park, a trip to the farmer’s market, or enjoying a cup of tea with a friend.

• Plan some leisure time away from the baby at least twice a week in the early weeks and more frequently later postpartum, even if just an hour each day.

• Avoid drugs, alcohol and caffeine. 

• Before attempting medication, try the recommended lifestyle changes, natural remedies and herbs for stress and emotions first, as they are non- toxic, effective and address the root causes, unless symptoms are too severe.  If you are already on medication, the natural modalities and suggestions here can be used in adjunct, and can ultimately support you when you one day taper down to lower doses and choose to stop taking them.

• For persistent symptoms, make sure to have your provider check a comprehensive thyroid panel with thyroid antibodies, your vitamin D and B 12 levels, fasting glucose and hemoglobin A1C and address issues accordingly. Do what you can to prevent postpartum depression and anxiety and minimize underlying possible causes.

• In Chinese medicine and many other ancient traditions, the dried placenta powder is recommended postpartum for its powerful healing properties, especially helpful for balancing emotions, prevent or lessen postpartum depression if there is a risk or history. Many doulas and birth professionals encapsulate placentas. If you encapsulated your placenta, take as directed by the provider who encapsulated it. 

Report to a healthcare professional if your symptoms of depression or anxiety worsen or last more than the first few weeks, if they interfere with your ability to carry out your daily tasks, if you notice significant changes in your eating and sleeping habits, if you feel desperate, hopeless, afraid, unable to cope, or have thoughts of harming yourself or your baby. 

Siblings

Postpartum is always a time of adjustment for siblings. It’s healthy and normal, and they each handle it differently. The youngest tends to have the hardest time, but not always. Some temporarily regress a bit. Some show upset towards mom, dad, or the new baby. Others become more needy and try to get negative attention and act out, if they can not get enough attention in a positive way. 

Although your heart doubles with each new baby, meeting the needs of the older children and balancing that with your own healing and newborn care can be challenging. Having a strong network of family, friends, mothers with similar aged children, or hired help is essential in the early weeks. This support system can help with the siblings’ care, give you time to heal, rest, and focus on the baby and mastering breastfeeding. Extra support is especially important if the sibling is a toddler or young child, as they usually need the most tending to. 

Take a deep breath and let compassion run through you, and imagine how you would feel if your partner just brought home a new girlfriend everyone's all excited about and loving towards, and encouraged you to love her too. Reassure them they are loved, give them a lot of approval, and include them in age appropriate ways if they are interested in helping to encourage them to feel involved and important. Try to spend some quality time with each of them alone regularly, so your attention can be focused on them completely without interruption, ideally after Bbaby has been fed and can be held by someone else. 

It is important to avoid expressing criticism or anger towards them when they are seeming to be acting out or trying to help, and do not suppress the expression of their feelings. A great book written in easy to read comic strip form, with great suggestions on helping older children adjust healthfully is Siblings Without Rivalry by Adele Faber and Elaine Mazlish.

If you haven’t already done so, get the wonderful book written by herbalist, midwife, and doctor Aviva Romm, Natural Health after Birth, for a more complete holistic and heartfelt guide to postpartum healing and wellness.

Need more help from me?

Check out my insider’s Guide to the joys and challenges of recovering from birth in these modern times created by a seasoned holistic nurse midwife who has seen everything! Learn simple tricks of the trade to make the journey to motherhood more holistically healthy and fulfilling.
You will have direct access to me through the Guides and I can help you:

• Help yourself recover postpartum healthfully and with easeful joy

• Get the support and guidance you need to answer all of your questions to create a postpartum experience you love and treasure forever

• Understand holistic modalities on common postpartum issues

• Get the support and tools you need for stress reduction

• Answer questions and make informed decisions

BUY NOW!

Give yourself this gift a lifetime to have the experience of your dreams, you will treasure forever.
As always, if you need more personalized support and guidance, schedule a chat with me so I can advise you about the best supplements, remedies and dosages specific to your situation.

My Natural Birth Secrets book 2nd edition is a great adjunct to the online Guide for postpartum and holistic modalities to common issues and discomforts.

For general postpartum healing:

INITIAL POSTPARTUM CARE AT HOME: YOUR COMPREHENSIVE GUIDE: PART ONE

POSTPARTUM CARE AT HOME: YOUR COMPREHENSIVE GUIDE TO THE FIRST FEW WEEKS - PART ONE

Welcome to the postpartum period, the fourth trimester, a period of healing and adjustment, of getting to know and comfort your baby, and mastering breastfeeding. All your baby needs now is love and breast milk. If you are unable or choose not to breastfeed, consider feeding baby pumped breast milk, or donor breast milk from registered milk banks. Breast milk is the ideal food for your baby, although organic goat milk formula is most similar to human milk and you can discuss best alternative options with your pediatrician. And do see the Postpartum Guide to Breastfeeding Postpartum, for initial issues specific to that.

The rest will follow naturally, as you learn on the job, take guidance from wise experienced others, and let Baby be your teacher. As in pregnancy and birth, trust your instincts and your heart. But, do not hesitate to ask for help and support as needed. Hopefully you prepared in your pregnancy so that you are well supported during this sensitive time, as it has always taken a village to raise a baby as well as new parents. A postpartum doula is a must if you do not have family and friends to help you. 

After the first week or so, but before your memory of details fades, it is a wonderful experience to reflect on your pregnancy and birth with heartfelt honesty, and write your pregnancy memories and childbirth story down in a bump to birthday journal. This is something special to share with your child one day, and it is also a wonderful gift to yourself. It can be especially helpful for healing if things were difficult, or your labor and birth did not go as planned or as you hoped. Journaling will help you express, later process, understand, come to terms and make peace with any painful feelings that come up more deeply. 

Below are some helpful hints to make the next few weeks easier and more comfortable, so you are more able to heal, enjoy and reflect upon your extraordinary new miracle. The most important advice is to slow down, stay in the moment, try to resist the temptation to do, do, do...and just be, be, be. Trust that you will heal, as you are perfectly designed to do, given the proper care and support. 

Nutrition for Postpartum Care

Maintain at least the same healthy nutrition as you did in pregnancy, especially now for recovery after birth, and during breastfeeding. This will help you to make good quality milk, and nourish your baby as well as yourself. Make sure to eat at least three whole food varied healthy meals and snacks, and even a little bit more than you would normally consume. And keep well hydrated with at least 64 ounces of water daily. 

