Your first week postpartum: a gentle, practical guide
Welcome to your first week after birth. This is a time of profound change—physically, emotionally, and in your daily rhythm. You are healing, learning your baby, and finding your footing. The aim of this guide is to offer clear, evidence-based steps you can use right now, with reassurance about what’s normal, what’s not, and when to reach out for help.
What to expect this week
In the first 7 days, your uterus contracts and shrinks, you’ll have vaginal bleeding (lochia), your milk may transition from colostrum to mature milk, and your sleep will be fragmented. It’s common to feel tender, tired, emotional, and unsure. With rest, good support, and simple routines, most discomforts improve day by day.
Your body’s recovery
Bleeding and cramps (lochia and “afterpains”)
Bleeding is usually bright red and like a heavy period for 1–3 days, then becomes pink/brown (days 4–10) and finally yellow/white. Small clots can be normal, especially after lying down, but they should be smaller than a golf ball. Uterine cramps (afterpains) are common—often stronger with breastfeeding as oxytocin helps the uterus contract.
Comfort steps: - Empty your bladder often (a full bladder can increase bleeding). - Use a heating pad for cramps. - Alternate ibuprofen and acetaminophen as advised by your clinician if appropriate.
Call your clinician urgently if you soak a maxi pad in an hour or less, pass golf-ball–sized clots repeatedly, feel faint, have foul-smelling discharge, or your bleeding suddenly gets much heavier after it had slowed.
Perineal care (vaginal birth)
If you had a tear or episiotomy, tenderness is expected. Swelling usually improves by day 3–4.
Step-by-step perineal care: 1) After toileting, rinse with warm water using a peri bottle; gently pat dry front to back. 2) For the first 24 hours, apply cold packs wrapped in cloth for 10–20 minutes at a time to reduce swelling. 3) Use witch-hazel pads between your pad and skin if soothing. 4) Take a warm sitz bath (or sitz soak) 1–2 times daily after day 1 to ease soreness. 5) Keep the area clean and change pads frequently; avoid tampons or douching. 6) Do gentle pelvic floor squeezes (Kegels): tighten the muscles as if stopping urine, hold 3 seconds, relax 6 seconds, repeat 10 times, 3 sets daily as comfortable.
Seek care if pain worsens after improving, you notice increasing redness, pus, bad odor, or the wound opens.
Cesarean incision care
Your incision will feel sore, tight, or numb around it. Some pulling is normal; sharp, worsening pain is not.
Step-by-step incision care: 1) Keep your dressing on as directed; once removed, gently wash with mild soap and water in the shower; pat dry. 2) Keep the incision dry; use clean, soft clothing and avoid rubbing waistbands. 3) Support your abdomen with a pillow when coughing or laughing. 4) Avoid lifting more than your baby; limit stairs; no driving while on narcotic pain medication. 5) Do not soak in baths or pools until cleared by your clinician.
Call promptly if you have fever (≥100.4°F/38°C), spreading redness, warmth, draining pus, wound separation, or severe pain. Also call for calf pain/swelling, one leg more swollen than the other, chest pain, or shortness of breath.
Bowel and bladder care
Constipation is common. Aim for: - Hydration: a glass of water at each feed. - Fiber: fruits, vegetables, whole grains. - Gentle walks as tolerated. - A stool softener (like docusate) if recommended by your clinician.
Hemorrhoid relief: witch-hazel pads, warm soaks, and avoiding straining. Burning with urination can improve with peri bottle rinses. If you cannot urinate or have burning plus fever, call your clinician.
Feeding your baby
Breastfeeding: getting started
In the first 24–48 hours, your baby gets colostrum—small, concentrated amounts. Milk volume usually increases between days 2–5. Expect 8–12 feeds in 24 hours, with cluster feeding at times.
Step-by-step latch: 1) Get comfortable: bring baby to you, tummy-to-tummy, nose level with your nipple. 2) Hand-express a few drops to entice baby; tickle the upper lip with your nipple. 3) When baby opens wide, quickly bring baby onto the breast, aiming the nipple toward the roof of the mouth. 4) Check for deep latch: more areola visible above than below, lips flanged out, chin touching breast, rhythmic sucks and swallows with no pinching pain. 5) If latch is painful after a few seconds, break the seal with a clean finger and try again.
