Up to now, all this handbook has been about caring for your baby; however, we care about your whole family as well. Also, there are issues with your health that affect your baby’s health as well.

Moms need to be sure to get plenty of rest; try to get help from family members, friends, church, etc. Moms also need to eat a well-balanced diet. Watch out for signs of for postpartum depression (baby blues). Find time with your spouse; fathers need to be sure to help.

Find time to pay some attention to siblings. Often just a little special time is all that is necessary. Usually in healthy families siblings adjust very well, even young children and toddlers. Try to be sensitive to their needs as much as possible. It usually helps to find ways to include siblings in baby care.

Remember that while your baby needs a lot of care and attention and time, she is a treasured addition to the family you already have, not the new center of the family. She should fit into your family’s routine, beliefs and values.

Family Vaccines

Most parents are aware that a number of vaccines are given to infants and young children to protect them from serious and sometimes deadly diseases. But mothers, fathers, siblings, and other household members also need certain vaccines to protect the baby until she is old enough to be vaccinated. These include a pertussis (whooping cough) booster for all moms, dads and siblings who have not already had one. Also, an annual flu vaccine is recommended for all household members of an infant less than six months old. If you have difficulty finding these vaccines at your doctor’s office, you can get them in our office. We provide vaccines for parents as one of the services we offer.

The Fourth Trimester

New guidelines have restructured postpartum care into a comprehensive, patient and family-centered care model, thinking of the postpartum period as the fourth trimester of pregnancy. (This term has been applied to the first few months of the baby’s life as well). The maternal mortality rate in the U.S. is too high and much higher than that of other countries. This comprehensive care model may help reduce that rate and improve the health and lives of women, children, and families. We wholeheartedly support this effort and consider ourselves to be part of mother’s postpartum neighborhood.

Mom’s medical follow-up

For many years, the recommended time of mom’s follow-up with her OB/GYN has been around 6 weeks after delivery. However, in 2018 new guidelines recommended that postpartum care should be a continuous process, with contact between mom and her doctor as needed, including phone or electronic contact in the first 3 weeks as well as a follow-up visit by 12 weeks after delivery.

If you have any medical problems, including high blood pressure or preeclampsia, be sure to follow-up when your doctor told you to, often within a week of discharge.

Talk to your doctor about any pain or problems peeing or pooping, or if you are leaking urine, gas, or poop.

Mom’s Warning Signs

Seek emergency care (911, ER) for: chest pain, difficulty breathing or shortness of breath, seizure, thoughts of harming yourself or your baby.

Call your doctor right away for: heavy, bright red vaginal bleeding, fever, severe headache, wound infection, leg pain, redness, and/or swelling, severe abdominal pain, severe vomiting, or a foul odor to your vaginal discharge or bleeding.

Seek medical advice for vomiting, pain or burning with urination, or an area of breast redness or pain swelling.

Your Baby’s Insurance

You will need to sign your baby up with your health insurance plan (or whatever plan your baby will have), usually within the first 30 days of life. If you wait too long, your baby may not be covered from the time of birth. You may also have to wait until the next open enrollment time, which means that your baby may not be covered for up to a year.
If you are having trouble getting insurance for your baby or yourself, see our Resources section.

Having what you need to care for your baby

Do you have everything you need to care for yourself and your baby? Are you worried or concerned about housing or having all the food you and your baby need? There are many places to get help; check out the Resources section for more information.

Support

Do you have the support you need? Help with meals, food, shopping? Do you have a way you can get rest and sleep when you need it, or a way to get away from newborn care when you need a short break? Try to be sure you have a support system in place. If not, don’t be afraid to ask for help from family members, friends, church, etc. There is no shame in asking for help. If you are having trouble finding the support you need, talk to your doctor.

Sleep

Sleep is one of the most important things you need, but it is in short supply the first few weeks! Rest when your baby is resting. Get someone else to help with baby care when it does not involve breastfeeding.

Smoking

Exposure to cigarette smoke is harmful to babies. Babies who are exposed to tobacco smoke are at higher risk of colds, cough, lung infections, ear infections, asthma, and sudden infant death (SIDS). They are also at higher risk of cancer and heart disease later in life. If you (mom) smoke, now is a good time to quit! Until then, never smoke in the house or car or anywhere around your baby and don’t let anyone else either.

There are excellent resources available to help you or a family member stop smoking, including medications you can take even if you are breastfeeding. For more information, see the Resources section.

Drug use

Recreational or illegal drugs or prescription drugs are a danger to you and to your baby not just during pregnancy, but now, even if you are not breastfeeding. They increase the risk of SIDS, of poisoning your baby, of impairing the care you or others give to the baby. Do not breastfeed if using marijuana or abusing alcohol, or taking any of these other drugs.
Treatment programs are available; see the Resources section for more information.

You and Your Baby’s Safety

Are you concerned about your safety or the safety of your baby? Talk to your doctor ASAP; see the resources section for ways to get help with domestic violence.

Physical activity & exercise

Most women can and should gradually resume physical activity and a healthy lifestyle after delivery as long as there are no complications preventing it. Check with your doctor before you leave the hospital or in the first few weeks after delivery. You should usually resume physical activity before 6 weeks postpartum. After vaginal delivery, you may be able to resume activities in a few days. After cesarean delivery, most moms can do light activity (walking, stretching) in a few days and full activity in 4-6 weeks. Guidelines recommend 20-30 minutes a day most days of the week.

