Many new mothers channel all their energy into taking care of their newborn babies and neglect their own health. Conditions such as insomnia, fatigue or depression may be easily triggered, said Associate Professor Tan Thiam Chye, Head and Senior Consultant, Inpatient Service, Department of General Obstetrics and Gynaecology at KK Women’s and Children’s Hospital (KKH), a member of the SingHealth group.

Ms Pauline Wee, assistant director of Nursing, and Ms Catheri​ne Chua, senior principal physiotherapist at the Rehabilitation Department​, both from KKH, give tips on how mothers can care for themselves during this period:

Adequate rest

As a newborn baby has no fixed schedule and needs to be fed seven to eight times a day, a new mother who is breastfeeding can be overwhelmed by exhaustion. She may not be able to get six to eight hours of solid sleep until the baby has settled i​​nto his own schedule a few months down the road. The mother should try to catch some sleep when her baby is sleeping, and relieve herself of all responsibilities other than feeding the baby and taking care of herself. This is because sleep deprivation will affect her breast milk.

Good nutrition

A new mother should have a balanced diet of five to seven servings of whole grains, pasta, rice or cereal, two servings each of fruit and vegetables and two to three servings of meat and low-fat dairy to make sure she has enough protein, iron and calcium. These are important nutrients, especially for postpartum and breastfeeding mothers. Those who are breastfeeding need an extra 500 calories on top of their daily 1,800 to 2,000 calories.

Hydration

It is a myth that mothers should not drink water during confinement, as that will supposedly cause water retention. In fact, it is important for women to drink eight to 10 glasses of fluids, including water, per day. This allows them to hydrate themselves and to have adequate breast milk production.

Physical exercise

After delivery, many of the physical changes of pregnancy will persist for four to six weeks. Women should resume pre-pregnancy exercises gradually. New mothers can aim to exercise at least three times a week, with each session lasting 30 minutes. They should ensure that they have at least five to 10 minutes of warm-up and cooling down exercises. Exercise is also more comfortable for them if they breastfeed before doing so. Adequate nutrition and hydration are also important before starting on exercise. They should aim for 1 to 2kg of weight loss a month.

Excessive weight loss may lead to a decrease in milk production. If a woman has had a caesarean section or an illness, she should check with her doctor before starting any exercises. Appropriate exercise, especially pelvic floor muscle exercise, helps to improve blood circulation and, in turn, helps women recover faster from the changes that their bodies underwent during pregnancy and birth. Although aching legs are normal after a long labour, a new mother should consult a doctor if there is any tenderness, warmth or pain in the calves. Swollen or reddened veins are warning signs of thrombophlebitis (inflammation of a vein).

Relaxed mental state

The new mother should try to rest as much as possible and ask for help from friends or relatives if she finds things too stressful. Due to the hormonal changes after birth, she may experience “baby blues” two to four days after the birth of her baby. It is normal to feel emotional, or have the urge to burst into tears for no apparent reason or for reasons that may seem trivial to others. She may also feel anxious, guilty, sad and even afraid she cannot cope with her newborn baby, but recovery usually occurs in a few days. If the depression worsens and lasts longer, it could become postnatal depression. Then medical help should be sought.

Postnatal massage

After delivery, the womb will contract immediately and shrink to the pre-pregnancy size within six to eight weeks. Postnatal massage may hasten this process. But it is important to ensure that the massage therapist is certified and experienced. Too much strength being exerted on the abdomen may cause increased bleeding. It is also important to have an empty bladder during the massage. If the masseur exerts pressure on a full bladder, it may rupture the organ and cause internal bleeding. Women who have had a caesarean section should not have the massage within two months of delivery as the wound may tear.

Ref: S13