Traditional foods for the early postpartum weeks across cultures typically include soups and stews with a lot of vegetables, including the starchy ones like sweet potatoes and winter squash, stew meat or chicken, and whole grains like barley and oats. Also, do eat plenty of eggs, seasonal fruits and vegetables. Much nourishment can be added to fruit/veggie smoothies, soufflés, whole grain hot cereals, and breads/muffins like zucchini-apple, banana-date or carrot-raisin, enhanced with almond flour or chopped nuts and seeds, nut milk, and eggs. 

Herbs and Supplements

Make sure to supplement your diet as in pregnancy, with herbs, vitamins, minerals, omega threes and probiotics to complete nourishment not supplied by diet alone. This will aid in your recovery and help supply all of your and your baby’s nutritional needs. Do increase iron foods and take an herbal iron, especially if you were anemic in pregnancy, have low iron stores, lost a lot of blood at birth, gave birth by cesarean, and/or are still anemic. 

Do continue your nourishing pregnancy herbal infusion to your diet but add alfalfa and red clover. You can have a support person make this by:

1. Blending a handful of dried Nettle leaf, a handful of dried Red Raspberry leaf, a pinch of Alfalfa, large pinch of Red Clover, and several Rose Hips. 

2. Add a pinch of Comfrey to help with healing. (optional) 

3. Brew in a mason quart glass canning jar of boiling water 1-4 hours. The longer the brew, the stronger the taste and effect.

4. Strain, and drink plain or lightly sweetened with Rose Hip infused honey and/or a splash of fresh squeezed lemon or lime juice.

5. Enjoy hot or cold, up to 4 cups per day.

 You can make it in larger quantities and store in the fridge.

Other herbal tonics for new moms to promote general physical and emotional postpartum recovery and healing include Ashwagandha and Gotu Kola (½ -1 tsp each twice daily), and Milky Oats (1/1-1 tsp 1-3 times daily), in addition to herbs mentioned below as appropriate for each specific issue.

To promote healing after birth, take 3-4 pellets of homeopathic Arnica 30 c under your tongue every few hours for the first 3 days, then three times daily for a week. You can also dissolve the pellets in a clean unused bottle of water, shake vigorously a few times, then gargle a mouthful before swallowing, which increases the strength of the remedy.

Treatment for Afterpains

Periodic cramping, known as afterpains, commonly occur as your uterus muscle fibers contract around the blood vessels that supplied the placenta. This is your body’s natural defense in order to minimize excessive bleeding and return to its non-pregnant size. They can be quite painful, and can occur with increasing intensity after each subsequent baby.  

Breastfeeding can temporarily increase the severity of these pains, which is actually helping your body heal and prevent excess blood loss. Afterpains should gradually subside over the next week and lessen significantly over the first 3 days after birth. 

Below are some suggestions to lessen the discomfort.

• Frequently empty your bladder, even though you don’t feel like you need to pee, as is common from the swelling after childbirth.

• Especially during the first 24 hours, check the top of your uterus several times per hour to make sure it is nice and firm like a hard nectarine or knuckle. Massage the top of your uterus gently when it begins to soften or feels boggy.

• Lie on your stomach with a pillow under your lower abdomen.

• Apply warm moist towel compresses, hot water bottles, hot herbal packs or rice packs heated with a few drops of essential oil of Lavender, or a heating pad to your lower abdomen. 

• Practice your breathwork, deep breathing and conscious relaxation exercises during the afterpains, dropping your focus right down into them, relaxing with surrendering to the intense sensations as you did in labor.

• Try soaking in a well-cleaned, warm bath with drops of Lavender or Chamomile.

• For an effective herbal infusion: 

  • Mix a large pinch of Chamomile blossoms and/or Catnip in 1 cup boiling water.

  • Brew covered for 10-20 minutes.

  • Strain in a glass canning jar.

  • Add honey to taste (optional).

  • Drink very warm, 1-4 cups daily.

• Take a dropperful of Motherwort herbal tincture up to 4 times daily. If without relief, try Cramp Bark herbal tincture, 1 dropperful every 30 minutes to 2 hours, then 2-3 times daily. You can add a dropperful of Black Haw tincture 3 times per day. You can make your own cramp bark infusion by steeping a handful of Cramp Bark and Black Haw with a pinch of Hops and generous pinch of Blue Cohosh root in a quart mason jar overnight.

• Take Wish Garden AfterEase herbal tincture as directed

• Take 3-4 pellets homeopathic Chamomilla, Arnica, or Caulophyllum 200 c. Try one remedy under your tongue. If no relief try the other. If the remedy works, repeat daily as needed.

• Try Moxibustion treatments by an acupuncturist.

• Try additional suggestions and remedies mentioned here for aches and pains in pregnancy. They work!

• If the pain is too much for you and interfering with your ability to breastfeed, rest and sleep, you can take ibuprofen (up to 800 mg every six hours) OR acetaminophen (up to 650 mg every four hours) ½ hour before nursing for the first several days only, as needed. But before reaching for these medications, try 1-2 grams of Curcumin (Turmeric), a natural herb studied to be as effective for pain relief than most over the counter synthetic analgesics without their associated potential risk of toxicity. 

Consult your practitioner for severe cramping or cramping that lasts longer than 1-2 weeks, or if accompanied by uterine tenderness, fever or foul smelling discharge.

Home Remedies for Bleeding

During the first two to five days, bleeding is no more than a heavy period with an occasional clot the size of a 50 cent piece or egg, dark red in color with a fleshy smell. It tends to be less after cesarean birth. Clots are simply congealed blood mostly that pools in the vagina when you are reclining, and can occasionally be as long as the vaginal canal. Sometimes bleeding increases with nursing, strenuous activity, heavy lifting and pushing motions, full bladder, and as you rise from a lying down position. 

During the next week or so, the bleeding becomes paler pink or brownish, and it lessens in amount so that you only need to change sanitary pads several times per day. Over the following two to four weeks, discharge becomes creamy white or yellow and even less in amount, but usually returns to red bleeding or spotting for a day or two around the second postpartum week.  

Some women occasionally spot on and off for longer periods of time or throughout breastfeeding. Suggestions for keeping clean and comfortable are:

• Take a daily bath in a well-cleaned tub (add Calendula tincture and Lavender oil to water if desired) or shower.

• Change disposable organic sanitary pads or herbal infused natural pads every four to six hours, and after going to the bathroom. Do not use tampons, menstrual sponges, or menstrual cups. The first day or two, especially at night, consider wearing adult diaper type pads simply because it is just easier, as bleeding can be heavier than common postpartum maxi pads can accommodate, and can leak onto your clothes and sheets. Use them with a smile.

• Wash hands before and after changing pads.

• Remove pad from front to back, squeeze a peri-bottle of warm water over perineum. If you had tearing with or without repair, you can also add 1 tsp Calendula tincture and Lavender oil to the water. Pat dry.

