Get Your Body Back After Baby

Weight Loss | Nutrition | Exercise | Relationships | Sex | Breastfeeding

By Muscle & Fitness

Triumph Books

Copyright © 2009 Weider Publications, LLC.
All rights reserved.
ISBN: 978-1-60078-364-7

Contents

INTRODUCTION,
Chapter 1 TAKING CARE OF YOU,
Chapter 2 NUTRITION AND WEIGHT LOSS,
Chapter 3 EXERCISE AFTER BABY,
Chapter 4 YOUR RELATIONSHIP,
Chapter 5 BONDING AND BREASTFEEDING,
Chapter 6 BECOMING A CONFIDENT MOM,
Chapter 7 BONUS: BABY-CARE BASICS,

CHAPTER 1

TAKING GARE OF YOU

You've made it through pregnancy, labor and delivery. You've got a beautiful new baby. What you didn't expect was how sore and tired you'd be after giving birth. What's more, taking care of a newborn is taking its toll on you, both physically and emotionally. As any mother will attest, those first six weeks can be overwhelming, exhausting and, in a word, hard.

To make it through, the most important thing you can do is take care of yourself. The following week-by-week guide to recovering after childbirth will help you gauge what's normal — and what warrants a call to your doctor. Plus, easy exercises designed to allay stress and strengthen the muscles most taxed during pregnancy and delivery will help you begin to feel like yourself again.

The key to recovering from childbirth and taking care of your newborn is to place nonessential activities on hold and take care of yourself, too. "Mothers think that because they're going home from the hospital, they're good to go," says Nancy Chandley-Adams, R.N., IBCLC, who works in the patient-education department at Women and Infants Hospital in Providence, R.I. "But their bodies still have to recover."

The key to recovery during your first six weeks postpartum is narrowing your to-do list down to the essentials. Easier said than done? Get down to basics with this week-by-week guide to taking care of yourself after you have a baby.

Week one

Giving birth impacts almost every part of your body. "Many new moms are surprised at how sore and tired they are," says Karen Ruby Brown, a certified nurse-midwife at the University of California, San Diego, Community Women's Health Program. Another surprise is how utterly "goopy" you feel. "The body is releasing so much stuff — blood, sweat, tears, milk — that women feel like walking bodily fluid factories," Brown explains. During week one you'll experience uterine contractions, bloody vaginal discharge, possible breast engorgement and post-episiotomy pain (if you had one). You'll pass clots that can be as large as a small plum. You'll feel even more uncomfortable and in pain if you had a Cesarean section. (For symptoms that require immediate medical attention, see "Red Flags," pg. 18.)

HOW TO CARE FOR YOURSELF

MAKE TIME TO MINIMIZE PAIN Strategies may include taking sitz baths, using hemorrhoid wipes, squirting the vaginal area with warm water (especially after going to the bathroom) and following your doctor's recommendations regarding incision sites. (For more information on recovering from a vaginal delivery or Cesarean section, see "Baby Your Body," pgs. 11 and 13.)

NURSE FREQUENTLY TO PREVENT BREAST ENGORGEMENT When your milk comes in, usually between days three and five, your breasts may become overfull, swollen and hard. You can relieve engorgement pain by applying ice packs or cold cabbage leaves. (The latter haven't been proved effective, but may work for some women.)

Baby your body To ease your recovery from labor and delivery, rest as much as you can, drink plenty of fluids and keep taking your prenatal vitamin. Also follow these self-care tips:

If you had a vaginal delivery

KEEP IT CLEAN Be sure to shower daily if you had a perineal tear or episiotomy.

KEEP IT COMFY If you didn't have a perineal tear or episiotomy, it's safe to take a daily sitz bath (sit in 2 inches of warm water) to soothe your perineum and/or hemorrhoids. Also apply witch hazel pads to your nether region.

AVOID BATHS Wait to bathe until six weeks after delivery, when your cervix is fully closed.

KEEP IT MOVING To prevent constipation, request stool softeners before you leave the hospital. Try milk of magnesia if you haven't had a bowel movement in four days.

SAY YES TO DRUGS Ease post-delivery aches and pains with a heating pad and 800 milligrams (mg) of ibuprofen (Advil or Motrin) up to three times a day.

If you had a cesarean section

PLAN TO GET UP AND ABOUT "We suggest that patients get out of bed and start moving within 24 hours of a C-section because movement decreases the risk of blood clots and gets your digestive system functioning again," says Alison Edelman, M.D., M.P.H., an assistant professor of obstetrics and gynecology at Oregon Health & Sciences University in Portland. You'll need to start slowly and with help from your nurse, as you may be a bit dizzy when you first get up. Soon enough you'll be able to take a stroll around your hospital floor. The need to get back on your feet is one reason you should take the pain medicine your doctor prescribes.

