Postpartum Care (Vaginal Birth) When Your Baby Is in the NICU: Care Instructions

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When your baby is in the neonatal intensive care unit (NICU) you may feel that your whole world has been turned upside down. It's hard to be apart from your baby, especially when you worry about your baby's condition. You may spend a lot of time at the hospital while your baby is in the NICU.

It's important to care for yourself too during this time. Your body will slowly heal in the next few weeks. You may feel tired and overwhelmed at times. Changes in your hormones can shift your mood without warning. You may find it hard to meet the extra demands on your energy and time. Take good care of yourself by eating well and getting enough rest.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

How can you care for yourself at home?

Taking care of your body

  • Use pads instead of tampons for vaginal bleeding. Bleeding may last 2 to 4 weeks or longer.
  • Ask your doctor if you can take an over-the-counter pain medicine, such as acetaminophen (Tylenol), ibuprofen (Advil, Motrin), or naproxen (Aleve), to ease cramps. Be safe with medicines. Read and follow all instructions on the label.
  • Ease soreness of hemorrhoids and the area between your vagina and rectum with ice compresses or witch hazel pads.
  • Ease constipation by drinking lots of fluid and eating high-fiber foods. Ask your doctor about over-the-counter stool softeners.
  • Cleanse yourself with a gentle squeeze of warm water from a bottle instead of wiping with toilet paper.
  • Sit in a few inches of warm water (sitz bath) several times a day. The warm water helps with pain and itching. If you don't have a tub, a warm shower might help.
  • Wait until you are healed (about 4 to 6 weeks) before you have sex. Ask your doctor when it is okay for you to have sex.
  • If you pump breast milk for your baby:
    • Start pumping right away.
    • Keep pumping every few hours to keep up your milk supply.
    • Ask your doctor, nurse, or lactation consultant about what type of pump you should use if you don't have a breast pump at home.
  • To help milk flow and to relieve pain, warm your breasts in the shower or by using warm, moist towels before you breastfeed or pump.
  • Put ice or a cold pack on your breasts after you breastfeed or pump. This can reduce swelling and pain. Put a thin cloth between the ice and your skin.
  • If you aren't nursing, don't put warmth on your breasts or touch your breasts. Wear a supportive bra or sports bra and use ice until the fullness goes away.

Taking care of your emotional health

  • Get support. You may go through many different emotions while your baby is in the NICU. It may help to talk with a friend, a family member, or a counselor. Your hospital may have a social worker or support group for NICU parents.
  • Rest whenever you can. Arrange for and accept as much help from friends and family as you can.

When should you call for help?

Share this information with your partner, family, or a friend. They can help you watch for warning signs.

Call 911 anytime you think you may need emergency care. For example, call if:

  • You have thoughts of harming yourself, your baby, or another person.
  • You passed out (lost consciousness).
  • You have chest pain, are short of breath, or cough up blood.
  • You have a seizure.

Call your doctor now or seek immediate medical care if:

  • You have signs of hemorrhage (too much bleeding), such as:
    • Heavy vaginal bleeding. This means that you are soaking through one or more pads in an hour. Or you pass blood clots bigger than an egg.
    • Feeling dizzy or lightheaded, or you feel like you may faint.
    • Feeling so tired or weak that you cannot do your usual activities.
    • A fast or irregular heartbeat.
    • New or worse belly pain.
  • You have signs of infection, such as:
    • A fever.
    • Vaginal discharge that smells bad.
    • New or worse belly pain.
  • You have symptoms of a blood clot in your leg (called a deep vein thrombosis), such as:
    • Pain in the calf, back of the knee, thigh, or groin.
    • Redness and swelling in your leg or groin.
  • You have signs of preeclampsia, such as:
    • Sudden swelling of your face, hands, or feet.
    • New vision problems (such as dimness, blurring, or seeing spots).
    • A severe headache.

Watch closely for changes in your health, and be sure to contact your doctor if:

  • Your vaginal bleeding isn't decreasing.
  • You feel sad, anxious, or hopeless for more than a few days.
  • You are having problems with your breasts or breastfeeding.

Where can you learn more?

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The Health Encyclopedia contains general health information. Not all treatments or services described are covered benefits for Kaiser Permanente members or offered as services by Kaiser Permanente. For a list of covered benefits, please refer to your Evidence of Coverage or Summary Plan Description. For recommended treatments, please consult with your health care provider.