Comfort steps for engorgement (full, firm breasts as milk “comes in”): - Feed frequently; do not skip feeds. - Use warmth for 1–2 minutes before latching; gentle breast massage toward the nipple. - Soften the areola with hand expression to help latch. - Apply cold packs 10–20 minutes after feeds for swelling. - Wear a comfortable, non-restrictive bra.
Call a lactation consultant if you have persistent latch pain, cracked nipples, baby is sleepy and hard to rouse for feeds, or you’re unsure baby is transferring milk.
How to know your baby is getting enough
Diaper output guide: - Day 1: at least 1 wet, 1 meconium stool. - Day 2: at least 2 wets, 2 stools. - Day 3: at least 3 wets, 3 stools; stools turning green. - Day 4: at least 4 wets; 3–4 yellow, seedy stools by the end of day 4–5. - Day 5–7: 6+ wets; 3–4+ yellow stools (some breastfed babies stool with every feed).
Weight: many newborns lose up to 7% of birth weight; losses approaching 10% or poor output warrant prompt evaluation. Call your pediatrician for increasing jaundice (yellowing of skin/eyes), very sleepy or difficult-to-wake baby, or fewer wets/stools than above.
If you are formula feeding (fully or in combination)
In the first week, typical volumes are small: about 5–15 mL (1–3 tsp) per feed on day 1, 15–30 mL by days 2–3, and 30–60 mL by the end of the week. Feed on cue (early hunger signs: stirring, rooting, hand-to-mouth), using paced bottle feeding so baby can rest and self-regulate.
Safe preparation steps: 1) Wash hands and clean surfaces. 2) Use clean bottles and nipples; sterilize before first use. 3) Prepare formula exactly as labeled; do not add extra powder or water. 4) Use safe water per local guidance; let boiled water cool before mixing when required. 5) Never microwave bottles; warm in a container of warm water and swirl. 6) Discard unfinished formula within 1 hour of starting a feed; refrigerate prepared formula within 2 hours and use within 24 hours as labeled.
Discuss any need for supplementation with your clinician or lactation professional.
Sleep and daily rhythm
Safe sleep for baby
For every sleep: place baby on their back, on a firm, flat surface (a crib, bassinet, or play yard) free of soft bedding, pillows, bumpers, or toys. Share a room, not a bed, ideally for at least 6 months. Avoid overheating and keep smoke- and vape-free air. Offer a pacifier once breastfeeding is going well if desired.
Your rest and recovery
Sleep when baby sleeps, even if it’s a short nap. Let others handle chores. Create a simple rotation with a partner or helper for nights: one person changes the diaper and brings baby to you, the other feeds; switch for the next wake-up. Keep water and snacks within reach. Set gentle boundaries with visitors—brief visits, or delay them until you feel ready.
Mood, emotions, and mental health
Many parents experience “baby blues”: mood swings, tearfulness, and irritability, peaking around days 3–5 and easing by two weeks. If symptoms persist beyond two weeks, feel severe, or include anxiety that won’t settle, panic, intrusive thoughts, despair, or difficulty bonding, reach out promptly—these are signs of postpartum depression or anxiety, which are common and treatable. If you ever have thoughts of harming yourself or your baby, seek emergency help immediately.
Daily mental health check: - Have I eaten, hydrated, and been outside briefly today? - Did I sleep at least one consolidated 3–4 hour stretch in the past 24 hours? - Do I have one person I can text or call today for support?
Red flags: call now or seek emergency care
Call your clinician urgently or go to emergency care for: - Heavy bleeding (soaking a pad in an hour), large clots, dizziness, or fainting. - Fever 100.4°F/38°C or higher, chills. - Severe headache, vision changes, swelling of face/hands, right-upper abdominal pain, shortness of breath—possible postpartum preeclampsia. - Chest pain, sudden shortness of breath, or one-sided calf pain/swelling—possible blood clot. - Foul-smelling discharge, worsening abdominal or perineal pain, or wound redness/pus. - Breast symptoms with fever and flu-like feeling—possible mastitis. - New or worsening jaundice in baby, very poor feeding, or fewer diapers than expected.
