The Postpartum Guide

The Postpartum Guide

Recovery from childbirth and discovery of your (new) self.

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This is not a time for keeping the house clean, “bouncing back”, or entertaining visitors who’ve come to “see the baby”. This time is about you. Your rest. Your recovery. Your time with your baby. Pregnancy pushes women to limits of human endurance. It is the most energetically expensive activity the human body can maintain for nine months, and it’s topped off with child birth. Which, no matter how you do it, is hugely taxing on your mind and body. You deserve respite. Time to heal, to slow down and find your feet as a new parent in a protected space.

Entering the world of post-birth is akin to embarking on a profound journey of discovery. Not only have you just introduced a new life into the world, but you're also navigating the transformative changes of your own body and mind. From the immediate physical aftermath of childbirth to the tidal waves of emotions and the mysteries of postpartum recovery, there's a lot to take in. As you tread these uncharted waters, it's essential to prioritise self-care. Whether it's relishing a comforting meal or indulging in a therapeutic massage, remember to take moments for yourself. And amidst the cacophony of baby cries and well-wishers, setting boundaries is paramount. This is a time of adjustment, bonding, and finding a new rhythm. Cherish it, embrace the changes, and always remember: this journey is uniquely yours.

You After Birth

The period of time immediately after birth is compounded by a myriad of both physical and emotional factors. To break down the immediate physical impacts of birth, below we focus on three major aspects; The Body, The Brain and The Bowels.

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The Body

Right after birthing your baby the umbilical cord will be clamped and cut. The baby will then be laid on your chest for skin-to-skin, a moment in time that may feel incredibly surreal. Some mothers will feel an instant and deep bond with their baby but others will not. Neither is ‘normal’ as every experience is completely unique. The benefits of skin-to-skin have been shown to include regulating your baby's heartbeat, their temperature and their blood sugar. Skin-to-skin can also be a positive initiation to breastfeeding. 

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From here you will birth your placenta and then pending whether you birthed via a vaginal delivery or a caesarean, your midwife or obstetrician will stitch up any wounds resulting from a tear, an episiotomy or an abdomen incision (i.e. a caesarean).

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The Brain

In the minutes, hours and the days following the birth, you will experience an overwhelming rollercoaster of hormones. Oestrogen and progesterone will drop while oxytocin and prolactin will rise. If you experience random highs (surges of endorphins) or moments of unexplained sadness, this can often be explained by your changing hormone levels. 

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You may also notice a direct correlation between noticeable emotional shifts and the heaviness of your bleeding. After birth (both vaginal and caesarean deliveries), you’ll bleed for a period of weeks. The bleeding you’ll experience is referred to as lochia and it’s your body's way of readjusting by expelling blood, mucus and uterine tissue. As you engage in moments that draw out emotion such as breastfeeding (where the body releases oxytocin), you’ll notice your bleeding becomes heavier. In this instance, the oxytocin causes your uterus to contract, promoting an expulsion of lochia.  

 The colour of lochia will appear a dark shade of red in the earlier days, fading to a darker brown overtime. If you notice continuous clots or excessive blood loss (for example, if you soak more than two pads in a period of 1 to 2 hours), it’s advised to make contact with your midwife or obstetrician. 

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The Bowels 

For some, the first poo after birth can be intensely overwhelming. Despite how you birthed, your abdomen, your pelvic floor and your buttocks are going to be far from excited about more ‘pushing.’ Fair enough. To help, drink lots of water and include plenty of fibre rich foods in your diet. Suitable probiotic supplements can also work wonders to reset your gut or your GP may suggest OTC stool softeners to get things moving along. The last thing you need during this vulnerable time of life is a bout of stubborn constipation. 

Some extra tips on the subject of poo; get yourself a small step for the toilet as your posture can make a big difference. Keep your knees higher than your hips, lean forwards and make a ‘moo’ sound. While doing so, you will feel both your abdomen expand and some added pressure downwards in the rectum and anus. This will assist with your bowel movement. If you’re worried about prolapse or placing any additional pressure on your pelvic floor, it can help to grab a wipe or some clean toilet paper and firmly hold your vagina while pushing. 

You’ll find some more helpful articles below:

Postpartum Emotions

As your hormones undergo extensive change following birth, experiencing emotional surges is to be expected, especially in the first 2-5 days. The contrasting rise and fall of various hormones could feel jarring and uncomfortable to manage.

