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Caring For Varicose Veins and Hemorrhoids During Pregnancy & Beyond
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Caring For Varicose Veins and Hemorrhoids During Pregnancy & Beyond

            One very uncomfortable (although very common!) challenge during pregnancy is varicose veins. “Varicose” actually means “distended”, this term describes exactly what is occurring. Due to a variety of factors (such as the increased blood volume, hormonal changes, weight of baby restricting blood flow, etc.) a mom’s veins will distend, which can cause considerable discomfort if not actual pain. Did you know that hemorrhoids are another form of varicose veins, just that these are located in the rectum?

If you notice the presence of hemorrhoids and/or extended veins (typically on your calves, but they can pop out in other places as well), it’s very important to start doing something about it right away, in order to have the best chance of keeping them from becoming a greater problem as the pregnancy continues.

Here are some practical ways to care for your varicose veins, and help to keep those veins strong and discourage further distention:

  • Exercise regularly (daily walks are great!) to keep your blood flow circulating.
  • Make sure your bowels are moving well, in order to prevent straining from constipation (this makes hemorrhoids worse). Take some extra fiber and magnesium if needed, and make sure your daily diet includes high-fiber foods such as flax meal, oatmeal, etc.
  • Take time to elevate your legs higher than your heart 2-3x a day for 20 min.
  • Whenever you need to sit, keep your feet elevated slightly and avoid crossing your ankles or knees.
  • Try not to stand or sit for long periods of time: keep your position changing!
  • Sleep on your side to encourage good blood flow.
  • Consider extra support: good quality support hose for varicose veins or a “V2 Prenatal Cradle” support for vulvar varicosities. Support should be put on first thing in the morning before gravity causes pressure on the veins.
  • Hot, moist compresses for pain relief.
  • Take care not to massage the veins, as this can dislodge clots.

Supplements are another way to build up the vein wall strength and encourage good blood flow:

And finally, if you’re looking for some topical ways to get some relief from the burning, itching and heavy sensations that varicose veins bring with them, you may find some of these options helpful:

I hope these ideas and suggestions can be a help to you, and provide you with some relief from this pregnancy discomfort! If you have a recommendation of something that really worked for you, I’d love to hear about it!

Proactive Preparation Tips: Helping You Achieve a Successful Vaginal Birth
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Proactive Preparation Tips: Helping You Achieve a Successful Vaginal Birth

Proactive Preparation

Proactive Preparation Tips: Helping You Achieve a Successful Vaginal Birth

If you’ve read much about preparing for birth, you probably have realized that there tends to be two different “extremes” when it comes to how much or how little you do to prepare your body for the marathon of birth. On the one hand, there are those who feel strongly that you need to “trust your body” to do what it was made to do, and that the addition of herbs and other proactive methods give moms a sense that their body is broken and unable to work on it’s own. The other hand tends to view the whole process of labor and birth as an “accident waiting to happen”, and rushes to medicalize every situation (for example, routinely inducing labor at 41 weeks just because it’s a week past your due date).

My personal opinion (and take this as my opinion-as with anything, you must do your own research and make your own decisions about these suggestions!), is that there should be a balance between these two extremes. I feel strongly that a women’s body was designed to grow, nourish, carry and deliver a baby, and that you can have confidence that this a totally normal and natural process (and not a medical emergency!). But just like any other capabilities your body may have, these abilities can be supported, enhanced and enabled to do their job more efficiently, smoothly and successfully. With that mindset, I’m going to share with you some suggestions on how to support and prepare your body in order to provide you with a greater possibility of achieving a low-risk, normal, natural vaginal birth.

Some of the biggest factors that arise that prevent moms from their desired birth outcome include: pain in pregnancy that prevent them from moving well at the end of pregnancy, going so far past your due date that your care provider feels like an induction is necessary, a long early phase of labor that prevents mom from getting adequate rest and results in exhaustion (which often ends in transport from home and/or an epidural to provide needed relaxation), and a long pushing period that sometimes ends in surgical or assisted delivery. While there are varying factors in all of these situations that can all be prevented, there are MANY things you can do to reduce your risk of these situations occurring, if you just know what to be aware of and how to help your body to prepare!

  • Movement, Alignment and Positioning:

One key factor that makes a difference in your pregnancy comfort level, baby’s ability to descend efficiently, and your overall length of pregnancy/labor is the position of your baby in relation to your pelvis. I highly recommend you find a good chiropractor in your area (for those who are local you can find some recommendations when you click on the “Local Resources” tab) who is certified in Webster technique and works with pregnant moms, and get regular adjustments specifically throughout the last 6 weeks of pregnancy. If your pelvis and muscles are out of alignment, they can keep baby from being able to descend into a position that is optimal for triggering the start of labor, and the ability of the baby to navigate the birth canal, which can then cause labor to stall and/or make it more challenging for you during the pushing phase.

For the best explanation of position and how this can affect labor (and what you can do about it!), I highly recommend that you take the time to watch the Parent Class taught by Gail Tully at Spinning Babies. Once you’ve watched it, check out the Spinning Babies website for more tips and suggestions on optimizing your baby’s position. And finally, if you are getting near your due date (or are past your due date and are waiting for baby!), taking time to complete a few rounds of the Miles Circuit exercises has been shown to improve baby’s position and encourage labor to happen.

