Post partum flares with IBD
While you were impatiently waiting for your baby’s arrival as most parents do, you may have been doing some preparation and getting things together. Of course, no amount of preparation can compare to the experience of learning to care for your baby once he/she is here. You shouldn’t rush your body to get back into any state. But, definitely account for managing flares, symptoms, and complications so that you are at your best (as possible) during feeding times, playing, etc. Frankly, the last thing a new parent wants is to feel sluggish, tired, and with a headache during the day or nighttime when you need to handle a new born. Alas, what is one to do when a post partum flare hits after a months of remission during pregnancy?
Post partum flares
First things first, prepare beforehand for when your autoimmune disease flares after giving birth. There are several autoimmune diseases that flare a few months after giving birth. In fact, studies show higher lupus activity during the first year postpartum. Additionally, women report flares at around 6 weeks post partum with rheumatoid arthritis, fibromyalgia, and a number of other diseases.
Other autoimmune diseases that flare postpartum:
- rheumatoid arthritis (RA)
- grave’s disease
- multiple sclerosis MS
Of course, crohn’s disease and ulcerative colitis are at the top of the list. Postpartum care is quite difficult especially with an IBD flare.
Have witch hazel pads for lining your underwear to soothe any stitching. Also, wet wipes, compresses, and heating pads to help relieve some discomfort associated with post partum flares. However, if you have an episiotomy or more serious stretching, you’ll need a few more things including ice packs!
If you suffer with IBS you’ll find yourself relating to similar symptoms mentioned. For some women postpartum digestive issues involve constipation, while for others it is diarrhea. In addition, women suffer from GERD, LERD (acid reflux diseases), excess gas, bloating, and other digestive problems that are not directly seen as difficulties with bowel movements. However, severe constipation or diarrhea during a post partum flare can make the first few weeks with your baby a lot tougher. A piece of advice to all mothers, is to not ignore post partum digestive symtpoms. Post partum flares can trigger depression, affect your milk supply if you are nursing, and of course deplete your energy levels needed to care for yourself and your baby.
Crohn’s disease postpartum symptoms
Some women report not even having flares during or after pregnancy. Instead, diarrhea at least once per day with some sort of associated fatigue (most likely due to pregnancy and dehydration). Postpartum crohn’s can really take its toll on a new mama. The amount of diarrhea some women experience requires additional nutrition and electrolytes. Usually, new moms are tired and are set on devoting all their time to the baby. However, if you are experiencing anything ranging from mild Crohn’s symptoms to a flare you should focus on treating the symptoms and flare.
Colitis postpartum flares
In general, it’s women who suffer with ulcerative colitis. Luckily, most women go into remission during pregnancy. For the most part, the symptom that bothers new moms as during postpartum is constipation. Dry and hard stools are very common. While it can be easy to ignore constipation because you have other things to do such as care for a new born it is just as important as chronic diarrhea when treating. The toxins, bacteria, and substances that are meant to excreted in your stool are reabsorbed! Drink plenty of fluids, add lemon and apple cider vinegar to your water, and consult with your doctor if you are on medications.
Common postpartum symtpoms:
- irritated hemorrhoids
Post partum self care – IBD
The truth is self care with IBD is difficult even before babies! Once your baby arrives, try to get into a habit of soothing the baby with something that helps promote calmness for the both of you. This way you can get those few minutes to clean up your ostomy, irritated hemorrhoids, fissures, etc.
During pregnancy, and after child birth the body changes and skin stretches. The skin around the stoma changes in a similar way. It flattens outs, and the stoma protrudes less and can increase in diameter. Also, the peristomal skin contours (dips, creases, and curves) can change so that more care is required. Sometimes this involves switching from a flat flange to a convex one as the pregnancy progresses. After childbirth, the skin is less taut and has more wrinkles/creases than previously. So, the stoma may begin to protrude again. This makes it easier to empty now that the stoma is in eye range and doesn’t require extra lubrication.
- consider switching to a longer pouch to make emptying into the toilet easier
- bring a few ostomy bags in your hospital bag, it will change change size/shape
Postpartum hemorrhoids self care
Extra sheets and clothes: Keep extra sheets and clothes around post partum to feel fresh and a more comfortable. Diapers, pads, burp clothes, spilled milk, nursing pads, etc.
