Postpartum Care with TCM: How to Optimize the Health of You and Baby
Updated: Oct 3, 2020
Shiaoting Jing, L.Ac., PhD, OMD (China)
Edited by Florence Lim, L.Ac., DAOM
Finally your baby has arrived! As new parents, you feel thrilled with joy in welcoming your newborn to the world. As a new mother, taking care of yourself and your newborn is very crucial. In Western medicine, the postpartum time period starts after the delivery of the baby; it is a time in which the mother recovers and returns to her pre-pregnant state while at the same time dealing with the changes of having a newborn in her life. This period often lasts 6-8 weeks. In Traditional Chinese Medicine (TCM), we call this time period “Chan Ru" (产褥). "Chan" means "childbirth," and "Ru" means "cotton mattress." Therefore, it is recommended to be on bed rest for 6 to 8 weeks following childbirth. This time period is also popularly called "Zuo Yue Zi" (坐月子), or "month-long period of confinement."
Below are some important things to keep in mind if you want to have a healthy, happy postpartum recovery!
Get adequate rest with an appropriate amount of activity.
In TCM, we believe that after the delivery of a baby, the mother's physical health may become susceptible to two states of imbalance: 1) a deficiency of Blood and Yin and 2) Blood stagnation. The delivery of a baby requires immense energy (Qi) expenditure from the mother, the loss of blood during childbirth injures her Blood/Yin, the sudden expulsion of the placenta depletes the body's Chong and Ren channels, and the blood vessels and channels are empty and prone to invasion by exterior pathogenic factors. Many medical conditions can occur during this time period.
When we speak of rest, we mean that during the first month postpartum, besides feeding, changing diapers, and attending to the baby's needs, the rest of your time should be spent in bed in complete rest. Here are a few tips during the first month to maximize your rest and minimize health issues:
Sleep when your baby sleeps. This may only be a few minutes or, if you're lucky, an hour, but all those minutes and hours will add up.
If circumstances allow, sleep with your baby during the first 3 months, which can save you a significant amount of energy and time. La Leche League provides some basic guidelines on how to sleep safely with your infant: https://www.llli.org/the-safe-sleep-seven/
Find someone to help you, such as a professional nurse, a well-trained postpartum doula, or caretaker.
Do not go outside. Though it may be tempting, really make an effort to stay in the house for at least one month. It's best to not invite too many family relatives and friends for visits in order to avoid you or the baby getting sick from pathogens. Remember that a new mom is like a house whose windows and doors have all been opened; it is very easy for intruders such as thieves, a cold draft, bugs, and germs to enter! So keep the doors and windows closed for now.
You can do simple, gentle stretches during this time in bed.
Pay attention to vaginal lochia. This is the vaginal discharge after giving birth that contains a mixture of blood, mucous, and vaginal tissues. It should be finished by about 6 to 8 weeks postpartum.
You still need to rest, but you may do some light house work. You can start venturing outside for some brisk walking or practice an appropriate amount of gentle exercises such as yoga, Pilates, Qi Gong, or Tai Ji Quan. Avoid lifting weights or doing heavy house work, however.
Strengthen the pelvic floor levator ani muscles and avoid uterine prolapse or leeking urine when you laugh, jump, or cough by performing kegel exercises.
Strengthen the abdominal muscles by practicing deep abdominal breathing or practicing sit-ups. It's best to work with an instructor who can guide you through proper breathing and movement mechanics.
Strengthen the lower back muscles through yoga or Pilates exercises. Again, best done under the guidance of an experienced instructor.
The mother should be getting stronger and able to resume more normal activities.
Postpartum Supplements and Important Nutrients
During childbirth, the mother loses an enormous amount of energy/Qi and Blood. On the other hand, her body needs to be able to produce adequate breast milk to feed the baby. Therefore, she absolutely needs to eat a healthy diet that contains a variety of fresh, organic foods as well as supplement with the following:
Prenatal vitamin with iron. It is important to replenish vitamins A, C, E, D, and especially iron to help maintain your energy levels. If you're breastfeeding, your iron stores supply your baby with iron for their proper development and thyroid function. Good iron sources include red meat, liver, clams, oysters, and dark green leafy vegetables. If you're a vegetarian, then spinach and black wood ear mushrooms are the best source.
Vitamin B12. B12 is required for proper red blood cell development, energy production, and helping to form our DNA. Babies with inadequate B12 levels are often more irritable and have an increased risk for failure to thrive, developmental delays, and poor brain growth. The best sources are animal foods, such as clams, tuna, liver, beef, and salmon. You can also obtain it from fortified dairy and cereals. Vegans are strongly advised to take a B12 supplement.
Omega-3 fatty acid. Research shows that infants of mothers with a high concentration DHA in their breast milk have improved brain and vision development. Even if you are not breastfeeding, there are many confirmed health benefits of EPA/DHA such as enhanced mental focus, reduced inflammation, and reduced risk of postpartum depression. Good sources include salmon, sardines, fortified eggs, and dairy (particularly pasture raised).
Choline. Choline is an organic, water-soluble compound. It is neither a vitamin nor a mineral. However, it is often grouped with the B vitamins due to its similarities. In fact, this nutrient affects a number of vital bodily functions. It impacts liver function, healthy brain development, muscle movement, your nervous system, and metabolism. Therefore, adequate amounts are needed for optimal health, especially during pregnancy and for breastfeeding mothers. Choline is also very important for infant memory and brain development. The best food sources are eggs, organ meat, liver, cod fish, salmon, and soybeans.
