Postpartum tips for your first week: a warm, practical guide
The first week after birth is a time of huge change. Your body is healing, your hormones are shifting, and you’re getting to know your baby. You are doing something extraordinary. This guide gives you evidence-based, compassionate tips for the first seven days—what’s normal, what’s not, and how to make a simple plan that supports your recovery and your new family.
What your body may feel like (and what’s normal)
Bleeding (lochia): It’s normal to have bright red bleeding at first that gradually turns pink/brown, then creamy. You may pass small clots, especially after resting, and bleeding can increase with activity or during breastfeeding. Call urgently if you soak a pad in less than an hour, pass clots larger than a golf ball, feel dizzy or faint, or your bleeding suddenly increases after slowing (ACOG, https://www.acog.org/womens-health/faqs/postpartum-care).
Uterine cramps: Cramping is common, especially while nursing, because oxytocin helps your uterus shrink. Heat on the lower belly and scheduled ibuprofen and acetaminophen can help and are compatible with breastfeeding (LactMed/ACOG).
Perineum or incision: If you had a vaginal birth, soreness, swelling, and stitches are common. If you had a cesarean, expect incision tenderness. Ice in the first 24 hours, then warm soaks for perineal soreness; for incisions, keep clean and dry and watch for redness, drainage, or fever (NICE, https://www.nice.org.uk/guidance/ng194; ACOG).
Breasts: Around days 2–5 your milk “comes in,” breasts feel fuller, warm, and sensitive. Feeding or expressing often softens them. If you have hard areas, redness, fever, or flu-like symptoms, contact your clinician—these can be signs of inflammatory mastitis (Academy of Breastfeeding Medicine, https://www.bfmed.org/assets/ABM%20Protocol%20%236%20Mastitis%202022.pdf).
Bowels and bladder: Constipation is common. Hydrate, eat fiber, and use a stool softener if recommended. Peeing may sting after a vaginal birth—pour warm water over your vulva while urinating to reduce discomfort (NICE; ACOG).
A simple day-by-day rhythm (a gentle plan you can repeat)
Step 1: Morning check-in. Before you pick up your phone, take two minutes to scan your body: pain level, bleeding amount, swelling, mood, breasts (any tender spots), and your incision or stitches. Note anything that’s worsening.
Step 2: Hydration and nutrition. Keep a large water bottle nearby and aim to drink whenever you feed the baby. Eat every 3–4 hours; include protein, complex carbs, fruits/veggies, and healthy fats. If you’re breastfeeding, you may be hungrier—follow your appetite (CDC, https://www.cdc.gov/breastfeeding/breastfeeding-special-circumstances/diet-and-micronutrients.html).
Step 3: Comfortable pain control. If your clinician advised it, alternate acetaminophen and ibuprofen on a schedule for the first few days. Avoid exceeding label doses; ask before using opioids, and avoid codeine/tramadol if breastfeeding (ACOG; LactMed, https://www.ncbi.nlm.nih.gov/books/NBK501922/).
Step 4: Gentle movement. Take two to three short, easy walks around your home or outside if safe. Do deep belly breathing several times a day. If comfortable, try a few gentle pelvic floor contractions (see below). Stop if you feel pelvic pressure, pain, or increased bleeding.
Step 5: Rest blocks. Plan two nap windows each day, even if they’re only 20–30 minutes. Ask a partner or support person to handle visitors, dishes, or messages so you can sleep.
Step 6: Feeding plan. Aim for 8–12 feeds in 24 hours (about every 2–3 hours, and on demand). Keep baby close, watch for early feeding cues (stirring, rooting), and track diapers to gauge intake (AAP, https://www.healthychildren.org/English/ages-stages/baby/breastfeeding/Pages/How-Often-and-How-Much-Should-Your-Baby-Eat.aspx).
Step 7: Evening wind-down. Warm shower, light snack, and set up your night station (diapers, water, snacks, pain meds). Remind yourself: nights are temporary; you are learning together.
