Following the birth of your baby (or babies) there are a variety of temporary physical changes that you may experience. The purpose of listing them is not to alarm you, but rather to reassure you ~ these are part of what can be considered normal in the postpartum woman. However, please note that not all women experience these changes, and even if one woman does experience one or more of these physical changes, she will not necessarily experience them all.

• Leaking urine. It's normal to leak a few drops of urine when you cough, sneeze, or laugh. This "stress incontinence" is a temporary nuisance that occurs while your bladder and pelvic organs are rearranging themselves back to their pre-pregnancy positions. Wear a sanitary pad for a few weeks until this annoyance subsides. You can do Kegel exercises to strengthen the pelvic floor muscles, which will help solve this problem.

• Profuse sweating. Another way your body gets rid of the excess fluids accumulated during your pregnancy is by perspiring more, especially at night. For the first night or two wear cotton clothing to absorb the perspiration and cover your sheet and pillow with a towel to absorb the night sweats. Excessive sweating is most prominent during the first week and gradually subsides by the end of the first month, although if you are breastfeeding, you may experience "hot flashes" or "sweats" well into the first few months of the postpartum period.

• Painful perineum. Your sensitive perineum has been stretched to the limit and it may possibly have been bruised or torn. If it has been cut into, it's bound to smart. Ask the nurse to instruct you on "peri-care". Heat increases blood flow and promotes healing; cold numbs pain and decreases swelling. Both measures are necessary to heal a traumatized perineum. The nurse will tuck an ice pack up against your perineum as soon as possible (it will feel so good). She will advise you about soaking in a warm bath and show you how to squirt warm or cool water over your perineum, using a "peri-bottle." Try using cool witch hazel pads between your perineum and the sanitary pad.

• Constipation. Your bowels may be as reluctant to work as your bladder is, and for similar reasons. The muscles involved in passing a stool may have been traumatized during passage of the baby. Drugs and anesthetics temporarily cause the intestines to be a bit sluggish; and your bowels were probably emptied naturally by the normal "diarrhea" that normally precedes birth. Besides these physical causes for problems with bowel movements, many mothers have a psychological reluctance to do any pushing with their perineal muscles, either for fear of hurting these tissues or because of a desire to rest them. Yet the sooner you get your intestines moving, the better you will feel.

• Gas and bloating. The bowel sluggishness that contributes to constipation also may make you feel gassy, especially if you are recovering from a cesarean section. Drinking and eating frequently, but in smaller amounts, and getting your body moving again, will ease these discomforts.

• Engorged Breasts ~ In the first couple of days postpartum you will notice only slight changes in your breasts. You may even wonder where all the milk is supposed to come from, as you produce only small amounts of the first milk, called colostrum. But then, around the third day, you may suddenly awake with breasts the size of a melon, and nearly as hard. You find that you've grown two-cup sizes overnight. This is breast engorgement. Some mothers find that their breasts become suddenly and painfully engorged, while others, especially those whose babies have been nursing frequently and effectively since birth, experience only a gradual increase in breast fullness. Yes, it's hormones at work again; as estrogen and progesterone levels drop in the days after birth, prolactin -- the milk-making hormone -- takes over. As the breasts begin to do their work, the tissues swell, partly with milk and partly with other fluids. These dramatic breast changes may not have been part of the lovely, peaceful breastfeeding experience you envisioned during pregnancy. After your baby learns to latch on properly and your breasts settle into a comfortable balance of milk production where supply equals demand, you will be well on your way to a gratifying, nurturing experience. If your breasts seem too full for baby to latch-on properly, use a breast pump or hand expression to soften your areola enough that your baby can latch onto more than just your nipple. The best remedy for engorgement is frequent breastfeeding. Nothing relieves breast fullness as quickly as a baby who is nursing well. Frequent feedings will also bring your milk supply in line with your baby's demands

• Sore nipples. Most sore nipples are the result of a baby who is not latching-on to the breast correctly. When a baby latches and sucks effectively, your nipple goes to the back of his mouth, away from the tongue and gum action that can irritate skin. Sore nipples are not an inevitable part of breastfeeding. If your nipples are starting to get sore, you need to pay some attention to what's going on during feedings. While you may want to call in some helpers (a knowledgeable nurse, a lactation consultant, an experienced friend, or a La Leche League Leader) for expert advice, you are the expert on your baby.

1. Be sure to break the suction before removing baby from the breast. Press down on the breast tissue, or slide your index finger inside his mouth between his gums. "Popping" a baby off the breast hurts!
2. Nurse on the least sore side first. Nipple pain usually lessens as the milk begins to flow. Switch to the other side after you notice signs of the milk ejection reflex (i.e. milk dripping from the other nipple, a tingling sensation in your breasts, and a change in the baby's suck and swallow rhythm).
3. Try stimulating the milk ejection reflex before you put your baby to the breast, using warm compresses, massage, or gentle pumping.
4. Breastfeed frequently ~ every two hours or so during the day. This will lessen engorgement and make it easier for baby to latch on.
5. Let your nipples air-dry between feedings. Express a few drops of milk and let them dry on the nipple. The immunities in your milk will help heal your skin.
6. Use a purified lanolin product (such as Lansinoh or Purell) on your nipples between feedings to keep the skin moist so it will heal more quickly. Avoid using preparations that must be wiped off (ouch!) before feeding the baby.
7. Wear an all-cotton bra that fits well, or go braless (if you feel comfortable doing so) under a cotton t-shirt. Avoid bras with plastic or synthetic linings that hold moisture against the skin.
8. Nursing pads with plastic in them can aggravate sore nipples. If a pad sticks to your breast, moisten it with water to release it and avoid skin damage.

1. Walk. Moving your body is likely to move your bowels.
2. Drink plenty of fluids.
3. Eat and drink natural laxatives ~ nectar (prune, pear, apricot), fresh fruits, whole grains, and vegetables. Avoid caffeine-containing foods and beverages, such as chocolate, coffee, and colas.
4. Relax. Don't worry that passing a bowel movement will pop your stitches. While straining may not be friendly to your hemorrhoids, you can start using your perineal muscles as you did before delivery.