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Please call (541) 385-8050 to make an appointment for your 6 week postpartum visit. Medications You may take Ibuprofen which is also known as Motrin or Advil. You may take 600 mg every 6 hours (or 800 mg every 8 hours) as needed for discomfort. Ibuprofen is preferable to Percocet because it does not cause sleepiness or constipation and it is non-addictive. Do not take Ibuprofen on an empty stomach. If you need additional pain relief, continue taking Ibuprofen, and add Percocet or Vicodin. You may take 1-2 Percocet or 1-2 Vicodin by mouth every 3-4 hours as needed for moderate to severe pain. Do not take on an empty stomach. These are narcotic medications that may cause sedation and constipation. Both medications are safe while breastfeeding. Be sure you are actively preventing constipation- Drink at least 64 ounces of fluids per day and eat a diet rich in fiber (whole grains, fruits and vegetables). Colace, Metamucil, and Milk of Magnesia can also be used to prevent or treat constipation; they are over the counter, safe to use while breastfeeding, safe to use together, and can be taken as directed on their bottles. Prenatal Vitamins/Iron Supplements/Birth Control- If you are not breastfeeding, continue taking your prenatal vitamin for 6 weeks. If you are breastfeeding, keep taking your prenatal vitamin for as long as you are breastfeeding. If you were taking Iron supplements during your pregnancy, continue until your 6 week postpartum visit. If you have postpartum anemia, your doctor will recommend starting Iron supplements. You may take Iron Sulfate (also known as Ferrous Sulfate) 325 mg 1-2 times per day for 6 weeks. Alternatively, you may take Elemental Iron 60 mg once daily for 6 weeks. Both are available over the counter. Birth control options will be discussed at your postpartum visit. Emotional Changes- You may feel tired, anxious or sad and you may notice you cry very easily. This is normal and is called “postpartum blues” or “the baby blues”. These feelings can begin a few days after delivery and usually disappear in about a week or two. Prolonged sadness may indicate Postpartum Depression. Please call the office to speak with us if you are experiencing prolonged or severe sadness. Sore Nipples - May be relieved by ice packs and regular feeding from both breasts. Avoid prolonged feeding sessions and ensure a good latch. Keep your nipples as dry as possible between feedings. Be sure to wear a good support bra and allow the nipples to air dry after feeding. Apply ointment (such as bagbalm, lanolin, cool tea bags, Vaseline and A&D) to any cracks. Blocked Ducts - Are usually felt as a hard, firm mass without a fever. Gentle massage, hot packs, and frequent feeding from both breasts are the best relief. Breast Infection (Mastitis) - Causes a red, warm and painful mass associated with a temperature over 100.4 degrees F. Should this develop, contact our office immediately. The usual treatment is antibiotics and hot packs. Avoid massage, as this can cause the infection to spread. Continue to breastfeed to avoid an abscess. Weaning - Can be accomplished at any time. Planning ahead is helpful, beginning with a gradual decrease in the length and number of feedings. Avoid hot showers or any stimulation to the breast area that would encourage milk production. Continue to wear a good support bra, apply ice and bind the breasts tightly. Medication is not recommended to stop breast milk. It is recommended to use ibuprofren to decrease discomfort. Uterine Cramps- Uterine cramping is normal, especially while breastfeeding. This cramping is how the uterus stops bleeding and returns to its pre-pregnant size. The uterus takes 4-8 weeks to return to its pre-pregnant size. Vaginal Bleeding and Discharge- Postpartum vaginal discharge, also called lochia, usually lasts about 2 to 6 weeks, yet even up to 8 weeks is normal. The color will change from bright red to brownish to tan and will decrease each week. It is normal to occasionally have a heavier gush of blood, especially after breastfeeding or with increased activity. Your bleeding should then return to the amount of flow you had prior to the gush of blood. Normal bleeding is less than a pad per half hour. If you are soaking a large maxi pad (soaked front to back, side to side, through and through) more than every ½ hour, more than once, please call your doctor. Do not use tampons until after your six week postpartum visit. Your period will resume in approximately 6-8 weeks if you are not breastfeeding. If you are breastfeeding, it is common not to have your period. Episiotomy Care- A “Sitz Bath” is simply sitting in a tub of warm water for 15 minutes, 2-3 times per day. This will help relieve the discomfort. Tucks pads, Witch Hazel and Lanacaine, may be applied to the external vaginal area as needed. You may also use oral pain medications as described above. Stitches will dissolve in 1-3 weeks. You will be more comfortable if you are not constipated; please follow directions above to prevent/treat constipation. Hemorrhoids- Sitz baths, as described above, can help alleviate hemorrhoid pain as well. You can also use topical agents such as Tuck pads, Witch Hazel pads, or Preparation H or Preparation HC. Actively prevent constipation. Activity- Rest! Do not do heavy housework or strenuous exercise for two weeks. Walking is the exercise of choice during this time period. If you had a vaginal delivery, and are not taking narcotics, then it is fine to drive. If you had a c-section, do not drive for 1-2 weeks (or longer if you are still taking narcotics). If you had a c-section, then you should avoid heavy lifting for 6 weeks. You may carry your baby in a car seat, but nothing heavier. It is fine to go up and down stairs. Pelvic Rest- Avoid tampons until your postpartum visit. Do not douche. Generally, we recommend abstaining from intercourse until you are 6 weeks postpartum. However, if you are between 4 and 6 weeks postpartum, you have completely stopped bleeding and your episiotomy is well-healed and non-tender, then it is okay to have protected intercourse.
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