Unfortunately, fatigue is part of the postnatal period. Although sleep deprivation is almost inevitable, utter exhaustion is avoidable. Here are a few tips and recommendations on how to manage your energy levels in the weeks and months after childbirth.

While some mothers feel “back on their feet” after just a few days home from the hospital, medical studies show that fatigue generally reaches its peak two to four days after you return home. Many women also go through a slump between the eighth and tenth week after childbirth when the accumulated lack of sleep really begins to cause damage. Only 50 percent of women feel that they have regained their usual energy levels within six weeks postpartum. Twenty-five percent more feel that they are back to normal only after six months. This means that a quarter of new mothers are still suffering from fatigue and low energy more than six months after childbirth. But then, remember also that two-thirds of babies aged six to twelve months, and a third of toddlers have trouble sleeping through the night….

Most mothers find that their biggest problem is lack of sleep. A sleep cycle is made up of four phases, which in total last about 90 minutes. The last phase, deep sleep, when physical recuperation takes place and the immune system works hardest, occurs mostly early in the night. Only after the full sleep cycle is complete can the body go into REM (rapid eye movement) sleep when we dream and process all the mental stimuli accumulated during the day. If a mother is woken during any stage of her sleep cycle, she will go back to its very beginning when she falls back to sleep, thus missing out on precious REM sleep. So even if you are sleeping the same number of total hours within a 24-hour period, you may still suffer from REM sleep deprivation.

Elevated hormone levels are notorious for disturbing sleep during pregnancy. These persist for the first weeks after childbirth. Add in a newborn’s erratic sleep patterns as well as the habits of your older children, and it seems that you can’t escape the burning eyes, chills, hunger for sweets, irritability, lethargy, difficulty in concentrating, and even depression that accompany “sleep debt.”

Fortunately, it takes just two or three nights in a row of uninterrupted sleep to cure these symptoms. Most importantly, fatigue is managed through prevention: by building up energy reserves that can be called upon in times of stress and by never letting yourself become completely exhausted.

Managing your time to make rest your top priority usually means a total reorganization of your normal routine. This must be planned well ahead of your delivery. Building a network of friends and family to whom you can assign tasks (household chores, baby-sitting, shopping/cooking/washing up after a meal) ahead of the baby’s birth is the most important step you can take. The secret to surviving the postnatal period is to delegate, delegate, delegate and to forget about what you cannot delegate.  

- Give your partner a list of daily responsibilities and leave him to do them at his pace and in the way he wishes to. Babies have an amazing capacity to adapt – and to express dissatisfaction. Rather than criticize, encourage the baby’s father to think about how happy he makes you when he helps you.

- Don’t assign yourself more than two tasks a day beyond those required in looking after the baby. Face each problem one step at a time. Your self-esteem will grow with each small solution.

- Keep at least one room in your home tidy and looking nice. You can go there when your spirits need a lift.

- If exhaustion threatens, get help! Ask your partner, mother or hire someone (a student for example) to come for part of the night or every other night to feed your baby expressed milk, so that you can sleep at least six hours in a row. Although it is not advisable to skip a night feeding when nursing, an exhausted mother’s urgent priority is to overcome her sleep deprivation.

- Go to bed very early. When trying to make up for lost sleep, it’s better to go to bed early rather than plan to sleep late.

- As soon as the baby is sleeping, drop everything and have a nap! Babies usually sleep longest after their bath and a feeding. Take advantage of this time slot.

- Organize your night feeds ahead of time. If you are breastfeeding and have the baby in bed with you or in a bassinet right by your bed, you can nurse while lying down. Just anticipate what you might need in the middle of the night (glass of water, snack, clean diaper, wipes, plastic bag for the dirty diaper). If the baby is in another room, prepare a comfortable chair with pillows and a blanket, along with a snack and drink for yourself. Set up a small lamp with a low-wattage bulb that you can leave on all night.

- Don’t forget to continue taking your pregnancy vitamin and mineral supplements.

- During the postpartum period, the need for good nutrition is greater than at any other time in your life. Make sure that you have good dietary habits, avoid fats and sugars, but DO NOT DIET for the first three months after childbirth. At this stage, your body needs carbohydrates for all sorts of hormonal and metabolic reasons. Strict dieting within the first three months after childbirth will lead to fatigue and failure.

- Try walking outdoors for an hour a day – this has an amazing effect on your energy levels.

- Recreation is almost as important as rest: schedule at least one fun activity each day. Plan ahead at least three occasions per month when you can go out alone with your partner or a friend. Try to organize activities with friends who also have young babies so that you can take turns watching the children.

- If your fatigue persists despite all the above measures, check with your doctor for possible anemia, potassium deficiency or thyroid malfunction – all causes of low energy.

Author:
Sylvia Brown wrote The Post-Pregnancy Handbook: The Only Book that Tells What the First Year After Childbirth is Really All About -- Physically, Emotionally, Sexually (Published by Griffin Trade Paperback; $14.95US; 0-312-31626-7) in response to her own frustration at the lack of comprehensive information for the mother in the weeks and months after childbirth.