Week Eight
Most women will have had a postnatal check-up with their midwife or obstetrician by now. Ideally this will have included an examination to confirm you are physically healing from any tears or wounds from the birth. If you had a straight-forward birth without complications, you are probably feeling something like your pre-pregnancy self. With the all-clear, you can resume exercise with a modified program. Kangatraining is a babywearing exercise workout designed for parents with babies and toddlers. There are parent-child yoga and other classes available too. Do check the qualifications of instructors to be working with women who have recently been pregnant and birthed. There is specialised training available for practitioners to support pelvic floor health.
If your childbirth experience involved interventions and/or surgery, recovery takes longer. Be guided by your medical adviser and do seek specialist physiotherapy as well. Rehabilitation of your pelvic floor and abdominal muscles now can help prevent problems later. If you have any continence issues with your bowel or bladder, it can be embarrassing to talk about. However it is important to get the treatment and support you need. Many women experience these problems and there are things you can do to be more comfortable and improve your condition.
Some breastfeeding mothers experience mastitis and/or blocked (plugged) milk ducts in their breasts. these usually occur if something has interfered with effective drainage of the breast during feeding or pumping. If you are sick or run down you can be prone to developing infection in the breast so it is important to be familiar with how your healthy breasts feel and look out for any signs something is different.
A blocked milk duct might feel like a distinctly firm or hard section of the breast. The most common part effected is near your armpit but blockages can appear in any lobe of the breast. There might be pain or redness or just a hard, full area. The breast might feel slight relief after feeding or expressing but not complete draining. Sometimes there might be a blockage at the very tip of the nipple, what is known as a white spot or milk bleb or blister. Here there is an overgrowth of skin tissue sealing the milk duct and preventing milk to flow. There are many ducts in each breast so milk will continue to flow to the baby during feeds even if one section is blocked.
Mastitis is an inflamed area of breast tissue. This might be after pressure or injury causes swelling or if a blocked duct puts pressure on surrounding tissue, having the same effect. Sometimes this might develop an infection, if bacteria has become involved. You can have mastitis without infection and without a blocked duct. And you can have a blocked duct without having mastitis. Because infection can be rapid when conditions are right, its a good idea to consult your doctor if basic management techniques don’t improve things quickly. A course of antibiotics might be prescribed even if measurable signs of infection aren’t present. Your body’s response to inflammation can be similar to that with infection. You might experience “flu-like symptoms” including aches and pain, fever and fatigue.
In the 20th century, doctors were taught to instruct women to cease breastfeeding immediately if they experienced mastitis. This often led to complications like severe infection and breast abscesses. Better knowledge about lactation led to a significant change in clinical management of mastitis and now we advice frequent and effective removal of milk from the breast by breastfeeding and/or expressing. Application of warmth can help a painful breast let-down the milk and cold after feeding or pumping can ease discomfort and reduce swelling. Although chilled cabbage leaves were popular in the past when gel cooling packs weren’t easily available, these are more hygienic and easier to keep on hand at home. Talk to your doctor or pharmacist about the best pain relief and rest as much as possible to help your body heal. Recurrent mastitis can be a problem for some women and an IBCLC lactation consultant can help identify potential triggers and create a personal management plan for you.
