Posts in birth
Maternity leave for the midwife!

  Hi everyone!  Most of you know that we're expecting our second baby in September, but I wanted to get the word out at any rate.  Next week is my last week at the office before I go into major mama mode and bring our new little one into the world.  I will be out of the office from 9/5/11-10/11/11.  When I come back, I will be in the office on a very part-time basis for the month of October.  I will add more hours in November and December, and will be back to my full schedule in January. While I'm out, Dr. Jenny Maurer (at our clinic) will be covering my practice.  She will be available to see you at the clinic for any of the concerns you would normally see me for.  If you have well-baby, well-child, or adult wellness checkups that are due, she is happy to do those too.  I will be in the office this Tuesday, Wednesday, and Thursday wrapping things up, so please give a ring if you have any questions!

We don't know if our baby is a boy or a girl (YET), but I will post here when the baby is safely born.  See you all this coming fall!!!

A handmade healing salve!

Today, I'm working in my kitchen, whipping up a treat for the folks who come to the Green Sprouts Festival this weekend.  I've been infusing fresh organic calendula flowers in olive oil for 2 weeks, and today I'm turning that oil into a salve. salve 1 |sav; säv| noun an ointment used to promote healing of the skin or as protection.

The first 75 visitors to our booth this year will get a free sample of the Family Tree Medicine Calendula Salve!  We use calendula salve for cuts, scrapes, bruises, and other types of boo-boos.

You can also enter your name to win a brand new Moby Wrap.  Dr. Maurer and I both used this wrap for our little ones when they were babies. So, if you or someone you know is having a baby soon, stop on by, say hi, and try your luck at winning.

We look forward to seeing you there, rain or shine!

Oregon is Rocking the breast-feeding stats!

Just read an interesting article about how the U.S. is really making the effort to ensure that babies are not only breastfed, but that they breastfeed for longer.  The recommended length of breastfeeding is 12 months for each baby. Last year, 75% of all newborns started life at the breast.  By 6 months, only 43% still nursed, and by 12 months, only 22%.  In Oregon, 40% of babies still nurse at their first birthday.  We know that breastfeeding is important in the prevention of asthma, diabetes, and childhood leukemia.  If you want to read the full article click here.

Green Baby Showers!

I love this article on how to love up a new mama, sustainably.  Babies are the biggest consumer population in the U.S. and there's so much available that's been gently used, or hardly used at all! Dr. Jenny and I will be at the Green Sprouts Portland festival again next month (Sunday, Sept. 26th), so mark your calendars!  We'll be doing a fabulous prize drawing and giving tips for Green Baby Showers & other health care pearls.  Best of all, it's FUN and FREE!  Lots of interesting talks and information---see you there.

Naturopathic care for Postpartum Mood Issues

Naturopathic doctors are trained to look for the root problem causing someone's symptoms, rather than just making the symptoms go away.  If we address the underlying cause, we can allow the symptoms to recede for good.  This is no different for postpartum women, and there are a number of reasons WHY women develop postpartum mood disorders.  Naturopathic doctors, especially those trained in the art of midwifery or who have had special training in pregnancy and birth, are very well-equipped to figure out how to best help each woman on an individual basis. Dr. Adriana Azacarate-Ferbel is a Portland area Naturopath who has studied Postpartum depression extensively.  I met with her last fall when I began researching this topic more myself.   She outlined the most common underlying reasons for development of Postpartum depression:

  • Fatigue and Sleep Deprivation
  • Hypothyroidism
  • Hyperthyroidsim
  • Immune system dysregulation
  • Pain
  • Low Cholesterol levels
  • Hormone imbalance
  • Neurotransmitter
  • Insulin resistance

Sometimes, it may be a combination of one or more of these that can cause postpartum mood disorders to develop.  Because this is true for many women, the Naturopathic approach is multifactorial as well.  The earlier we can recognize the symptoms and determine what's actually going on, the better.  In my office, a primary work-up to determine the underlying cause may include:

  • Thyroid testing, followed by nutritional supplementation and/or medicine to balance the thyroid gland (if needed)
  • Combination Hormone and Adrenal Saliva testing, followed by treatment with herbs and nutrients known to balance female hormones, DHEA, and/or cortisol (and are safe for breastfeeding).
  • Lipid panel, to look at cholesterol levels, followed by nutritional counseling to ensure adequate levels.
  • Comp. metabolic screen, Iron panel, and Complete blood count, to assess for blood sugar issues, anemia, and immune system problems
  • Musculoskeletal assessment to determine sources of pain that may be adding to increased stress and fatigue, followed by massage, acupuncture, or other forms of physiotherapy
  • In some cases, neurotransmitter testing will be done first.  This is especially true if someone has a marked history of depression, anxiety, or psychosis.

I could write pages and pages on this topic.  This is just a jumping-off point.  There is still a lot to learn about this realm of women's health, but we have a very good grasp on how to make the transition to motherhood a happy and healthy time.

Be strong.  Live healthy!images

Baby blues

imagesDid you know that about 80% of all new moms experience some form of postpartum mood flux?  There is a normal drop in mood, increase in anxiety and tearfulness that occurs in most women right after they have a baby.  In most of these women, it is hormonal.  The pregnant body is pumped full of estrogen, progesterone, relaxin, prolactin, and oxytocin.  When the baby is born, all these amounts shift---mostly dropping off like the cliffs of the Grand Canyon. Having a baby opens women up in so many ways: physically, emotionally, and spiritually.  It is a very wonderful and overwhelming time in all regards.  It is also a very vulnerable time because the body is going through so many changes AND there is a tiny little being that must be tended to 24 hours a day.  "Baby blues" affect up to 80% of new moms within the first few days postpartum.   I've seen that days 4-6 postpartum tend to be the most difficult for women mood-wise.

