Postpartal Discharge Instruction

Introduction

Postpartal Discharge Instruction

Newborn’s Discharge Instruction

2
 ❤
Introduction
Postpartum period
▪ refers to the 6-weeks period after childbirth
▪ termed the fourth trimester of pregnancy
▫ involution of the uterus and vagina
▫ production of milk for lactation
▫ restoration of the normal menstrual cycle
▫ Beginning of parenting role

3
Postpartal Discharge Instruction

4
 Postpartal Discharge Instruction
Breast care
Clean breast daily with clean water; wear If milk does not flow well:
well-fitted bra → Apply warm compresses.
→ Have someone massage your back
and neck before expressing.
→ Perform breast and nipple massage

Engorged breast- use ice packs for 15

Lactational amenorrhoea method (LAM)
to 20 minutes at a time. Lie flat while
• A breastfeeding woman is protected from pregnancy only if:
applying ice, if possible.  Usually
→ she is no more than 6 months postpartum, and
resolves in two to three days.
→ she is breastfeeding exclusively (8 or more times a day,
including at least once at night: no daytime feedings more than
Express a small amount of breast milk
4 hours apart and no night feedings more than 6 hours apart; no
before starting breastfeeding to soften
complementary foods or fluids), and
nipple area so that it is easier for the
→ her menstrual cycle has not returned.
baby to attach.

5
 Postpartal Discharge Instruction
General activities

Avoid heavy work (lifting or straining for Elevate the feet when sitting or lying
at least first 3 weeks after birth. down and make sure you drink a lot of
fluids to help your body get rid of the
excess fluid.

A good rule to follow is that you should

Kegel exercises. This movement is similar to
not lift anything heavier than your baby
stopping the flow of urine. Squeeze for three
in the car seat.
seconds and release. Begin with 10
repetitions twice a day, gradually building up
to 100 repetitions twice a day. 
6
 Postpartal Discharge Instruction
General activities

Rest as much as you can. A good time to nap is Shower as often as you like, but avoid tub
when the baby sleeps. Lack of sleep can affect your baths or swimming until after your postpartum
mood and can increase anxiety. Allow friends and checkup. There should be nothing placed in
relatives to help with housework, cooking and other the vagina until after your postpartum
chores.   checkup.

Driving should be avoided for one to two weeks, or

When cleaning the perineum, always do until the operation of an automobile will not be painful
it from front to back ( pubis toward or cause undue exertion. Do not drive if you are
rectum) or from clean to dirty area taking narcotics for pain relief.

7
 Postpartal Discharge Instruction
Bowel Care

Bowel movement is common after having a Constipation occurs because of relaxation of

baby. Often mothers fear tearing their the abdominal wall and the intestine.
stitches or experiencing pain. Bowel For constipation, take an over-the-counter
function should return to normal three to stool softener (Colace, Metamucil) or add
four days after delivery. prunes, prune juice or bran to your diet.

A diet high in fiber and fluids can help avoid

constipation. Walking promotes bowel
movements, passing gas and increased
general circulation. Raising your feet onto a
stool during a bowel movement can help
decrease straining.
8
 Postpartal Discharge Instruction
Uterine changes/bleeding/perineal
care
Contractions (afterbirth pains) after delivery
are temporary. Use relaxation/breathing
techniques and the pain medications
prescribed by your doctor to lessen
discomfort.
Sitz bath soothes healing tissue, decreases
inflammation by causing vasodilation in the area
thereby reduces discomforts and this will help
dissolve any stitches
- water is maintained 38 to 41 C, it feels
warm not hot
- use it 3 to 4 times a day for a maximum of
20 minutes each time
In the first day at home, an increase in
bleeding or darkening in bleeding due to
increased activity; may be a sign for need in
more rest. Passing of some blood clots,
especially if have been sitting or lying down
for long periods of time is normal. Passing of
frequent clots or clots larger than an egg,
please contact your health care provider.
If breastfeeding, the first period may not start
until after the baby wean.
If are not breastfeeding, the first period will
probably start four to six weeks after delivery
and may be unusually heavy. aa
9
 Postpartal Discharge Instruction
Nutrition
Food should be high in protein, vitamins and
minerals needed for good tissue repair and diet
should between 2200 and 2300 cal. Daily.
Adequate supply of roughage to help restore
peristaltic action
If breastfeeding, woman needs an additional of
500 cal. (2700 kcal) and additional 500 mL of
fluid to encourage production of high quality
breast milk
Refrain from any weight-reducing diets until
after your postpartum checkup. Most women
lose eight to 10 pounds just from delivery. It
takes almost a full year to return to your pre-
pregnancy weight.
If you have a family history of food allergies or
are concerned about food allergies for your
baby while breastfeeding, consult your physician
for guidance.
10
Other ways you and your family can adjust
to a new baby are:

• Be flexible. It takes time to get to know your

baby.
• Let others help you. Accept offers to bring dinner,
go to the market or do other necessary chores.
• Spend special time with your other children and
your partner. A new baby is an adjustment for
them as well.
• Talk to other parents who are going through
some of the same experiences.

