women
Following the birth, you may have a range of concerns about you and your baby . However, few of these are serious and are usually easily remedied or are part of the normal development of your baby or your recovery process. The concerns in this section may require more attention from yourself or a health professional.

Maternal problems

Mastitis

This painful inflammation of breast tissue most commonly affects breast-feeding women. There may be localized redness, hardness, and soreness in the breast; the breast may feel swollen and hot; and there may be flulike symptoms. Research shows that 10 percent of women experience mastitis within the first three months of giving birth, although it can occur up to two years after the birth.

Causes

Mastitis is either noninfectious or due to a bacterial infection. Noninfectious mastitis is caused by a blocked milk duct that allows milk to stagnate in the breast tissue. If bacteria get into the blocked duct, infectious mastitis can occur. If not treated, an infection can develop into a painful abscess.

What to do

It’s important to continue breast-feeding to help remove the blocked milk. Massaging the breast from under the arm (axilla) toward the nipple while feeding can also help, as can expressing milk after a feeding. Rest is advised and it’s important to drink lots of fluids. A warm compress on the breast and mild analgesia such as acetaminophen can relieve pain. If an infection is present, treatment with antibiotics is required. An abscess will need to be surgically drained.

Bladder problems

After a vaginal birth, you may have problems controlling your bladder. You may leak urine when you cough, sneeze, laugh, or move around, known as stress incontinence, or you may have a sudden, intense need to urinate referred to as urge incontinence or overactive bladder.

Causes

Both conditions are caused by the stretching and weakening of pelvic floor muscles and are exacerbated by excess fluid from pregnancy. Bladder problems should improve in the days and weeks after the birth as your pelvic muscles start to tone up.

What to do

Kegel exercises  to strengthen and tone muscles are recommended. If problems persist, your doctor may check that you’re doing the exercises properly and that there are no other symptoms, such as cloudy urine, pain on passing urine, or an odor, that could indicate an infection and require treatment with antibiotics. You may be referred to a urologist.

Postpartum depression

This affects about 1 in 10 new mothers. It usually develops 4–6 weeks after the birth, but can come on any time in the first year after the birth. If left untreated, it can persist and have a serious effect on a woman’s life.

Emotional symptoms include anxiety; irritability; tearfulness; panic; a prolonged low mood; an inability to cope; a lack of interest in appearance; difficulty in concentrating or getting motivated; and not bonding with the baby. There may also be feelings of inadequacy, guilt, rejection, and isolation. Physical symptoms include not sleeping; fatigue; headaches; lack of appetite; loss of libido; stomach pains; and feeling unwell.

Causes

The causes are unclear, but there are several factors than may increase the risk of postpartum depression. These are having a previous history of depression or mental health problems, experiencing a traumatic birth; or having relationship problems.

What to do

In mild cases, emotional and practical support may be sufficient. More serious cases are often treated with antidepressants and counseling or psychotherapy may be recommended.

Postpartum psychosis

This is a severe psychotic illness that affects 1 in 500 women and occurs in the first two weeks after the birth. The mother may be confused, unable to cope, may neglect her appearance, and forget to take care of her baby. In severe cases, she may have suicidal thoughts and could possibly harm her baby.

What to do

This needs treatment from a psychiatrist. The mother may be admitted to a hospital and will need follow-up care.

Perineal problems

In a vaginal delivery, the perineum, the area between the vagina and anus, may stretch and subsequently feel sore. If you had a tear that needed stitches or an episiotomy, this can be especially painful. If, after stitches, the area becomes red and swollen or you have throbbing pain, you may have an infection.

What to do

Warm baths are soothing, as are chilled witch hazel pads. Pouring warm water over stitches when urinating eases stinging, and Kegel exercises can help with healing. Your doctor may prescribe prescription medications or suggest a stool softener or over-the-counter painkillers for mild to moderate pain. Cooling gel pads can reduce swelling and bruising, and a pillow or inflatable swimming tube can make sitting easier. If your pain won’t go away or you have signs of infection (the wound becomes hot, painful, and swollen or you notice pus) contact your doctor.

Secondary postpartum hemorrhage

Excessive bleeding more than 24 hours and up to six weeks after the delivery occurs in around one percent of women with postpartum hemorrhage. The most common cause is retained tissues or bits of placenta, which may in turn become infected. The bleeding may be accompanied by symptoms such as fever, abdominal pain, and feeling generally unwell. Infection is treated with antibiotics and retained tissues are removed under anesthesia.

Congenital problems in babies

Down syndrome

This is the most common chromosomal abnormality, affecting 1 in 700 newborn babies. Babies with Down have some developmental delay and learning difficulties and an increased risk of other congenital abnormalities such as heart problems. Down causes a number of typical features, such as floppy muscle tone at birth; distinctive facial features such as upward slanting eyes; a single skin crease running across the palms; and a somewhat flat back of the head.

