POST-PARTUM SUPPORT

Post-Partum Care

By Lauren Ellis

Every woman needs a ‘Nanny McPhee’ when it comes to post-partum support. This can take many forms: someone to assist in debriefing or processing the birth; someone to listen; someone to cry with; and someone to hold your hand and tell you that everything is going to be ok. Once a baby is born, there is often an immediate shift in focus from mama to the little one. This can be overwhelming, as pressures about feeding and pelvic floor healing coupled with the societal pressure to grin through the discomfort often leave mothers feeling guilty and unsupported. Poor recovery, pain and exhaustion are amongst the leading causes of postpartum depression and health issues. This is where people like Lauren Ellis step in.

Lauren is a physiotherapist specialising in women’s health, breastfeeding and pelvic support. Her own struggles on the journey of motherhood have shaped the way she helps others, and she is deeply passionate about supporting and empowering women in the perinatal stages.

Lauren works alongside a holistic team of specialists, including lactation specialists, GPs, breast surgeons, paediatricians, CFT physiotherapists, ENTs, doulas, yoga teachers and other women’s health physiotherapists. We chat to her about a holistic approach to this time in a mother’s life…

1. What is a women’s health physiotherapist?

Women’s health physiotherapists provide holistic, targeted care to help moms navigate, manage, and treat a wide variety of physical health issues that can spring up before, during and after pregnancy.

2. How do you help women during and after pregnancy?

During pregnancy, I look at things like pelvic pain, skeletal pain, restless legs, incontinence, constipation and preparing for delivery. After birth, I assist with mobility, positioning, wound support, breast care (such as addressing breast hardness and lumps), as well as tear and episiotomy care. No perinatal journey is the same - some women feel hard, ‘golf ball’-like lumps in their armpits, whilst others may struggle with scar management or returning to exercise.

3. What are your top tips for managing engorgement?

Engorgement refers to when the breasts become larger and feel heavy, warmer and uncomfortable. Generally speaking, most women will experience a period of 12 - 48 hours of hard, engorged breasts. When your colostrum phases into milk, it increases in quantity and ‘comes in’ roughly two to five days after birth. This is a normal hormonal change, regardless of whether you are feeding or not.

Ensure that you stay very well hydrated – aim for 500 ml of fluid a feed; develop a good latch with baby; feed frequently; and warm your breasts beforehand (for about two to three minutes – be gentle and do not burn yourself). Gently massage your breasts with frozen cabbage leaves after a feed (avoiding the nipple). If your engorgement is not settling and you are battling to feed, it is best that you find yourself a breastfeedingfriendly physiotherapist. They will use a therapeutic ultrasound and gentle massage to help relieve pressure and encourage milk flow for effective feeding.

4. How can women prepare and manage the dreaded ‘cracked nipple’ phase of nursing?

Cracked nipples are every new mother’s worst fear! This happens when the baby isn’t latching or is tongue-tied, or your flanges are the incorrect size. When nipples become cracked, it can feel like millions of little micro cuts, which can cause a sharp, shooting pain, swelling, bleeding, and blistering. While breastfeeding may be a sensitive affair, it should never be painful.

In order to manage cracked nipples, I would suggest correcting the latch with a registered lactation consultant; getting laser therapy done by a women’s health physiotherapist; airing your nipples out in direct sunlight for three to five minutes twice a day; and applying some APNO cream (you don’t need to buy all the fancy brand name creams).

5. What advice would you give to new moms leaving hospital after giving birth?

Make sure that you’ve passed stool before leaving the hospital. Once home, seek lactation support, and possibly consult a women’s health physio. Allow your body time to heal, but also keep moving. Gentle forms of exercise like restorative walking are best. Have a meal plan in place, and limit your number of visitors, as this can interfere with initial breastfeeding.

For more information or to get in touch, visit www.laurenellisphysio.co.za.