• Do not douche.

• Check the top of your uterus for firmness several times per hour when awake for the first 24 hours, then several times per day for three days. It should feel as firm as a hard nectarine. If it feels soft, massage it firmly so it re-contracts.

• To prevent excessive bleeding, take homeopathic Arnica 30 c as described in the supplement section.

• Take herbal Shepherd’s Purse, 1 dropperful of the tincture three times daily for the first 3-5 days.

• Wear an abdominal binder or Bellefit’s postpartum support girdle. You get a $20 off with code: ANNE20 at checkout.

• Continue your herbal iron dose until your bleeding stops in 4-6 weeks, which may need to be increased per your practitioner if there was hemorrhage. Eat foods high in iron, like red meat, dark turkey meat, eggs, dark leafy green veggies, and dried fruits.

• If bleeding becomes heavy (you are saturating more than a large maxi pad every half hour):

  • Try herbal Shepherd’s Purse tincture (1 dropperful under your tongue), repeat every few minutes as needed)

  • Add 3 dropperfuls tincture of Cotton root, 2 dropperfuls each of Lady’s Mantle, Witch Hazel and Blue Cohosh, and 1 dropperful Yarrow. Take them every 10 minutes under your tongue until the heavy bleeding resolves, but only up to an hour. 

  • If heavy bleeding persists, take 2 dropperfuls of HerbPharm Erigeron/Cinnamon tincture of Erigeron and Cinnamon  under your tongue every 20 minutes for no more than 2 hours, and add 1 dropperful of Angelica if without relief.

Report to your practitioner if you’re saturating more than one pad an hour for more than a few hours not relieved by the other suggestions above, especially if you are starting to feel lightheaded, weak, disoriented, cold and clammy with rapid shallow breathing and heart pounding. Contact them also if you’re experiencing large clots, foul-smelling vaginal discharge, severe lower abdominal pain, temperature over 100.4 after the first few days, and deviation from the described pattern of bleeding.

Perineal and Vaginal Discomfort

After delivery, your perineum and vaginal area may feel sore, swollen and uncomfortable. Any pain or tenderness should gradually lessen over the next several weeks, or longer if you had a large tear. 

Suggestions are:

• Practice good perineal hygiene as previously described in the section on bleeding.

• Don’t forget to take the homeopathic remedy Arnica 30c as directed above, in the first few weeks to support healing after giving birth, which definitely helps your perineal and vaginal areas.

• For a small tear that did not need stitches, using a peri-bottle, squeeze warm water with several drops of Calendula tincture and Lavender oil over the area as you urinate to reduce stinging. Squirt Vitamin E oil a few times daily on the tear to promote healing. Motherlove and Earth Mama make wonderfully soothing and healing herbal combination perineal sprays.

• Apply a perineal ice pack or frozen maxi pads saturated with Witch Hazel for the first 24 hours (with 30 minute respite each hour) or as long as you feel it is soothing.

• Periodically sit in a cool sitz bath during the first 24 hours or as long as you feel it is comforting.

• After the first 24 hours, take a warm sitz bath, or warm shallow bath 2-3 times per day. You can also add tea tree oil, tincture of calendula, garlic, ginger and/or lavender, or try herbal sitz bath combinations with Uva Ursi, Comfrey and Sage or Calendula and Oatmeal (both combos have Witch Hazel, Yarrow and Plantain). You can also try herbs with Epsom and Dead Sea salt or herbal salt soaks and see which feels best for you. You can use any leftover unused liquid for compresses or your peri bottle rinse.

• Use a pillow or cushion when you need to sit.

• Contract your pelvic muscles (Kegels) or even better, engage your mula bandha (all of your pelvic floor muscles) when changing positions.

• Take the homeopathic Arnica 30 c as directed above for general recovery.

Report pain that worsens or does not improve over time, an increased area of redness, swelling or pus-like discharge.

If You Have Difficulty Urinating

During the first four hours after birth, many women have trouble urinating such that they feel no urge, feel the urge but cannot urinate, or feel burning after the urine comes out. It is essential that you urinate within eight hours after birth as difficult as it may be, to prevent infection and excess uterine bleeding.  

Suggestions to help you urinate are:

• Listen to running sink water.

• Squeeze warm water over your perineum with your peri-bottle, infused with a few drops of oil of Peppermint.

• Dabble your fingers in water.

• Apply light pressure to the area above your pubic bone.

• Put oil of Peppermint in the toilet.

• Sit in a sitz bath with several drops of the oil of peppermint.. 

• Take a bath or shower.

• Blow your thumb.

• Concentrate on relaxing and opening your pelvic floor muscles while imagining the urine flowing out.

• Drink eight glasses of water per day.

• Try homeopathic Arsenicum or Causticum both at the 30 c dose.

Report inability to urinate more than eight hours after the birth, burning pain before or as the urine is coming out, feeling the urge to urinate frequently but little urine comes out, fever, or back flank pain.

Cesarean Birth 

If you birthed your baby by c-section, it will take more time to heal physically, and psychologically - especially if unexpected and unplanned, or traumatic. Trust that you will get back to your new mama self. The scar will be there but will eventually fade. Allow for at least 3 months recovery for your body from major abdominal surgery, possibly longer to heal the mind and heart. Homeopathic remedies help tremendously and definitely speed and enhance your recovery safely and naturally.  If your cesarean is planned, start Arnica 200 c three times daily the day before and continue through 3-4 days postpartum. 

Other remedies helpful to have on hand are Aconite 30 c for intense fear and panic before surgery, Bellis Perennis 200 c post cesarean to boost healing after you finish the Arnica, Staphysagria 200 c for incisional pain and healing, and Hypericum 200 c for shooting nerve type pain from the spinal anesthesia (only if needed). Use one remedy at a time and take it three times daily until you feel improvement. Consult your classical homeopath for more personal guidance.

The first week is the hardest in terms of postoperative pain, so take ibuprofen or acetaminophen if absolutely needed, then switch to more natural pain relief remedies like ginger or turmeric that are safe for you and your breastfeeding baby, but still effective. 

Use the skills from breathwork and mindfulness to center and ground yourself, stay present one breath at a time, surrender, lean into and embrace the temporary painful sensations you feel, without the story, with love and compassion towards yourself. Whenever you feel overwhelmed or stressed, take a few minutes to simply breathe, keeping your focus softly on a distant nonmoving object (drishti) or close your eyes and internally gaze between your eyebrows, relaxing deeper with each exhale. Send your love and breath (divine life force) and imagined light to areas of pain. Use visualization to support you as you desire. This is powerfully healing.