  • Exercise:

As they say, you don’t decide to run a marathon and then complete it tomorrow! I think it’s wise to go into labor with a similar mindset as one would in preparing for a long-distance athletic event. Regular exercises that help to strengthen your legs, open your pelvis (think deep squats and lunges) and build your stamina can play a role in encouraging baby to come in good time, helping to improve your ability to handle the rigors of labor and provide you with a much better recovery. Even if you’re only able to include ten minutes of purposeful exercise a day, it will give you great benefits. Here’s one to get you started: 10 Minute Pregnancy Workout. Long, brisk walks and swimming are also great exercises to consider including in yoaur routine.

  • Herbal Supplements:
    • Red Raspberry Leaf Tea has amazing health benefits, besides helping to prepare and tone your uterus making contractions more efficient. I have more information on this great tea in my post over here, and you can begin drinking one cup a day during the 2nd trimester, increasing to 3+ cups per day as you near your due date.
    • Birth Preparation Formula: I have personally had great success taking an herbal supplement during the last 5-6 weeks of my pregnancies that is specifically geared towards preparing your uterus and cervix for labor. Yes, I take it in addition to Red Raspberry Leaf tea. If you have a history of preterm birth, you would want to wait to start this until 36 weeks, and on the flip side, if you tend to go way past your due date, you could begin taking it at 34 weeks up until delivery. The moms that I have had take this tend to have shorter labors, earlier deliveries, and minimal postpartum bleeding (myself included!). There are several different brands available, though I tend to think the tincture forms work the best. My all-time favorite is the  Gentle Birth Formula. You will need 4 to 6oz in order to take it daily for 5-6 weeks, and it’s best to not consume the tincture in the late afternoon/evening, as it can cause contractions that may prevent you from sleeping!
    • Evening Primrose Oil or Borage Oil: The high GLA content in either of these oils can help to soften and prepare your cervix for labor, which can assist the body in working more efficiently once labor actually begins. You want a “mega” gel-cap with 1000mg or more per capsule, and this can be taken orally every day for the last trimester, and then also inserted vaginally at bedtime during the last few weeks of pregnancy.
  • Abdominal Support:

Some moms just need some extra support for their abdominal muscles, especially if they have had a few babies, or if their babies tend to be large. The muscles that support the uterus and help it to contract efficiently can become stretched (think of a rubberband that has been completely stretched out, and doesn’t quite return to “normal”), and are unable to “hug” baby enough to get a consistent labor pattern started, or even get baby low enough to obtain a good position to begin with! One way to work with this is to consider regularly providing your uterus with support, in particularly during the last 6-8 weeks of pregnancy. You can purchase a maternity support belt (Belly Bandit has some great, albeit expensive options), but many women find that using a rebozo or long scarf/piece of scarf works great, such as is illustrated in this post here  and another option here. The goal is to pull the uterus slightly up and towards you, mimicking the way your muscles naturally pull, with provides a firm, consistent support (which also relieves pressure from your back!).

  • Eating Dates!

The benefit of consuming dates during the last weeks of pregnancy has only recently been discovered. The suggested protocol is to eat 4-6 dates daily beginning around 36 weeks until you deliver. To find out more, you can check out the details of a recent study at Evidence Based Birth and see what Mama Natural has to say here.

With the exception of eating dates (this is newer option I’ve discovered!), I have personally tried all of the above suggestions for my own five pregnancies and births, and have seen many women successfully use these recommendations throughout my midwifery practice over the past 11+ years. I wish I would have known about many of these earlier in my practice, as I think it would have prevented more transfers and unnecessarily lengthy labors. Another side benefit to following these suggestions is that your body is that much more prepared and ready should an induction actually be medically indicated. While I rarely have reason to need to get labor started, when there is this need and the body is ready for labor, then there are many more options available that have a high likelihood of actually working (in case you’re wondering, one method many midwives use is the Midwife’s Brew, but you should never attempt this without discussing the details, risk vs. benefit, etc. with your care provider!). And if you end up needing a hospitalized induction, the above suggestions will also increase the chances that you end up with a successful induction and normal vaginal birth.

Understanding Gestational Diabetes (and your testing options)
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Understanding Gestational Diabetes (and your testing options)

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I recently worked on updating the information I give to clients on Gestational Diabetese screening during pregnancy. Compared to 12 years ago when I was first delving into midwifery studies, there is so much more helpful information out there about this subject! For this month’s blog post, I decided to share my updated “informed consent” handout (this is something that each client recieives in order to help them make a truly informed choice regarding their screening options), as well as some links that may be helpful for those who are wanting to research this topic further.

Informed Consent Regarding Glucose Testing and Screening for

Gestational Diabetes

What is Gestational Diabetes?

John Hopkins Medicine describes Gestational Diabetes as follows: Gestational diabetes mellitus (GDM)  is a condition in which a hormone made by the placenta prevents the body from using insulin effectively. Glucose builds up in the blood instead of being absorbed by the cells.

Unlike type 1 diabetes, gestational diabetes is not caused by a lack of insulin, but by other hormones produced during pregnancy that can make insulin less effective, a condition referred to as insulin resistance. Gestational diabetic symptoms disappear following delivery. Approximately 3 to 8 percent of all pregnant women in the United States are diagnosed with gestational diabetes.

Although the cause of GDM is not known, there are some theories as to why the condition occurs: The placenta supplies a growing fetus with nutrients and water, and also produces a variety of hormones to maintain the pregnancy. Some of these hormones (estrogen, cortisol, and human placental lactogen) can have a blocking effect on insulin. This is called contra-insulin effect, which usually begins about 20 to 24 weeks into the pregnancy.