You also can shower within a day of your surgery; doing so helps reduce the risk of infection. "Don't scrub your incision, but let the soapy water run over it," Edelman says. (Your bandages will likely be removed about 24 hours after surgery and replaced with small sticky bandages called Steri-Strips; it's fine if these get wet.) Dry the area by gently patting it or using a blow-dryer set on cool. It's safe to take a sitz bath when the incision has healed, generally seven to 10 days after surgery.

EXPECT UNEXPECTED PAIN Most women realize that they'll have pain after a C-section — it's major surgery, after all! But many are surprised by the intestinal spasms — OK, gas — they experience; this is a result of air becoming trapped in the abdomen during surgery. Getting out of bed and walking will help relieve gas pains. Additionally, your physician might also recommend taking simethicone tablets (Gas-X), which help alleviate gas and bloating. Also move your legs around while in bed — any bit of activity helps.

PREPARE TO TAKE IT EASY AT HOME "Don't drive for at least one week after a C-section delivery, limit stair climbing, and avoid heavy housework," says Henry Lerner, M.D., an OB-GYN in Newton, Mass., and a clinical instructor at Harvard Medical School. The age-old advice — don't lift anything heavier than your baby for two weeks — still stands. The staples that are commonly used to close the incision will probably be removed within three to seven days of delivery, but even then, it's important to avoid any strenuous activity for the first two weeks. Also pay attention to the following symptoms of infection; if you have any of them, call your doctor immediately: fever above 100.4° F; heavy vaginal bleeding; pain at the incision site that gets worse instead of better; blood or other fluid draining from your incision; or, reddened edges around your incision

EMBRACE YOUR BABY'S BIRTH For women who planned and hoped for a vaginal delivery, having a C-section can be emotionally devastating. If you just can't come to terms with your C-section, visit Postpartum Support International at postpartum.net. They'll guide you to support groups and even counselors who specialize in this area.

Week two

You'll start feeling better during week two, but that doesn't mean you should launch into major housecleaning mode. Instead, try to get outside. You'll continue to have vaginal discharge as well as soreness and itching at any incision sites. If you're breastfeeding, your nipples may be sore.

HOW TO CARE FOR YOURSELF

DON'T OVERDO IT Vaginal discharge, which was bright red during week one, will turn brown during week two. If you exert yourself too much, it will turn red again — that's a warning sign you're doing too much and need to slow down.

START TAKING BRIEF WALKS This will exercise your muscles and reduce your risk of developing blood clots, which are more common after childbirth. Take it easy, but do a little each day and increase the distance gradually.

GET HELP IF BREASTFEEDING HURTS Some nipple soreness is normal, but if they are cracked, bleeding or truly painful, contact a certified lactation consultant (Visit iblce.org, the International Board of Lactation Consultant Examiners).

Week three

During pregnancy, estrogen and progesterone levels are about 10 times higher than normal; once you give birth, they begin to plummet. By postpartum day seven they return to prepregnancy levels, but the emotional ups and downs are just starting. "Your hormones impact every organ system, and your body needs weeks to adjust," says OB-GYN Tracy W. Gaudet, M.D., director of integrative medicine at the Duke University School of Medicine in Durham, N.C. During this time your emotions can be all over the place.

HOW TO CARE FOR YOURSELF

DON'T SUFFER IN SILENCE Talk to your doctor, nurse or midwife as well as family and friends if you can't shake your moodiness, especially if you have a history of depression. (For more information, see "Avoid the Baby Blues," pg. 17.)

LOWER YOUR STANDARDS Give yourself a break if you don't measure up to prepregnancy expectations regarding housework and social obligations. When you're caring for a newborn, it's OK for the laundry to wait.

TAKE A BREAK EVERY DAY Do something special for yourself, even if you just call a friend, listen to music or read.