Follow-up and planning ahead
Postpartum and newborn check-ins
Plan contact with your obstetric provider within the first 3 weeks (earlier if you have high blood pressure, cesarean birth, significant bleeding, mood concerns, or diabetes). Your newborn is usually seen within 24–48 hours after discharge and again at about 1–2 weeks; follow your pediatrician’s schedule.
Activity, movement, and pelvic floor
Short walks and gentle stretching are encouraged as tolerated. Avoid heavy lifting (more than your baby) and high-impact exercise this week. Begin gentle pelvic floor contractions if comfortable. If you feel pelvic heaviness, bulging, or urinary leakage, mention it to your clinician; pelvic floor physical therapy can help.
Nutrition and hydration
Choose easy, nutrient-dense foods: yogurt, eggs, nuts, beans, whole grains, fruits, and vegetables. Keep a water bottle nearby; many breastfeeding parents find they need extra fluids. If you’re taking iron for anemia, pair with vitamin C–rich foods and manage constipation proactively. Continue prenatal vitamins unless advised otherwise.
Sex and contraception
There’s no rush to resume intercourse; wait until bleeding has stopped, you feel ready, and any perineal or incision pain has healed—often after the first few weeks. Discuss contraception early; ovulation can return before your first period. Options compatible with breastfeeding include condoms, copper or hormonal IUDs, implants, progestin-only pills, and injections. Lactational amenorrhea method (LAM) is effective only if exclusively breastfeeding, your period has not returned, and baby is under 6 months old.
Vaccinations
If you were not up to date during pregnancy, ask about postpartum Tdap, influenza (in season), COVID-19 vaccines/boosters, and MMR if non-immune to rubella. Vaccination protects both you and your baby.
A simple daily checklist
- Feed the baby on cue (about 8–12 times in 24 hours for breastfeeding). Track diapers.
- Drink water at every feed; eat small, frequent, nourishing meals.
- Rest or nap at least once during daylight; arrange one longer sleep stretch at night with help if possible.
- Take pain medication as prescribed; use ice/heat as helpful.
- Do gentle pelvic floor squeezes; take a short walk if comfortable.
- Do one thing that feels good: a shower, a snack you love, or five deep breaths by an open window.
- Ask for and accept help—meals, laundry, holding the baby while you nap.
You’re doing better than you think
This week is about healing and learning, not perfection. If something feels off, trust your instincts and call. If you need support, reach out—you deserve care and kindness as you care for your baby.
References and trusted resources
- American College of Obstetricians and Gynecologists (ACOG). Optimizing Postpartum Care. Committee Opinion No. 736. https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2018/05/optimizing-postpartum-care
- World Health Organization. WHO recommendations on maternal and newborn care for a positive postnatal experience (2022). https://www.who.int/publications/i/item/9789240045989
- American Academy of Pediatrics. 2022 Policy Statement: Sleep-Related Infant Deaths: Updated 2022 Recommendations for a Safe Infant Sleeping Environment. https://publications.aap.org/pediatrics/article/150/1/e2022057990/188279
- Centers for Disease Control and Prevention. How Much and How Often to Breastfeed. https://www.cdc.gov/breastfeeding/breastfeeding-special-circumstances/diet-and-micronutrients/how-much-and-how-often.html
- Centers for Disease Control and Prevention. Jaundice and Kernicterus. https://www.cdc.gov/ncbddd/jaundice/index.html
- Centers for Disease Control and Prevention. How to Prepare and Store Powdered Infant Formula. https://www.cdc.gov/infant-toddler-nutrition/formula-feeding/infant-formula-preparation-and-storage.html
- Academy of Breastfeeding Medicine. Clinical Protocol #36: The Mastitis Spectrum (2022). https://www.bfmed.org/protocols
- National Institute for Health and Care Excellence (NICE). Postnatal care up to 8 weeks after birth. https://www.nice.org.uk/guidance/ng194
- Postpartum Support International. Help for Moms and Families. https://www.postpartum.net
- CDC Hear Her Campaign: Urgent Maternal Warning Signs. https://www.cdc.gov/hearher/maternal-warning-signs/index.html