As the placenta grows, more of these hormones are produced, and the risk of insulin resistance becomes greater. Normally, the pancreas is able to make additional insulin to overcome insulin resistance, but when the production of insulin is not enough to overcome the effect of the placental hormones, gestational diabetes results.

For more information on understanding Gestational Diabetes and Insulin Resistance during pregnancy, I highly recommend checking into these websites: EvidenceBasedBirth.com and LilyNicholsRDN.com, and by reading Real Food for Pregnancy by Lily Nichols (available through my office lending library).

Risks Associated with GDM for mother and baby:

Ÿ Increased risk of developing Pre-eclampsia

Ÿ Increased risk of developing Type 2 Diabetes

Ÿ Maternal injury

Ÿ Increased risk of Cesarean section

Ÿ Shoulder dystocia

Ÿ Macrosomia (infant weight over 8lb 13 oz)

Ÿ Neonatal hypoglycemia

Ÿ Neonatal jaundice

Ÿ Stillbirth

Ÿ NICU stay

Ÿ Birth injury

Predisposing Risk Factors can include:

Ÿ Pre-pregnancy BMI >25

Ÿ Family history of diabetes

Ÿ GDM in previous pregnancy

Ÿ Polycystic Ovarian Syndrome (PCOS)

Ÿ Chronic hypertension

Ÿ Maternal age over 25

Ÿ Ethnicity (African-American, Native American, Hispanic, South & East Asian, Pacific Islander)

ŸPrevious macrosomic infant

Ÿ History of Cardiovascular disease

ŸPoor nutrition

Potential Signs and Symptoms of GDM:

Not all mothers will have any symptoms, but these are indicators of the possible presence of GDM:

Ÿ Polyuria (excessive urinary output)

Ÿ Polydipsia (extreme thirst)

Ÿ Weakness

Ÿ Poor healing/susceptibility to infections

Ÿ Size large for dates

Ÿ Recurrent glucose in urine

Ÿ Recurrent yeast infections

Ÿ Ketones in urine

Ÿ Excessive weight gain

Ÿ Polyhydramnios (excessive amniotic fluid)

Ÿ Polyphagia (excessive hunger)

What are my testing options?

The American College of Obstetricians (ACOG) recommends universal screening for every mom between 24-28 weeks for pregnancy. Women with a history of GDM or have high-risk factors are encouraged to screen as early as possible in pregnancy, and typically Glucola is used as the glucose load. Due to the preservatives, dyes and other ingredients found in Glucola, other glucose options are offered, such as a dye-free glucose drink, or the option of consuming 28 jelly beans per the article published by American Journal of Obstetrics and Gynecology. If opting for either of these tests, it is recommended to eat an average of 150 grams of carbohydrates daily for three days before testing. The standard testing procedure is as follows:

  • 1 hour Oral Glucose Challenge test: This involves drawing blood for blood sugar testing one hour after consuming a 50g glucose load (non fasting). Blood sugar levels should be under 140mg/dl. If the blood sugar levels are higher than this, then a 3 hour test is recommended to confirm or rule out a diagnosis of GDM.
  • 3 hour Oral Glucose Tolerance Test (GTT): This four-step test is performed after fasting for at least 12 hours, and includes drinking a 100g glucose drink. Blood is drawn fasting, and then again at 1, 2 and 3 hours after drinking the glucola. If two or more levels are out of range, the mother is diagnosed with GDM. Consultation with a physician is recommended, and transfer of care may become necessary should diet changes be insufficient to keep sugar levels within target ranges.

During recent years, more physicians are becoming comfortable with an alternative to the above traditional protocol as described here by Rebecca Dekker at Evidence Based Birth (near the end of the article):

Home blood sugar monitoring: “Another alternative could be for people to monitor their blood sugar levels at home and discuss the results with their care provider. This is another controversial way to screen for GDM. We didn’t find any studies on GDM screening that compared home blood sugar monitoring versus a standard oral glucose drink.

However, we hear of some people using this method. Basically, they are following a similar path that people do when they’ve been actually diagnosed with GDM. Usually, after a GDM diagnosis, mothers monitor their blood sugar levels four times a day, once after fasting (first thing in the morning) and again after each meal (AGOG, 2018).

The ADA and ACOG recommend that fasting blood sugar levels should be <95 mg/dL, and post-meal blood sugar levels should be <140 mg/dL at 1-hour. Other recommendations for healthy blood sugar level targets during pregnancy are even lower. For example, the California Diabetes and Pregnancy Program (CDAPP) Sweet Success recommends fasting/premeal levels at <90 mg/dL and post-meal levels at <130 (Shields and Tsay, 2015).

Monitoring your blood sugar levels at home might be an option for someone who cannot take a glucose test because of the side effects, or prefers not to drink the glucose solution. However, home blood sugar monitoring is demanding and has some drawbacks. Mothers may have to purchase their own testing kits, and they have to remember to set alarms and carry their testing supplies with them throughout the day. Some people would consider it a major downside that blood sugar monitoring requires constant finger sticks, although others may not mind. Since home blood sugar monitoring is usually done after GDM diagnosis, there is no clear-cut standard for screening/diagnosing gestational diabetes based on home blood sugar checks. It’s important to discuss any results with a care provider to determine if testing can be stopped, if home monitoring should be continued, or if consistent high values mean that treatment for GDM is needed. Also, with this method, it is important that mothers follow their normal diet while testing, to get a “real-life” picture of their blood sugar results over time.”

