I'll be the first to say that postpartum is a beast - it requires so much support and a lot of intentional planning to make things as smooth as possible. (I've dedicated an entire podcast episode just for this topic!) And even with all that planning, it's still hard.
After two postpartum recoveries, an impending third, and working with hundreds of postpartum mamas, I've been around the block a few times and there's one piece of advice in particular that I actually don't like very much: the 5-5-5 rule.
And you might be wondering, "you're going to advise against such a traditional thing as a functional perinatal nutritionist, women's health coach, and mom?"
Yes, yes I am. And this blog post will explain why I don't recommend the 5-5-5 postpartum rule for new moms and what I recommend instead.
Keep reading to learn:
Before we can even dissect the 5-5-5 rule, you need to understand what's going on in early postpartum recovery. I'm going to speak to you as if you were the mama.
First, the beautiful baby you spent 9 months growing is no longer inside your body, and neither is the placenta. Remember, the placenta is an organ that only exists during pregnancy and it's responsible for all of the hormones that keep you and baby safe, so once the baby and placenta are delivered, that's a massive change in physical and hormonal structure. You now have a wound the size of a dinner plate in your uterus that will continue to bleed for up to six weeks.
In response to the sudden cliff dive of essential sex hormones, two new hormones prolactin and oxytocin take the stage to initiate lactation, regardless of whether or not you plan to breastfeed.
If you had a vaginal birth, you most likely tore, and the tear could range from nearly nonexistent to absolutely horrific. If you had a cesarean birth, you had to endure the marathon of labor in addition to major abdominal surgery.
You might not be pregnant anymore, but your body has still been stretched to the max and will need months of care to return to a *somewhat normal* baseline. Your organs are still out of place, your uterus is still massive, and your ligaments and muscles are weak.
The nutritional demand from pregnancy has left you with major deficiencies that impact your cognition and emotional wellbeing, as well as physical symptoms like hot flashes, constipation, and hair loss.
And lastly, the pure physical trauma from birth (regardless of how "beautiful" or "easy" your birth was) was so intense that your body will be in fight or flight mode for weeks.
Whew. That's A LOT. Mothers are superheroes and deserve all the care and support during the 4th trimester. And, with the correct care from healthcare providers, family, and close friends, postpartum can truly be a transformative experience in the best way possible.
So where does the 5-5-5 rule come in to play?
This rule describes how new mothers should recover for the first 15 days after having their baby. The tradition encourages five days in bed, five days on the bed, and five days near the bed.
In those first weeks of the early postpartum period, the postpartum injuries, stress of the new baby, lack of sleep, establishing milk supply, and household tasks all take a toll on the mother's body and can hinder her recovery if she's not given ample time to rest. Moms who had a cesarean birth (c-section) also have to recover from major abdominal surgery.
All of these stressors can impact both short-term recovery and long-term health if mom is not given the support she needs, which includes a lot of rest.
That's why this postpartum recovery rule has been around for so long - it encourages moms to ask for the rest and help they need so they can simplify their daily routine and allow their body to recover as best as possible.
That being said, I actually don't encourage my mamas to follow the structured approach of the 5-5-5 postpartum rule!
After having two babies of my own, scouring decades worth of research, and supporting hundreds of moms in their own postpartum recovery, I've found a better way to help mamas recover after birth.
But before we discuss why, let's talk about both the pros and cons of the 5-5-5 rule so we have all the information.
Obviously this principle wouldn't be passed down from generation to generation if there weren't good things to come from it.
Some of the possible benefits of the 5-5-5 rule are:
While there are obvious benefits of the 5-5-5 rule, I've found that there are more drawbacks with it, as well as things that are just impractical and unreasonable. Here are some of the downsides of the 5-5-5 postpartum recovery rule:
If you have other kids at home, especially if this is your second baby, your other kids still have routines, needs, and emotional support that they need even though you just welcomed a new baby to the family.
If mama doesn't have a large support system to allow her the convenience and luxury of staying in bed for 15 days, those other children aren't going to get the physical and emotional attention they need.
