Postpartum for Beginners in the First Week: A Warm, Practical Guide
Welcome to your first week postpartum. Whether you had a vaginal or cesarean birth, your body and mind are doing remarkable work. This guide walks you through what to expect, how to care for yourself step by step, and when to reach out for help. It’s evidence-based, but also kind and realistic—because healing and learning with a newborn are not linear. You’ve got this, and support is available.
The Big Picture: What the First Week Often Looks Like
First 24 hours: Expect bleeding like a heavy period, crampy “afterpains” as your uterus contracts (especially with breastfeeding), and fatigue. If breastfeeding, you’ll produce colostrum (early milk). Lots of skin-to-skin and frequent feeding help milk supply and baby’s transition. Nurses will check your bleeding, blood pressure, and incision or perineum.
Days 2–3: Your bleeding may briefly increase with activity. If breastfeeding, your milk often begins to “come in,” and baby may cluster feed. Many parents feel “baby blues”—mood swings, tearfulness, and overwhelm—which usually peak day 3–5 and ease within two weeks.
Days 4–7: Bleeding should gradually lessen. If breastfeeding, breasts may feel full or engorged; baby’s stools change from dark meconium to greenish, then yellow and seedy. Soreness (perineal or incision) should slowly improve. You may feel very tired—short, frequent rests help.
Your Simple Daily Checklist
1) Rest in short stretches whenever baby sleeps. 2) Drink water every time you feed (aim for pale yellow urine). 3) Eat small, frequent, nourishing meals. 4) Take pain relief as prescribed (acetaminophen/paracetamol and ibuprofen are generally safe in breastfeeding; confirm with your clinician). 5) Pee every 2–3 hours; use a stool softener if prescribed. 6) Walk short, frequent laps at home to support circulation and bowel function. 7) Check your bleeding, perineum or incision daily. 8) Ask for help with chores and visitors’ timing. 9) Call your clinician if anything worries you.
Bleeding and Uterine Recovery (Lochia)
Normal: Bleeding is heaviest in the first days and should slowly decrease. Color typically changes from red (days 1–3) to pink/brown (days 4–6) to yellow/white (after day 7). Small clots (smaller than a golf ball) can be normal early on. You should not pass foul-smelling discharge.
Self-care: Use pads, not tampons. Empty your bladder often. Gentle uterine cramps are normal and may intensify with nursing or after multiple births.
Call right away if you soak through a pad in an hour for 2 hours, pass large clots (golf-ball size or larger), bleeding suddenly increases after slowing, discharge has a foul odor, you feel dizzy/faint, or your heart races—these are urgent maternal warning signs (CDC).
Perineal Care After Vaginal Birth (Tears, Stitches, or Episiotomy)
What’s typical: Soreness, swelling, and stinging with urination are common for several days. Stitches dissolve on their own.
Step-by-step care: 1) After using the toilet, rinse front to back with warm water using a peri bottle; pat dry gently. 2) Change pads every 3–4 hours or sooner. 3) For the first 24 hours, apply wrapped ice packs to the perineum for 10–20 minutes at a time, several times a day. 4) After 24 hours, try warm sitz baths (or a clean shallow bath) for 10–15 minutes, 1–3 times daily, to ease pain and promote healing. 5) Use witch-hazel pads for hemorrhoid or perineal comfort if helpful. 6) Take prescribed pain relievers and stool softeners. 7) Avoid lifting heavy items and high-impact activity.
Call your clinician if you notice worsening pain, increasing swelling, pus-like discharge, separation of the wound, or fever (≥100.4°F/38°C).
Cesarean Birth Recovery
What’s typical: Incision soreness, fatigue, gas pain, and slowed bowels in the first days. Gentle walking reduces clots and supports recovery.
Step-by-step care: 1) Keep the incision clean and dry; shower water can run over it, then pat dry. Avoid soaking baths until cleared. 2) Support your abdomen with a pillow when coughing, laughing, or standing. 3) Walk short, frequent laps daily; increase gradually. 4) Avoid lifting anything heavier than your baby for the first couple of weeks. 5) Do not drive while taking narcotic pain medication and until you can brake comfortably (often around 2 weeks; confirm with your clinician). 6) Look daily for redness spreading, warmth, opening, foul drainage, or fever; call if present.
