supplements

Pre-conception Considerations: Things to Think About Before Getting Pregnant
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Pre-conception Considerations: Things to Think About Before Getting Pregnant

I’ve had several ladies reach out this year asking for information to consider as they hope to conceive sometime in the next few months. As I started replying to some of these inquiries, I realized that it might be helpful for others in similar positions to have some of this information at their fingertips. My hope is that some of these suggestions can help you to achieve the healthiest pregnancy possible as you actively prepare your body for the amazing stress and strength that growing a baby places on your entire system-this is certainly worth seriously considering and prepping for, and I can guarantee you won’t regret any time and effort you invest before pregnancy!

Let’s start at the beginning:

  • Educate Yourself on Your Hormones and Cycle:
    • Understanding how your body works, and how to read your fertility signs (temperature, cervical mucous, etc.) can make a huge difference in both your ability to conceive and in determining an accurate due date. There are some disorders or challenges that can be identified early on if you have been keeping track of your fertility signs, and this can save you time, money and heartache if you know what to look for and when to get medical intervention. Simple things such as knowing you ovulate “late” compared to traditional due date calculators can save you the challenge of being considered “overdue” when you actually didn’t have an accurate due date to start with!
    • For better understanding, I highly recommend the book Taking Charge of Your Fertility by Toni Weschler. This guide helps you to really get to know how the women’s body works, how to chart your cycle, and how to understand all the information you are pulling together. The TCOYF app is also a great way to track your cycle, and it’s free! Another helpful book on the subject is The Fifth Vital Sign by Lisa Hendrickson-Jack (as a disclaimer, I JUST ordered this book and have it sitting in my “to read” pile-it looks great, but I haven’t read through it yet!).
    • For those particularly wanting to use fertility tracking as a guide to Natural Family Planning, the Art of Natural Family Planning Student Guide is a good way to delve into some of the details, which can also be an aid in achieving pregnancy.
  • Birth Control/Hormonal Contraception:
    • If you’ve been on hormonal contraceptives, it’s important to remember that it can take up to three months for normal cycles and fertility to return. The sooner you can get off any hormonal BC the better for  your overall health! Aviva Romm has a great article on fertility issues after hormonal contraceptives and getting off the pill here: Post Pill Reset and I highly recommend the new documentary The Business of Birth Control for better understanding of how hormonal contraceptives can negatively affect your overall fertility and health while providing an introduction to other non-hormonal options.
  • Deal with Any Current Health Concerns Now
    • Do you have weight you need to gain or loose? Start understanding healthful eating, and work on that now BEFORE  you add pregnancy to the mix! I’ll add more on diet below, but healthful eating habits should begin now, and will provide a great foundation for the demands of pregnancy on your body.
    • Are you currently on any medication that could have a negative effect on a developing baby? Many health challenges (such as elevated BP) can be managed by diet, lifestyle and supplement changes, and these are best achieved before pregnancy. If you’re hoping to have a low-risk delivery at home, this is even more important to consider, as any compilation of medications can increase your risk and rule out homebirth. Also, remember that you should be under the care of a physician or medical provider before attempting to wean off any medications, especially for BP, anxiety, depression, etc. You need to do this safely, and sometimes these changes can take time!
    • Thyroid health: many women these days experience thyroid imbalances, and it can make a huge difference on your ability to carry a healthy pregnancy if you are on top of these imbalances before pregnancy, and have a provider who can work with any sort of needed thyroid medication especially during the early days of pregnancy. Learn more about thyroid and it’s effect on pregnancy by reading Aviva Romm: Thyroid in Pregnancy
  • Learn more about healthy food choices:
    • There are so many things to learn about how food and our daily choices affect the way in which our body works! From supporting the organs, optimizing brain function, regulating blood sugar…the food we eat has so much to do with how our entire body operates. Add to this the growth and development of an additional entire human body and placental organ, and you’ll start to get a glimpse of how important solid nutrition is to your body and that of your future baby! The best book on the subject that I have read is Lily Nichol’s Real Food For Pregnancy, and I would encourage any woman who is pregnant or considering pregnancy to read it and really digest her wisdom and suggestions. Lily covers more than just diet, and her overall suggestions when it comes to regulating blood sugar, exercise guideline, and prenatal vitamin recommendations are all amazing and educational.
  • Support your Liver!
    • This might seem like an odd topic, but did you know that your liver performs under extra stress during pregnancy? There are many pregnancy complications that can arise when the liver is not functioning well, and there are some studies that suggest that a healthy, supported liver can reduce the amount of morning sickness a mom might experience. With all of these factors on the table, I highly recommend either purchasing a liver cleanse and using it a few months before getting pregnant, or at least taking a high-quality Milk Thistle supplement for a month or two before conception, and continuing to take it during the first trimester. Here is an article that addresses this further: Milk Thistle for Morning Sickness
  • Prenatal Vitamins:
    • Start your research on prenatal vitamins now, and begin taking them daily. Remember, the critical time for baby’s development are in the early weeks, so your body needs to start getting a good foundation of nutrients so that your body is ready to nourish the developing brain, organ and other nutrient needs of a growing tiny baby. Many moms end up sick enough that they cannot continue taking prenatal vitamins during part of the first trimester, so having this foundation laid ahead of time is key!
  • Further Reading:
    • If you’re wanting to read more about how to optimize your fertility and prepare well, many providers recommend the book It Starts with The Egg. Rebecca Fett goes into detail about diet, supplements and other foundational principles of helping your body to achieve healthy conception!

