SingaporeMotherhood | Parenting

March 2014

What to Expect: Post-Delivery

The first six weeks after delivery is often a challenging time for a new mother. Not only does her body undergo many changes during this recovery period, she also has to help her baby adapt to his new environment. As every child is different, a new mother would have to learn her baby’s cues and adjust to his unique behavioural patterns. Knowing what to expect and how to handle some of the hiccups can make this adjustment period much smoother for both you and your baby.



What to expect: Some new mothers experience backache after delivery. This is possibly caused by poor posture during pregnancy. Your back may also have been strained by an incorrect posture during delivery.

How to deal with it: Ensure that your back is well-supported, especially when you carry or breastfeed your baby. Wear a back support girdle to relieve the strain. During your confinement period, confinement nanny Nguk Choo recommends brewing a Chinese herb called “du zhong” together with the traditional red date tea that is taken by new mothers. Alternatively, you could consume some “Waist tonic” together with herbal confinement soups. These are believed to help strengthen the back muscles. If you are breastfeeding, check with your doctor before taking any herbs or tonics.


What to expect: More than 50 per cent of newborns develop jaundice two to three days after birth. Jaundice is due to an excess of bilirubin in the blood, which causes the skin and whites of the eyes to take on a yellow tinge. Bilirubin levels peak around five to six days after birth. It then decreases as baby’s liver matures and become more efficient in removing bilirubin.

Five to 10 per cent of breast fed babies may develop “breast milk jaundice” which becomes more noticeable when the baby is two to three weeks old. This can persist till the baby is four weeks old. The jaundice level usually returns to normal when baby is between six and 10 weeks old.

How to deal with it: For babies with mild jaundice, exposure to indirect sunlight is sufficient to help break down the bilirubin. Lay your baby in a safe position next to a window between 7 a.m. and 9 a.m. in the morning. Do not “sun-tan” him in direct sunlight as there is a risk of him getting dehydrated or sunburnt.

Babies with high serum bilirubin levels approaching 340 mmol/L (20mg/dl) may need to be hospitalised for phototherapy.

jaundice baby in basket crop


What to expect: Some babies have a reversed day/night rhythm. They may sleep through the day but fuss and cry for hours during the night. They may scream to be fed or cuddled frequently, and at times, nothing seems to settle them.

How to deal with it: You can help baby to adjust his body clock by setting a predictable routine for him. Play music, chat to him, and engage baby with toys during the day. Have a fixed bedtime routine, giving him a warm bath, singing a soft lullaby and dimming the lights. Some babies may settle into a routine after two to three weeks while others need up to six weeks.


What to expect: For the first few days after delivery, your breasts will produce a liquid known as colostrum. The amount produced is small, so your baby may feel hungry and cry for milk frequently. Your milk supply will gradually increase after the third day and gradually adjust to baby’s requirements.

How to deal with it: Feed your baby on demand. This will help to establish your milk flow as your body adjusts to meet baby’s needs. Try to avoid supplementing your baby with formula milk as this decreases the amount of breast milk that he drinks. As a result, your body will not be sufficiently stimulated to produce the correct amount of milk which your baby actually needs.

You can also consume foods which help increase the supply of breast milk. Nguk Choo recommends a soup made using fish bones and soya beans as is more effective in increasing the mother’s milk supply than merely eating fish meat.

Mel, a masseuse who provides post-natal massage services, recommends a soup made with “cekur manis” (sweet leaf), fish and green papaya. Stir-fried “pengaga” (a type of vegetable available from the wet market) with garlic and ikan bilis is also effective in increasing breast milk supply, she says.

Do not feel shy or embarrassed about seeking help from a breastfeeding helpline, a lactation consultant, or a breastfeeding councillor. There is a list of resources here.


What to expect: Due to frequent feeding and poor latching, abrasion may occur and your nipples may bleed.

How to deal with it: You can apply a nipple cream containing lanolin to cover the wound and aid the healing process. Use a nipple shield to reduce abrasion during nursing. If you are bleeding quite badly, it is not advisable to breast feed until you have recovered. However, you should continue to express your milk to maintain your milk supply.

Breast feeding, if done correctly, should not result in pain or injury. The long term solution is to latch baby on correctly. This takes time and practice for both mother and baby, so be patient, and do not get discouraged.

Mother Breastfeeding her newborn baby


What to expect: If your body produces more milk than what your baby is drinking, you may experience engorgement. This usually occurs between three and five days after delivery when your milk “comes in”. According to Ms Wendy Deshpande, an International Board Certified Lactation Consultant in private practise, registered nurse and Vice President of the Breastfeeding Mothers Support Group Singapore, engorged breasts feel “hot and painful. They look and feel hard and tight. The skin may be shiny or red and inflamed. The milk will not flow easily and the mother may have a fever. If engorgement is not treated effectively, it can lead to mastitis (a breast infection).”

How to deal with it: Ms Deshpande recommends applying a warm compress to help the milk to flow. Prior to latching your baby, you can hand express some milk in order to soften the breast to enable baby to latch on. “Once the baby has fed, cold compresses will help to sooth the warmth and discomfort. Engorgement can usually be avoided by early frequent breastfeeds and effective attachment,” she adds.

As part of her post-natal massage routine, Mel boils a hot stone in water for ten to 15 minutes. She then wraps it in several layers of cloth so that the stone emits warmth but remains comfortable to the touch. Using the stone, she rubs each hard lump in the breast in a circular motion. Thereafter, she places one hand on each side of the breast. Applying firm pressure, she strokes the milk in the direction of the areola to express it.

In cases of severe engorgement, Ngyuk Choo suggests putting cold cabbage leaves on the engorged area. However, this should only be done as a last resort as cabbage leaves contain a substance which can significantly decrease your milk supply.


What to expect: “Blocked milk ducts occur when milk is not being removed effectively from the breast. Often this affects only one or two ducts and commonly shows as a red, inflamed area on the breast,” Ms Deshpande explains.

How to deal with it: As with engorgement, the treatment is to empty the affected breast. After applying a warm compress, Ms Deshpande encourages mothers to feed their babies or express the milk “until the area feels well drained. If draining the area does not resolve the symptoms and you feel progressively worse with a fever and flu-like symptoms, then mastitis should be suspected and you need to see a doctor for a prescription of antibiotics and painkillers. Breastfeeding should not be stopped. The most important factor is to keep emptying the breast.”


What to expect: In the days before your milk flow stabilises, your baby may cry for milk and yet suddenly jerk his head away after sucking for a while at the breast. He may continue to scream, feeling hungry, yet seemingly rejecting your milk.

How to deal with it: Your baby may be unable to cope with your milk flow, which may be too fast, especially when you have “let down”. This article helps you to understand how your baby reacts to your milk flow and suggests ways in which you can tailor your breastfeeding to his needs.

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What to Expect: Post-Delivery