Postpartum and Postnatal Care: Healthy Mummy for Healthy Baby

Congratulations, you are finally going to deliver your baby! After months of being very conscious of your diet and health, you must be excited to welcome your child to this world. However, it is still important to be mindful of your food and mental and physical well-being, especially the postpartum and postnatal care during the first 42 days after childbirth. 

Postpartum – related to the mother – and postnatal – related to the newborn – care is essential. This will ensure that you and your child are healthy. Find out how you can care for yourself and your little one after delivery.

Nursing Yourself Back to Health

Do you know that postpartum and postnatal care services at home are free of charge for all Malaysian citizens? 

Within 24 hours after childbirth, family members should notify a nurse in a nearby clinic so that the nurse can arrange for home visits based on your medical condition.

The nurse will thoroughly examine your condition during these visits. They will check vital signs, wounds, postpartum blood – also known as lochia – and breasts. They will also conduct checks on your baby, including body weight, temperature, signs of jaundice, urination, and bowel movement. 

In addition, the nurse will also guide you on different aspects of postpartum and postnatal care. These include breastfeeding, newborn care, nutrition, wound care, and exercises.

Traditional Confinement Practices in Malaysia

Apart from these routine medical check-ups, 86% of postpartum mothers in Malaysia also use complementary and alternative medicine. They are mostly based on traditional medicinal practices passed down for generations. The most used alternative treatments are manipulative body therapy (84%), including massage and body wrapping, and herbal medicine (33%). 

Each race in the multicultural demographics of Malaysia has its own traditional medicine practice. It also covers postpartum and postnatal care during what is commonly known as the “confinement” period. Typically, the primary focus of this period is to support the recovery of a new mother’s physiological and psychological functions, as well as the organ healing process.

Although the Malays, Chinese and Indians believe that confinement is for healing and restoring energy and health in mothers, the duration for each race differs – typically 44 days for Malays and 30 days for Chinese and Indians. 

All three races share the common fear of the “wind” and “cold”. They are thought to cause body aches, fever and bloating, and hinder recovery. To care for Malay mothers, midwives perform manipulative body therapy such as hot compress (bertungku), heat treatment (berdiang), herbal bath, whole-body massages, and body wrap (berbengkung/berbarut). Mothers avoid “cold” foods, such as cucumber and crabs, and consume hot foods or herbs like jamu or maajun. 

Chinese mothers stay at home throughout their confinement period and avoid bathing or using fans. After a few weeks, mothers may bathe in naturally cooled warm water mixed with herbs. Mothers should also avoid the consumption of vegetables during confinement since most of them are categorised as “cold”. Foods that can help expel “wind” or warm up the mother’s body include old ginger, ginseng, and red dates. 

Traditional Chinese Medicine (TCM) believes that childbirth causes a deficiency of blood, qi and yin, and blood stasis. According to TCM physician Ho Li Ying, new mothers should consume a Sheng Hua decoction within a few days after delivery to do away with blood stasis and clots, improve circulation, disperse “cold”, and support the expelling of vaginal discharge. This well-known traditional Chinese herbal formula can also help the uterus return to its normal size. It can also prevent the postpartum collection of blood in the uterus (hematoma). 

In the same way, mothers can consume a Ba Zhen decoction as a daily meal and herbal teas prepared using Dang Shen (Codonopsis pilosula) and jujubes to nourish blood and qi. 

Among the Indian community, mothers must only take a bath with warm water boiled with herbs. They would apply body scrub (lalur) made from herbs during each bath. Like the Malays and Chinese, the Indians avoid “cold” or “windy” foods. Herbs and spices that keep the body warm, such as cardamom and turmeric, are encouraged. Indian mothers would also receive daily massages using neem, mustard, or coconut oil before binding the mother’s abdomen with a long cloth (bengkung). 

Alternatively, postpartum care also involves several lifestyle allowances and restrictions. For instance, mothers may take showers, but they should dry their bodies and hair immediately after. Baths, on the other hand, should be avoided to prevent a genital infection.

Mothers should stay away from sexual intercourse during the first few weeks after delivery as the vagina, and other bodily functions need time to heal. They should also avoid strenuous or weighted exercises. Heavy workouts can cause a uterine prolapse when pelvic floor muscles and ligaments do not provide enough support for the uterus.

Mothers should wear comfortable clothes made with cotton, to ensure proper airflow in the house. Allowing fresh air into the house is essential for preventing bacteria growth, prominent in cold and stifling spaces.

Taking Care of Your Mental Health

Your mental health is equally as important as your physical health. According to a survey conducted in Malaysia, 80% of new mothers have symptoms of depression. Postpartum depression (PPD) is a type of mood disorder associated with childbirth. Symptoms may include an overwhelming sense of hopelessness, extreme sadness, anxiety, and inability to bond with the newborn. It usually occurs 6 to 8 weeks after childbirth and attributes to discomfort from physical changes, poor sleep quality and various uncertainties related to the newborn. Globally, 1 out of 5 women suffers from PPD.

Further analysis showed that unhealthy food consumption has the most significant impact on depression among postpartum mothers – unhealthy diets lead to higher body mass index, eventually contributing to depression. These results highlight the importance of having a healthy lifestyle and diet after childbirth.

Even though medical treatment programmes effectively reduce depression levels, many mothers don’t seek professional help when they experience PPD symptoms because they are ashamed or afraid. However, when left untreated, these symptoms can worsen over time and become chronic depression. When your depressive feelings start interfering with your everyday life, talk to your doctor as soon as possible.

Take comfort in knowing that certain lifestyle practices can go a long way in easing the symptoms of postpartum depression. These include performing deep breathing exercises, listening to calming music, reading a book, or regularly communicating with family members.

Aromatherapy — a holistic treatment that uses essential oils to improve — can also be help mothers unwind postpartum.

Interestingly, mothers can also experience anxiety due to insufficient breast milk supply. To synchronise your milk supply with your baby’s needs, you should breastfeed your baby only when they are hungry. Doing so will also enable you to establish intimacy with your baby. 

Childbirth is a joyous event, but mummies also experience immense stress and fatigue. Postpartum care is critical to ensure your physical and mental well-being so that you can take good care of your baby. As soon-to-be parents, discuss with your gynaecologist how you can better prepare for life after childbirth.