Postnatal care at Spa Kuala Lumpur, Malaysia.
This is based on NICE guidance.
- Women should be offered information to enable them to promote their own and their baby's health and well-being and to recognize and respond to problems.
- At the first postnatal contact, women should be advised of the signs and symptoms, and appropriate action for potentially life-threatening conditions.
- All maternity care providers should encourage breast-feeding.
- At each postnatal contact, women should be asked about their emotional well-being, what family and social support they have and their usual coping strategies for dealing with day-to-day matters.
- Women and their families/partners should be encouraged to tell their healthcare professional about any changes in mood, emotional state and behaviour that are outside of the woman's normal pattern.
- At each postnatal contact, parents should be offered information and advice to enable them to:
Maternal activity
- The mother should start walking about as soon as possible, go to the toilet when necessary and rest when she needs to. She may prefer to stay in bed for the first 24 hours or longer if she has an extensive perineal repair.
- This is an important time for the woman to be encouraged to breast-feed and learn to care for her infant.
- Uterine contractions continue after birth and some women suffer after-pains, particularly when breast-feeding, and may require analgesics.
Breast- and bottle-feeding
- Women who chose to breast-feed or bottle-feed often need a lot of advice and support, especially with their first baby (but experienced mothers shouldn't be assumed to know everything and support and advice should always be available).
- Breast-feeding should be strongly
encouraged (first-time mothers may need a lot of support and
encouragement initially). Breast-feeding has many advantages, including:
- Boosting the baby's immune system.
- Reduction of autoimmune disorders later in life.
- Reducing risk of cot death.
- Reducing gastrointestinal problems.
- Promoting bonding between the mother and her baby.
- Breast engorgement may cause a lot of discomfort but is usually relieved by good bra support and analgesia.
- Women who are unable to breast-feed or prefer to bottle-feed also need support and advice, including feeding routines and sterilising.
Contraception
This is covered in detail in our separate article Postpartum Contraception.- Contraception is not necessary in the 21 days after childbirth.
- Methods that are suitable choices for breast-feeding women include the lactation-amenorrhoea method, barrier methods, intrauterine devices (including the levonorgestrel-releasing intrauterine system), the progestogen-only pill, injectable progesterone contraceptives, the etonogestrel implant and sterilisation. The combined oral contraceptive pill is not recommended, as it interferes with lactation.
- The lactational amenorrhoea method is 98% if:7
- There is complete amenorrhoea.
- The woman is fully or very nearly fully breast-feeding.
- The baby is no more than 6 months old.
- Methods that are suitable choices for women who are not breast-feeding include all those for breast-feeding women but combined oral contraceptives can also be used.
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