Be alert to the signs of infection and call your doctor or nurse right away if you have any of these symptoms:

• Pain and burning while urinating
• Passing urine in small amounts
• Passing blood in urine
• Chills
• Fever
• Pain in the lower abdomen or back

Sore Breasts

Three to five days after giving birth, your breasts may swell as milk production increases. This swelling is called engorgement and may be uncomfortable. Your breasts also may leak at times.

If you are breastfeeding:

• Nurse at least eight times daily.
• Wear a well-fitted support bra.
• Seek the help of your doctor or lactation specialist if engorgement continues to be a problem.

If you are bottle-feeding:

• Wear a well-fitted support bra.
• Place an ice pack under each armpit to help decrease swelling and pain.
• Take your pain medicine as prescribed.
• Avoid running hot water over your breasts.
• Avoid frequent touching or handling of your breasts.
• The engorgement usually goes away in a few days. There are no safe medicines to "dry up" the milk.

Hemorrhoids

Hemorrhoids are enlarged veins in the rectum. They are caused from the extra weight of the pregnancy and birth process. You may have tenderness around the rectum from hemorrhoids, which may cause problems sitting. Hemorrhoids usually shrink 6 weeks after giving birth.

How to help yourself:

• Use an ice pack to help decrease swelling.
• Use your medicated spray or ointments.
• Take warm or hot sitz baths 2 to 3 times a day.
• Sit on a soft cushion or rubber ring.
• Follow the suggestions under "Constipation" to keep your BMs soft. This will help decrease discomfort when moving your bowels.

Fatigue (Tiredness)

A period of high energy and excitement usually follows the baby's delivery. This may last 1 to 2 days after delivery. However, you are bound to feel some physical and mental fatigue from both labor and caring for a newborn. Other causes of fatigue are physical changes, hormonal changes, emotional adjustments to motherhood and lack of sleep.

How to help yourself:

• Limit unnecessary activity like frequent stair climbing.
• Do not lift items heavier than your baby.
• Whenever possible, sit down to do work. If you are too active, you may notice an increase in the amount of vaginal discharge.
• Get plenty of rest. Nap when the baby sleeps.
• Accept offers of help.
• Eat a well-balanced diet.
• Limit telephone calls and visitors if you need more rest.
• Treat yourself to something special, like going out to eat, getting a new hairstyle, or getting your nails done.

Night Sweats

Once you are beyond the first few postpartum weeks, the rapid and radical changes that your body has undergone since delivery will slow down. You may still have puffy hands, legs or feet for a few months. Some women experience "night sweats" for a few weeks. When these occur, you may wake up during the night to find yourself drenched with perspiration and needing a complete change of clothes. These sweats are not related to breastfeeding, but to hormonal "ups and downs."

Hair Loss

Another postpartum event that is often unexpected and may occur 6 to 12 weeks after giving birth is a certain amount of hair loss. Although seldom severe, it can continue for several months. Both breastfeeding and bottle-feeding mothers experience it. It, too, is caused by the influence of hormones, which takes hair follicles from a growing phase (present all during pregnancy) to a resting phase.

When to Call Your Doctor

While some discomfort is common after your pregnancy, there are other problems that require the advice of a doctor. If you have any of the problems listed below, or any concerns about your condition, take your temperature, then call your health care professional immediately:

• Heavy bleeding. Passing blood clots or heavy bleeding is not normal. Vaginal bleeding will decrease every day. Bleeding will change from a red color to pink to dark brown and then to clear. This discharge will continue for 2 to 4 weeks. Bleeding that begins one month or more after the birth of your baby is probably your period. If you are passing bright-red blood clots or need to change your pad more often than every 2 hours, your bleeding is considered heavy.
• Chills with fever of 101°F (38^o C) or more
• Frequent and painful urination
• Blood in your urine
• Swelling and/or pain in your legs or feet
• Dizziness, headaches and/or blurred vision
• Soreness, pain, red spots or red streaks on the breasts
• Severe and persistent pain in the abdomen, vagina or in the area of stitches
• Vomiting
• Foul-smelling vaginal discharge
• Drainage from an incision or sudden opening of an incision
• Feeling like you cannot cope with caring for yourself and the baby (excessive crying, anger, or feeling overwhelmed are all signs of difficulty adjusting to this new lifestyle)

If you have any questions or concerns, call your doctor or nurse. He/She will be happy to help you.