Physical activity will help with your sleep, returning to a pre-pregnancy weight, mood, blood pressure, diabetes, and many other benefits as well.

Adjusting to new baby

Having a new baby is hard, even if it is not your first baby! While it is a joyful time, it is also tiring and sometimes stressful. Moms are sleep deprived from caring for the newborn baby. There is natural anxiety about caring for a newborn, especially when it is the first child. There are many hormonal changes after delivery in the first month, which also have an effect. Most mothers are physically tired from delivery, recovery, postpartum body changes, and breastfeeding. Parents are often sleep deprived from caring for the newborn baby.

It is important that you have a support system in place to help you and your family. It may be grandparents or other family members, people from your church, friends and neighbors, or local support groups. You can and should also talk to your doctor about how you are feeling. That may be your OB, primary care doctor, even your baby’s pediatrician, who should be checking on you and your family as well.

Don’t be too hard on yourself! Fatigue, sadness, anxiety, and mixed feelings are completely normal. You do not have to be the perfect mother or father. In fact, you are the perfect parent for your baby. Your baby was given to you, and you are exactly what your baby needs.

While these feelings are normal, there are times when they can be more serious.

Baby blues

There are many feelings a new mother (and father) have after the birth of a baby, including joy, excitement, and love. But many mothers will have other feelings too, including exhaustion, anxiety, sadness, fear, and inadequacy. There are a variety of reasons for these feelings, which are usually called the “baby blues.” Almost every mother (and father) experiences these to some degree; when they are more serious, the condition is called postpartum depression. It is estimated that 80-90% of mothers experience baby blues.

Postpartum depression

When the symptoms are more frequent, more severe, and when several are happening at the same time, then depression is more likely. If you have more than one of the following symptoms, and they are more intense than normal, and they occur every day for more than two weeks, then you may have postpartum depression. Postpartum depression can appear anytime during the first year.
Like other forms of depression, it is usually diagnosed based on how many symptoms you have and how severe they are. Screening questionnaires have been proven reasonably effective at detecting postpartum depression. Any healthcare provider can screen moms, and the tests are available online as well. Since mothers do not see their doctor until 6 weeks after delivery, it is now recommended that pediatricians screen all mothers for postpartum depression.

What are the symptoms?

Symptoms include:

  • Frequent crying
  • Feeling sad most of the time
  • Severe fatigue
  • Loss of appetite (or eating too much)
  • Feeling trapped by circumstances
  • Loss of pleasure and enjoyment
  • Withdrawal from family and friends
  • Not caring for yourself or your baby
  • Emotional numbness
  • Difficulty sleeping
  • Feelings of failure, guilt, or worthlessness
  • Feelings of panic or of being unable to cope
  • Mood swings
  • Thoughts of disappearing, getting out, or harming yourself

What causes it?

No one is sure what causes it. Whatever the cause, it is not your fault and it does not mean that you are a bad mother.

How is it treated?

There are two main treatments:

  • Counseling. Counseling can help you re-frame your thinking and how you handle stress and cope with your feelings, as well as new strategies for solving problems. Counseling can also help you improve relationships.
  • Medication. Medication can be very helpful in treating postpartum depression and can make counseling more effective. Newer antidepressant medications have fewer side effects and are safe to use while breastfeeding.

What to do next

Call your doctor if you think you have symptoms of postpartum depression.
Go to an emergency room or call 911 if you have thoughts about harming yourself or your baby.

Where to get help

Ways you can help your mental & emotional health

  • Get plenty of rest. Take a nap while your baby is sleeping. See if someone can watch your baby or your other children while you get a few hours of sleep.
  • Eat a healthy diet. Drink plenty of water, eat a lot of fruits and vegetables and some protein. Avoid too many sweets, and also avoid alcohol.
  • Get some exercise. Just going for a walk is good exercise. Do some gentle stretching if you are allowed to.
  • Get out of the house. Go for a walk, out to eat, to church, a park, or a friend’s house. It’s okay to take your baby out.
  • Try to have a normal routine. Having a baby makes it hard, but try to get into a routine, including meals, getting dressed, showering, etc.
  • Go easy on yourself. You don’t have to be perfect. You don’t have to have it all together or have everything figured out. It’s okay not to get everything done, to have a messy house, or whatever it is. People on Instagram and Facebook posting about their perfect babies, perfect postpartum bodies, and perfect lives, are not normal or likely even really the whole truth.
  • Use your support system. Talk to your friends and family about how you are feeling. Have someone help you or stay with you if you need to. You don’t have to do it all by yourself. Whatever you do, don’t isolate yourself.
  • Find a support group for mothers or for mothers with depression. It helps to find out that you are not alone. Some of these groups are available online.
  • Talk to your doctor or your baby’s doctor.

Fathers

Fathers experience many of the same emotions of fatigue, uncertainty, and anxiety. Fathers can also experience the symptoms of baby blues and even and postnatal depression. In fact, up to 10% of fathers may experience postnatal depression.

Risk factors include having a partner with postpartum depression, a personal history of depression, lack of sleep, stressful relationship with partner or family members, economic struggles, and poor support system.

The symptoms of depression in men are often different than that of women. Symptoms in men may include:

  • Sad mood
  • Feeling discouraged
  • Fatigue
  • Loss of interest in work or hobbies
  • Increased anger, irritability, or violent behavior
  • Frustration
  • Increased drug or alcohol use or misuse of prescription medicine
  • Becoming a workaholic, working constantly
  • Thoughts of dying or suicide

See resources above for ways to help yourself and where to seek more help.