Breast and Chest Care, Feeding, and Milk Coming In
If breastfeeding/chestfeeding: Aim for 8–12 feeds in 24 hours. Offer at early hunger cues: rooting, hands to mouth, lip smacking, stirring. A deep latch should feel like strong tugging, not sharp pain. By day 4–5, baby should have 6 or more wet diapers and 3–4 or more yellow, seedy stools per day, and should be seen by a pediatric clinician at 3–5 days of age for weight and feeding check (AAP).
Encouraging a good latch (step-by-step): 1) Get comfy; bring baby to you. 2) Tummy-to-tummy, nose to nipple, hips aligned. 3) Tickle lips with your nipple; wait for a wide-open mouth. 4) Bring baby onto the breast chin-first so more areola is in the mouth below the nipple than above. 5) Listen for steady swallows; cheeks rounded, not dimpled. 6) If painful after a few seconds, break suction with a clean finger and try again.
Engorgement relief (days 3–5): 1) Feed frequently. 2) Before latching, apply warmth for a few minutes and use gentle breast massage. 3) If the areola is too firm, use “reverse pressure softening”: press gently around the nipple for 60–120 seconds to move fluid back. 4) After feeds, apply cool compresses 10–15 minutes to reduce swelling. 5) Hand express a small amount for comfort if baby can’t latch, but avoid routinely pumping to empty if you don’t need to, as this can increase oversupply (ABM).
Watch for mastitis signs: a firm, painful area with redness, fever, flu-like aches, or worsening breast pain. Keep feeding; call your clinician promptly—early treatment speeds recovery (ABM).
Medication note: Most common pain medicines (acetaminophen and ibuprofen) are compatible with breastfeeding, while high-dose aspirin should be avoided. If you need other medicines, check with your clinician or consult LactMed.
If formula feeding: 1) Feed on baby’s hunger cues; typical intake in the first week is small and frequent (often 0.5–2 ounces/15–60 mL per feed), increasing gradually. 2) Pace feeds: Hold baby semi-upright, hold bottle more horizontal, and pause often to allow breaks. 3) Prepare formula safely each time. Wash hands and bottles; for powdered formula, use safe water per local guidance. Follow label instructions exactly; never dilute more than directed. Store prepared formula and discard leftovers per guidelines (CDC/WHO). 4) Hold and cuddle during feeds; avoid propping bottles. 5) Track wet/dirty diapers similar to breastfeeding expectations by day 4–5.
Your Mood Matters: Baby Blues vs. Postpartum Depression/Anxiety
Baby blues are common (up to 80%): tearfulness, worry, and irritability that start a few days after birth and improve within two weeks. If sadness, anxiety, irritability, intrusive thoughts, hopelessness, or inability to sleep/eat persist beyond two weeks or feel severe at any time, you may have a postpartum mood or anxiety disorder—common and treatable. If you have thoughts of self-harm or harming your baby, seek help immediately.
Get support: Share how you’re feeling with your partner or a trusted person. Contact your clinician, or reach out to Postpartum Support International (Text 800-944-4773; Call 1-800-944-4773 in the U.S.). In an emergency, call your local emergency number or 988 (U.S.).
Comfort, Pain, Bowels, and Bladder
Pain management: Take medications as prescribed. Ice and heat can help (ice early for perineal swelling; warmth for uterine cramps or back pain). Gentle abdominal or back support garments may feel good; avoid tight binding that increases discomfort.
Bowels: Prevent constipation with fluids, fiber-rich foods, and prescribed stool softeners. Try a short walk daily. Place feet on a low stool when on the toilet to ease pressure.
Bladder: Pee every 2–3 hours. If you have burning, difficulty voiding, or leakage that doesn’t improve, call your clinician.
Pelvic Floor and Early Movement
Breath and posture (day 1 onward): 1) Practice diaphragmatic breathing a few times a day—inhale to expand your ribs and belly; exhale and gently engage your lower belly. 2) Roll to your side to get in and out of bed to protect your core and incision/perineum.
Gentle pelvic floor activation: If comfortable, do very gentle Kegel contractions (lift and release) a few times a day without pain or strain. If it hurts, stop and try again in a few days. Walking is the best early exercise; add more as pain allows.
Avoid high-impact exercise, heavy lifting, or core strain early on. If you have significant pelvic heaviness, bulging, or urinary/fecal incontinence that persists, ask for a pelvic floor physical therapy referral.