In closing, I hope you’ve found these suggestions informative! I’d love to hear what else you would add to this list, and what has helped you as you’ve prepared for pregnancy. Maybe you’re not pregnant yet, but you’ve found a great resource…or maybe you followed some preconception guidelines and are currently in the middle of pregnancy…either way, I’d love to hear what you found most helpful!

Anemia During Pregnancy & Postpartum: what it is & what to do about it
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Anemia During Pregnancy & Postpartum: what it is & what to do about it

If you are like many moms, struggling with low energy can be a challenge during pregnancy. Understanding how to support your body as it faces the increased demands of growing a baby can help you to have a better experience, and improve your recovery during the postpartum weeks. For many moms, the lack of energy is due to low hemoglobin levels, which can be linked to low iron. There are many ways to boost these levels naturally, thus providing your body & baby with the nutrients they both need in order to thrive!

What is Hemoglobin?

In a nutshell, hemoglobin is component of your blood that carries oxygen to your cells. If your hemoglobin count is low, you can experience some or all of the following symptoms:

  • Low energy
  • General Fatigue
  • Shortness of breath (especially after climbing stairs or exerting yourself)
  • Heart palpitations
  • Dizziness or lightheadedness

How do I find out if I have low hemoglobin?

Having routine labwork performed during pregnancy can tell you where your hemoglobin levels are. In my practice, we often check these levels towards the beginning of pregnancy, and then again after you reach 28 weeks of pregnancy. As you progress in pregnancy, your blood volume expands, preparing you to be able to handle the blood loss that occurs with delivery. For many women, their total volume increases over 25%, and tends to peak by the time you hit the beginning of the third trimester. Testing your hemoglobin soon after 28 weeks tells us how your body has handled this blood volume expansion, and gives us time to really hit support should your levels be low at this point in pregnancy.

What if my hemoglobin levels are low?

If your results are low, my first step is to look at all of your lab results to see if we can get a clue as to WHY they are low. There are a few different types of anemia, and the two most common in my practice are:

  • Iron Deficiency: caused by a lack of iron, which can show up as low hemoglobin combined with a low hematocrit ratio on your lab results.
  • B12/Folate Deficiency Anemia: caused by a lack of adequate B12 vitamins and folate, and can be indicated by an elevated “mean corpuscular volume” (abnormally large red blood cells) on your lab results in combination with a low hemoglobin level.

In occasional instances, low hemoglobin levels can also happen if a mom bleeds excessively after delivery. This is one of the reasons that it is so important to get your hemoglobin in an optimal place before birth, as it increases the body’s ability to handle blood loss. But if your hemoglobin is low and you need iron support after having your baby, the following suggestions will also pertain to you!

What can I do to bring up my hemoglobin?