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Baby Blues 

According to The Royal Women’s Hospital, the baby blues is experienced by 80% of new mothers. The baby blues is a period of time where a new mother may feel sad, worried, overwhelmed or a little hopeless. Usually it sets in 2-3 days post birth and it can hang around for a few days or a few weeks. It’s best to contact your GP if it’s still hovering after 2 weeks, or if these feelings are causing you distress or impacting your ability to function.  


The change in hormones are a major contributor to baby blues, as is the overwhelming adjustment to life with a new baby. Eating well, reducing your coffee and alcohol consumption are advised, and it’s encouraged you find ways to catch up on sleep and get out into the fresh, open air. We know, easier said than done, but be kind to yourself and lean on those around you for support.

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Postpartum Depression (PND) or Postpartum Anxiety (PNA)

To differentiate between PND and PNA; Depression is usually distinguished by ongoing (lasting more than a few weeks) feelings of flatness, disconnection, lethargy and hopelessness. Anxiety on the other hand, is characterised by feelings of worry, restlessness and panic. A mother experiencing anxiety may start to catastrophize an outcome before it actually happens. 

 

Differentiating between a bout of the baby blues and PND/PNA, can come down to timing, or the duration of the depressed periods. If your depressed mood extends past a few days – 2-3 weeks, worsens, or causes you distress and impacts your ability to do the things you want/need to do, it’s imperative you tell someone and/or call your GP. Experiencing a low mood or anxiety does not make you a bad parent, but could indicate that you need some support with your mental wellbeing.

 

It can be helpful to remind yourself that you are not alone. 1 in 5 new mothers will experience Postpartum Depression (PND) or Postpartum Anxiety (PNA). The best way to help yourself is to let others help you. 

 

If a feeling of shame surfaces, perhaps write down everything that is challenging you right now. Seeing the words in a physical form may release a sense of empathy. In moments like these, you need to back yourself. Understand that having a baby is exceptionally challenging and it’s to be expected to feel overwhelmed or low as you adjust to such extreme change.

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Both PND and PNA are serious but treatable issues that require immediate support. There are a range of support options available to you (e.g., counselling, psychology, psychiatry, medication) that will be individualised depending on a range of factors (e.g., symptoms, stage).

While you’re in these deep waters, it can be helpful to try to:

-       build a community of support around you

-       look after your physical and mental health (e.g. fuelling and moving your body, staying socially connected, sleeping (when you can), engaging in calming or relaxing activities)

-       Focus your time on things that bring joy 

-       Eliminate unnecessary angst.  

Experiencing either PND or PNA is no easy feat but you have an ocean of support around you. 

 

If you are unsure of whether you need to seek help, there are a range of mental health checklists (dependent on your stage) available at PANDA. These checklists won’t diagnose you but they will ask you questions based on possible symptoms of postnatal anxiety and/or depression. This can help you to better understand what you are experiencing, and assist you to get help if needed. 

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Further resources:


Postnatal Depletion 

Postnatal depletion is another common byproduct of postpartum life. It’s something to look out for as it can wreak havoc during a vulnerable time of life. 

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Postnatal depletion is not the same as being ‘burnt out’, or ‘sleep deprived’, or ‘depressed.’ In the postnatal context, postnatal depletion is a period of time where your body and mind are literally ‘emptying' or becoming ‘reduced.’ Every cell in your body is trying to recalibrate and adjust to life with a baby, however due to the weight of change endured during pregnancy and birth, this adjustment phase can have some hefty implications.

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How will you differentiate if you’re suffering from postnatal depletion vs postnatal depression or postnatal anxiety?

  • If you are feeling exhausted, yet you’re still able to ‘feel joy’ when moments in life bring goodness - this is likely depletion. Those who suffer depression will find their moods very ‘flat line’ and feeling joy and happiness will not be easy.
  • Sleep is another good indication. If you are up during the night and able to fall back to sleep quite easily, again, this is likely depletion. Those with depression, despite utter exhaustion on a physical and mental level will find it very hard to reduce the noise in their brain, keeping them awake for up to an hour or more, before they’re able to fall back asleep.

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Further resources:

Caring For Your Body

Postpartum is a time for TLC and becoming your own personal cheerleader (and boundary setter). Your body has achieved some serious feats whilst growing and birthing a baby, so it’s important you give yourself time and space to heal.

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After a Vaginal Birth

As your cervix dilates to 10cm, it’s no surprise to learn that a woman’s body is wonderfully intuitive and behaves with such reactionary physicality during birth, and the vagina, in many cases, is the MVP. While some women will birth without ‘injury’ or assistance, others will experience tears or require an episiotomy (a controlled cut in the perineum to allow space for the baby to be born). This is common and you will heal. 