This is especially difficult if the new baby is the second child, because the first child is probably still pretty young, they've been an only child their entire life, and they're going to have a lot of big feelings about this transition. (Even with my mom in town 24/7 for two weeks, my firstborn still really needed me once I came home from the hospital and I didn't have the ability to self-isolate in my room.)
Because movement is as minimal as possible with the 5-5-5 rule, this can actually set mama up for a longer recovery.
Gentle movement and regular blood flow is so important during those that initial 14-day period because it allows the body to shuttle nutrients around, keep mama's metabolism active, and minimize blood clots and tight muscles/ligaments/fascia. Staying dormant and horizontal for 15 full days does not support the body's natural process of healing from major wounds, especially if you have a c section scar to tend to. That scar requires active blood flow and gentle movement to heal properly, and the more you don't do early on, the longer and more painful your recovery could be.
The International Journal of Sports and Physical Therapy published an article in the National Institute of Health in 2022 (PMC9528725) with recommended guidelines for comprehensive postpartum recovery for female athletes and I believe that regardless of your physical activity prior to pregnancy or childbirth, these guidelines apply to you.
In this review, they outline their professional opinion for "maximizing recovery in the postpartum period" and they explicitly say that during the first two weeks postpartum, moms should do "safe and appropriate movement to facilitate healing," including "appropriate performance of diaphragmatic breath...10 minutes of asymptomatic walking...and pelvic floor physical therapy."
TLDR: movement is crucial in the first two weeks postpartum and should not be removed from your lifestyle!
Just like I mentioned above, in order to heal wound sites both internally and externally, the human body requires gentle movement to facilitate adequate blood flow to those wound sites.
Restricting movement as much as the traditional 5-5-5 rule encourages could affect blood flow to wound sites, which could impact the body's ability to clot blood properly, which could increase the risk of postpartum hemorrhage, even if you've been discharged from the hospital.
When advising on c section care, WebMD specifically says that "it’s important to get out of bed and walk around within 24 hours after surgery" because "this can help ease gas pains, have a bowel movement, and prevent blood clots."
I see this so many times with my mamas both with the 5-5-5 rule and the 6-week recovery period. Because it's an objective numbered timeline rather than a subjective "feel-it-out" timeline, they think that once that window is up that they're good to go and they end up doing too much too soon.
15 days (and even 40 days) is not enough time for your body to heal completely, and it's hard to remember that if you choose to strictly adhere to the recommended timeline.
Having mom go from nearly 100% participation to nearly 0% participation in the family routine is not only jarring on the entire family, but it's also unreasonable in today's day and age.
Maybe 200 years ago it would've worked more regularly, but in today's economy, most parents require two incomes and two active parents to keep the family going. Taking mom out of that equation in all areas of support (not just maternity leave) isn't practical, especially if there isn't adequate family or community support.
To say that this is the best and most recommended way of healing postpartum does a disservice to those who just aren't able to do it, like those without a partner. If following the 5-5-5 rule isn't possible for them, does that mean they're never going to heal completely from pregnancy and childbirth and they're just worse off? (Absolutely not; I will explain why below)
One of the best ways a new mama can support her physical, mental, and emotional recovery in early postpartum is getting fresh air and sunshine. It helps her circadian rhythm, brain development, and overall mood. Telling mama to stay in the bed or near the bed for a full two weeks removes this crucial part of recovery from the equation.
To make this recovery protocol possible, mama needs a strong support network to cater to her every need and make sure she doesn't need to do anything for herself, either than use the bathroom and change her clothes. For a majority of families, this just isn't possible.
Physical recovery from something as intensive and traumatic as pregnancy and childbirth requires more than just resting. While resting is a huge part of recovery, nutrition and lifestyle practices that support emotional well-being are also crucial for recovery, and this rule doesn't account for any of that. Some mamas may thing that 15 days of rest is enough to heal, when they're actually missing two other huge pieces of the puzzle.
LEARN MORE: The New Mama: A Holistic Postpartum Recovery Cookbook
This is so unfortunate, but at least in America, this type of protocol just isn't possible unless you are very wealthy and very well connected. The workforce doesn't support adequate paternity leave, childcare is outrageously expensive, and many businesses market their products and services to new moms in the hope to help moms "bounce back" as quickly as possible instead of encouraging them to take their time.
I am all for ancient wisdom, tradition, and promoting true recovery. (In fact, that's exactly why I wrote my postpartum recovery cookbook and started The Well Nourished Mama - we need more of that!)
However, instead of following the 5-5-5 rule to a T, I encourage my mamas to follow the principles behind the rule. In other words, it's more about the "spirit of the law" vs. the "letter of the law."
What does this look like?
Well, let's identify the principles of the 5 5 5 postpartum rule:
Now, let's take these key principles and create a much more effective postpartum recovery plan that is flexible, based on current research, and caters to each mama. Here's what I suggest:
Gentle movement around the hospital room after delivery (when your situation allows) and gentle movement around the house when you're home recovering. Sleep when you want, avoid active playing with other kids, and incorporate short bursts of slow walking when you can.
Ideally, you're able to achieve a slow 10-15 minute walk outside by two weeks postpartum, even if you had a c section. As always, don't push yourself more than your body allows, but don't remain immobile or dormant for long periods of time (other than night sleep of course).
Lots and lots of skin to skin snuggles. Experiment with different positions of breastfeeding if that's part of your plan. Take lots of contact naps if possible. Kiss them all over, hold them, take pictures, smile, enjoy that newborn smell. This stage goes so quickly and there's no better excuse for adoring your baby than the need to rest and bond.
Delegate as much housework as you can to your partner, family, and friends. Heck, set up a schedule if you have to! You shouldn't be doing anything except eating, refilling your water bottle, and changing your own clothes.
If you don't have a constant or substantial support system, give yourself some grace on some of the things you'd normally be doing. Instead of regular dishes, try using paper plates/plastic silverware/paper cups to minimize dishes. Leave the clean laundry in the laundry basket instead of putting it away (it's still clean and usable in the basket!). Ask your neighbor to take out the garbage for you for a few weeks. Get creative with how you keep your house going without putting strain on your physical and mental health.
If lactation is a part of your feeding decision for baby, this time is critical for establishing milk supply. Focus on frequent, regular feedings and sufficient milk removal. Work with a lactation consultant to understand the mechanics of breastfeeding and have baby evaluated for any latch issues, oral restrictions, or overall stiffness/tightness in the body.
Understand how your body works as a whole to support breastfeeding! I have tons of resources that will teach you how to support your milk supply through nutrition and lifestyle habits.
LEARN MORE: The Milk Mama Lactation Cookbook
LISTEN HERE: all podcast episodes about milk supply/lactation
Whether that's just your partner, your neighbor(s), your church congregation, your extended family, or your community, your support system is going to be so much help in any way possible. This support can also begin during pregnancy!
Invite your friends over for a "nesting party" and have them help you wash bottle parts, get your snack station ready, set up the nursery, and instead of gifts or registry items, have them pitch in to make months worth of freezer meals for postpartum.
Above all, no matter how many people are in your village, you need a postpartum plan. Check out this podcast episode to learn more about how I created my postpartum plan for baby #2 and snag the free printable checklist that goes along with it!
If you have the financial means, hire a postpartum doula to live with you for as long as you need. They can help with preparing meals, watching the older kiddos, and cleaning the house.
If you are the wife of an active duty service member (like myself), "TRICARE will cover up to six [home visits] by a certified labor doula. Labor doulas are trained, non-medical professionals who provide support for the birthing parent before, during, and a short time after labor." To learn more about these services and how to qualify, visit Tricare's website here.
You can also invite professionals like lactation consultants, nutritionists (like me!), and chiropractors to be a part of your team. Your postpartum health and recovery is so much more than your uterus shrinking, and it's important to have as many people as possible on your team supporting you.
If you'd like to have me be a part of your team, I have one-on-one coaching calls available and I also have my postpartum recovery cookbook that walks you through the first six weeks postpartum with nutrition, movement, and lifestyle habits that will facilitate the best recovery possible.
As you progress throughout your postpartum recovery, your activity levels should slowly increase in duration and intensity. Notice how I'm not even talking about exercise here, just light activities!
This includes things like walking around the neighborhood, household chores, and active playing with your other children. By the end of the first 15 days, your pain should be minimal, you should be able to move freely, and you should be able to tolerate a gentle 10-15 minute walk with baby around the block.
You will know if you're pushing yourself too much if you see an increase in bleeding/blood clots, pelvic pressure/pain, or lethargy.
"Okay, Brooke, I think I get it, but I still don't see how to actually apply this. What would this look like for the first few weeks postpartum?"
Great question! Here's an idea of how you could structure your recovery schedule after birth:
If you had an epidural, your medication is still wearing off; if you had a c-section, you're probably using pain medication around the clock and you have a fresh surgical wound on top of all the other trauma from childbirth.
If you're breastfeeding or pumping, you're trying to latch as frequently as possible and get your body into lactation mode.
Lastly, you're exhausted from labor and need lots of gentle nutrition and nourishment to recover.
With all of this, get as much rest as you can. You just endured childbirth and met your baby for the first time!
However, this rest does not mean "don't move" for 48 hours. Even if you had an epidural or c section, you should try your best to at least walk around your recovery room a few times a day and get that blood flow going.
(You're also going to need to go to the bathroom at some point, and the less you move, the harder the bathroom experience will be!)
If you gave birth at home, same advice applies: focus on walking around your room every few hours, even if it's just for a few minutes.
You'll still be bleeding a lot, but you should have sized down in your pad/diaper situation by now. Continue to walk around your room/home in short bursts and avoid carrying anything except for your water and your baby.
Spend this time getting as much sleep as your situation allows, bonding with baby, and nourishing your body back to health. For specific recipes geared towards the first week postpartum, check out my postpartum recovery cookbook!
Be intentional about supporting your circadian rhythm and nervous system by getting sunlight first thing in the morning (before you eat breakfast), getting fresh air throughout the day, and eating a high protein breakfast.
Continue to prioritize walking throughout the day. If you feel up for it, take baby on a short walk in the stroller to the mailbox and back.
Continue to prioritize nourishing your body back to health. Your nutrition at this early stage of healing to going to heavily influence the next 12 months of your life, so be diligent about staying on top of your calories, hydration, and nutrient-dense meals.
Begin incorporating diaphragmatic breathing into your daily routine for five minutes each day. This will help you reconnect your core to your pelvic floor and your diaphragm, as well as support your nervous system.
Most importantly, and I can't stress this enough, you need a postpartum plan. Most women prepare for pregnancy and especially birth, but besides a few freezer meals, postpartum is often forgotten about. I believe this is one of the reasons new moms struggle so much!
When thinking about your postpartum recovery and how you're going to support your needs while still maintaining a functioning household, there are a few areas you need to solidify.
You should be thinking about household work, care for the other children at home, your relationship with your partner, dividing responsibility with the new baby, meals, and expectations around visitors.
I created a FREE printable checklist to help you plan in all of these different areas and my podcast episode number 7, I talk about what I did personally to give you some ideas and practical tips of what might work for your family. You can access both of these free resources below!
LISTEN HERE: How I'm Preparing for Postpartum #2 (+FREEBIE)
Another important aspect of postpartum is how your health care provider is going to support your recovery. There is so much more that needs to be done outside of the 10-minute visit at six weeks postpartum, but unless you say something, nothing will happen. (Let's be honest, that check up is nothing close to a comprehensive postpartum visit!)
Check out my podcast episode below to learn more about working with your healthcare provider after the six-week checkup.
LISTEN HERE: Advocating for Your Health and Recovery in Postpartum
Lastly, there are so many other little things that you might not know you need or want until you're in the thick of it. Check out my blog post below to see more than 70 gift ideas for new moms and see if there's anything you might want that you haven't thought of yet!
READ MORE: 70+ Best Gifts for New Moms
Understanding the importance of postpartum healing is essential for both short term recovery and long-term health. Setting aside time for thorough postpartum planning during the third trimester of pregnancy can transform your postpartum experience during the fourth trimester, and understanding how to support your body during the first two weeks will make all the difference in your health and recovery, too.
The New Mama: Holistic Nutrition for Postpartum Recovery
Rest is the key to recovery after having a baby, but does the structured framework of the 5-5-5 rule actually promote a healthy recovery? In this article, learn why I don't recommend the 5 5 5 rule for postpartum recovery and what to do instead.
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