Sleep, Hydration, and Nutrition
Sleep in small chunks: Two 20–40 minute rests can make a big difference. Trade off with a partner or helper. Keep a low-light, calm environment at night to support your body’s rhythm.
Hydration and food: Aim for regular fluids (about 2–3 liters/day, more if thirsty). Focus on protein, fiber, fruits/vegetables, and iron-rich foods. If breastfeeding, you may need an additional ~450–500 calories per day. Limit caffeine to about 200–300 mg/day while breastfeeding (roughly 1–2 cups of coffee), as larger amounts may affect baby (CDC).
Sex, Birth Control, and Activity
Sex is typically deferred until bleeding has stopped and you feel ready, often after 4–6 weeks, but there’s no one-size timeline—comfort and healing matter. Discuss contraception early; you can ovulate before your first period. If exclusively breastfeeding, have no return of periods, and your baby is under 6 months, the Lactational Amenorrhea Method (LAM) can be highly effective, but it’s easy to slip outside criteria—consider a backup method. Many options are safe during breastfeeding, including condoms, certain progestin-only methods, and IUDs; ask your clinician (ACOG/WHO).
When to Seek Urgent Care
Call your clinician or go to emergency care for any of the CDC’s urgent maternal warning signs: heavy bleeding (soaking a pad in an hour for 2 hours), large clots, chest pain, shortness of breath, seizures, severe headache that won’t go away, vision changes, swelling/pain in one leg, fever ≥100.4°F (38°C), incision or perineal wound that is opening or has pus or spreading redness, thoughts of harming yourself or your baby, or feeling that something is very wrong. Postpartum preeclampsia can occur in the first week even if your pregnancy blood pressure was normal—seek care for severe headache, vision changes, right upper abdominal pain, shortness of breath, or swelling with high blood pressure (ACOG/CDC).
Follow-Up and Support
Schedule postpartum follow-up: ACOG recommends contact within the first 3 weeks postpartum, with ongoing care as needed and a comprehensive visit by 12 weeks. If you had a cesarean, you may have an incision check within 1–2 weeks. Your baby should see a pediatric clinician at 3–5 days after birth and again as advised (AAP). If you had high blood pressure or preeclampsia, ask about a blood pressure check in the first week.
Lean on your village: Ask visitors to help with dishes, laundry, or a meal. Keep essentials (water, snacks, diapers, pads, peri bottle) in a small caddy by your resting spot. Say yes to help and no to anything that drains your energy.
You’re Doing More Than Enough
The first week is a swirl of learning, healing, and love. If each day you rest a bit, feed your baby, nourish yourself, and ask for help when you need it—you’re succeeding. Reach out to your care team with questions; that’s what they’re there for.
Sources and Further Reading
- American College of Obstetricians and Gynecologists (ACOG). Optimizing Postpartum Care. https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2018/05/optimizing-postpartum-care
- Centers for Disease Control and Prevention (CDC). Urgent Maternal Warning Signs. https://www.cdc.gov/hear-her/maternal-warning-signs/
- CDC. Breastfeeding: Maternal Diet. https://www.cdc.gov/breastfeeding/breastfeeding-special-circumstances/diet-and-micronutrients.html
- Academy of Breastfeeding Medicine (ABM). Clinical Protocols (Mastitis Spectrum; Supplementation). https://www.bfmed.org/protocols
- American Academy of Pediatrics (AAP), HealthyChildren.org. How Often and How Much to Breastfeed. https://www.healthychildren.org/English/ages-stages/baby/breastfeeding/Pages/How-Often-and-How-Much-to-Breastfeed.aspx
- National Institute for Health and Care Excellence (NICE). Postnatal care up to 8 weeks after birth (NG194). https://www.nice.org.uk/guidance/ng194
- World Health Organization (WHO). How to Prepare Formula Safely. https://www.who.int/publications/i/item/9789241595414
- National Library of Medicine. LactMed Database (medications and breastfeeding). https://www.ncbi.nlm.nih.gov/books/NBK501922/
- ACOG. Postpartum Birth Control. https://www.acog.org/womens-health/faqs/postpartum-birth-control
This guide is educational and not a substitute for care from your own clinician. If you have concerns, please contact your healthcare provider.