Swollen feet after birth: how long postpartum swelling lasts, what helps and the warning signs

Swollen feet after birth are normal for most new mothers, and the swelling usually goes down on its own within a few weeks. KKH's pregnancy planner says the water retained in your ankles, wrists and the rest of your body "will take about 4 to 6 weeks to resolve", and that you will pass urine more often until it does. Raise your feet when you can and walk a little every day. Keep drinking plain water, and cut the salt instead. Two kinds of swelling are not normal: one leg that is more swollen, painful, red or warm than the other, which can be a blood clot, and sudden swelling of the face or hands with a headache or blurred vision, which can be a sign of pre-eclampsia. Both need a doctor the same day.

Why your feet swell after giving birth

During pregnancy your body holds on to extra fluid. After the birth it has to get rid of it, and that takes time. KKH's confinement myths guide explains that "the kidneys will produce more urine in the first few weeks after the baby is born to remove the excess fluid that has accumulated during the course of the pregnancy."

Feet and ankles swell most because, as SingHealth's GPs explain, staying in one position for a long time "can cause fluid to pool in your lower limbs". Things that add to it after the birth:

• Long hours sitting to feed, with your feet down
• Less walking in the first days, especially after a caesarean
• Salty food, including some confinement dishes and sauces
• Tight clothing, which SingHealth says can restrict blood flow

How long swelling lasts after birth

Bring up any swelling that hasn't settled at your post-delivery check-up, which KKH's pregnancy planner says takes place six weeks after the birth, when your doctor also checks that your blood pressure is back to baseline.

What helps swollen feet and ankles

SingHealth's GPs list simple steps for mild leg swelling in both legs, and they work after the birth too:

• Raising your feet is what SingHealth calls "the most effective and simplest remedy". Get your legs above the level of your heart for 15 to 20 minutes, several times a day; lying on the bed with your feet on two pillows while your baby naps does it.
• Walking and ankle circles make your calf muscles pump the pooled fluid back up. After a caesarean, SGH's recovery plan has you walking with help soon after surgery, then out of your room three times a day.
• Compression stockings go on in the morning, snug but not uncomfortably tight, says SingHealth. KKH's physiotherapists also screen mothers on the obstetric wards and prescribe anti-embolism stockings to lower the risk of a blood clot.
• Salt is the one to cut. HealthHub's postpartum nutrition guide says: "To alleviate water retention, limit your salt intake by using less table salt, seasoning and sauces, and consume less processed foods." In practice that means going easy on soy sauce, salted fish and preserved vegetables.
• Plain water helps rather than hurts, as the next section explains.
• Loose clothes and comfortable shoes let blood flow freely; SingHealth warns that tight clothing around the thighs "can act like a tourniquet".

Feeding is the time you sit longest, so set up a footstool or a pillow on the coffee table where you usually feed. Our postnatal recovery guide covers the rest of the first six weeks.

The confinement water myth

Some confinement traditions say you shouldn't drink plain water because it makes you retain more. Singapore's hospitals disagree. HealthHub answers this directly: lactating women "are encouraged to drink about 12 glasses of water per day. Plain water is the best", with red date tea and other brewed drinks as an occasional change, limited to about a glass a day if they are sweet. KKH lists "I cannot drink plain water at all during confinement" as a myth and says adequate fluid "is advised especially if the mother is breastfeeding."

Too little water can lower your milk supply, says HealthHub, and its advice for water retention is to cut salt, not water. Our guides to foods to avoid during confinement and the confinement guide go through the other common rules and which ones Singapore doctors back.

Warning signs: when swelling is not normal

SingHealth's GP guide lists significant swelling in one leg "especially if it is accompanied by pain, redness, or warmth", and swelling with "shortness of breath or chest pain", as reasons to see a doctor straight away. HealthXchange says pregnancy is a risk factor for a deep vein thrombosis, and that a clot can become life-threatening if a piece breaks off and travels to the lungs.

Pre-eclampsia usually starts after week 20 of pregnancy, and SGH says blood pressure is expected to return to normal within a few weeks of delivery. If you had high blood pressure or pre-eclampsia, keep your follow-up checks. KKH lists sudden swelling of the ankles or feet, sudden puffiness of the face, severe headaches, visual disturbances and right-sided upper abdominal pain as signs to get help at once. See our pre-eclampsia guide for what doctors check.

Frequently asked questions

How long do swollen feet last after birth?

KKH says water retention in your ankles, wrists and the rest of your body takes about four to six weeks to resolve after delivery. Swelling that is getting worse, or still there at your six-week check, should be seen by your doctor.

Should swelling go down every day after giving birth?

It should go down steadily over the first weeks as your kidneys clear the extra fluid, KKH says, though it is often worse in the evening after a day of sitting. Swelling that keeps getting worse, or affects one leg only, needs a doctor.

Should I drink less water to reduce swelling during confinement?

No. HealthHub encourages breastfeeding mothers to drink about 12 glasses of water a day and says plain water is best. To ease water retention, eat less salt instead.

Do compression socks help postpartum swelling?

Yes. SingHealth recommends compression socks or stockings for mild leg swelling, put on in the morning and snug but not too tight. KKH's physiotherapists prescribe anti-embolism stockings to some mothers after delivery.

When is swelling after birth an emergency?

Call 995 or go to A&E if swelling comes with chest pain or shortness of breath. See a doctor the same day for one painful, red or warm leg, or sudden swelling with a severe headache or blurred vision.