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Even for those who don’t experience any tearing or require stitches, your vagina will still be quite swollen and sore. Keeping it iced and clean are some of the best things you can do for yourself during this time. 

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As you could be sitting down for long durations in those early weeks feeding, you’ll inadvertently place continuous pressure on your downstairs region. To alleviate swelling, try gentle movement (for example slow walks around the house) or sitting on a ‘donut shaped’ pillow. Something else that may help is to feed in the Side Lying position, which can support rest and pelvic floor recovery, plus be very calming for your baby.

How to care for your perineum

If you experience a tear, an episiotomy and/or you require stitches, it’s normal to feel sore and tender. You potentially have broken skin, fluid retention and bruising surrounding an incredibly intimate area of your body so be sure to go easy. Icing your vagina using cool packs and/or a specific type of maternity pads with inbuilt cooling can be hugely effective quite quickly. 

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For women who have stitches, paying extra attention to hygiene via adequate washing of your perineum is critical. Due to the position of your wound and the expulsion of lochia, the area surrounding your perineum and your vagina can be more prone to bacterial build up. 

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Regularly changing your pads, regularly changing your underwear and showering at least once a day in the first few weeks post birth are simple and effective ways to keep the area clean. In terms of keeping the actual wound clean, a perineal wash bottle is precise in terms of both targeting and cleansing sensitive areas. It can also be used to splash the area after a wee, as urine can lead to an uncomfortable sting.

After a Caesarean Birth

Caring for your body after a caesarean is critical as you’ll have a delicate abdominal wound to nurse and keep clean as it heals. You will also have to make some adjustments around the house as you may be immobile for a few days or weeks. This is a window of time where you’ll find value in the help from others, like; cooking, helping with the washing and taking other children to and from daycare or school. Maybe order your groceries online, just ensure someone else carries the bags inside and unpacks the food for you.

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Impacts to your body, what you can and can’t do 

In terms of what you can do … you can keep clean and comfortable. After the birth, after your catheter and IV drip have been removed and pending the level of feeling in your lower body, your midwife will help you to wee in the toilet and take a shower. This first shower can be intensely nerve wracking as you’ll probably see steri-strips covering quite a raw abdominal wound. Deep breaths! Warm, running water is fantastic for cleanliness so take this opportunity to enjoy it. Note; it’s advised to avoid soaps, fragrant oils and/or wiping or scrubbing motions around the scar area in the early days to avoid irritation. 

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After your shower, gently pat dry your body and belly and allow your midwife to redress your wound. From here, slip into some postpartum pants to accommodate your bleeding and some comfortable clothing that allows your body to move without restriction and your skin to breathe.

When you return home, the midwife will continue to change your dressings and check on the healing of your wound for the first days. After a few days (timings are different for all), you’ll be encouraged to expose the wound to fresh, clean air to allow the site to dry and scab. During this time, continue to shower but avoid soaps and irritating fabrics. Smooth, firm (but not overly tight) high waisted briefs are great. You may want to try the ModiBodi Postpartum Control Brief, SRC Recovery Shorts or the 3-in-1 Pregnancy, Postpartum & C-Section Original Belly Band to support your muscles coming back together.

Keeping your scar clean during this time can be made a lot easier with cotton balls and damp q-tips. Both can be used to softly pat or wipe away any dried blood or dampness.

What you can’t do? In the first 6 weeks this list may feel relatively long. To summarise, you should avoid driving, heavy lifting (including lifting any other children) and all other strenuous movement. 

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How to care for your scar 

Caring for your scar is about keeping it clean, dry and avoiding anything that could rupture your stitches, cause further pain or lead to an infection. Daily showers, clean underwear (especially if you’re wearing high-waisted briefs that cover the scar) and changing your dressing as instructed, are the basics. Keeping your scar warm with layers of clothing can also be helpful as it’ll promote blood flow to the area.

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While strenuous movement is not advised during the healing period, gentle movement such as slow walks around the house can help your circulation, digestion and muscle recovery. Pending the stage of your healing, gentle massage can also help to manage increased sensitivity and numbness, as well as reduce pain and restriction around the abdominal region. Make sure you check with your GP or midwife prior to commencing massage techniques. 

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Linked below is a video demonstrating the above. If or when you feel pain, or whenever you're in doubt - it’s always best to stop and contact your healthcare provider. 

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Above all else, rest, rest, rest. Lay down and put your feet up as often as possible! 

