Postpartum comfort

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Specializes in Postpartum, Newborn Nursery.

Hi everyone, new member here. :) I am a nurse in postpartum and am curious about something. Our unit used to give our moms rice socks that they could heat up in the microwave to help with cramping, and also incisional pain; however, JCAHO and risk management made us get rid of those. We now have these disposable warm packs, but they barely get warm and only last for about an hour. Our patients have really not liked them so far and we go through them so fast. What do other places use?

Also, just curious about what you use for ice packs for perineal swelling right after delivery? (We literally put ice in a plastic bag).

Thanks for the info!

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Specializes in Nurse Educator; Family Nursing.

At a hospital where I take students, L & D has a blanket warmer. We use warm blankets for the abdomen for cramping. I know it seems extravagant laundry wise, but most mom's don't need a warm blanket 24/7, and the blankets stay warm for at least an hour when placed under the covers next to the skin. We also use ibuprofen in 600-800 mgm doses for cramping. Some caregivers prescribe the ibuprofen prn, others order it every 6 or every 8 hours around the clock.

For ice bags for perineum, we fill a glove with ice, knot the end of the glove and cover it with a washcloth before placing next to the skin. The ice melts in about 20 minutes which is the amount of time recommended for ice to be used for pain relief. Again ice is only the first 24 hours, and not for constant use.

Hope this helps. . .These are things we did when I was in practice as a nurse midwife, too.

We also used the rice sock (this was in the early 90's) for back pain in labor and cramping postpartum. Moms brought the item with them from home (childbirth educators had it on their "things to take to the hospital" checklist). I understand how JACHO could be concerned about this practice, though. Is the microwave disinfected between warmings? (C-section moms might be at greater risk for incisional infection if not.) There is always the potential for people to get burned by the item.

As an after thought, I have a bedsock that I use for shoulder and back pain. I purchased it back in the 90's. It's filled with silicone and works great and I know it's about 15 years old.

Sorry for the long post. . .just random thoughts of an old nurse...

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Specializes in Perinatal, Education.

I have been at hospitals that have fancy ice packs in peri-pads and others that had nothing. My favorite is to put ice in the newborn diapers. Kind of a home-made peri pad ice pack.

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Specializes in L&D, PP, Nursery.

At our hospital we put water in the newborn diapers and freeze them. Works wonders on the perineum. We also use "k-pads" for heat. It is a water filled machine with a heating pad type attachment that the temp is set by central and not allowed to be changed. Most patients like it very much.

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Specializes in Emergency Midwifery.

We have a few things we can use.

We use the gel hot/cold packs (not for peri pads). Of course they need replacing occasionally but that is usually because they walk out the door with the patients.

Expired saline bags (1000mls) get placed in the blanket warmer and can get used for hot packs (they are marked so they don't get used for IV).

We make our own ice peri packs out of frozen condoms and place them inside pads.

Nic.

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Specializes in OBGYN, Neonatal.

Our unit has the peri pad ice packs that you twist and activate. They only last about 30 mins but the moms like them. They do not absorb blood well so it makes the bleeding look worse sometimes.

We have the warm packs too, that are just like what you are talking about and I don't think they stay warm for very long but nobody has complained. I have heard that we have k-pads but I've not ever used one.

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Specializes in student; help!.

I used frozen maxi pads and they were fabulous. Toss a couple glugs of witch hazel on that bad boy and life is good.

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Specializes in L&D.

'At a hospital where I take students, L & D has a blanket warmer. We use warm blankets for the abdomen for cramping. I know it seems extravagant laundry wise, but most mom's don't need a warm blanket 24/7, and the blankets stay warm for at least an hour when placed under the covers next to the skin. We also use ibuprofen in 600-800 mgm doses for cramping. Some caregivers prescribe the ibuprofen prn, others order it every 6 or every 8 hours around the clock.

For ice bags for perineum, we fill a glove with ice, knot the end of the glove and cover it with a washcloth before placing next to the skin. The ice melts in about 20 minutes which is the amount of time recommended for ice to be used for pain relief. Again ice is only the first 24 hours, and not for constant use."

These are the things we do where I work too.

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Specializes in Community, OB, Nursery.

We have standing 'round-the-clock Motrin for SVDs and prn Percocet/Darvocet ordered.

For perineal pain, I like ice diapers - take a diaper, rip the top open & stick it under the ice machine, though I imagine water & freezing would be essentially the same thing. I don't like putting washcloths (over gloves) down there because our washcloths are really rough. :( This for the first 24 hours. Plus the usual dermoplast & witch hazel pads.

If mom wants something warm afterward, we can do sitz baths. My sitz bath was my best friend for about 2 weeks postpartum and a 2nd degree lac.

Our hospital recently 'outlawed' microwaved hot packs, mostly because there is no way to ensure a temperature that won't cause a burn like you can w/ a blanket warmer.

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Specializes in Cardiac Care.

When I had my baby they had peri-pads that were twist activated for cold. The L & D I did my clinical at this weekend uses frozen filled condoms and the RN I was working with had not heard of the twist cold peri-pads. Weird and ironic I thought. ( the condom part ) lol

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We also use peri pads cut up then rinsed in water and frozen. We call them "Fish sticks." We also have the fancy twist and break the seal cool peri pads but usually only use those right after delivery and then go the less expensive "fish sticks" later.

For heat we use Thermacare menstrual cramp pads. They really do work for about 8 hours and I have personally had to take them off b/c I felt it was getting too warm on my tummy. Most patients love them!!! Especially multips.

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To all of you nurses out there who struggle with perineal post partum cold therapy. I am a buyer in Purchasing and we have these same issues at our 7 hospitals in our state. We are working with Medline on a new product designed specifically for post partum cold therapy. It is is a slightly wider peri pad with 2 layers of "enclosed" poly filling. We used baby diapers with ice, like many of you, but the airborne particles when you open the diaper became a problem. We had to stop using them.

On the new pad, you place ice between the layers of poly and then close the end with a tape closure. The bottom layer of poly absorbs the melting ice and provides the cold therapy with protection to the perinium from direct ice. The top layer absorbs the lochia. It will be out very soon. If you are interested in this, please email me and I can get your information to the Medline staff. I anticipate the catalog # will be available in the next month or so. We were using this product from another supplier but their manufacturer went away. Our nurses loved them and we cannot wait to get them back again.

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