Avoid the baby blues

As many as 70 to 80 percent of new mothers experience the "baby blues," a mild change of mood beginning in the first few days after giving birth. Up to 10 percent develop true postpartum depression (PPD), according to the American College of Obstetricians and Gynecologists; women with a history of severe PMS, thyroid illness, or a personal or family history of depression are at increased risk. Symptoms of PPD include insomnia, loss of appetite, feeling emotionally disconnected from or resentful of your infant, memory loss and severe anxiety. "Postpartum depression is a very treatable illness, but getting to it quickly is important," says Diana Lynn Barnes, Psy.D., of Woodland Hills, Calif. Here are simple ways to help avoid PPD:

EAT OMEGA-3S One study found that countries in which people eat more omega-3-rich seafood had a lower rate of PPD. According to study author Joseph Hibbeln, M.D., a National Institutes of Health researcher, you should get 1 gram of omega-3s a day; sardines, cooked salmon, shrimp, avocados and flaxseed oil are all good sources (3 ounces of sardines provide about 1.3 grams). Fish-oil capsules — which contain only trace amounts of mercury — also are a good way to supplement your diet, according to Hibbeln.

SNOOZE It's tempting to catch up on daily tasks while the baby is sleeping, but don't. "One of the major risk factors for post-partum depression in new moms is sleep deprivation," says PPD expert Barnes.

GET ACTIVE "Exercise is a natural mood booster that can improve psychological health by relieving stress," says Kelli Calabrese, M.S., a lifestyle and weight management consultant in Flower Mound, Texas. The company of others during exercise also helps. "Postpartum exercise classes or mommy-and-me groups that allow women to reach out to other women can be reassuring and lessen the possibility of depression," Barnes says.

PLAN BABY-FREE TIME "Make sure you get some time alone as a new mom, whether it's to practice yoga, meditate, write in a journal or even just take a bath at the end of the day," Barnes advises. "And don't feel guilty about it."

GET HELP While most mothers experience the "baby blues," if these feelings intensify or persist beyond a few weeks, call your doctor right away. You may be suffering from PPD. Or contact these organizations: Postpartum Support International (800-944-4PPD, postpartum.net) or Postpartum Education for Parents (805-564-3888, sbpep.org).

Red flags Contact your OB-GYN or midwife if you experience any of the following during your first six weeks postpartum:

* Hot or reddened breasts, with fever, chills or headache

* Foul-smelling discharge from the vagina or an incision site

* Loss of control over bowels or bladder

* Unexplained swelling, leg pain, chest pain, vomiting or fever

Week four

Your body has done a lot of healing by week four, but your brain may be foggy with exhaustion. "Never in your life will you be as sleep deprived as you are when you have a new baby," says Alice D. Domar, Ph.D., executive director of the Domar Center for Mind/Body Health in Boston. "But remind yourself that this phase of your life is temporary."

HOW TO CARE FOR YOURSELF

SLEEP WHENEVER YOU CAN Remind yourself to put everything but the most essential tasks on hold (e.g., leave the dirty dishes for later), nap when the baby does and sleep close to your baby so you can get maximum rest.

GET DAD'S HELP WITH FEEDING If you're nursing, once breastfeeding is established (after about a month or so), have your partner give the baby a bottle of pumped milk during the night so you can sleep.

PRACTICE STRESS-RELIEF TECHNIQUES Try meditation, a mindfulness exercise or a mini-relaxation: inhale slowly and deeply, hold for a couple of seconds, then exhale slowly and fully. (For three effective stress-relieving exercises, see "Stretch Away Stress," pg. 22.)

Week five

Although you are mostly healed, parts of you still feel strange. You may be leaking urine, itching from hemorrhoids or struggling with constipation. You wonder if your body will ever return to normal — you feel fat, your belly is poochy, your breasts are huge, and even the smallest amount of physical activity seems to wear you out.

HOW TO CARE FOR YOURSELF

START TAKING LONGER WALKS Daily exercise burns calories, tones muscles, improves mood and gets you out of the house. Don't want to leave your baby? Put her in a front carrier or stroller and take a walk together.

MAKE EVERY CALORIE COUNT Pack your diet with fresh fruits, vegetables, whole grains, nonfat dairy and low-fat protein. A peanut butter sandwich on whole-wheat bread with an apple and a glass of milk is a perfectly nutritious meal that takes only a few minutes to prepare.

DRINK PLENTY OF WATER It boosts your milk supply, helps your digestive system function effectively and fills you up.

BE PATIENT WITH YOUR BODY "Some women may feel completely recovered within a couple of weeks, but for others this process may take a good deal longer," Brown says.

Week six

Your body's (finally!) returning to normal. In fact, at your six-week checkup your doctor has probably given you the OK to start having sex again and return to work. But your life is completely different now that you've had a baby.

"Becoming a mother often triggers women to re-evaluate who they are and their course in life," OB-GYN Gaudet says. "It's a hugely transforming event."

HOW TO CARE FOR YOURSELF

KEEP A JOURNAL Writing helps you examine and understand your emotions and find answers to difficult questions.