11
Newborn’s Discharge Instruction

12
 Newborn’s Discharge Instruction
Breastfeeding

•Babies should be exclusively breastfed for the first 6

months of life.
→ helps baby's development and mother/baby
attachment.

Feed your baby “on demand

▪ DO NOT force the baby to take the breast.
▪ DO NOT interrupt feed before baby wants.
▪ DO NOT give any other feeds or water (risk
of Hyponatremia).
▪ DO NOT use artificial teats or pacifiers.

For good attachment, you should:

→ touch your baby's lips with your nipple
→ wait until your baby's mouth is opened wide
→ move your baby quickly onto your breast,
aiming the infant's lower lip well below the
nipple. 13
 Newborn’s Discharge Instruction
Bathing
Your baby should be cleaned only by sponge
baths until after the umbilical cord falls off and
the area at the base of the cord has healed
completely. Babies may only need a bath 2 to
3 times each week.
Sunlight exposure
Expose the baby to early morning sunlight 15-
30 mins daily between 7am to 8am.
▪ it helps the body to produce vitamin D that
helps the body to absorb calcium
▪ strengthening bones
▪ melatonin synthesis
14
Adequate newborn weight gain
▫ Anticipate up to 10% weight loss after
delivery and regain to birth weight by 2 weeks
▫ Infant doubles birth weight in 6 months
▫ Triples in 12 months’
▫ Quadruple in 2-2 1/2 y.o

Adequate hydration
▫ Expect clear Urine Output 6-8 times daily
▫ Call physician if: Less than 3 wet diapers
per day
15
Stool
Meconium- 1st stool; black green, sticky, odorless( sterile
intestine, no bacteria) will pass within 24-36 hours
breast-fed baby: soft and mushy stool with sour milk
smell.
bottle-fed baby: pale yellow, firmer stools that are less
frequent with offensive odor.
Stools can normally be yellow, brown or green in color.

Problems: Constipation
Try Apple, pear or prune juice 1 ounce 1-2x/day
Maximize fluid intake (Breast Milk or formula)
Consider Glycerin suppository if continues
Call physician if:
Constipation: Less than 5 stools/week for 2 weeks
Diarrhea: Stool runs out of diaper
16
Sleep
 Your baby should always sleep on:
• his/her back for naps and at night.
• a firm sleep surface close to, but separate from
you, and should never be placed in bed with
you when you are sleeping or likely to fall
asleep.
• Co-sleeping increases the risk of sudden infant
death syndrome, and is not considered safe for
your baby. Keep soft objects, toys, bumper
guards, and loose bedding out of your baby’s
sleep area.

Avoid unnecessary exposures to illness

 Keep persons with acute illness away from
newborns
 Stay away from supermarkets or malls
 Avoid second hand smoke exposure

17
 Umbilical Cord
 Clean cord area with water only
 Do not use Alcohol
- Call physician if:
Infection signs (discharge or
redness at Umbilicus)
Umbilical Cord not detached by
2 week

1 2 3

18
Child Safety Seat
 Rear-facing seat, semi-reclined position (45
degrees) maintains airway
- Rear-facing position supports head and neck
- Front-facing does not offer head and neck
support

Genitalia
 Gently clean area with warm water at diaper changes
from front to back
 Boys
• Uncircumsized boys
- Do not retract foreskin forcefully
(Phimosis risk)
• Circumcision care
- Vaseline to area with each diaper change
for 5 days
 Girls
• Small bloody Vaginal Discharge in newborns is
normal and last for a week

19
Red flags requiring immediate evaluation
1. Signs of infection
Fever over 100.4
Decreased alertness
2. Signs of dehydration
Dry lips
Decreased Tears
Weight loss >9% of birth weight (urgent)
Increased Tiredness or sunken Fontanelle
Less than 3 wet diapers per day
Baby vomits repeatedly (more than spitting up), or the vomit is green
3. Signs of breathing problems
Breathing more than 60 times per minute
Using neck, chest or abdominal muscles to breath
Wheezing
4. Signs of significant Jaundice
Yellow Skin below nipple line suggests Bilirubin test

20
▪ WHO IS WATCHING THE BABY?
Never leave your baby alone with another child or pet.

▪ NEVER SHAKE YOUR BABY!!

Shaking your baby can cause DEATH or cause SEVERE INJURY to your baby such as:
brain damage, retardation, paralysis, blindness, and delays in normal development.
▪ If you feel angry, DO NOT LOSE CONTROL.
Instead, try the following:
 Walk to another part of the house.
 Telephone family, friends or your pediatrician for support and advice.
 Parenting classes can teach alternate methods of discipline.
 FOLLOW-UP CARE

21
THANK YOU!

22