Squirt Bottle: The hospital provides these because they can really help a new mom out. Hemorrhoids don’t just make wiping after a bowel movement more difficult. Many mothers use a squirt bottle after they pee to help rinse the sore perianal areas.
Bath salts: Relax and provide relief to perianal pain from hemorrhoids post delivery. An epsom salt bath is a gentle detox for anybody with IBD, and provides relief to mom’s with post partum flares as well.
How to take care of yourself post partum when baby is crying?
Happiest baby on the block mentions 5 Ss. Crying takes a toll on parents and babies. Use these techniques to soothe yourself and your baby. When baby falls asleep and you get some time to yourself you can choose 1 self care task to take care of. For instance, consider warming up some broth to boost your gut health and nourish your body. Perhaps, taking a shower and getting into clean clothes to relieve some discomfort. Or even, doing your hair if you have been feeling down and need a bit of a pick me up while you rock being a new mom!
Self care after birth – IBD
Feeling beautiful when your body is achey and upset is one of the best things in the beginning. Something as minimal as a nice nightgown or robe can make a big difference. These will boost your comfort and self esteem and make you feel like the competent and confident mother you are.
Good self esteem can go a long way when dealing with a needy new born. Most importantly, eat as well as possible and make sure to drink PLENTY of water. This makes a big impact on overall mental and physical well being.
The first week:
The first week the baby mostly sleeps. The hardest part is your body, mostly sore, tired, and quite painful. Maxi pads, hormones, and sleep deprivation are all part of the first week. Your adrenaline, and maternal instinct kick in and help you manage the first week.
The second week:
Meanwhile, the second week is a bit different. The baby is awake for longer periods of time. Walks, swaddles, and more attention are part of this period. Entertain your baby with a playmat, clip-on mobile for the bassinet, or another safe toy when you need to take care of things.
As your baby grows you will develop a rhythm and get into a routine so that you can be comfortable taking time for yourself to do something as simple as using a remedy, tracking symptoms, or caring for your ostomy.
Post partum depression
Initially, there is extra help and hands with the baby. However, once you are left alone with the baby for the first time and begin to settle into the new reality it is normal to feel a bit scared. Anxiety and baby blues while common in the first few weeks should settle. It’s quite normal to feel nervous about rearing a child by yourself. But after all, the female body is built for this and your maternal instinct will kick in and be magnified sooner than you expect. Reach out to family and friends, send a text message with question and take all the help you can get. If you feel depressed tell those around you, contact your doctor, friends, and anybody that you can reach out to for help. Post partum depression is real and very serious.
Post partum weight loss
Remember to be gentle and give your postpartum body extra care. Losing weight after giving birth is a concern for many women. However, in the IBD world some mothers have the same amount of difficulty keeping weight on as others do losing it. Postpartum weight loss is affected by medications, treatments, and of course general health. Make sure that you are nourishing your body with nutrient dense whole food meals and let weight naturally shed as your body heals. Post partum flares as a result of heavy exercise, stressful diet, or weight worries may actually set you back from fitness goals.
Nursing + IBD
This study, observed the role of breastfeeding with disease activity in mothers with IBD. The findings revealed most women with IBD do not breastfeed nursing does not increase disease activity, although most women with IBD do not breast feed.
Should I plan to pump for my post partum flares? Tips or experience for breastfeeding with IBD
Mothers definitely agree that you should pump in the first months when milk production is very high. It helps get the baby accustomed to a bottle, for events where you won’t be able to breastfeed. Whether you have milk on hand for a day where you are feeling too sick to breastfeed, or an off night when you are going to an event, pumping when you don’t need the milk helps (alot). Start off, by pumping a couple ounces if you feel engorged, and this will help relieve some pressure. Just knowing that you have enough milk for those days or weeks with post partum flares helps calm stress and even post pone that dreaded flare!
Tips for post partum flares
- have clean comfortable clothing, (pants, pajamas, robe, nursing gown etc.) handy for
- when baby takes morning nap, prepare for your day by showering, looking for things you will need later like pads, witch hazel etc.
- stay hydrated and well fed. Drink broths, coconut water, and fluids to keep you from dehydrating as a result of the flare up.
- consider a wrap similar to an ostomy cover or underwear so that you can apply pressure and heat/cold as you need.
Do you suffer with another autoimmune disease and post partum flares? Comment on your experience below.