While in the hospital, it is important to take deep abdominal breaths also to keep your lungs fully expanding (use the incentive spirometer many hospitals give you), and to get up and walk within 12-24 hours after birth for 10 minutes each waking hour, especially to prevent serious blood clots and painful abdominal gas buildup. The more you walk, the sooner you pass gas and get your bowels moving, and you keep your blood flowing rather than stagnating from immobility.

Ask to be progressed from a clear to regular diet within this time, and choose healthy foods and bottled spring water from the hospital menu (if that even exists!) or have your family and friends bring you more wholesome real food meals and snacks. For gas and bloating, limit:

• Gluten containing foods found in wheat, spelt, rye, barley and some oats

• Some fresh fruits and veggies

• Cow dairy if lactose intolerant

• Carbonated liquids

• Chewing gum. 

Eat slowly, chewing thoroughly and mindfully. Natural remedies for gas and bloating include chewing Fennel seeds, drinking Fennel tea, or taking 2-4 ml of the tincture three times per day, taking Slippery Elm lozenges 3-4 three times daily, and a high quality multi species probiotic twice daily on an empty stomach. Eat and drink more fermented foods like kefir. For bad gas and abdominal pain, take 1 dropperful each of Chamomile and Passionflower, ½ dropperful each of  Hops and Lemon Balm, and ¼ dropperful of Lavender tinctures every four hours.  

The dressing over your incision should be removed within 12-24 hours, so your incision is kept clean and dry to prevent infection. You can apply a clean maxi pad over the incision if your belly is folding over it, so it does not stay warm and moist, inviting bacterial growth. You have been sewn back together in many layers, and the skin is brought together by a glue like substance, absorbable stitches or staples, or removable metal staples. While it takes time to heal, when all is proceeding normally, it is unlikely to open as commonly feared. 

Sometimes they use steri-strips over the incision which will come off eventually or you can remove them in a few days. You can definitely shower, but do not use soap initially on the incision. Dry the area gently. A little oozing of blood is common to see on the dressing, as is a tiny amount of clear, white, or yellowish fluid, as long as it is not pus- like discharge. Look at your incision so you can monitor its healing as well as work on acceptance and appreciation for the journey you and your baby needed, made especially for you both. Once you go home, you can apply herbs for perineal and vaginal tears mentioned above to soothe and enhance healing. Earth Mama makes a lovely herbal balm specific to healing a cesarean scar and there are other organic balms that also help the scar fade. 

Make sure to keep Baby skin to skin in dim quiet as much as you can, bonding and soothing baby with your love, telling Baby all is well, Baby is safe and acknowledge that was a tough journey for both of you. Get help with breastfeeding as soon as possible. Baby may be sleepy from the medications, and it takes longer for the full breast milk to come in, but you will get the breastfeeding going with excellent support and patient perseverance. 

I encourage you to love, be proud and grateful for your cesarean scar. This may take time to cultivate, but is a worthwhile goal. Do not be shy to ask for extra needed help, and get support processing and healing emotionally. For online and local group support and advocacy, there are many wonderful resources like ICAN, but you may want to consider breathwork to release the strong stuck emotions and trauma energy in your body if it is interfering with your well-being. If you are suffering from birth trauma or you suspect your baby has it as well - as is common after cesarean birth - there are resources for healing for you and for your baby.

Consult your practitioner with:

• For fever over 100.6 with general muscle aches and chills

• Persistent or worsening pain

• Area of tenderness/foul smell/pus/redness/swelling by your incision

• Area of leg swelling, redness, warmth and pain worse when you flex your foot

• Unusually frequent, urgent or painful urination

• Heavy or foul smelling vaginal bleeding

• Vision changes, nausea, vomiting, chest pain and/or headache, especially if you had high blood pressure

• Anything unusual you are concerned about. 

Obviously, if you have problems breathing, feel weak, disoriented and faint, call 911.

Constipation and Your First Bowel Movement

It is normal to go a few days after delivery without having a bowel movement. Many have loose stools before labor and pooped during pushing, and those who birthed in hospitals who don’t allow eating in active labor probably did not eat much, if at all, in labor, unless they (hopefully!) respectfully challenged that outdated policy, or simply sneaked it. So you have a few days leeway. Some mothers are afraid that a bowel movement will be painful or open their tear more or stitches if they had them. Other women are too busy and preoccupied with all that is involved postpartum to even think about taking the time. Do rest assured that although the first few bowel movements may be uncomfortable, they will not open your tear or effect the stitches. Even if you had a large tear, it’s extremely rare for them to be torn by a BM.

Suggestions to limit your discomfort and prevent constipation are similar to remedies in pregnancy with some additions:

• Replace refined highly processed foods with whole grains, lots of fresh fruits with the skin, and vegetables (especially green leafy salads).

• Drink at least 64 ounces of fluid each day, preferably filtered, spring or well water, or herbal tea. Consume between meals, at least 20-30 minutes before or 2 hours after eating.

• Do Kegels and abdominal muscle toning exercises.

• Drink warm prune juice or a cup of tea or coffee on an empty stomach.

• Drink Smooth Move Tea, which tastes yummy and works like a charm.

• Mix 2-3 Tbsp oat or wheat bran, or ground flax seed, in your hot cereal or apple sauce. Or, mix with stewed prunes or dried figs. 

• Try raisin bran muffins with black strap molasses (ask someone to make you a batch, with whole grains, or Paleo - gluten, sugar and dairy free).

• You can take these remedies in these doses for preventing and treating constipation which include Magnesium or the powdered liquid equivalent in Natural Calm, herbal Floradix liquid Magnesium, Triphala, Psyllium seed husks, or homemade Dandelion and Yellow Dock root infusion. 

• Use Colace (stool softener) as directed if your bowel movements are getting hard despite these above suggestions, and you are on opioid pain medication after a cesarean birth.

• If you are taking iron, use alternative sources of iron other than ferrous sulfate, such as ferrous fumarate, ferrous gluconate, or herbal iron.

• Do not ignore the urge to have a bowel movement, which usually occurs ½ hour after breakfast.

• Take an interesting book or magazine into the bathroom with you to enjoy some relaxing time on the toilet.

• While on the toilet, rest your feet on a low stool and avoid straining. Support your perineum by applying counter pressure with a folded tissue if needed.

• If it hurts while having the first few bowel movements, do some relaxation and deep breathing exercises, relax into the discomfort instead of fighting it and tensing up, or try splinting the perineum with your hands to provide extra give to the area.

• Avoid relying on enemas and laxatives on a regular basis.