Some key factors to consider as you weigh your options for iron and vitamin support:

  • Typically natural-based supplements take consistency and time to really be effective. This is why to start helping your body early, as the body will then have time to respond. Many iron and vitamin supports will take one to two weeks to really start working to bring levels up.
  • Look for products and options that are whole-food or plant based when possible, as these will cause less constipation and be able to be more easily utilized by your body.
  • Pay attention to labels, and stay away from supplements that contain synthetic ingredients. This is particularly key when it comes to “folate”, as you do NOT want the synthetic form called “folic acid”. Due to genetic issues, many women are unable to adequately absorb synthetic folic acid and synthetic forms of B vitamins, which increases the specific problem of B12/folate deficiency anemia. To understand more about folate and the importance of methylated vitamins, check out this article here by Wellness Mama.

Now onto options for increasing iron levels!

Borderline anemia: if your levels are borderline, and you are looking for some general ways to boost your levels and provide more support to your body, these are some great ways to start:

  • Use cast iron cookware for cooking.
  • Eat foods high in iron (beans, lentils, red meat, liver, spinach, turkey, pumpkin seeds, broccoli, black strap molasses, etc.)
  • Increase your vitamin C intake with a high-quality Vitamin C supplement once or twice daily.
  • Make sure you aren’t mixing calcium supplements with your iron-rich foods or supplements (they will block the absorption of the other, negating the benefits of either one!)
  • Alfalfa Tablets, Moringa capsules & Yellow Dock tincture.
  • Drink several cups Red Raspberry Leaf tea daily during the 2nd and 3rd trimesters (and during postpartum as well), or drink several cups of NORA tea daily (a combination of Nettles, Oatstraw, Red Raspberry Leaf and Alfalfa). To learn my favorite recipe for Red Raspberry Leaf, click here or for NORA tea, check out this link.

True Anemia Support: for those who need to seriously boost their hemoglobin levels, here are some additional supplements to consider, in addition to the list above:

Many moms have found this combination very effective at bringing up their iron quickly (combined with some of the above suggestions):

  • Liquid Chlorophyll (drink 2-3 tablespoons daily, and 1/4c. daily during the first week postpartum)
  • Hemaplex Tablets (make sure it’s these tablets, as they do not contained the synthetic forms of folate)
  • Desiccated Liver capsules (grass-fed organic is best)

Others have found the combination of Chlorophyll with one or two of the following to work for them:

For additional information on anemia during pregnancy, I’d encourage you to check out the following links:

And for more suggestions on anemia in general, Aviva Romm has some great suggestions here: Aviva Romm on Anemia

I’d love to hear from you: what has helped to bring your hemoglobin up, and help you have adequate iron levels during pregnancy and postpartum?

Basic Supplements for a Healthy Pregnancy
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Basic Supplements for a Healthy Pregnancy

Are you confused with the myriad of pregnancy supplements out there, and wondering how to make the best choices that are good for you & baby while at the same time not depleting your budget? Have you wondered, too, which supplements are key and which aren’t actually necessary? And which supplements are going to actually provide you with the nutrients you need? And what are the basic supplements you should focus on? You’re certainly not alone in your musings!

As a midwife and a mom, I’ve had the same questions. I also know that it can be overwhelming to sort through brands, AND remember to take multiple vitamins and pills every day, especially if they have to happen at different times. I also want to make sure the moms and babies I’m caring for are getting the nutrients they need, which means NOT relying on the cheapest brands and options. If you’ve spent any amount of time researching options, you know that there lots of things to consider as you think about vitamins and supplements. Ideally, you want to use a brand that focuses on whole foods, organic sources, and includes bio-available nutrients (such as folate instead of synthetic folic acid). Of course, these vitamins aren’t going to be the cheapest ones available, which means that you will want to choose wisely, and consider using fewer supplements and making sure the ones you ARE taking are high-quality!