Causes

Down is due to an extra chromosome 21. Increasing maternal age makes Down more likely, although most are born to younger mothers, because overall more babies are born to younger women.

What might be done

Some parents who are told they are expecting a baby with Down syndrome choose to have a termination. Parents who continue with pregnancy usually find that their child has a good quality of life with advances in education meaning that many enjoy a degree of independence when older; life expectancy with Down is around 55 years.

Clubfoot

Clubfoot describes the condition when a baby is born with one or both feet turning down and inward.

Causes

doctors don’t know the exact cause of clubfoot.

What might be done

Treatment generally begins soon after birth. You may be referred to a pediatric orthopedist. The most common treatment is the Ponseti method, in which the baby’s foot is manipulated into the right position and a cast put on. The foot is repositioned and a new cast placed every week for several weeks. More severe cases may require surgery to lengthen the tendons. The baby will wear casts and/or a brace for some time after surgery to prevent deformities from returning. The results are usually excellent, with a normally functioning foot and ankle.

Hip dysplasia

About 1 in 1000 babies is born with a hip socket that is too shallow, meaning that the hip is easily dislocatable. It’s more common in girls than boys. After birth, the pediatrician will check the hips by moving them around and making sure they’re well situated within the sockets. If the condition is suspected or there is an increased risk of the condition, an ultrasound may be done.

Causes

The risk is increased if there is a family history of congenital dislocation of the hip, if a baby is breech, or if a baby has clubfoot.

What might be done

Treatment involves placing baby in a Pavlik harness for a month or two to keep the hip in place and allow the sockets to develop properly. If the problem goes undetected until the baby is walking, she will walk with a limp and will probably require surgery.

Cleft lip and palate

In this condition, which occurs in 1 in 700 babies, the two halves of the face don’t join properly, causing a gap in the upper lip and/or palate. A cleft lip can be symmetrical or, more commonly, asymmetrical, with the cleft on one side of the lip distorting a nostril. This may be detected prenatally, but isn’t always so it can be a shock initially. There’s evidence that extra folic acid in pregnancy can reduce the risk of having a baby with cleft lip and palate.

What might be done

Treatment may begin soon after the birth. Special bottle nipples and appliances may be used to aid feeding. Usually, at around three months, surgery is done to close the gap in the lips, and surgery to close the gap in the palate at about 6 to 18 months.

Congenital heart disease

Any abnormality involving the structure of the heart chambers or connections between the chambers can affect the function of the heart. Some heart problems are detected prenatally and you will be given advice about where your baby should be delivered and what will happen after the birth.

Septal defects

These holes in the heart consist of a small hole between two heart chambers; some types may cause a murmur that is picked up at birth. In many babies, a hole closes on its own.

Blue baby

Some babies are blue at birth because they have a major problem involving abnormal heart connections. This is an emergency. The doctor will do a series of tests and your baby may need surgery to repair the problem.

Patent ductus arteriosus

If the duct between the lungs and the heart fails to close after birth, oxygenated and deoxygenated blood mix. Treatment may be needed in the form of medication and sometimes surgery.

Undescended testicles

This occurs in around 3–4 percent of full-term boys. In most cases, just one testicle is undescended. Testicles often descend naturally within a year. Otherwise, surgery is advised since undescended testicles can affect sperm production and fertility and increase the risk of testicular cancer later in life.

Syndactyly

Sometimes babies are born with two digits, either the toes or fingers, joined together. This condition, called syndactyly, is usually caused by the soft tissues fusing together and is often linked to other congenital abnormalities, such as Down syndrome. Treatment is surgical and skin grafts are used.

Birthmarks

Marks present at birth may be long lasting, although they often fade over time.

Stork bites

These pink skin patches on Caucasian babies often fade by 2–5 years.

Mongolian blue spots

Some babies, particularly of Asian or American Indian origin, have extensive gray markings on the lower back, buttocks, and other areas that resemble bruises. Known as Mongolian blue spots, they fade over a few years. They do get mistaken for bruises, so it’s worth asking your pediatrician to make note of them.

Port wine stains

These permanent marks are caused by abnormal blood vessels in the skin and may occur anywhere on the baby. If one occurs on the face, your baby may be referred to a specialist for laser treatment.

Strawberry nevus

This is an overgrowth of blood vessels, but is not permanent and usually needs no treatment. The nevus, or hemangioma, looks like a strawberry, and although it can be upsetting, it vanishes in a few years. It appears days after the birth and grows over a few months. If it’s in a critical area, such as obstructing an eye or nose, your baby may be referred to a specialist.

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