End of the postnatal period

At the end of the postpartum period, you may experience pulling stitches. This often disappears on its own, but if it causes a lot of discomfort, the midwife can remove the stitches from the skin. 

You will also notice that the blood loss, which was previously bright red, becomes lighter in colour and brownish. You can wear normal sanitary towels again. In total, this can take around 6 weeks, and the bleeding may increase again and become bright red if you are more active. This is normal. Please note that as long as you are still bleeding, you should not take a bath, use tampons or go swimming (risk of infection).

If you have given birth by caesarean section, your body will need more time to recover and regain its strength than after a vaginal delivery. Take it easy for at least 6 weeks, do not push yourself too hard and make sure you still lie down regularly. Avoid heavy lifting (>5 kg), exercise and driving in the first 6 weeks. After 6 weeks, you can slowly build up your exercise routine, but listen carefully to your body. Read more about recovery after a caesarean section.

After a week, you will clearly feel the urge to urinate again. However, you may still experience stress incontinence (loss of urine when pressure is applied) from time to time. This is normal for the first three months, but should improve when you start doing pelvic floor exercises.

When you first go outside, start with a short walk and never go alone the first time. You will notice that your legs are still unsteady and that your pelvic floor is still weak. You will usually feel this at the end of the day as a heavy feeling in your lower body. If you notice this, you have probably done too much and your body is asking for rest. Listen to your body. Doing pelvic floor exercises is important to regain strength in your pelvic floor. Your pelvic floor will need several months to recover. Are you experiencing pelvic floor problems? Consult a pelvic floor physiotherapist in your area. 

It is not uncommon for a new mother to develop the early stages of mastitis. This usually occurs 2-3 weeks after giving birth. You will notice this through fever (>38.0), shivering, muscle pain and painful/sore breasts. Sometimes you will see red discolouration at the site of the developing infection, which will be hard and sensitive. As long as your fever is <38.5, you can follow a number of recommendations to prevent further infection:

• Rest your breasts: do not squeeze or massage them.
• Continue to feed/express milk as normal on demand, not more often. 
• Take an anti-inflammatory (400 mg ibuprofen 3 times a day) and painkiller (1000 mg paracetamol 4 times a day).
• Cool the breast with cold compresses.
• Take lecithin to promote milk flow in the breast (1200 mg 3-4 times a day).

If the symptoms have not improved significantly after 24 hours, or if the fever becomes very high (>38.5) and you feel very ill, you may have a bacterial breast infection. In that case, antibiotics may be necessary. Consult your GP. It is not necessary to stop breastfeeding while treating the swelling and/or inflammation, even if bacteria are involved and you need antibiotics. You do not need to throw away your milk either.

According to the latest insights, the cause of mastitis is almost always an imbalance in the breast tissue and an excess of milk. The breast tissue swells and closes the milk ducts, inhibiting the flow of milk in that breast. Severe swelling that is not treated can lead to (severe) inflammation of the breast tissue and abscesses. This imbalance usually occurs between 2-4 weeks after giving birth. Sensitive, full and tense breasts are normal during breastfeeding, but a persistent red, painful area or a sore feeling may indicate the onset of inflammation.

It is normal to find the postnatal period overwhelming and intense. This can also manifest as low mood or negative emotions. Alongside these normal mental struggles, mental health conditions such as postnatal depression, post-traumatic stress disorder or postnatal psychosis can also occur.

A major trigger is sleep deprivation. For this reason, try to catch as much sleep as you can, especially when your baby is asleep. If you’re struggling, ask for help. In addition, basic needs such as good hygiene and a healthy diet are also fundamental to mental health. Make sure to discuss this with your midwife, GP or those around you. Especially if you’re feeling very low, can’t sleep or are experiencing fears or thoughts that aren’t realistic, be sure to speak up! Here are a few places you can turn to for help:

• Postpartum Centre Netherlands
• Limbicum Coaching
• Babyblues Domstad

We often see that breastfeeding mums experience what are known as ‘regulation days’. These are days when your baby wants to feed frequently in order to adjust the composition of your breast milk to suit his or her needs. This usually happens after a growth spurt. These days are characterised by your baby wanting to feed constantly, and they pass of their own accord. You’ll usually recognise them around 10 days, 3 weeks, 6 weeks and 3 months, although this varies from child to child. If you’re still unsure whether it’s something other than a ‘regulation day’, feel free to contact a lactation consultant. 

Many mothers choose to express milk when they need to give their production an extra boost in the first week or later when they return to work and the baby goes to daycare/childminder. This does not have to fill a freezer. Enough milk to feed the baby a few times is usually sufficient. Pumping too much will increase your milk production, which can lead to an imbalance in the breast tissue and ultimately to inflammation. So don't be too enthusiastic about pumping and building up a supply. Pumping every other day an hour after your morning feed is often enough to build up a supply.

To ensure that your baby can also drink your breast milk from a bottle, it is important to practise this regularly. If your baby is older than two months, this is difficult to relearn, so start early! Aim to bottle-feed your baby a few times a week. This is also a nice moment for your partner!

There are various breast pumps available, each suitable for different needs and situations. If you need a breast pump at the beginning of your maternity leave, we recommend renting one. You can do this through breastfeeding and more, but also through various home care organisations such as Vegro or through My Pump. If you plan to breastfeed for longer and are considering purchasing a breast pump, it is a good idea to do some research. Which breast pump is best for you depends on several factors, such as how often you pump, ease of use, cost and how comfortable the breast pump feels. The choice between a manual or electric breast pump is personal and depends on your preferences and lifestyle. You can read more about this here to help you make your choice.

When you give bottle feeds or switch to bottle feeds after breastfeeding, there is a handy formula for estimating the minimum amount of feed your child should drink: Namely: 150 ml * weight in kg/number of feeds = minimum number of ml you should offer a child per feed. Many children exceed this amount.