Further resources:

Aiding your recovery

Recovery is defined by; ‘a return to a normal state of health, mind, or strength.’ While physical recovery is important (i.e. caring for your scar), allowing space, patience and time for the entirety of your mind and body to recalibrate is an integral part of the postpartum period. Focus on finding your own rhythm. It won’t come overnight, but it will absolutely come with time.

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Food

Nourishing your body with warm, rich and comforting foods is a no brainer. Nutrition plays a pivotal role in digestion, lactation, energy (including sleep) and physicality. It’s unlikely you will have the opportunity to shop, cook and serve delicious nutritious meals directly after birth. Instead, outsource! Ask your partner and family and friends if they can bring you a meal (fresh or frozen). 9 times out of 10, the answer will be, ‘Of course!”. Another great option is to engage in a meal delivery service like Golden Month or New Bub Club, who specifically cater for women in postpartum.

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Making time for yourself to lean into nurturing self care such as postnatal massage is a helpful way to nurse your fatigued and vulnerable body back to health. Mother Roasting is another self care ritual worth looking into. Mother Roasting is based on traditional restorative technique that involves ‘warming’ the postpartum body while providing deep, relaxing, restful, restorative massage. It’ll allow your physical self to unwind which is exactly what you need during this all-consuming time of life.

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Setting Boundaries

Returning home with your new baby can be many things. It can be exciting, overwhelming, stressful, exhilarating … exhausting. While some new mothers will experience a bubble of utter love and deep connection to their baby, others may feel slightly detached from ‘life as they know it’ as waves of ‘newness’ entangled with sleep deprivation leave them feeling like a fish out of water.

Regardless of how you feel, claiming personal space and family time is important. Make sure to set times or designated days where you feel comfortable inviting visitors. There is no rush and plenty of time for meet and greets. For now (and for as long as you need it), your recovery comes first. Take time to bond, adjust, rest and just ‘be’ without worrying about anything else. This time is yours.

Postpartum contractions

After birth, it’s not uncommon to experience ‘after birth pains’ i.e. postpartum contractions. This pain is experienced as your uterus retracts (shrinks) to its pre-pregnancy size. The level of pain endured by women will vary. Some will feel almost nothing and others will find they're curled over and unable to talk. For around 7-10 days post birth, these contractions are likely to spur at random times, however they’ll usually ramp up when you’re breastfeeding, because it releases oxytocin, which causes your uterus to contract.

What are they? 

Postpartum contractions feel similar to cramps. They’re simply indications that your uterus is contracting and shrinking back to its usual size. This is a normal part of recovery. 

How long do they last? 

Usually speaking, most women will experience postpartum contractions for around 7 to 10 days following the birth. The contractions tend to be the most painful around the second or third day and from here they should ease off. 

What to look out for if they continue? 

It’s advised to contact your GP if you notice any of the following; 

  • If the contractions continue for more than 10 days following birth. 
  • If you notice the odour of your lochia is offensive or just unusual. 
  • If you develop a fever.
  • If the pain does not dilute with pain relief.
  • If your postpartum contractions feel less like muscle cramps and more like sharp/stabbing pains. 

Postpartum sleep deprivation

There is something to be said for the urgent need to wee 10 times or more per night during pregnancy. There is even a little something to be said for pregnancy insomnia, as insidious as it can be. While these sleep interruptions are irritating and emotionally testing, there is one positive side.They can help women prepare for aspects of sleep deprivation when their baby comes along. 

Be prepared for sleep interruptions in those early days 

During the immediate period after birth, your baby will be itching to feed, cuddle, develop and grow. These are all beautifully positive signs of a happy, healthy baby but it can be particularly hard on those breastfeeding. 

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You could be awake every 1-3 hours in the first 6-12 weeks (less or more for some), so it’s a nice idea to create the most comfortable, secure and inviting space possible for your overnight feeds. 

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Create a breastfeeding station: a cosy chair, a nightlight, a supportive pillow, and a caddy stacked with water, snacks, airpods, burp cloths and all your breastfeeding aids.

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How to work with your partner 

Every couple will differ in terms of how they support each other or how they manage the night feeds as a pair … 

  • If you feel your partner is best left to sleep so that they can care for other children in the morning, walk the dog or take the lead in the housework - perfect.
  • If you’d prefer your partner to share the load by taking charge of the dream feed (around 10/11pm) or doing a bottle feed during the wee hours - make it happen. 
  • If you can make it work and you’d prefer to alternate nights or perhaps designate the weekends to your partner - do it. 