• Ask your classical homeopath, or refer to books like Homeopathy For Pregnancy, Birth and Your Baby’s First Year by Miranda Castro, for a homeopathic remedy specific to your unique symptoms.

Consult your practitioner if there is no bowel movement by the end of the fourth postpartum day, or you experience unusual pain or bleeding.

Treating Hemorrhoids

Hemorrhoids are varicose veins of the rectum, and are a common postpartum occurrence. They resemble a pile of red grapes or marbles just outside the anal area, but they can be internal as well. They can itch, bleed and be quite painful during the first 2-3 days, before gradually becoming smaller. Refer to the suggestions for natural remedies for hemorrhoids in pregnancy as many still apply now.

Suggestions for relief are:

• Herbal sitz baths as mentioned above for your perineum, with Epsom salts, Witch Hazel, and/or Comfrey.

• Use a pillow or cushion when you need to sit on a chair.

• Sleep on your side.

• Lie down several times each day with your hips and legs elevated with pillows.

• Try gently placing the hemorrhoids back inside your rectum with a lubricated finger, and then tightening your rectal muscles around them for 2 minutes.

• Natural remedies with dosing are here for internal and topical use, and include applications of already made Witch Hazel compresses (known as Tucks in the pharmacy) or make your own by pouring Witch Hazel onto round cotton pads, plantain, pure Aloe Vera gel, clove of garlic insert, and homeopathic Hamamelis and herbal combinations in a salve or ointment.

• Shine a red heat lamp on the affected area.

• Avoid constipation and straining.  See above.

Report if pain, swelling or bleeding worsens or becomes severe.

Postpartum Dizziness or Faintness

It is very common to feel dizzy, light-headed or faint the first few times that you get up from a lying or sitting position, especially after a long, hard exhausting labor with a large amount of blood loss.  

Suggestions are:

• Make sure you are eating well and drinking enough water as described in nutrition and constipation sections. 

• Have someone assist you the first couple of times that you have to rise.

• Rise from lying down gradually. First sit, then stand slowly.

• If feeling lightheaded or woozy while standing, lie down with your feet elevated or sit down with your head between your knees. Ask for someone to bring you a few large glasses of juice, as well as a high quality whole carbohydrate, fat and protein meal. For example, a nut butter and jelly sandwich on sprouted multigrain bread, or yogurt with fruit and granola.

• If you feel faint or do faint, sniff ammonia or smelling salts. This is an important first aid item to have, especially if birthing at home.

• Open windows to get fresh air.

• Splash water on your face.

Contact your practitioner with dizziness that lasts longer than the first few days or any actual fainting.

CONTINUED NEXT MONTH….STAY TUNED!

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As always, if you need more personalized support and guidance, schedule a chat with me so I can advise you about the best supplements, remedies and dosages specific to your situation.

My Natural Birth Secrets book 2nd edition is a great adjunct to the online Guide for postpartum and holistic modalities to common issues and discomforts.

Routine Newborn Procedures

Many mamas who want a natural birth may not be as familiar with the the number of choices they need to make regarding interventions to baby postpartum. These are routine in many hospitals, with more freedom of decision making out of hospital at a freestanding birthing center or home with a midwife. Healthy babies are suctioned, all exams and procedures are done in the nursery, not by bedside, they are bathed, given Vitamin K injection and antibiotics in their eyes, and Hepatitis vaccine, and babies with a penis are told they need medical circumcision. Other procedures are pulse oximetry to screen for critical congenital heart disease not picked up on the mid pregnancy anatomy scan if baby had one, audiology screening, and the newborn screening blood test.

Healthy vigorous babies born vaginally can clear their own lungs and don't need suctioning - even with bulb syringe. That's not a gentle welcoming for them, but invasive and traumatic. Suctioning can be harmful to baby’s transition from womb to world, and isn't evidence based care. It's more effective and less harmful to do percussion and postural drainage or use ambu bag if needed. Most of the lung filled fluid is cleared with the big squeeze through the birth canal. The rest is absorbed into the body, and for ~ first 24 hours, baby spits it up, coughs or sneezes it out.

All routine baby exams and decided upon procedures can be done in room with parents. It’s an important part of bonding, nursing and sensitivity to baby’s nervous system. Baby needs to be skin to skin for warmth and comfort after birth, close to mama for nursing. There’s no medical reason for healthy newborn nurseries, with babies separated from parents in bright rooms in isolettes filled with strangers. Nurseries serve hospitals, not babies. If mama needs a rest, it can be done with baby in room cared for by another support person.

Babies born in hospitals are still be given unnecessary baths with chemically laden soaps and kept dry with toxic talc and artificially fragranced baby powder. The birth juice and meconium can be wiped with your own natural products by you or your partner, but there is no rush to wash off the skin disrupting the flora of good bacteria that protects baby’s health, and remove the vernix (the white waxy, cheesy protective material that covers baby’s skin) so most of it can absorb into baby’s skin and allow baby to receive its protective benefits. It is not only a skin moisturizer and softener, it’s also an antioxidant and skin cleanser with anti-infective properties. It regulates baby’s skin pH needed for health, helps control baby’s temperature and insulate the baby, so crucial after birth from womb to world. It might help babies latch, as the scent of vernix may trigger neural connections in babies’ brains needed for breastfeeding, and bonding with that delicious new baby smell. It also smells of mama, which can provide comfort to baby and enhance bonding after birth. The The World Health Organization (WHO) recommends waiting at least six hours — and if you can go a full 24 hours, even better to give the first bath. Since it doesn’t fully absorb until day 5-6, I’m not sure why the first bath can’t wait until then. Leave it on and even rub it in like body butter. Don’t let anyone wash it off.

Hepatitis B vaccine is given to prevent baby from blood born infection spread by contact with blood and body fluids like unsafe sex, IV drug use, accidental professional needle stick, and high risk communal settings. If baby has not had these sources of exposure, it can be delayed until prior to entering school, if you choose infant and childhood vaccinations. Refer to my blog on immunization for more info.

Vitamin K injection and Antibiotic eye ointment are given routinely to all babies born in US hospitals without considering individual situations. In some states you can refuse, in others it’s the law and they can report you to Child Protective Services - but these organizations have bigger problems to deal with and often the case is dropped after some unnecessary stress and aggravation. We don’t have these laws in most homebirth settings.