For those who have wondered, here is a list of the basic supplements that I routinely recommend to clients. Of course, more need to be added in the presence of specific conditions, but for most moms, these are the basics that I would encourage any mom to take during pregnancy (and while you’re nursing!):

For special considerations, these are typically the first recommendations:

  • B Vitamin (if dealing with low energy especially: your midwife can do blood tests to determine if it’s caused in part by a B vitamin or folate deficiency).
  • Iron (if low energy seems to be iron deficiency related)
  • Magnesium drink at night before bedtime to help promote restful sleep: Natural Calm
  • Trace Minerals to help with restless legs, leg cramps, muscle soreness: ConcenTrace Trace Mineral Drops

Most moms with low-risk pregnancies who are consuming a high-quality diet don’t need more than these to have a healthy pregnancy and healthy baby! For more information on understanding diet & supplements and their effect on mom and baby’s health (and what ingredients are important to be aware of!), I’d highly encourage you to check out the following sites:

Dr. Aviva Romm on Prenatal Vitamins

Lily Nichols on Folate vs. Folic Acid

Lily Nichols-information on diet and nutrition during pregnancy

And finally, if you’re looking for a place to purchase vitamins and supplements, I encourage all my clients to check out www.vitacost.com, as I typically find the best prices at that site!

I’d love to hear what prenatal vitamins and other supplements have worked for you! Feel free to share in the comments below so we can all learn together. And be sure to share this post with other moms that might benefit from the links and information!

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.

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!

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!

Preparing Well for Postpartum Recovery
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Preparing Well for Postpartum Recovery

The longer that I am a mom and midwife, the more I have come to realize how important it is to adequately rest and recover after giving birth. But this does not “just happen”…it takes some serious thought and planning!! Why is it that we spend hours and hours preparing for pregnancy and birth, yet no time or focus is given to what happens AFTER the baby arrives? With this in mind, I’m hoping that these questions and comments will help families to come up with a plan on how to cultivate an intentionally restful and healing postpartum period. I’d encourage you as a couple to sit down and talk about these questions, and figure out what you could do to be better prepared emotionally, mentally and physically for the initial 6 weeks after giving birth.

If you want to read more about some of my own favorite items to have nearby during the initial days postpartum, check out the link here

Reading and Preparation:

Let’s start with some book suggestions. We spend lots of time reading books about pregnancy and birth, right?!? So why not read about how to care for oneself postpartum? Here are some titles to get you started. I’ll note that I don’t endorse everything these authors share, but I do appreciate the way they help me to think through our thoughts and expectations surrounding postpartum adjustments and recovery.

Some Facts to Consider:

As you talk about your expectations for postpartum, it’s good to think about some facts, especially for the dads who wonder if it’s really necessary for mom to spend so much time resting! I love to show the new parents the placenta after the birth, which is generally the size of a small dinner plate. Picture a wound of the same size on the inside of mom’s uterus. Seriously! That’s the wound that needs to heal, and even though the uterus continues to contract and get smaller over those first days/weeks, there is a still a significant amount of healing that needs to happen inside. Add to this any amount of blood loss, any stitches/tears, the length of labor, swelling, and the amount of work it takes to push a baby out, and you can quickly see why it’s important for mom to take care of herself! All of a sudden the reasoning behind “not lifting anything heavier than your baby” makes complete sense, doesn’t it? Along the same note, almost anyone recovering from any type of surgery is usually given a two week minimum recovery time…new moms need AT LEAST that long!

As the postpartum days progress, mom’s body is going through a lot of changes, which include a drop in hormones from the expulsion of the placenta and baby, and a surge of more hormones as her body transitions into producing milk. Keep this in mind those first days…mood swings and emotional roller coasters are NORMAL. But it sure helps if you are expecting that as part of those initial days. And it’s good for husbands to know that this is a normal part of adjustment. Mom needs rest, understanding, and sometimes NO MORE VISITORS!

Another thing to remember is that you won’t be getting a lot of sleep those first few weeks. It’s good for baby to eat every 2-3 hours to establish good nursing habits and milk supply, but it does not contribute to a restful mom. Keeping life low key, and expectations to a minimum can really make a difference in allowing this time to be as stress-free as possible. Along the same lines, nourishing foods and lots of liquids are also hugely important in helping to establish a plentiful and healthful milk supply.

Lastly, try to view the postpartum period as a 6 week MINIMUM. I understand you may not be able to take that much “time off” of your normal home duties. But the longer you can rest and care for yourself in the initial weeks, I can promise you the better off your long-term postpartum experience will be. These initial 6 weeks your baby needs you as much as he needed you when he was inside, and this means an unpredictable schedule, lots of nursing, skin-to-skin time, and lots of cuddles. A slow re-entry into normal life will be beneficial to everyone, and lowering your personal expectations of this time can be a life saver!

