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

Overview

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 will probably need about 6 weeks to fully recover. 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 or nurse advice line (811 in most provinces and territories) 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.
  • If you have strips of tape on the incision, leave the tape on for a week or until it falls off.
  • Keep the incision clean and dry.
  • You may shower as usual. Pat the incision dry when you are done.
  • Hold a pillow over your incision when you cough or take deep breaths. This will support your belly and decrease your pain.
  • If your bowel movements aren't regular right after surgery, try to avoid constipation and straining. Drink plenty of water. Your doctor may suggest fibre, a stool softener, or a mild laxative.
  • 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.
  • Be active. Walking is a good choice.
  • Allow your body to heal. Don't move quickly or lift anything heavy until you are feeling better.
  • Do not do sit-ups or other exercises that strain the belly muscles for 6 weeks or until your doctor says it is okay.
  • 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.
  • Ask your doctor when you can drive again.
  • You will probably need to take at least 6 weeks off work. It depends on the type of work you do and how you feel.

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 counsellor. 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.

Where to get help 24 hours a day, 7 days a week

If you or someone you know talks about suicide, self-harm, a mental health crisis, a substance use crisis, or any other kind of emotional distress, get help right away.

  • Call or text Canada's suicide and crisis hotline at 988.
  • Call Talk Suicide Canada: 1-833-456-4566 or text 45645 (4 p.m. to midnight ET).
  • Go to the Talk Suicide Canada website at https://talksuicide.ca for more information.

Consider saving these numbers in your phone.

Call your doctor, midwife, or nurse advice line now or seek immediate medical care if:

  • You have loose stitches, or your incision comes open.
  • 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 light-headed, 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 symptoms of infection, such as:
    • Increased pain, swelling, warmth, or redness.
    • Red streaks leading from the incision.
    • Pus draining from the incision.
    • A fever.
    • Frequent or painful urination or blood in your urine.
    • 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.
    • Swelling in the leg or groin.
    • A colour change on the leg or groin. The skin may be reddish or purplish, depending on your usual skin colour.
  • 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.
  • You have signs of heart failure, such as:
    • New or increased shortness of breath.
    • New or worse swelling in your legs, ankles, or feet.
    • Sudden weight gain, such as more than 1 to 1.3 kilograms (2 to 3 pounds) in a day or 2.3 kilograms (5 pounds) in a week.
    • Feeling so tired or weak that you cannot do your usual activities.
  • You had spinal or epidural pain relief and have:
    • New or worse back pain.
    • Increased pain, swelling, warmth, or redness at the injection site.
    • Tingling, weakness, or numbness in your legs or groin.

Watch closely for changes in your health, and be sure to contact your doctor, midwife, or nurse advice line 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?

Go to https://www.healthwise.net/patientEd

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