Feeding your baby (and caring for your breasts)
Latching basics: Hold baby belly-to-belly with you, nose to nipple, wait for a wide open mouth, then bring baby quickly onto the breast so more areola is in the mouth. You should feel strong tugging, not sharp pain. If pain persists beyond initial seconds, gently break the latch and try again. Persistent nipple pain, cracks, or bleeding are signs to get lactation help (WHO/UNICEF BFHI, https://www.who.int/teams/nutrition-and-food-safety/food-and-nutrition-actions-in-health-systems/breastfeeding/baby-friendly-hospital-initiative).
Normal patterns: Cluster feeding (frequent evening feeds) and day 2–3 sleepiness are common. Wake a very sleepy newborn to feed at least every 3 hours in the first week. Expect diapers to increase: day 1 about one wet/one meconium stool; day 2 about two of each; by day 4–5, at least six wet diapers and three to four yellow stools daily (AAP).
Engorgement comfort: Before feeds, apply warmth and gently hand express to soften the areola. During feeds, massage firm areas toward the nipple. After feeds, apply cold compresses 10–15 minutes for swelling. If baby can’t latch because of fullness, try reverse pressure softening around the nipple (ABM).
Nipple care: Air-dry milk on your nipples, ensure deep latch, and change damp breast pads. Lanolin or hydrogel pads can soothe, but addressing latch is key (ABM).
When to supplement or pump: If baby has signs of dehydration, persistent poor latch, excessive weight loss, or low diaper counts, contact your clinician or a lactation professional promptly. Medical evaluation should guide supplementation; when needed, prefer your expressed milk first, then donor milk or formula (ABM Protocol #3, https://www.bfmed.org/assets/ABM%20Protocol%203.pdf). If separated from baby or if baby isn’t nursing effectively, begin hand expression or pumping at least eight times in 24 hours, including overnight.
Perineal and cesarean incision care: step-by-step
Perineal care: For the first 24 hours, use cold packs for 10–20 minutes at a time to reduce swelling. After 24 hours, warm sitz baths or a warm peri-bottle can soothe. Pat dry front-to-back. Support the perineum with a folded pad or your hand when coughing or having a bowel movement. Take prescribed stool softeners and don’t strain. Call your clinician if you see worsening pain, foul odor, pus, or separation of stitches (NICE).
Cesarean incision: Wash gently with soap and water in the shower, then pat dry. Keep the area clean and avoid tight waistbands. Watch daily for increasing redness, warmth, swelling, drainage, or fever. Sudden sharp pain, bulging, or wound opening needs urgent care (ACOG).
Pelvic floor, bowels, and bladder
Gentle pelvic floor work: When comfortable, try a few light Kegel contractions—exhale, gently lift the muscles you’d use to stop gas for 3–5 seconds, then relax fully for twice as long. Do 5–10 reps, 2–3 times a day. If you feel pelvic heaviness or pain, stop and rest. Pelvic floor physical therapy is safe and helpful postpartum (APTA, https://www.aptapelvichealth.org/).
Constipation care: Drink water regularly, eat fiber-rich foods (fruit, vegetables, oats, legumes), and consider a stool softener if recommended. Place feet on a low stool, lean forward, and relax your belly when having a bowel movement. Support your perineum with a hand or folded pad if sore (NICE).
Safe sleep and realistic rest
Your baby should sleep on their back, on a firm, flat surface in your room, with no pillows, blankets, or bumpers. Avoid sofas and armchairs for infant sleep. If you feel sleepy while feeding in bed, prepare a safer space by removing pillows and heavy bedding from baby’s area. Do not bed share if you or your partner smoked during pregnancy, used substances, or are very tired (AAP 2022, https://publications.aap.org/pediatrics/article/150/1/e2022057990/188218/).
Mood, emotions, and when to ask for help
Baby blues—tearfulness, irritability, and feeling overwhelmed—are common and usually peak around day 4–5, improving by two weeks. If sadness, anxiety, panic, intrusive thoughts, or hopelessness are intense, last more than two weeks, or you have thoughts of harming yourself or your baby, seek help immediately. Postpartum Support International offers a helpline and resources (https://www.postpartum.net/). Screening tools like the Edinburgh Postnatal Depression Scale can help identify concerns; contact your clinician if your score is elevated (USPSTF, https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/depression-in-adults-screening).
