Third Day Postpartum Assessment
The healthcare provider must check the flow of milk (lactation establishment) during the third day of the postpartum period, as this is the critical timeframe when lactogenesis II (copious milk production) typically occurs and breastfeeding support is most impactful. 1
Rationale for Milk Flow Assessment
The third postpartum day represents a pivotal window for breastfeeding establishment:
Lactation physiology: Milk "coming in" (lactogenesis II) typically occurs between 48-72 hours postpartum, making day 3 the optimal time to assess milk flow and address any breastfeeding difficulties 1
Evidence for intervention timing: Education and support for breastfeeding are most valuable when offered during both the prenatal and postnatal periods, with professional provider-led interventions during the early postpartum days significantly increasing exclusive breastfeeding rates at 6 months 1
Breast engorgement management: Day 3 is when breast engorgement commonly develops as milk production increases, requiring assessment and guidance on breast massage, continuing breastfeeding, and pain relief 1
Why Other Options Are Incorrect
Uterine prolapse (Option B): This is not a routine third-day assessment item. Uterine prolapse in the immediate postpartum period is extremely rare, particularly in primigravidas, and would present with obvious symptoms requiring emergency evaluation rather than routine screening 2, 3
Exclusive breastfeeding (Option C): While breastfeeding support is important, "exclusive breastfeeding" as a measurable outcome is typically assessed at hospital discharge and at 6 months, not specifically on day 3 1
Complete uterine involution (Option D): Complete involution takes 6-8 weeks postpartum, not 3 days 4. On day 3, providers assess uterine tone and fundal height to monitor for complications like atony or retained products, but complete involution is physiologically impossible at this timeframe 5
Comprehensive Third-Day Assessment
While milk flow is the answer to this question, the third postpartum day requires monitoring of multiple parameters:
Blood pressure monitoring: Every 4-6 hours while awake for at least 3 days postpartum, as preeclampsia may develop de novo or persist 6, 7
Uterine involution progress: Assessment of fundal height, uterine tone, and lochia to detect hemorrhage or infection 5
Wound healing: Evaluation of perineal tears or episiotomy sites for signs of infection or dehiscence 5
Laboratory monitoring: If abnormal before delivery, repeat hemoglobin, platelets, creatinine, and liver transaminases until stable 6, 7