The antibiotic eye ointment is to prevent sexually transmitted infections gonorrhea and chlamydia that could cause blindness in newborns after exposure in birth. It is given within the first hour of life during the most alert time of baby after birth, interfering with vision at such a sacred crucial time when initial bonding and breastfeeding take place. It is irritating to baby and disrupts the delicate balance of flora in their eyes which can lead to other infections. Needing to give antibiotics is not relevant to babies born to mutually monogamous parents who do not have these infections. Taking into consideration that one may not know for sure there is another secret partner, these infections can be tested for in a pregnant mama at term, and if negative, the antibiotics can be refused in good faith. If you do test positive for one of these sexually transmitted infections, you and partner can be treated and retested to see if cured, but it may be wise to consider the antibiotics for baby’s eyes, since exposure can happen again. Then you can delay the medication until after you and baby look into each other’s eyes, have some time for bonding and breastfeeding.

To give vitamin K to the newborn within the first hour of birth is to prevent a rare but serious blood clotting disorder called vitamin K deficiency bleeding (VKDB). There is an early onset VKDB that happens within the first 24 hours, classical expression in 2-7 days, and late onset that usually occurs in 3-8 weeks of life. Our bodies need vitamin K to help the blood to clot when needed. Giving it to babies at the recommended dose via injection is currently evidenced based care, but still not a simple matter.

The American Academy of Pediatrics opines strongly in favor of it. The current evidence does support the injection, saying there is little risk other than rare potential allergic reaction, and that the benefits far outweigh the potential risks. The injection is mega dosed, with 20,000 times the amount new baby has at birth, 5000 times the recommended daily allowance. It is injected into the muscle, which is a more rapid route than oral. In its synthetic form, it is considered a class C drug which means its safety is unknown in pregnancy, risk cannot be ruled out, there are no satisfactory studies in pregnant women, but animal studies demonstrated a risk to the fetus or potential benefits of the drug may outweigh the risks. The package insert itself warns that it can cause sometimes fatal allergic reactions when injected into a muscle or vein, and is ideally take by mouth or injected under the skin. The synthetic medication contains concerning chemical preservatives. It is available, but not accessible in most hospitals without the preservatives, but the preservative free vitamin K still does have some chemicals to increase absorption. It is also concerning to ponder the impact of overdosing on a fat soluble vitamin that stays in the system, as opposed to water soluble vitamins in which excess is excreted out in the urine.

In formula fed babies, the risk of VKDB is negligible as the formula contains synthetic vitamin K. For babies who breastfeed, an alternative is the oral form of vitamin K, in which some protocols have not been as effective as the injection in preventing VKDB - although some of the increased risk was related to parents not administrating of all the doses. Vitamin K using the Danish protocol is just as effective at preventing VKDB, though not accepted by modern medicine and hospital practice in the USA. Several European countries have a licensed oral vitamin K available with varied protocols, for those who wish to decline the injection, which is most effective according to the research to prevent vitamin K deficiency bleeding in babies. Except the Danish protocol. The Danish protocol is preferred as it seems to be just as effective as the injection according to the studies. It is vitamin K1 - phytonadione: 2 mg orally at birth, the 1 mg once weekly for 6 months as long as breastfeeding is greater than 50% of the baby’s diet. As it is a supplement in the USA, it is not regulated, FDA approved or certified like the injection made from pharmaceutical companies, for preventing VKDB in new babies. That does not mean it is not effective or unsafe. Still many who decline the injection prefer it as a viable alternative. Finding it in the states can be a challenge, but some homebirth supply companies and midwives carry it. If doing this protocol, best to do with a feeding as vitamin K is fat soluble, to increase absorption.

Little research is available on the alternatives, such as breastfeeding mamas eating more vitamin K or supplementing (like with 5 mg daily) to boost levels in breastmilk and prevent the rare vitamin K deficiency in newborns.

But as with all other routine interventions in the entire healthy normal physiological process of having a baby, the more we study, the more we find their lack of benefit and increased risk, and that mother nature or the Divine intelligence that created it all did not get it wrong. Maybe there is a reason we do not know yet why newborns are born with low vitamin K that does not reach optimal levels until the eighth day of life, from the gut flora. Is it a deficiency if they are all born that way? I defer to Dr. Sara Wickham who has analyzed the research for over 20 years and even wrote a book on this subject alone. “Several thousand babies need to be given vitamin K in order to prevent each case of vitamin K deficiency bleeding (VKDB), a disorder formally known as hemorrhagic disease of the newborn. Unfortunately there is little research interest (as is so often the case) in questions such as 1- how we might be able to pick out the babies who are truly at risk rather than giving the universal prophylaxis and 2- whether and why it might benefit babies to have a relatively low level of vitamin K compared to adults.”

Newborn screening checks a baby for serious but rare and mostly treatable health conditions at birth. It includes blood, hearing and heart screening. The newborn screening blood test may screen for up to 50 diseases, including phenylketonuria (PKU), sickle cell disease, and hypothyroidism but know it is only a screen that leads to more testing to confirm or more likely rule out the rare diagnosis. It has a high false positive rate, as there are more than 50 false-positive results for every true-positive result identified through newborn screening in the United States. This means baby tests positive on the screen but do not actually have the disease. Screening is mandatory in and funded by nearly all states - despite the varied diseases for which each state screens; although most will reluctantly allow parental refusals on religious and other grounds, and such refusal does not usually engender civil or criminal penalty. The American Academy of Pediatrics opines strongly about the importance of the screening, but it does not control the different conditions screened for by each state. You or your partner can certainly hold and comfort baby during the blood test which hurts for a few moments.

The American Academy of Audiology supports early identification, assessment, and intervention for all types of hearing loss in infants and young children to minimize deleterious effects on speech, language, education, and social/psychological development. The screening should take place by an audiologist at 1 month of age and does not need to be done after birth. It is not an invasive screening and can be done in your room by your side, so if you gave birth at the hospital it can be more convenient doing it there. Or you can take baby to an audiologist by one months of age if you choose the hearing screen.

Pulse oximetry screening is a simple and non-invasive procedure used to measure how much oxygen is in the blood and has been found effective in screening for critical congenital heart disease (CCHD) in newborns, if done within 24 hours after birth. Current evidence supports consistent accuracy for detection of CCHDs in newborns by pulse oximetry screening in addition to prenatal ultrasound and clinical examination. Overall, early diagnosis of CCHD with pulse oximetry is judged to be beneficial, identifying disease that may be treated and lifesaving, and potential harms associated with false-positive tests are not serious, but stressful, while missing CCHDs and other serious diseases detected by hypoxemia without pulse oximetry screening can lead to serious consequences. It is interesting that this is not the position of other institutions such as the United Kingdom National Screening Committee and the Royal College of Pediatrics and Child Health. Further research is required to understand and improve the effectiveness and efficiency of the screening and its algorithm. Some mamas do not want this philosophical standard medical approach of looking for diseases, prefer to address the issue if baby shows signs, and have Divine faith that whatever happens is meant to be.