Warning signs that need urgent care
Call your clinician urgently or seek emergency care for any of the following: soaking a pad in less than an hour or passing large clots; chest pain, shortness of breath, or coughing blood; one-leg swelling, redness, or pain; severe headache, vision changes, right upper belly pain, or blood pressure at or above 160/110 if you’re monitoring at home; fever of 100.4°F (38°C) or higher with worsening pain; thoughts of self-harm or harming your baby; signs of wound infection. The first six weeks carry increased risk of blood clots and hypertensive complications—don’t wait to be seen (ACOG; CDC, https://www.cdc.gov/hearher/).
If you had preeclampsia, hypertension, diabetes, or a cesarean
Blood pressure: If you had high blood pressure during pregnancy, check BP at home as advised. Seek urgent care for severe headache, vision changes, or readings 160/110 or higher; call your clinician for persistent readings 140/90 or higher (ACOG, https://www.acog.org/womens-health/faqs/preeclampsia-and-high-blood-pressure-during-pregnancy).
Diabetes: If you had gestational diabetes, ask about a 4–12 week postpartum glucose test and how to manage blood sugars now (ACOG, https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2018/12/optimizing-postpartum-care).
Cesarean recovery: Avoid lifting more than your baby, increase walking gradually, and wait to drive until you can brake hard without pain and are off opioids. Support your abdomen with a pillow when coughing or laughing (ACOG).
Follow-up care, contraception, and vaccines
Schedule contact with your obstetric provider within the first 1–3 weeks, with a comprehensive visit by 12 weeks postpartum, sooner if you have concerns (ACOG). Discuss contraception—fertility can return before your first period. If exclusively breastfeeding, the Lactational Amenorrhea Method can be effective for up to six months if all criteria are met; ask your clinician about options compatible with breastfeeding. If you didn’t receive Tdap during pregnancy, get it now; MMR or varicella may be recommended if you’re non-immune, and flu/COVID vaccines per season and guidance (CDC, https://www.cdc.gov/vaccines/pregnancy/hcp/guidelines.html).
Build your village and delegate
Ask loved ones to handle meals, laundry, pet care, and messages so you can rest and feed your baby. Set visiting hours and request handwashing. Keep a bedside “nest” with water, snacks, diapers, wipes, nipple balm, peri bottle, pads, phone charger, and your medications. Remember: healing is your job; everything else can wait.
A few parting words
You are learning a new person and a new version of yourself. Progress is not linear, and needing help is normal. Celebrate small wins: a better latch, a longer nap, a shared laugh. If something feels off, trust your instincts and reach out—you deserve timely, kind care.
References and trusted resources
American College of Obstetricians and Gynecologists (ACOG). Optimizing Postpartum Care. https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2018/12/optimizing-postpartum-care
ACOG. Postpartum Care FAQ. https://www.acog.org/womens-health/faqs/postpartum-care
ACOG. Preeclampsia and High Blood Pressure During Pregnancy. https://www.acog.org/womens-health/faqs/preeclampsia-and-high-blood-pressure-during-pregnancy
Academy of Breastfeeding Medicine. Mastitis Spectrum, 2022. https://www.bfmed.org/assets/ABM%20Protocol%20%236%20Mastitis%202022.pdf
Academy of Breastfeeding Medicine. Supplementary Feedings in the Healthy Term Breastfed Neonate. https://www.bfmed.org/assets/ABM%20Protocol%203.pdf
American Academy of Pediatrics (AAP). Breastfeeding guidance. https://www.healthychildren.org/English/ages-stages/baby/breastfeeding/
AAP. 2022 Safe Sleep Policy. https://publications.aap.org/pediatrics/article/150/1/e2022057990/188218/
World Health Organization/UNICEF. Baby-Friendly Hospital Initiative. https://www.who.int/teams/nutrition-and-food-safety/food-and-nutrition-actions-in-health-systems/breastfeeding/baby-friendly-hospital-initiative
NICE Guideline NG194: Postnatal care. https://www.nice.org.uk/guidance/ng194
CDC. Postpartum warning signs (Hear Her). https://www.cdc.gov/hearher/
LactMed (Drugs and Lactation Database). https://www.ncbi.nlm.nih.gov/books/NBK501922/
Postpartum Support International. https://www.postpartum.net/