CARE OF THE MOTHER
1. Temperature: Take your temperature using an oral glass or digital thermometer
if you feel as though you may have a fever. Your range of normal is 96-99 degrees.
If your temperature is greater than 100.4 call the midwives.
Always recheck an abnormal result.
2. Pulse: Always take your pulse after resting. The normal range is 60-100 beats
per minute. If greater than 100 beats, lie down and rest for 20 minutes. Drink a
glass of water. If you are experiencing pain from cramps, perineum or muscle aches,
take medication and recheck. If your pulse remains over 100 beats per minute,
call the midwives.
3. Breast Care while Breastfeeding: Wearing a bra is optional. If you choose to
wear one, make sure it is supportive and does not have under wires. Nipple soreness
is expected for the first 3-7 days, but severe pain, cracking and bleeding is not normal.
If you experience these symptoms or have other breastfeeding difficulties, call the office
of the midwives to speak with our lactation specialist. Express breast milk onto the nipple
after each feeding and air dry to relieve soreness and help with healing. Do not allow the
nipples to remain damp with pads or a bra. Avoid soap on the nipples. Engorgement usually
does not occur if you nurse often enough, long enough and do not miss feedings.
4. Breast Care if Formula Feeding: Wear a snug bra to help prevent engorgement. Ice,
Tylenol, or Ibuprofen (Motrin, Advil) will help ease the discomfort of your milk coming in.
Do not express out any milk. This will only help to continue milk production. For engorgement,
wrap your breast with cold, raw green cabbage leaves. After the leaves have become wet
and limp, remove and reapply fresh leaves. Repeat as often as necessary.
5. Checking the Uterus: It is important to check your uterus to make sure it is firm and at
or below the level of your navel. If it is not, empty your bladder, rub the uterus and try to
nurse your baby. If you are unable to get your uterus to firm up, call the midwives.
6. Vaginal Bleeding: Your bleeding will the heaviest on the first day and will decrease
slowly and become more like a normal period. If your bleeding increases, check your
uterus for firmness, empty your bladder, lie down and nurse your baby. A few golf ball
sized clots are possible at times. If you are passing larger clots or also have a large
amount of bleeding, call the midwives.
7. Caring for Your Perineum and Stitches: Use ice in a bag to your stitches for the first
24 hours. After 24 hours, use warm baths, compresses and soaking will help with the
discomfort and healing. Fill the tub with clean, warm water and soak for 15-20 minutes.
Comfrey tea can be steeped in warm water and added to the tub or sitz bath. Use the
plastic peri-bottle with warm water to rinse your perineum every time you go to the
bathroom to keep clean.
8. Elimination: Empty your bladder every 2-3 hours for the first 3 days. If you are unable
to urinate, call the midwives. It may be up to 3 days before you are able to have another
bowel movement after the birth. Eat high fiber foods (fruit, vegetables, bran, popcorn)
and drink plenty of fluids including juices. If your have not had a bowel movement by 3-4
days we may suggest a natural laxative.
9. Nutrition: It is important to eat a well balanced diet including protein, fruits and vegetables.
Eat 3 meals plus snacks or small, frequent meals. Avoid junk food and empty calories. Continue
to take your prenatal vitamin and iron (if prescribed) until the midwives instruct you to discontinue
them. Drinking to thirst will ensure adequate hydration. If you are thirsty you need to drink.
Limit the amount of caffeine you take in. Do not try to diet right away; your body needs to recover
from the birth.
10. Rest/Exercise: Once you’ve had your baby, you need to go to bed and try
to sleep as long as possible. Four to six hours would be great if your baby will allow it.
You must not do anything more than sleep, feed the baby, eat and care for yourself for
the week. Making sure you get adequate rest will insure a complete recovery from your
birth. Sleep when the baby is sleeping since babies usually want to eat frequently and
for much of the night. If necessary take the phone off the hook and put a sign on the door
so that you are not disturbed. No heavy lifting and avoid heavy exercise until your 4-6 week
visit with the midwives. You can begin pelvic floor exercises, abdominal tightening and chin
lifts now. Up to 30 pelvic floor exercises, 3 times a day are recommended.
11. Help at Home: Try to get as much help as possible for at least the first
week. You will have all you can handle just caring for you and the baby. Over doing it will only
make you exhausted and prolong your recovery time. Enjoy being pampered, you earned it!
You may experience hormonal changes that cause you to feel depressed, overwhelmed, or emotional
without much cause. This is normal. If these feeling persist or become intense, call the midwives.
12. Medications: If you have been instructed to take any medication, know what it is for
and take only as prescribed. You may take Tylenol or Ibuprofen for pain. Take your prenatal
vitamins and iron. If you need Rhogham because your baby is Rh Positive it will be administered by the midwife.
CARE OF THE NEWBORN
1. Temperature: Learn how to take a baby’s temperature. Anytime you think the baby
is sick and you are going to call the pediatrician, it is good to check the baby for a fever.
A digital thermometer may be used and will signal when it is ready. Check the temp under
the armpit, unless your pediatrician tells you differently. The normal range is between
97.6 to 99 degrees.
2. Respiration: Count the baby’s breathing for a full minute by watching or feeling the
chest as it rises and falls. Do this while the baby is quiet or sleeping. A newborn’s breathing
will be irregular. The normal range is 30-60 breathes per minute. The breathing should not
be labored nor should the baby have any blueness around the mouth.
3. Bulb Suctioning: The bulb syringe is used to help remove any mucus from the nose
or mouth. To use, you must first compress the bulb, then insert into the nose or mouth,
release the bulb to suck up any mucous. The bulb is also helpful if the baby has spit up
and needs help clearing his mouth.
4. Jaundice: This is normal in the newborn, however we do not want the level to get
too high. One way to help decrease jaundice is to sunbathe the baby by placing him
by a sunlit window. Babies usually have their bilirubin levels checked before they go
home from the hospital.
5. Feedings: Feed the baby on demand regardless of how you have chosen to feed.
If breastfeeding, you can expect your milk within 24-72 hours. The colostrum that is
present is sufficient to nourish the baby until your milk comes in. Newborns typically
nurse 8-12 times in 24 hours and sometimes cluster some feedings together.
6. Elimination: The baby must urinate and stool within the first 24 hours. Expect a
diaper for every day of life until your baby is consistently wetting 6-8 diapers at 1
week old. The baby should stool at least once a day. Often they have several stools
a day. After the meconium stools have passed, the stools will be green, then yellow
and mustard-like in consistency. This is not diarrhea.
7. Activity: Newborns require a great deal of sleep, up to 20 hours a day. When the
baby is awake she should be alert and active. Help to stimulate the baby during this
wakeful time by talking, touching and playing with her. Newborns can see up to 14
8. Umbilical Cord: At every diaper change or at least 3 times a day soak a cotton
ball with alcohol and wipe the cord, making sure to get the base where the skin
and cord meet. Keep the diaper from covering the cord.
9. PKU and Supplemental Screening: This blood test for the baby will be done
by the midwife at your home 2 days after the birth. The PKU is required by state law
to be done on all babies.
10. Enjoy your baby!