While this testing method has gained acceptance in some medical communities, it is important to note that it has not been officially documented as a standard for diagnosing GDM. However, research is ongoing, and this method does provide you with an accurate day-by-day picture of how your body is responding to your normal diet. For clients who choose to do home glucose testing (whether in addition to or in place of the Glucose Challenge Test), I am happy to provide you with a glucometer, supplies and a chart that you can use to track your glucose readings for two weeks.

What if I have Gestational Diabetes?

Many women are able to control GDM through regular exercise and dietary changes. For clients who test positive for GMD, I will ask you to read Lily Nichol’s books Real Food for Gestational Diabetes and Real Food for Pregnancy, and we will discuss a plan for your care, including necessary diet changes and logging, home glucose monitoring, and exercise routines. If additional insulin is needed to control sugar levels, this will result in a transfer of care, as insulin-dependence significantly raises risk factors making a homebirth not a safe option for mother and baby.

Conclusion: Informed Consent

I highly recommend checking out these websites for more information on Gestational Diabetes Screening:

I also would encourage you, regardless of your choice to screen for GDM, to spend time reading Lily’s Nichol’s books (mentioned above) and implementing her dietary suggestions for pregnancy. Excellent information is available at her website: LilyNicholsRDM.com

As an expectant mom, it is your responsibility to choose first whether to screen for Gestational Diabetes, and if so, which method of screening to utilize. This document is intended to begin the conversation and aid you in researching what is best for your health and the health of your baby, and I welcome your further discussion and questions at any time.

In your Client Information Folder you will find a document entitled “Consent & Waivers for Common Procedures”, on which is listed screening for Gestational Diabetes. Please indicate your choice on this form, after you have spent time reading the risks and benefits of screening and the type of screening.

Did you find this information helpful? I’d love to hear about your experience with GDM and your testing/treatment options! If you’re wanting to research this topic further, here’s some links to other helpful posts, many written by moms sharing how they made a decision regarding GDM screening for their pregnancies (note, many of these posts are personal opinons shared for your consideration, though they may not include documented studies or be supported by general medical literature):

If you have more to add, or resources to share, feel free to comment below! 

Boosting Energy During Pregnancy
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Boosting Energy During Pregnancy

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If you’re like me, one of the huge challenges of pregnancy (especially early pregnancy!) is the severe lack of energy. Honestly, if you stop and think about it, your body is pouring so much into making a tiny baby that there just isn’t enough energy to do much else! While you might KNOW that your productivity can’t be measured by what you get done visibly, it can be hard when you feel like there isn’t enough of mommy to go around to all the needs at home.

In this post, I want to share a few tips that might help you get through pregnancy while keeping your energy levels up. There are many different factors in the equation, and honestly each one could be the subject of a separate post. For instance, a diet that is low in simple carbs & sugars, and has a good array of healthful fats and proteins can make a big difference for some women. To get more pointers on this, I’d highly recommend reading Lily Nichol’s book Real Food for Pregnancy. Another factor is getting some sunshine and movement (a walk outside can help immensely!). Yet another factor is finding ways to curb morning sickness (this is another topic on my mind for a future post).

While you may find that early on in your pregnancy you may have to forego your prenatal vitamins due to sickness (did you know prenatal vitamins can sometimes make you feel worse those first months?!? My personal philosophy is that if the vitamins keep you from keeping food down, then it’s best to scrap them for awhile!), once you’re able to take pills again, it’s key to find a quality vitamin. Getting adequate levels of minerals, as well as easy-to-absorb forms of folate, B12 and other vitamins can all contribute to boosting your energy levels. Check your labels to make sure that your vitamins contain folate (and NOT the synthetic form called folic acid), and that the B vitamins are methylated in order to promote absorption. This article on Folic acid vs. Folate may help you to better understand the difference, and why it matters.

Whether you can take your prenatal vitamins or not, I’ve found that supplementing with additional B vitamins can be a huge help, especially during the early months when your body is working so hard and fetal development is so rapidly taking place. During one of my pregnancies, I found that B vitamin injections provided me with some relief from morning sickness as well as boosted my energy levels, and when those weren’t available for me for my most recent pregnancy, I spent some time researching other options. I stumbled upon this gem, and found it to be an incredible energy boost: Max Stress B is a fermented, liquid B complex that provides a combination of B vitamins in a form your body can utilize quickly. Another helpful supplement is a B complex lozenge, which you can slip under your tongue before getting out of bed in the morning, and/or take throughout the day. Two brands I have appreciated are Jarrow  and Seeking Health. If you are only looking for B12, I find that these lozenges are great when you need an extra boost and mama doesn’t have time or opportunity for a nap: Jarrow B12. I even keep these on hand and use them when I’m up all night at births!

Low iron (anemia) can also be a reason for low energy, though sometimes this can even be corrected by the above B vitamins, as some types of anemia are actually caused by a B12 and folate deficiency (your midwife or care provider should be able to determine whether this is the cause by looking at your prenatal blood work). If your hemaglobin is actually low, then some suggestions would include supplementing with a plant-based whole-foods iron supplement such as  Garden of Life Iron,  adding daily doses of liquid chlorophyll, and even regularly consuming Blackstrap Molasses , all of which can help to gently increase your iron levels. If you need more iron suggestions and information, check out this article from Mama Natural on anemia during pregnancy.