Vitamin D. It supports the immune system, brain, and nervous system, and reduces risk for postpartum depression and anxiety. The best dietary sources of vitamin D are fatty fish like salmon and tuna, liver, fortified dairy and orange juice, and egg yolks.
Recommended Postpartum Foods
Grains: millet, rice, oats, corn, barley, or other cereal grain, even whole wheat (if well-tolerated)
Protein: eggs, cod, salmon, sardines, shrimp, organic lean meat, pasture raised chicken, black chicken, sesame seeds, walnuts, pecans, pine nuts, peas and mung bean, black bean, avocado, etc.
Vegetables: Choose a variety of vegetables - dark green, red, and orange colored vegetables; legumes (peas and beans), starchy vegetables. For example, spinach, seaweed, nori, Chinese yams, broccoli, Chinese broccoli, asparagus, etc.
Fruits: Fruits may be fresh, canned, or dried, but not frozen. One serving recommended per day. Cantaloupe, honeydew, bananas, mangoes, apricots, prunes, red or pink grapefruit, etc.
Dairy: organic whole fat milk, yogurt, cheese
Foods to Avoid During Postpartum Time Period
Alcohol and smoking
Oranges, onions, and garlic may cause bloating and diarrhea in the newborn
Chives, hot chili, pungent foods
Frozen or icy cold foods and drinks of any kind (ice cream, water, soda, etc)
Sugary foods such as cakes, pastries, and desserts.
Overly oily or greasy, fatty foods such as bone broth without the fat removed
Fried or barbequed foods such as French fries, barbeque chicken
Ginseng or barley (ptisan) tea
Recommended Postpartum Diet: A Month to Month Guide
In TCM, we consider the body as being "reborn" again after giving birth, and therefore the mother's teeth can be weak and loose after delivery. The mother should eat soft foods as much as possible and make sure she is eating adequately to provide rich, healthy breastmilk for the baby. All food should be well cooked, soft, and easy to digest during the first month.
For mothers who had natural delivery:
1st meal post-delivery: best to drink boiled ginger tea with dark brown sugar, organic whole milk, steamed egg custard, and millet or rice porridge with goji berry or dates.
From the 2nd day on, the mother should be able to eat more normal foods such as boiled or poached eggs, steamed egg custard, pig's feet soup, chicken noodle soup, rib noodle soup, carp tofu soup. Remove any excess fat and oils from the soups because too much fat may give the baby diarrhea. Millet or rice porridge with dates is the main food in Chinese culture that a mother eats during the first month postpartum.
Recommended to eat three meals per day with soup two or three times; smaller, frequent meals are advised.
For mothers who gave birth through C-Section:
Day 1 post C-section: Drink hot/warm daikon/ginger soup to help the colon and digestive system recover after surgery.
Day 2 post C-section: hot/warm millet/rice porridge, chicken noodle soup, tofu soup, fish soup, egg drop soup, poached egg soup with seaweed. Can add sesame oil, green onion, and a little bit of salt to taste.
Day 3 post C-section: Eat normal foods as recommended in previous section.
Months Two and Three
After the first month, the mother can begin gradually eating normal foods, including fruits and salads. We do not advise trying to lose pregnancy weight during this time period since you are breastfeeding and trying to get the body into a more balanced state through healthy diet, rest, and an appropriate amount of gentle exercise.
Keep the body warm, but do not overly sweat. After childbirth, the mother should avoid exposure to the cold, as the channels and blood vessels are vulnerable and in an "open" state after childbirth are are therefore prone to invasion by external pathogenic factors. Also, the mother should avoid excessive exposure to heat, as sweating tends to consume and deplete one's Yin/Jing/Blood. Therefore, the mother should not go sunbathing and excessively sweat during the summer.
Keep balanced emotions, and calm the Shen/Spirit. Having a baby is wonderful! But at the same time, it involves many changes, both physically and emotionally. Learning how to be a good mother and taking care of your newborn can be very challenging. In TCM, we believe that during labor, the mother exerts a lot of energy and loses a large amount of blood, which can lead to Heart Blood deficiency. In TCM theory, the Heart houses the Shen/Spirit. When there is Heart Blood deficiency, then the mind and spirit have no place of residence, and the mother can more easily become depressed and anxious. Acupuncture and Chinese herbal medicine can really help to nourish the Heart and rebalance the body's Yin and Yang energies back to a more harmonious state.
The Role of Acupuncture and Herbs in Postpartum Recovery
Many new mothers ask the question: How many days after childbirth should they start getting acupuncture treatments and/or take the postpartum herbal teas? Here are our recommendations:
Usually we recommend that you start drinking the herbal teas two days after delivering the baby. This special tea is called "Sheng Hua Tang" modified, combined with a special yellow rice wine. From a TCM viewpoint, the herbal teas rebalance the body's yin and yang energy, nourish the blood, eliminate blood stasis, and strengthen Spleen and Stomach channels' digestive functions. From a western viewpoint, the herbs promote milk production, warm the uterus and improve uterine blood flow, help the uterus to shrink back to normal size, and rebalance the hormones and emotions.
We recommend that patients start coming for acupuncture two weeks following delivery to start a course of treatments called "100 days of postpartum care in TCM." Our highly trained professional practitioners will give a customized treatment to help each individual reach her goal of returning to a more emotionally balanced and physically healthy postpartum state.
The following conditions can be treated with Chinese herbs and acupuncture treatments:
Abdominal pain following childbirth
Persistent lochia discharge
Subacute and acute mastitis
Postpartum joint pain
Constipation and hemorrhoids after childbirth
Postpartum hair loss
Catch the video of our presentation below!