TALK WITH OTHER NEW MOTHERS Share thoughts and ideas with friends or women you meet in play groups, postpartum support groups or mom-baby exercise classes.

MAKE BIG DECISIONS CAREFULLY You're experiencing one of the most dramatic life transitions — it's not a good time to quit your job, leave your husband or move cross-country.

Stretch away stress

Three easy moves to strengthen and relax your overworked muscles.

Does your body ache? If so, it's not surprising. The daily responsibilities as a new mother can take a toll on your body, probably more than any other job you've ever had in your life. Constant lifting (of the car seat, stroller, baby, etc.), breastfeeding and diaper changing, coupled with heavier-than-normal breasts and weakened abdominal muscles, can all add up to a strain on your body's natural alignment. The result is that you feel tired and achy all day long.

The following moves are so gentle they can be done as early as the day after you deliver. Repeat them throughout the day as needed, holding each stretch for three full breaths. Remember to breathe in through your nose and out through your mouth. Always check with your doctor before starting any new exercise program.

1 CHEST, CALF AND HIP STRETCH Stand with feet hip-width apart, then take a step back with your right foot, toes pointing straight ahead, right heel down. Lace your hands together behind your lower back, lifting your chest as you take a deep breath (Remember to breathe in through your nose and out through your mouth). Keeping shoulders relaxed, lengthen your torso as you bend your left leg, keeping your knee in line with your ankle, buttocks tight and abs drawn in [shown]. Switch sides and repeat.

2 CHEST OPENER Stand with feet hip-width apart and lace your hands behind your head, elbows wide. Breathe deeply in through your nose and out through your mouth. Gently press your head into your hands [A]. Straighten arms, palms up, and lean back slightly, keeping your thighs and buttocks firm [B].

3 LOWER-BACK STRETCH Stand with feet hip-width apart, knees bent, hands on thighs, fingers facing in. Lean forward from hips and point your tailbone back to straighten your spine [A]. Inhale, then exhale as you round your back like a cat, drawing your abs in and bringing chin toward chest [B].

Brand-new mom moves

Help your body recover and get energized with moves so gentle you can do them the day after you deliver.

Pregnancy and childbirth put a strain on your body, leaving you feeling out of shape and low on energy. But, gentle moves that encourage deep breathing can help you feel like yourself again. The following workout, designed by Jennifer Gianni, an Asheville, N.C.-based specialist in prenatal and postpartum Pilates, incorporates deep breathing and increases circulation, which in turn will help to speed your recovery.

The moves are safe to do after a vaginal or Cesarean delivery and are so gentle that you can start them the day after you give birth (with your doctor's OK). Begin with the first move and slowly build your strength until you can complete the program. Start with five repetitions of each move, gradually working up to 10.

1 CHEST AND SHOULDER OPENER Sit comfortably with your legs crossed and lean back against a cushion or pillows. Lace your fingers behind your head, opening your elbows wide. Sit tall and lean back slightly, lifting your chest as you take a breath, slowly and deeply, until your ribcage expands [shown]. Exhale slowly and relax.

2 RIBCAGE BREATHING Sit in a comfortable position, legs crossed, and lean back against a cushion or pillows. Lightly place your hands on your torso, just under your breasts, spreading your fingers wide along your ribcage. Inhale slowly and deeply through your nose, feeling your ribcage expand under your fingers. Exhale through your mouth as you gently draw your abs in [shown] and do a Kegel (See "Do Your Kegels," pg. 27).

3 GENTLE PELVIC TILTS Sitting erect on the edge of a chair, bed or cushion, place your hands on your knees. Inhale deeply through your nose as you lift your chest and lengthen your neck. Exhale slowly through your mouth as you round your spine, gently tucking your pelvis under and drawing your abs in [shown] as you do a Kegel. Return to starting position.

4 DRAWING IN Place your hands on your belly. Inhale slowly through your nose, expanding your belly, then exhale through your mouth and gently draw your abdominal muscles in, away from your hands, as you do a Kegel [shown]. Slowly release and repeat.

5 PELVIC TENSIONS Lie on your back without arching it, knees bent and feet flat on the floor. Inhale through your nose, then exhale through your mouth, gently drawing in your abdominals. Slightly squeeze your glutes (buttocks) without lifting your hips [shown]. Slowly release and repeat.

(Continues...)Excerpted from Get Your Body Back After Baby by Muscle & Fitness. Copyright © 2009 Weider Publications, LLC.. Excerpted by permission of Triumph Books.
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