These are just a few suggestions to get you started, and if you’ve found something that helps you with maintaining good energy levels during pregnancy, I would love to hear about it. And if you try any of these recommendations, let me know how it works for you. I love getting feedback and knowing what works for different people!

Probiotics: A Key for Fussy Babies?
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Probiotics: A Key for Fussy Babies?

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Note: I am sharing this post from my own personal experience, in hopes that it might encourage another mom and perhaps give you some ideas as you research options and solutions for colic and fussiness. This is not to be taken as medical advice, but rather an introduction to provide you with a foundation for further investigation and research.  I also want you to keep in mind that this post deals with just ONE aspect of what can cause extra fussiness in an infant…there are often a multitude of factors that can be part of any situation, so I’m just tackling this particular aspect in this post! The products that I mention are ones that I have used myself, and I am not receiving any incentive or gain by recommending these!

As I was preparing to welcome our fifth child at the end of last year, I was resuming my usual research into how to help prevent excessive fussiness in infants. If you’ve followed my blog for long, you know that all of my babies have tended to be fussy and “high maintenance”. Nursing challenges have been part of that, and so have issues with sensitive tummies (I’ve ended up needing to go dairy free at some point in my breastfeeding journey with each of them!), but there’s always been this underlying fussiness that has not tended to improve until they reached 6 months or older. This has presented a number of challenges, as it really takes away from the joy of adding a new baby, if the baby needs constant juggling, bouncing and soothing!

While reading anything I could find on how to help soothe fussy babies, I came across this article that talks about a study that showed b.infantis linked to reducing inflammation in infants.

Shortly after reading the article, I saw a post on a Mommy group that I am part of, where a friend of mine recommended an infant probiotic, noting that it had made a world of difference in the temperament of her baby.  Earlier in the year, I had a client who told me how her  youngest baby has been her happiest ever, and credited a nightly bottle of goats milk kefir as part of what made a difference.

I also kept running into articles such as this one on babies needing L. reuteri, and others that talked about how different probiotic strains can help with colic such as this one: Can Probiotics Soothe Colicky Babies?  Then there is this article that, while encouraging people to purchase their company’s products, has some good information on why fermented foods and probiotics are essential components of health, and in particular infant health:  Introduce Babies to Probiotics.

I found it interesting to think about how years ago our typical diets contained more fermented foods (think about the sauerkraut and other fermented products that were a necessity in the days before refrigeration), and how antibiotic usage is so much more common these days. We are still figuring out what all the possible long-term effects are caused by frequent antibiotic usage over the course of our lives, and how these effects may come into play on our children. Here’s some interesting data looking at long-term effects of antibiotics on our micro-biome: Long-term impacts of antibiotic exposure on the human intestinal microbiota.

After reading and researching these articles and more, I decided that it was worth trying for my baby, as it obviously couldn’t hurt! There are many different products available on the market, and it can be hard to determine which one is best. I was searching for one that specifically had the strains B. infantis and L. reuteri, and would also be easy to give (with five children I knew that I wouldn’t make it happen faithfully if I had to be mixing and syringe feeding anything!). I ended up trying Humarian Probonix that my friend had recommended, and I started giving baby Tirzah a few drops beginning on the third day after birth. I gradually increased it to the 6 drops recommended, and she’s been getting that daily ever since. Occasionally I will give her another brand/type, but the Probionix drops are by far the most convenient. While there may be many other factors at play, this baby has been my happiest by FAR, has had regular diapers, hardly any skin issues, and has not had nearly as sensitive of a tummy as my other babies. I have to think that regular probiotics have been one element in helping her, so I wanted to share this in case it can help another mom out!

There are plenty of other brands out there, and Mama Natural has a whole blog post devoted to discussing the pros and cons of these and other probiotics specifically for infants here, along with her own brand of infant probiotics which can be found here. Mary Ruth Organics also offers a good broad spectrum option here.  By reading about them, comparing ingredients and determining your own needs, you should be able to find something that can work for your baby. And if you’re looking for more info on the benefits of cultured foods for baby, there’s a great article here.

Have you given your baby probiotics? Do you feel like it’s helped? What else have you found beneficial for fussy babies? I’d love to hear about your journey! And if you end up using probiotics for your infant, I’d also be interested to hear what brand you used, and whether you saw it make a difference.

Resources and Info on COVID-19: Links, Practice Changes, Recommendations & More
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Resources and Info on COVID-19: Links, Practice Changes, Recommendations & More

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With the COVID-19 crisis in full swing, it can be hard to know where to go for good information. As a midwife wanting to give my clients the best, up-to-date, evidenced based care as possible, I have found it extremely challenging to navigate all the information being thrown around as everyone scrambles to learn what they can about this new virus. Even information from reputable sources can contradict each other, leaving one’s head spinning, and making you unsure of what measures should be taken to protect your clients and your loved ones from any unnecessary exposure, while also caring for the emotional and physical needs of expectant moms! I’m sure you’re probably in a similar boat, so I’m wanting to make available some information sources for you as you try to understand how the current crisis may or may not affect you, your baby, your care, and your birth.