Initial days postpartum:

  • Consider staying in bed for several days, getting up only to use the restroom, and perhaps joining the family for one meal a day. This can be beneficial for several reasons: visitors don’t stay as long if you’re in bed, you can sleep when baby does, and it reminds everyone that you are recovering!!
  • Prepare your room or a special corner ahead of time to make it a pleasant place for recovery. You’ll relax better if you find your space enjoyable and refreshing. Think about getting some special reading material or audio books together ahead of time to enjoy while you spend hours nursing your new baby. And don’t forget to have some comfortable clothes to wear that promote easy nursing access and yet allow you to rest well!
  • Limit visitors, and the amount of time that they stay. This can be dad’s job: remember that even if your wife loves people, new moms find extra company more draining than they initial expect. Short 10 or 15 min visits are sufficient, and this allows mom to not be separated from baby too long (since many visitors want to hold the new baby the entire time they are present).
  • Have nourishing snacks, foods and drinks gathered ahead of time: a new nursing mom is ALWAYS hungry and thirsty that first week!
  • Remember that your body is going through some major changes and may need some help: have some ibuprofen, nipple cream, icepacks, heat packs, hemorrhoid balm and magnesium available in case you need them.
  • Consider some ways to have meals taken care of: freeze some ahead of time, or ask a friend to organize a meal train or signup list where friends can bring food. It can be nice for the entire family to have meals provided for the first days/weeks as the whole family adjusts to the new baby.
  • If you have older children, it’s a good idea to think about how to implement the “no lifting” rule…sometimes it can be helpful to invest in a step stool that the older sibling can use to climb up beside mom so that she isn’t tempted to lift him or her up.

First Two Weeks:

  • An old midwife’s adage is “5 days in the bed, 5 days on the bed and 5 days around the bed”. While many moms balk at this amount of recovery time, it’s not a bad idea to consider! Mom will continue to bleed for around 2 weeks, and the longer she rests oftentimes the shorter the time she bleeds.
  • Continue to follow the “no lifting anything heavier than baby” rule until at least 2 weeks to maximize the uterine healing that needs to happen.
  • Keep stressful visitors to a minimum-this may mean telling well-intending friends and family that they need to wait to come see mom and baby, especially if that entails a lengthy visit of several days. Sometimes it’s hard for people to remember that mom is recovering and needs to spend time with baby, so this is NOT the time to be socializing and holding a newborn for hours on end.
  • Consider getting some household help these first weeks (longer if possible!). This would preferably be someone who can come and keep up housework, prepare food as needed, entertain older children if present, and take care of household duties so that mom can rest mentally as well as physically. As you consider this possibility, keep in mind that this works best if it is someone that mom feels completely comfortable with-sometimes this is a family member, but sometimes it is someone totally unrelated, and even hired for this express purpose. Talk honestly about what type of person would work best in your family situation. After my fourth child was born, we were blessed to have a girl who was willing to come spend 2 days a week with us during the first three weeks. This was sufficient time to catch up laundry, clean the house, and keep after work that wasn’t getting done, as my husband had a flexible work schedule the other days of the week. I found it much easier to rest when I knew the house wasn’t falling apart while I rested!
  • As you feel your energy increasing, start slow…remember that the sooner you jump in to “normal life”, the sooner everyone else will expect you to stay that way!
  • If people offer to help, take them up on it! An offer to babysit can mean an extra nap for mom, and many friends are more than willing to run get your groceries if they know you need something. Don’t turn any offers of help down!

