The thrills and challenges of the postnatal period

If you are already a seasoned mum, you know roughly what to expect in the first weeks after birth. You can prepare more easily and you will probably wait for your baby’s arrival with fewer worries.

If you are expecting your first baby, you may feel some anxiety or uncertainty because the experience is new. It is worth finding out more, because if you get to know the things you will meet right after birth, the situation will already feel more familiar.
By the end of the postnatal period most mums know their baby’s likes and reactions well. They recognise their cry and what it means. It is only a few weeks, yet the flow of new experiences is so intense that you will find your rhythm quickly.

It begins in hospital 

At the start of the postnatal period, after giving birth, the mother settles into her ward or room in hospital. During these few days, usually 3 to 5, there are big changes compared with the last weeks of pregnancy. These are not only physical and related to new tasks, but emotional too.

In these moments, a first time mum realises she has become a mother. She barely has time to rest and gather her thoughts, which are still circling around memories of labour, when her newborn is brought for the first feed, and she can see them calmly for the first time.

From here things get going. Alongside rest there is always something to do, because feeds happen at regular intervals, and once milk comes in, regular latching helps to establish supply, the balance of demand and supply. Many mums can already store expressed milk while in hospital.

The hospital phase, with the support of health professionals, is a time when a new mum can learn a great deal about baby care. Doctors keep an eye on the newborn’s condition and the mother’s recovery, and the nursery nurses offer practical tips. It is worth accepting their guidance and asking questions whenever something is unclear.

In hospital both mum and baby are learning

Feeding a baby feels so natural that we might think it needs no learning. Sometimes everything goes smoothly, or mum is experienced because she already has children. With a first baby, however, you do need to learn a comfortable feeding position, the teamwork, and get to know each other’s cues. This will take shape with practice. Hospitals also have breastfeeding counsellors who teach mums everything they need.

Over these days, mum and baby start to get to know each other. They tune in and the bond deepens. Mum learns how to care for the little one, and the baby begins to recognise mum’s voice and movements and respond to them.

What to keep in mind during the hospital days 

Right now the mother’s key tasks are to establish and maintain milk production and for her body to return to its pre-pregnancy state. For milk production, drink plenty of fluids, mainly water. It is best to avoid gassy fruit drinks, as these can affect the baby as well. Milk production takes a lot of energy, so it is important that mum can rest properly, even during the day. Exhaustion, worry and stress can hinder milk supply.

Going home 

Everyone has been waiting for this day with great excitement. The family can be together and mum can return to the warmth of home. If you feel worried about managing on your own, know that this is perfectly normal and very common for first-time mums, people simply talk about it less. Remember that you will also have help at home from family, your health visitor and your GP.

On the last day you will prepare the baby’s going-home outfit and any other items the hospital might request for discharge, for example nappies or sterile breast milk storage bags if you have expressed milk to take home.

Whether mum dresses the baby with support or the nursery nurses do so depends on the hospital. For the journey, be mindful of the weather and bring clothing for the baby accordingly.

The new family member arrives home 

You have likely guided relatives in advance about visiting in a way that suits you. This often follows family traditions. A lovely custom is when grandma helps her daughter with the newborn’s first bath at home.
As a new mum you may feel very active in these first few days.

What to expect in the first 6 weeks 

As you feed and care for your baby, you grow more attuned to each other. Your little one learns your voice and scent, the taste of breast milk, and how to signal when they feel hungry.

In this period your baby mostly sleeps, yet develops at a rapid pace. By the end of the postnatal period they turn their head towards sound, and use different cries to signal hunger, fear or sleepiness. You will notice the beginnings of a daily rhythm. Later this can easily shift, which is normal.

One key area, breastfeeding, may still bring questions in the weeks ahead. Problems may arise that you can discuss with your health visitor or a breastfeeding counsellor at any time. You can also find a specialist for sleep support if needed.

Physically you recover more each day. Your uterus gradually returns to its original size. You may feel this during feeds as cramping, that is the effect of oxytocin. Care for any perineal stitches carefully to avoid infection. Postnatal bleeding is normal and lasts 4 to 6 weeks.

Even if you have a lot to do, make time for your feelings. Processing the birth experience matters in every case, whether you experienced it very positively or not. As the swirl of emotions rises, accept them as natural. Mood changes are strongly influenced by drastic hormonal shifts, the strangeness of a new role and the memories of labour.

What problems may appear in the postnatal period 

Breastfeeding difficulties 

It can happen that a baby does not want to, or cannot, latch. There are several possible reasons, for example very full breasts can be harder to latch onto. If the issue is linked to nipple shape, this usually becomes clear in hospital along with the solution. If these kinds of problems arise, seek help from a breastfeeding counsellor.

Mastitis 

If one or more milk ducts do not drain well, they can become blocked and a painful lump can form. Sometimes feeding clears it on its own, but not always. If it spreads across the breast, the breast becomes very tender and tight, and mum may develop a fever.

When there is no inflammation yet, gentle massage can help loosen the ducts so milk can flow freely. If inflammation develops, see a doctor.

Pain after a caesarean 

Every mum experiences pain differently after a caesarean. Everyone has their own limits, but caring for a newborn always requires the mother too. If the pain is very limiting, seek medical help for pain relief.

Haemorrhoids 

Haemorrhoids are a very common companion of pregnancy and birth. They can cause bleeding, pain and itching. Good hygiene and a fibre-rich diet matter here. The good news is that they often settle on their own a few weeks after birth. If not, it is worth seeing a colorectal specialist.

Postnatal depression 

Some mums do struggle with mood disorders after birth, and people now speak openly about this. Symptoms include persistent sadness, crying, lack of interest and motivation. Mum may not be able to feel joy about her baby and may find it hard to bond. If symptoms are serious, it is important to see a specialist who will help you through this difficult time.

We wrote earlier about the mental load mothers face, it may be useful to read.

During the postnatal period it is worth accepting every well-meant offer of help, because mums still need a lot of rest at this time.

Sources:

NHS — Postnatal depression, overview

NHS — Mastitis: symptoms, causes and treatment