Here are some links that I have found helpful:

Aviva Romm Series on Covid-19 Info

WHO info for Pregnant and Nursing Mothers

National Association of Certified Professional Midwives: Covid-19

WHO Info-graphs

While information is changing on a day-to-day basis, I am currently implementing the following changes to my practice in order to minimize risk for my current clients, and enable safe midwifery care to continue in my community:

  • I am available to answer any questions clients might have via email or phone/text at any time.
  • Pushing prenatal visits further apart to minimize person-to-person contact.
  • Practicing social distancing and limited exposure for myself and my family, and not seeing any clients if myself or one of my family members are sick.
  • I will be performing April prenatal visits in client’s homes to reduce the risk of transmission or exposure. My current client load is light as I am just coming off of maternity leave, so this feels like the best option as I look into ways to make my home office space more practical for office visits due to the stringent recommended disinfectant protocols.
  • I am not taking on new (non-repeat) and/or long distance clients during April. I hope to resume new client consults and prenatals in May, but will base this on information as it becomes available, as well as on how able I am to handle the extra time needed to maintain the possible new protocols, etc. Having to unexpectedly homeschool two children this month, as well as juggling the demands of a nursing infant (and trying to understand what risk there could be to her health) all combine to make my days extra full right now, without adding in the hours of research needed to stay on top of current medical news!
  • If you are just beginning to look into the option of homebirth due to concerns with exposure at the hospital, I would suggest you begin by reading these two links:

I am also asking clients to follow these guidelines:

  • Please reschedule your visit if you or one of your family members are experiencing any of the typical Corona symptoms, including:
    • Fever
    • Coughing
    • Shortness of breath
    • And remember that Covid-19 care is outside of the scope of practice for your midwife to advise you on, so please contact the proper medical authorities if you suspect you may have contracted it!
  • Try to limit your exposure to illness by practicing safe social distancing from ill persons, and practicing good hygiene and hand washing.
  • Due to the unknown severity of respiratory complications for both mom and infant, a home birth will be out of the question if you test positive for COVID-19 over the time you are in labor.
  • Realize that there may be some changes in birth practices as more information and studies become available, so feel free to reach out with any questions, and stay tuned as I continue to research and keep you up to date on current research and practice guidelines/changes. Some of these changes may include restrictions on children attending prenatal appointments, amount of people in attendance at your birth, etc. As time goes by, I hope to have more concrete information to guide our practice protocols for the safety of everyone.

I would also strongly encourage all expectant moms to do what you can to boost your body’s (and your family’s!) natural ability to fight any virus (there are other illnesses out there you don’t want to catch, as well!). I don’t think we need to just sit back and hope we don’t get sick-you can be proactive in assisting your body in being able to resist and fight illness right now. There are some great resources available that help you to consider how healthy eating (low sugar, lots of whole foods) combined with adding some immune-boosting supplements (such as high-quality vitamin C, regular vitamin D, probiotics and others) and regular exercise can help you and your family to stay healthy and strong. Here are some resources to get you started in thinking about the possibilities:

Advice from a Pediatrician

Aviva Romm on Natural Remedies

If you’re interested on hearing additional perspective on the crisis from a well-known, more “naturally minded” pediatrician, then you may appreciate Dr. Sear’s podcast series: Coronavirus Update: Are We Doing it Right? Pt. 1

And finally, some practical ways to help you handle the extra challenges from social distancing right now, tips on reducing anxiety, and helps in understanding more about the virus: COPE Updates on Covid-19

If you have found a source to be especially helpful as you navigate the news surrounding Covid-19, I’d love to hear about it. And if you are in a different area, I’d love to hear how your midwife/care provider is implementing changes to their practices. Blessings to all of you expectant mamas navigating this new territory during this time in your life-I know it’s a challenge, and I am committed to continuing to provide you with personal, safe, gentle midwifery care!

 

Tips for Boosting Your Milk Supply: Recipes & Supplements
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Tips for Boosting Your Milk Supply: Recipes & Supplements

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As I write this, I’m sitting here nursing my fifth child who will be 7 weeks old tomorrow. My experience with nursing and milk supply has been different with each child, as you may know if you’ve read this blog over the years. All of my babies have had issues with tongue and lip-ties, some of which were quickly resolved, and others where that wasn’t the case. One nursed well and gained quickly, another nursed okay, but I had to be very careful as my supply would tank quickly if I was extra busy or exercised much. Both of my boys struggled for months, with both of them needing to be supplemented and then fully bottle-fed by around 4-6 months (you can read about their stories and some of the things I learned and experienced here and here). With both of them, the challenges of poor nursing/latch also resulted in really low supply on my part. Those days were so long & discouraging. If you’re in the position of facing lots of challenges with feeding your baby, I totally get you!

So in preparing for baby #5, I had no idea what to expect. I did know I wanted to be prepared for lots of challenges just in case. We were also planning to do a significant amount of traveling when baby was still very young, and I wanted to make sure to have things on hand to boost my supply if it was needed, as I’ve learned from experience that it is MUCH easier to encourage a robust milk supply if you don’t let it drop too far to begin with! Before baby Tirzah was born, I spent some time researching additional options to add to my list of things to help boost supply.

IMG_3347 (2)This experience has been different yet! The first few weeks found baby gaining really slowly (she lost a pound after birth, and took three weeks to regain it!), which of course had me worried after everything that happened with my previous baby. But around 3 weeks old, things began to shift, and her suck got stronger and she began to gain weight! By now, at 7 weeks, she is a healthy, chunky 11 pounds, which means she has put on 2 pounds in just over 2 weeks! I thought perhaps there might be some other moms out there looking for ways to increase and improve their milk supply, so I’m going to share some of my favorite suggestions…some of these I found helpful when I was exclusively pumping for baby #4, and they have gone on to be helpful this time around.