The right solution is whatever works for you and enables you to operate. If you’re open with your partner and they feel as though they have purpose during the turbulent nights, you may find that your household feels cohesive and united. 

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Some ways a non-birthing parent can get involved.

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Exercise, sunlight, fresh air 

Overtime sleep deprivation can naturally compound with other postpartum factors such as changing hormone levels, learning to breastfeed and physically healing. Feelings of sadness, overwhelm and spiralling confidence are all things to look out for when your body is deprived of rejuvenating rest and deep sleep. You may feel teary, irritable, snappy or exceptionally foggy more often than not at times - and none of this is your fault. It’s an exceptionally tough phase, so try and be kind to yourself. 

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To help your mood find a smile, the release of endorphins through exercise and the release of serotonin through exposure to natural sunlight are two beautifully accessible ways to feed yourself a little TLC. Getting outside with your baby and into the fresh air can do wonders. While some days it may feel almost impossible to leave the house, it’s worth a go.

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Sometimes just sitting in a cafe and enjoying surrounding chatter can lighten feelings of loneliness and ease the discomfort that follows exhaustion.

Postpartum Nutrition

Similar to craving hydration, electrolytes and carbohydrate rich food after running a marathon, after giving birth your body will be hungry for hydration and nutrient dense foods. Think of foods and meals that champion iron (to cater for blood loss), protein (tissue repair), good fats (inflammation reduction), grains (energy and milk supply) and of course, fibre or food rich in probiotic properties (digestion and bowel movements). 

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If you’re breastfeeding, don’t be alarmed by big hits of hunger. The production of milk requires a lot of energy, and the more you fuel up, the more balanced and calm you will feel and the better your supply. Please note that adequate calorie intake is not the only factor affecting a woman’s milk supply. 

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To prevent your blood sugar levels from dropping too low, which may cause feelings of lethargy, fatigue and shakiness, be mindful to snack often throughout the day. Steer clear of sugars and processed foods and if you drink coffee, ensure you maintain good levels of hydration. A big water bottle will be your best mate. 

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Many women rave about the benefits that come with incorporating Chinese Medicines and herbs into their meals during the postpartum period. Bone broths and congee are highly regarded for their tissue repair qualities, and warming foods such as cooked vegetables, soups and eggs will favourably nourish your inner body with vitamins, minerals and omegas.

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Finally, research has shown that deficiencies in particular nutrient sources such as iron and zinc, can increase a new mothers risk of postnatal depression and anxiety. Loading up on red meat, poultry and hearty grains is a good way to ensure you’re nurturing your body with adequate meals in terms of their nutrient levels. 

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Food to prepare and have on hand

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Ask loved ones to support you by bringing you a fresh meal and/or freezer ready meal. Curries, soups, broths, salads loaded with leafy greens, roast vegetables and warm grains, pastas, quiche and of course, a few good ol’ lasagnes to line your freezer … just say yes! Think comforting, balanced and warmth inducing foods to stock up on. 

Throughout the day, snacks are king, to keep your energy levels sustained, your mood in check, your milk production humming and your inner body healing. Raw balls, lactation teas and cookies, nut and seed bars, vegetables and dip, cool fruits, wholemeal toast with nut butter or avocado, breastfeeding safe protein bars or smoothies and/or a warm cup of broth or soup. Postpartum is a time to cater to your body's needs like never before.

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Supplements to take

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Postpartum supplements can be a fantastic way to ensure you’re feeding your body with adequate vitamins and minerals to both sustain healthy levels and balance lingering deficiencies. While the postpartum experience is varied for all women, navigating sleep deprivation, adjusting to breastfeeding and supporting the tender state of your body, can be a good time to look into a supplement/s to ‘pick up the slack’.

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Supplements that hero safe and helpful herbs, vitamins and minerals can offer new mothers effective and efficient ways to care for their mind and body, while getting through the first few tough months. For mood and sleep (magnesium and saffron are wonderful), energy (vitamin B-12, iodine, iron), lactation (protein, vitamin D, vitamin K, iron), and digestion (probiotics, vitamin C, ginger, digestive enzymes). 

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Around the 3 or 6 month mark postpartum, it could help to test your bloods and check for any noticeable deficiencies, simply ask your GP for a referral. You might be completely fine or you might spot a very treatable issue which could save you from future health implications such as low iron, leading to fatigue. 

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Shop the memo range of supplements here and remember to check anything over with your health practitioner prior.

Further Resources: