
Should I Take Multivitamin During The Postpartum Period? Should I Ask For A Biophysical Ultrasound?

I was wondering about post-natal vitamins. Do I need to take any if breastfeeding and if so, are there special ones or do I take the prenatal one? My vitamin has 600mg of calcium, 200mg of magnesium and 18 mg of iron and all the other multivitamins. Is it ok to keep taking this after birth?
My baby is barely moving - I know he has grown now and will not kick as hard, but I can barely feel him. Also, he does not move often, often 5-6 hours go without movement (that was the case before too, just now I barely feel him though). They did a non-stress test 2 weeks ago and he was ok. But now his moves are barely noticeable. Should I ask for a biophysical ultrasound? Or that is not needed and a regular ultrasound will do? Or should I even ask for another non-stress test and not an ultrasound? Thanks!
During the postpartum period, it is important to stay on a prenatal vitamin. You need these 'building blocks' for breast milk production and to help replace blood lost at the time of delivery. I think that the current vitamin is adequate assuming a normal diet otherwise as well.
With regard to fetal movement, here is what I tell patients:
1. After 32 weeks, fetal movement should be very predictable
2. In any two hour period, if you are paying attention, you should be able to feel movement (and any movement counts as a movement)
3. You should be able to get to 10 movements in 2 hours
4. There are patterns of movement throughout the day - more after meals and in the evening.
At 33 weeks, I would be mildly concerned about the lack of movement that you are describing. In someone with your report I would do the following:
1. Check a followup growth to make sure the baby is growing normally
2. Have them confirm that the fluid volume is normal
3. Schedule you for weekly BPP's (mainly because your self-reporting of fetal movement is unreliable as far as a measure of fetal well-being in between visits)
By the way, the BPP checks for several measures of fetal well-being: movements, tone, breathing, fluid volume. It is well correlated with fetal well-being - i.e. the chance of a bad outcome in the week following a normal BPP is extremely low.
I hope that this helps and please ask for clarification if needed!


Thanks
XXXXXX
1. A weekly BPP (often done without an NST) - which is an ultrasound
OR
2. Twice weekly NST's and once weekly fluid volume (often called a modified BPP)
Either of these are acceptable. Please let me know if this helps or if you would like me to expound further!


Also, is a weekly ultrasound in some way harmful to the baby or there is no such evidence? I definitely see how the benefits would outweigh the risks, so I hope my doctor would prescribe it to me, but just checking.
Thanks
XXXXXX
If there is not normal report of fetal movement, then something needs to be done to evaluate the fetus and the fluid volume.
Good luck and please ask if you have more questions!!

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