If you are needing to establish or boost supply, your first step is to nurse frequently!! Lots of skin-to-skin time, especially in those first weeks, really helps to establish that supply, as well as nursing whenever baby is interested and for however long (and make sure the don’t go longer than 3 hours during the night those first few weeks!). Next, remember to drink lots of fluids. I would keep a water bottle at my bedside so that I would drink throughout the night (along with a snack!), which I continued to do until I was confident that my supply was adequate. Throughout the day make sure to keep drinking large amounts, as it really helps your body as it manufactures milk for that little one! And don’t forget that your body needs lots of nourishing calories to feed a second person-remember that your baby is still depending upon you for all of his/her nutrition, and baby is now bigger (and growing rapidly!), so now is not the time to cut back or diet. You actually need an additional 500 calories than what you needed while pregnant!

Besides these three things, here are some other supplements that I have found really give my milk production a boost (and just a side note, these are NOT affiliate links, so I’m not benefiting in any way by suggesting these!):

Maxi-Milk by Mountain Meadow Herbs has been one of my favorite supplements over the years. I began taking it twice a day around day 3 postpartum this time, just to give my body a boost since baby was loosing weight and I wanted to get my milk supply off to a good start as it started coming in. This is the one supplement I have always kept on hand after each baby, and any time I feel my supply dropping, I start taking it, and can see a difference within 24 hours. It’s especially helpful during those days when baby has a growth spurt and wants to eat all the time, and you can feel your body struggling to keep up with baby’s demands!

Legendairy Prouducts offers several different supplements for helping build and maintain milk supply. I had heard about them in the past year, and had them recommended to me by other moms who had tried them. I knew I would be dealing with more stress and less sleep while traveling with such a young baby this time around, so I started adding the “Liquid Gold” supplements to my daily routine. I’m now trying the “Cash Cow”, and both seem to be helpful! I was especially intrigued by their formulas and the lack of fenugreek, as my babies tend to have very sensitive tummies, and have not always done well with the traditional high-fenugreek content of other supplements.

Moringa is a green super-food type supplement, that has been used for a variety of health reasons, but has a history of helping to encourage milk production. Check out the link to find out more about it! I take it each morning at breakfast.

Spirulina is similar to Moringa, and is recommended for boosting supply and the nutrition-density of mom’s milk. This is the first time I’ve tried taking it regularly for this purpose, but it’s one of those supplements that has so many benefits that it sure can’t hurt to add it to a new mom’s daily regimen! Once again, click on the link to find out more of it’s benefits.

When it comes to adding some nutrient-dense calories, AND keeping good, quick snacks on hand for a hungry (and busy!) nursing moms, these two recipes below are my favorites. They include such things as nutritional yeast, oatmeal (oatmeal is an old-time favorite to boost milk supply!), flax-meal, coconut oil, and other great ingredients to feed and nourish a new mom and baby. The first recipe is one that my mother-in-law perfected during the year I was trying desperately to increase my milk supply for my little guy who had so many nursing issues. They are super yummy while also having great ingredients. When I was exclusively pumping, I could see first-hand how these helped to keep my supply up! The second recipe is a variation of a granola bar that a friend brought to me after I had my third child-ever since then, I always make a big batch of these around the time baby is due, as it is a wonderful snack to have on hand for those first weeks of nursing round the clock (I keep one beside my bed for nighttime feedings during the first few weeks!).

Grandma Martin’s Lactation Cookies

1&1/2 sticks softened butter
4 TBSP coconut oil
1 & 1/2 cups organic sugar  (I use coconut sugar)
5 TBSP Brewers Yeast
3 TBSP ground flaxseed (golden tastes the best!)
2 eggs
2 tsp Vanilla
1/2 tsp EACH salt, baking powder and soda, cinnamon
1 TBSP ground Fennel seed
1tsp ground Fenugreek (I grind these 2 together in coffee grinder)
1 & 1/2 cups flour (for Gluten Free cookies use 1/2 cup each of brown rice flour & whole oat flour and 1/2 cup of another flour)
3 cups rolled oats
1 cup coconut
Chocolate chips or raisins as desired.

Roll into balls, place on ungreased baking sheet. Bake at 350 for about 10 minutes. Makes 3 dozen. These freeze well, and taste delicious frozen!

Energy Bars/Balls

1 cup warmed honey

1 cup natural peanut butter (or almond butter)

½ cup oat bran (or oatmeal ground really fine)

1/2 cup golden flax meal

1 cup unsweetened coconut

1/3 cup seeds (sunflower, chia, etc.)

1 c. chopped nuts (I like to use a blend of mixed nuts, though just almonds or pecans work as well)

1/2 tsp Celtic or Himalayan Pink salt

2 + cups old fashioned oats (enough to make mixture thick enough to form balls or press)

1 cup chocolate chips

Mix all together and form into balls or press into a pan to form bars, refrigerate until firm. I like to cut these into bars and wrap them individually for a quick on-the-go snack.

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In closing, I’d love to hear about what has helped you to maintain a good milk supply for your little one(s)! If you try any of these supplements or recipes, let me know what your results are. Blessings as you nourish your baby today!

2019 Year End Update
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2019 Year End Update

img_3054.jpgDear Friends & Clients of Gentle Delivery,

As we come to the end of the year, I have to think about how blessed I have been to work with so many families during 2019 and to experience the special privilege of being involved as you welcome new life into your homes and families. Thank you for allowing me the opportunity to participate in these sacred times!