Medical (non-religious) circumcision is the most controversial routine surgical procedure done mostly in the US on babies with a penis, prior to discharge. The vast majority of boys in world aren't circumcised. There's no evidence to justify this routine procedure on medical grounds & its risks are downplayed. The American Medical Association classifies it as a non-therapeutic procedure, as it has no proven benefits and risks outweigh them. The American Academy of Pediatrics has never, in its over 75 years of operation, recommended routine newborn circumcision. The foreskin is a normal, sensitive, functional part of the body, protecting the head of the penis from urine, feces, and irritation; it also has an important role in sexual pleasure, as it has specialized, erogenous nerve endings, gliding and lubricating functions. For a thorough analysis of the literature, science & research, potential risks & alleged benefits, cultural/religious roots & human rights bioethical issues see here.
THIS ISN’T ABOUT PAST, HOW WE WERE ADVISED MEDICALLY OR CULTURED TO DO. IT’S ABOUT DECISIONS MOVING FORWARD.

I like to promote informed choice, question routine status quo, and help those interested in studying the data and what factors create opinion and dogmatic policies, as well as encourage those who wish to ponder this topic with a more critical eye and make their own decisions about their baby’s health care.

Educate yourself & make an informed decision about what you want or don't want for YOUR baby, with my online Guide to Pregnancy, Birth and Postpartum. And in adjunct, my Natural Birth Secrets book 2nd edition, as in many cases, it is totally safe and appropriate to investigate natural alternatives.

POSTPARTUM CARE AT HOME: YOUR BREASTFEEDING GUIDE

POSTPARTUM CARE AT HOME: YOUR BREASTFEEDING GUIDE

Congratulations to you and your family on the birth of your baby! You did it!! You are a rockstar, superhero, however and wherever you birthed. Now it is time for some postpartum care. But through it all, do what you can to go with the flow. Tune into your body and your baby’s natural rhythms. Embrace it all as a normal healthy phase of your life as a new mama, shared with mamas around the world since the beginning of time. Try to have fun with it and keep your sense of humor. 

Welcome to the postpartum period, the fourth trimester, a period of healing and adjustment, of getting to know and comfort your baby, and mastering breastfeeding. All your baby needs now is love and breast milk. If you are unable or choose not to breastfeed, consider feeding baby pumped breast milk, or donor breast milk from registered milk banks. Breast milk is the ideal food for your baby, although organic goat milk formula is most similar to human milk and you can discuss best alternative options with your pediatrician. 

The rest will follow naturally, as you learn on the job, take guidance from wise experienced others, and let Baby be your teacher. As in pregnancy and birth, trust your instincts and your heart. But, do not hesitate to ask for help and support as needed. Hopefully you prepared in your pregnancy so that you are well supported during this sensitive time, as it has always taken a village to raise a baby as well as new parents. A postpartum doula is a must if you do not have family and friends to help you. 

Below are some helpful hints to make the next few weeks of breastfeeding easier and more comfortable, so you are more able to heal, enjoy and reflect upon your extraordinary new miracle. The most important advice is to slow down, stay in the moment, try to resist the temptation to do, do, do...and just be, be, be. Trust that you will heal and get into your breastfeeding routine, as you are perfectly designed to do, given the proper care and support.  Do not hesitate to reach out to an IBCLC lactation consultant sooner rather than later if there are breastfeeding issues beyond what your midwife or doula can help you with.

Nutrition for Postpartum Care & Breastfeeding

Maintain at least the same healthy nutrition as you did in pregnancy, especially now for recovery after birth, and during breastfeeding. This will help you to make good quality milk, and nourish your baby as well as yourself. Make sure to eat at least three whole food varied healthy meals and snacks, and even a little bit more than you would normally consume. And keep well hydrated with at least 64 ounces of water daily. 

Traditional foods for the early postpartum weeks across cultures typically include soups and stews with a lot of vegetables, including the starchy ones like sweet potatoes and winter squash, stew meat or chicken, and whole grains like barley and oats. Also, do eat plenty of eggs, seasonal fruits and vegetables. Much nourishment can be added to fruit/veggie smoothies, soufflés, whole grain hot cereals, and breads/muffins like zucchini-apple, banana-date or carrot-raisin, enhanced with almond flour or chopped nuts and seeds, nut milk, and eggs. 

Herbs and Supplements

Make sure to supplement your diet as in pregnancy, with herbs, vitamins, minerals, omega threes and probiotics to complete nourishment not supplied by diet alone. This will aid in your recovery and help supply all of your and your baby’s nutritional needs. Do increase iron foods and take an herbal iron, especially if you were anemic in pregnancy, have low iron stores, lost a lot of blood at birth, gave birth by cesarean, and/or are still anemic. 

Do continue your nourishing pregnancy herbal infusion to your diet but add alfalfa and red clover. You can have a support person make this by:

1. Blending a handful of dried Nettle leaf, a handful of dried Red Raspberry leaf, a pinch of Alfalfa, large pinch of Red Clover, and several Rose Hips. 

2. Add a pinch of Comfrey to help with healing. (optional) 

3. Brew in a mason quart glass canning jar of boiling water 1-4 hours. The longer the brew, the stronger the taste and effect.

4. Strain, and drink plain or lightly sweetened with Rose Hip infused honey and/or a splash of fresh squeezed lemon or lime juice.

5. Enjoy hot or cold, up to 4 cups per day.

 You can make it in larger quantities and store in the fridge.

There are some nice herbal breastfeeding teas like those made by Earth Mama Organics and Traditional Medicinals. Use two bags per cup of tea to get the benefits. You can have your special someone make your own delicious, nourishing combination of herbs that helps with breastfeeding and enhances the nutritional content of your breast milk: 

1. Mix a handful each of dried Chamomile blossoms, Catnip and Blessed Thistle, a pinch each of Fennel seeds and Fenugreek powder or seeds, and a few dried Lavender flowers.

2. Put 1 tablespoon of the mix in a cup, fill with boiling water, and steep for 10-15 minutes.

3. Strain in the glass mason jar, and drink plain or lightly sweetened with Rose Hip infused honey, and a dash of anise. 

4. Drink 1-3 cups daily.

Breastfeeding

Note ways to prepare for breastfeeding and common myths to be busted, as well as  5 essential tips to get the breastfeeding going.

Your newborn baby’s stomach is tiny, like the size of a cherry the first few days, a small apricot at one week, and a large egg at one month of age. Only tiny amounts of milk are tolerated initially. Expect your baby to drink about 1-1 ½ tsp per feed on the first day, 1½-2 ounces by one week, and 2 ½-5 ounces per feed by one month of age. This is just what you have to give. 