Weeks 3-6:

  • This is when it can get hard to remember to rest. Even though you feel much better by now, remember that you need to go slow, and say no to anything extra in life, even if you FEEL energetic. Your baby still needs lots of time to nurse, and your body is still going through significant changes. One day you feel on top of the world, and the next you are in the dumps…all of this is part of your body learning to regulate it’s hormones again! There are supplements you can take to help with this-check with your midwife if you experience lots of these swings.
  • Start slow with exercise. It’s best to wait the full 6 weeks before engaging in anything specific to rehab, but I do encourage moms to get out in the fresh air and start taking slow walks if they are having minimal or no bleeding by week 2 or 3. Put baby in a stroller or in a carrier, and stroll. Don’t push yourself, just give yourself the chance to get some sunshine and fresh air.
  • Make sure you are taking your prenatal vitamins and consider adding some extra Vitamin D and Evening Primrose Oil to help with hormonal balance.
  • Try figuring out a way to get just a little bit of time to yourself each day…perhaps your husband can take care of the children while you slip out for a short walk, or perhaps you can meet up with a friend for coffee (and let her hold the baby!), or even get a chance for a short nap by yourself. These things can help with managing the mental load, and can be a big step in preventing postpartum depression.
  • Find a friend you can talk with and share with as you go through the many adjustments during these weeks. It’s always reassuring to be reminded that this stage of life doesn’t last forever, and you will sleep again someday!
  • Continue to get help with basic household duties as you can, and don’t turn down the offer of food!
  • Consider trying to get some intentional time as a couple: the unique stress of this period, combined with mom’s unpredictable hormones, interrupted sleep, and all the other factors can add some significant stress on your marriage. Getting away for an hour (with baby in tow) to concentrate on your relationship can really help you to navigate this time and grow stronger in your relationship.
  • Eat nourishing, healthy foods, and don’t worry about weight loss while your body is establishing milk supply!

 

In closing, I’d love to hear what you would add to this list? What was most helpful to you when you were anticipating the arrival of your little one? What helped you recover? Please share your tips and input!

Preparing for Cold Season: Pregnancy-safe Remedies to Stock in Your Medicine Cabinet
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Preparing for Cold Season: Pregnancy-safe Remedies to Stock in Your Medicine Cabinet

img_4329As we head into the fall and winter months, I thought it might be a good time to mention a few of my favorite pregnancy-safe cold and flu remedies. During pregnancy, the extra demands on  your body combined with a suppressed immune system make for a greater chance of picking up an unwanted virus. But there are things you can do to help boost your body’s immune system, and to be ready to battle off a cold at the first sign or symptom!

One question I get asked often is whether or not there are medicines you can take safely during pregnancy, especially to help with fever or cold symptoms. As a general rule, you want to avoid ibuprofen (found in Advil or Motrin), but acetaminophen (Tylenol) is okay for occasional use, as long as you stay away from the cold combinations marked as “multi-symptom” (these are too strong for pregnancy). But I would strongly suggest that you really do reserve any type of medications as only an emergency remedy (like needing relief so you can be at the family wedding, for instance!), as there are still conflicting results in the medical literature, and you certainly want to be extremely careful about what you putting into your system during such a crucial time in your baby’s growth and development.

But did you know there are some really good natural ways to fight off a cold? Here are some great remedies…and let me note here that I am in no way affiliated with any of these particular brands or companies-in other words, I’m not being paid to pass this information on to you!

  • Extra Vitamin C: I like to keep a high-potency Vitamin C (such as the Ester C picture) in the cabinet for the times when I feel a cold coming on. Taking several thousand miligrams a day for a couple of days will help give your immune system a needed boost!
  • Emergen-C: these little packets that you mix into water to create a fizzy drink can really give you some extra energy during those days you feel tired and down from being sick. Full of extra B vitamins, other vitamins and needed minerals, these are great to keep around for emergencies.
  • Infant Immune Booster from Mountain Meadow Herbs is a combination of Elderberry and Echineacea in a glycerin base, and is safe for use during pregnancy, as well as being safe to give your little ones.
  • Immune Boost for Pregnancy by Wishgarden Herbs is a gentle combination of specific herbs that help to boost your immune system while still being pregnancy-safe.
  • Garlic-lots and lots of garlic! Garlic is a great way to fight off a cold, and you can take it by capsule, or eat it straight. This is one remedy, though, where everyone will know what you’re doing. 🙂
  • Elderberry Syrup: you can purchase this on Vitacost.com (my favorite place to purchase supplements that are reasonably priced!), and take it regularly whenever you feel the need.
  • And finally, when you (or your little one!) are struggling with a cough, here is my favorite natural cough syrup: Olba Natural Cough Syrup. I was delighted to find this one, and I can tell you that it really does work! Sweetened with honey and full of herbs, it is a great addition to your medicine cabinet.