I’m also grateful for the women who have served alongside me as assistants.  Due to a variety of reasons (maternity leave, relocation, etc.) there were a number of faces to the assistant role, and I am thankful for each one! I also enjoyed getting to involve several students who were completing their requirements for certification, and I’m grateful for those of you who allowed these young ladies to participate in your care. A big thank you to Kristina, Marcile, Hannah, and Lynelle, as well as to my back-up midwife, RoseMarie, whose willingness to cover several times made it possible for me to enjoy some quality away-time with my own little family throughout the year.

It’s always fascinating to see how a year plays out and the variety that it can contain. Baby sizes ranged from 6lb 10oz up to almost 9 lb. Families served were expecting everything from baby #2 to baby #7, and I especially enjoyed serving several families for the second and third times-it’s special to be able to work with families for multiple pregnancies, and to see the older babies growing up! As usual, there were fast births (one little lady didn’t wait for me to arrive!) and those who took their time, and smooth pregnancies & births as well as those who experienced numerous complications—we were so thankful to see God answer specific prayers for the health of these moms & babies who are all thriving and doing well now.

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One of our recent playdates!

I’ve enjoyed the opportunity to continue connecting with clients during our quarterly playdates throughout this past year. If you haven’t joined us, please consider it! You can watch the Facebook page for updates, or email me to be put on the update list. It’s a great way to stay in touch and meet other moms and homebirth babies who are in similar stages of life!

My own family is doing well, and the children are growing up so quickly, making us want to treasure this time we have while they are young. The biggest event in our lives this year was welcoming Tirzah Raquel into our home on December 14! Once she IMG_0933decided to make her appearance she came quickly, and we were once again thankful for Lynelle’s help as there was no way our midwife could arrive in time. I had really hoped to try using the birth pool this time, and was so grateful for how this helped the intensity! (I’ll post her birth story on the website sometime this next year, so be sure to follow so you get the notification, or watch the Facebook page!) We are thoroughly enjoying time to relax and recover as we adjust to adding a fifth child, and our older children are thoroughly smitten with her. It’s so special to see how much they love having a baby sister to snuggle and love on.

IMG_2695    As 2020 begins, I’ll be taking some time off call to concentrate on my own newborn, and to do some traveling as a family. But I’m already looking forward to the anticipated arrival of babies as we head towards the summer months. In closing, thanks again for your support, and blessings as you head into the New Year!

~ Kelsey Martin for Gentle Delivery Midwifery Services

Welcome Baby G…A Local Home Birth Video!
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Welcome Baby G…A Local Home Birth Video!

Have you ever wondered what a home birth might look like? This fall I was privileged to help welcome Baby G into her sweet family, and the event was documented by Jill at Echos of Eden Photography  It’s the second time this year that one of my families have chosen to utilize the services of a birth photographer, and I am grateful for their willingness to share their experience! Enjoy this beautiful video, and feel free to contact me with any questions you might have after watching!

 

Pregnancy Health: Red Raspberry Leaf Tea
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Pregnancy Health: Red Raspberry Leaf Tea

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For a bit of a different post this month, I’m passing on one of my favorite ways to drink Red Raspberry Leaf Tea. Perhaps you’ve heard of this “women’s health” herb-there are seriously so many reasons why you should be consuming Red Raspberry Leaf on a regular basis, even when you’re not pregnant! It’s high in minerals and vitamins that your body needs, and has the added benefit during pregnancy of helping to tone and prepare your uterus in preparation for labor. In light of this fact, it’s wise to avoid this herb during the first trimester, as that is one season in which your uterus needs no extra stimulation. But once you reach the second trimester, I highly recommend making this supplement part of your daily routine. You can receive benefits by taking this herb in capsule or tincture form, but tea form is a great way to get the maximum benefit out of this particular herb.

If you’re wanting to learn more about the benefits of Red Raspberry Leaf, here are some great resources to check out:

One of the downsides to this tea, though, is that it doesn’t remotely taste like raspberry! And if yours does, the you’re drinking the wrong thing! If I drink red raspberry leaf tea straight, it doesn’t take long to be turned off-which is why today I’m sharing with you my favorite way to make it. If you have a favorite method, share it in the comments below so we can benefit from it, too!

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First, gather your ingredients:

  • Organic Cut & Sifted Red Raspberry Leaves (I use Frontier Co-op brand that I purchased through Amazon)
  • Raspberry Zinger Herbal Tea Bags from Celestial Seasonings
  • Lemon
  • Stevia or your choice of sweetener (honey also works)-pictured above is the NuNaturals Pure Extract Stevia that I use.
  • Purified Water

Fill a small pot with about 4 c. of purified water, bring to a boil. Turn off and add your tea: I like to use several re-usable tea strainers, that I fill with Red Raspberry leaves. For one batch, I use about 1/3c. total of loose leaves. Then I add four bags of Raspberry Zinger tea, to help improve the flavor. Stir this around, then cover and let steep for about 20-30 min.

Pour your concentrated tea into a glass pitcher (about a half gallon), and add the juice of half a lemon. Next, add a few dashes of stevia or other sweetener to taste. Fill the rest of your pitcher with purified water, and let sit until cool. Pour over ice, and enjoy! I store this in the fridge, and drink it cold, and I can consume so much more tea this way. Even my children love it!