The liquid gold colostrum that your breast produces makes no more than a few teaspoons per feed, but when your full breast milk comes in, you will have more than enough to accommodate. Often women have a misconception that they do not have enough milk when they have exactly what baby needs, and they get into a tension and supplemental feeding cycle that actually does decrease supply. 

If you had labor or birth complications, needed epidural or spinal anesthesia, baby was birthed by cesarean or had to be in the intensive care, establishing breastfeeding can be more challenging at first but you can do it. Get help by a certified lactation consultant (IBCLC) as soon as possible if there is any difficulty. Baby-friendly hospitals should all have them on staff, or you can ask your midwife, pediatrician or local La Leche leader for recommendations. If you need additional guidance to boost low milk supply first follow these steps. All you may need to do is keep nice and calm with baby skin to skin and nurse more frequently, avoid formula and glucose water, and do not use pacifiers until your breastfeeding is well established. 

You can increase emptying if needed, which boosts your supply, by using a double electric breast portable Willow pump every 2-2½ hours for 15-20 minutes, but know that a healthy baby is the best breast pump. If you do pump, freeze the milk for later use, like when you need to go out or want a break from a nightly feed. Take herbal combinations like More Milk Special Blend, drink non alcoholic beer or Hops tea and several cups Sesame milk daily. You may need to add increased amounts of the individual herbs like Goats Rue, Blessed Thistle and Fenugreek, 2-3 capsules each up to 3 times per day, or add the tincture of More Milk Special Blend, 2 ml 4 times per day to increase your supply. 

Treating Breast Engorgement

Your breasts will begin filling with milk and can become engorged by the third or fourth postpartum day whether or not you are breastfeeding. Initially, you may notice that your breasts become larger, fuller, heavy, lumpy, slightly tender and warm. They may leak milk and you may notice a short-lived low grade fever. The skin of the breasts may be pulled tight and become shiny, hard, painful and throbbing, and the baby might be less able to grasp the nipple.  

Suggestions to minimize discomfort with breastfeeding include:

• Practice early, frequent breastfeeding (on demand or every 1½-3 hours) without supplemental bottles for at least the first month. The breasts will learn to replace only what baby takes. (This is a good reason not to pump significantly in addition to nursing initially, as breasts will replace that too). Allow the milk to run freely into a bottle from one breast as the baby nurses on the other side. The bottled milk can be frozen for a later nighttime feed your partner can give Baby to give you some needed sleep once engorgement resolves.

• If Baby is having a hard time latching, try manually hand expressing a small amount of milk before nursing. You can also do so afterwards if still uncomfortably full after each feeding.

• Rub Arnica oil gently over breasts, except nipples, then apply a comfortably hot washcloth/compress or stand under a warm shower 5-10 minutes before nursing.

• Gently massage breasts downward while nursing using Arnica massage oil or lotion.

• If you are uncomfortable between feedings, you can let comfortably hot shower water run over your breasts and massage them downwards using a fine tooth comb dipped in soap, or gently hand express just a small amount, or soak your breasts into a sink full of comfortably hot water. If engorgement is severe add 1-2 ounces of Marshmallow root tincture to the water. 

• For severe engorgement, apply cold packs just during the short term period of extreme discomfort. Ideally, make these by defrosting frozen cabbage leaves rolled over with a rolling pin.

• Apply cold compresses of Comfrey (soak washcloths with the tincture and store in the fridge). You can try comfortably hot Comfrey compresses and add Parsley tincture.

• If you are not nursing and need help drying up your breastmilk, drink lots of Sage tea and do not pump. 

Report any areas of increased heat, redness, swelling and severe pain; fever over 100.4 after the first few days; and chills, headache and generalized aches like you have the flu.  

Sore Nipples

Your nipples may be tender or downright sore during the first week or so of getting accustomed to breastfeeding your baby, whether you are a first time mom or have nursed successfully before. You may also feel some pain, usually lasting no longer than one minute, each time the baby latches onto the breast in these early weeks, which lessens as baby nurses. If your baby is improperly sucking, or incorrectly positioned, your nipples can become very sore and the pain is intense the entire feed.

Suggestions to minimize nipple soreness are:

• Remember this pain is temporary as your nipples adjust to normal healthy breastfeeding, and use your tools from labor and breathwork to breathe and relax into the sensations rather than to fight them. This actually helps tremendously.

• Have an experienced person observe for proper positioning, latch and sucking during breastfeeding from the beginning, especially if you have severe nipple pain during the entire feed and your nipples are very sore.

• Release the baby’s suction with your finger before removing the nipple from the baby’s mouth anytime you need to stop the sucking, especially when the latch is shallow.

• Soak nipples in a cup of 0.9% physiologic saline solution, then expose breasts to fresh air 20 minutes after each feeding, ideally in the sun, in front of a 60 watt light bulb, or a blow dryer. Yes, spend some time topless.

• Apply some breast milk to the nipple.

• Avoid synthetic breast creams and nipple shields.

• If mild, massage plain organic Cocoa Butter, Almond oil or Vitamin E onto the nipples after each feeding. If without relief, apply homeopathic calendula cream or herbal salve made with Calendula, Marshmallow,  Aloe Vera, and Chamomile, or Lanolin designed for sore nipples after each feed and gently remove any residue before nursing. Apply pure Aloe Vera gel to the cracks and cuts, as well as Comfrey, but wipe off before nursing so baby does not ingest it. Try several formulas and see what feels best for you.

• Nurse more frequently for shorter periods of time.

• Alternate positions of nursing each feeding to vary pressure points on the nipple.

• Initiate nursing on the least sore side. You can nurse only one breast a day to allow the other to heal, pumping the sore breast to relieve engorgement during each nursing session. Then nurse the alternate breast the next day (pumping the other), and continue this until nipples have recovered.

• Take a daily bath or shower, washing nipples with water only (no soap).

• Wear all cotton bras, avoid tight bras, and minimize the use of breast pads. If breast pads are occasionally needed, use organic bamboo or cotton washables or nontoxic disposable breast pads without plastic, changing when wet to keep nipples dry.

Report to your practitioner if your soreness lasts longer than a week or is getting worse, if your nipples are cracked and bleeding, or severe nipple pain persists during entire feed indicating a latch issue.

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Need more help from me?

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• Answer questions and make informed decisions

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If you need more personal guidance, schedule a consultation with me.

My Natural Birth Secrets book 2nd edition has helpful tips as well, and is an excellent resource in adjunct to the Guide.