So, here’s wishing you a healthy fall…and hoping these suggestions can be a help if you find yourself down with a cold or needing an extra immune boost. What are your favorite natural and/or pregnancy safe remedies for illness? I’d love to hear about it! Thanks for taking a minute to share this post with your friends!

Suggestions for a Healthy Pregnancy
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Suggestions for a Healthy Pregnancy

Recently I’ve been searching for a short, easy-to-read handout on nutrition and exercise. I was having trouble finding what I wanted…something that hit the high points, but wasn’t so detailed that no one would take the time to read it. Here’s what I came up with, though there is SO much more that could be said. I encourage each of you mama’s to research nutrition, supplements and exercise so that you know WHY you are doing what you’re doing for you and your baby!

2266-19942-1-SPDuring pregnancy, your body faces extra demands and nutritional needs. Making wise choices in caring for your physical needs can help to build a healthy baby, improve your energy levels, experience less complications during birth, and have a more rapid recovery. How is that for motivation?

Diet Recommendations:
There are many varied suggestions out there as far as pregnancy diet goes. While it is important for you to do your research and make the best choices for your particular situation, the following are a few principles to go by when it comes to what you eat:
– Major on high-quality protein. Protein helps to give you sustained energy, builds good skin integrity, and keeps your blood sugars in check. Some ideas include: Greek yogurt, cheese, nuts, nut butter, chia seeds, eggs, meat, and seeds.
– Consume a variety of vegetables, preferably organic whenever possible. This helps to provide you with more fiber, and the multitude of natural vitamins and minerals that vegetables contain.
– Add quality oils to your diet. Recent research has proven that quality fats are good for us, contrary to what we used to be told! Coconut oil, olive oil, and butter (esp. if it’s grass fed!) are examples of good fats to be consuming.
– Reduce your intake of carbs-especially simple carbs. While carbohydrates are good in moderation, they shouldn’t be considered the foundation of your diet. Carbohydrates tend to elevate blood sugar levels, as well as adding extra pounds to you and the baby during the last several months of pregnancy. When eating carbs, do your best to make sure they are made of whole grains whenever possible, which provide you with fiber and a slower sugar release. Using a variety of organic grains (such as oats, spelt, rye, etc.) are better choices than only consuming wheat products.
– Stay away from artificial sugars, and limit your intake of refined sugar. Try using maple syurp, honey, coconut sugar or other more natural-type sugars when you need something sweet!
– Try to limit fruit juices, and eat whole fruit instead.
– Keep healthy snacks on hand, so that it’s easiest to make good choices when you’re hungry!
Supplements:
Ideally, your nutritional needs should be met through a healthy, balanced diet. But most of us can still use a bit more help!  The basis of your supplements should include a high-quality prenatal vitamin, one made from natural food sources instead of being chemically engineered. Seeking Health, New Chapter Organic, and Thorne Research are good brands, but there are more out there. Most moms are also lacking in sufficient calcium and magnesium, and I recommended taking a minimum of 1000 mg. of calcium each day. This can also help you to sleep better at night, and experience less muscle cramping and discomfort. Other supplements are normally suggested and added as needed, and we can discuss your particular needs during our prenatal visits.newborn

Exercise:
In preparing for your labor and birth, it’s good to keep in mind that it is similar to preparing for a marathon. No one decides to run a marathon and then does it the next day-it takes lots of preparation and training for the big event. It’s much the same with giving birth. The more prepared and equipped your body is, the better able you’ll be able to handle the challenge and the easier your recovery will be. I highly recommend the following:
– Take a brisk walk at least 3 times each week, trying to go at least 1 mile in distance.
– Incorporate some type of exercise program (even just 10 min. long!) into your daily routine, and make it happen at least 3 times a week. There are many different 10 min. pregnancy workouts on youtube, and many other options you can take advantage of. A routine that incorporates lots of squats and leg-strengthening moves can be especially helpful in getting your body prepared for birth.
– Visit the “spinningbabies” website for information on daily exercises that encourage good alignment for mom and good positioning for baby. I have an excellent DVD on this subject that I encourage each of my clients to borrow and watch.
– Consider visiting a chiropractor during the last trimester to ensure your body is ready for birth!