About 10% of new moms will go on to develop postpartum depression.  The onset of postpartum depression actually tends to be anywhere from 6 weeks to 6 months after the birth.  The symptoms are similar to depression: low mood, sleep issues, appetite changes, panic, anxiety, disinterest--plus constant concerns about ability to care for the new baby, and possible fears of actually harming the baby.  If a mom has had issues with depression prior to pregnancy, she is at a higher risk for developing postpartum depression.  Sometimes, it can be due to underlying physiological issues like hypothyroidism (which can also develop in the postpartum period).  So it's good to rule out root problems to best help with treating the symptoms.

Roughly 2% of new moms will suffer from postpartum psychosis.  This is a very serious condition that must be addressed immediately and is thought to also be due to the drop-off of hormones that occurs after the birth.  Symptoms of postpartum psychosis are seen within the first 2-3 weeks following the birth and include:

  • insomnia (other than not being able to sleep because the baby is awake)
  • mania
  • flight of ideas
  • self-harming
  • constant thoughts of harming the new baby
  • disinterest in the new baby
  • complete shift of mental status (that friends and family easily notice)

Often, these women need in-patient help with stabilizing mood, but there is a lot that can be done naturopathically to support a woman in this situation.  With the right support, these women go on to embrace being a mother.

There is a whole slew of new research coming out on postpartum and antepartum mood disorders.  More prenatal care providers are broaching the subject with their patients as well.  One of the best tools we have is to educate the patient and her family about the signs and symptoms so early intervention can occur.images-1

Next week, I'll be writing about some of ways naturopathic doctors help women who may be at greater risk for developing postpartum depression, anxiety, or pychosis.  Until then, enjoy the days as we begin to welcome Summer this year!

Postpartum Nutrition

Good Morning!  It looks to be another beautifully sunny morning here in Portland, Oregon.  Wow, we have really been blessed with some fantastic weather the past few weeks.  Our clinic garden is looking great as well as the garden my family and I are growing at home.  I'll be taking some photos to show you all just what I mean! imagesToday I'd like to round out this series on Nutrition during pregnancy by providing some guidelines about postpartum dietary needs.  The postpartum period is defined as the time from the birth of the baby and placenta to 6 weeks afterwards.  I personally believe that this extends to 3 months after the birth at minimum, with the first 6 weeks being the time when the body makes most of it's transition back to "normal".

I put normal in quotations because it is very common for women to feel like they have a totally new body after having a baby.  images-1To a certain extent, it's true.  It's not the same body.  It looks, acts, and feels different than before pregnancy.  Therefore, it has different needs.  This is especially the case if the new baby is breastfeeding. Let's have a look at some guidelines for women in the postpartum period:

  • During pregnancy, women need 200-300 extra calories per day to grow a baby.  During breastfeeding, women may need up to 500 extra calories per day to make enough milk to feed their new baby.
  • Also needed for milk-making is WATER.  Most women will need between 2-3 LITERS of water a day to keep up with the demands of making milk.  I like to get the whole family involved in the process, stashing bottles full of water wherever mom might end up nursing the new baby.  Intense thirst universally follows feeding the new baby, and moms everywhere love having a big glass of water while they nurse.
  • Many women need extra iron after having a baby.  Moms who had a lot of bleeding with childbirth are in a higher risk category for developing postpartum anemia.  To prevent severe anemia (which can lead to excessive fatigue and lowered mood):
  1. Increase iron in the diet: red meat, eggs, enriched cereals, and blackstrap molasses are good ways to get iron.
  2. Increase Vitamin C intake: Vitamin C helps you absorb more iron from your food.  Take with meals.  Do not exceed 3000mg/day unless being supervised by a health care practitioner.
  3. No black tea: Tannins in the tea decrease iron absorption.
  4. Cook with cast-iron pots and pans.  Believe it or not, you will get good doses of iron from doing so.
  • Continue to take your prenatal vitamins through the end of breastfeeding.  You still need the nutrients.  Plus, the extra B vitamins will give you much-needed mental and physical stamina.
  • Omega-3 fatty acids with a higher DHA:EPA ratio.  Studies show that infants benefit (neurodevelopmentally) from DHA supplementation in pregnancy and breastfeeding.  Moms also need these healthy fats to help heal and replenish the reproductive and nervous system.  DHA can be found in coldwater fish and algae most readily.  Taking an encapsulated form of DHA is a sure-fire way of getting enough.

Next week I'm going to address Postpartum depression, anxiety, and mood disorders.  It's more common than you think, and there's more that can be done to help prevent it from affecting you and the ones you love.  images-2

Herbal Nutrition in Pregnancy

DSC_0606Herbal Nutrition for Pregnancy Red Raspberry Leaf (Rubus Idaeus): tones the uterus during pregnancy, prevents hemorrhage, provides excellent source of Vitamins C and E.  Also good source of Calcium and Iron.

Nettles (Urtica dioica): great tonic.  Has lots of Vitamins A, D, C, and K. Provides Calcium and Potassium as well.  The Vitamin K is instrumental in preventing hemorrhage during birth.  Also good for leg cramps and hemorrhoids.

Mint family (Mentha spp.): safe and helpful in pregnancy for digestive issues: morning sickness and indigestion.

Oatstraw (Avena sativa): good source of minerals for growing baby and for integrity of veins.  Oatstraw is calming and nourishing.  This herb is a personal favorite!

Specific issues during pregnancy*

Morning sickness:  1-2 cups Raspberry leaf tea, 1-2 spoonfuls of ginger root (Zingiber off.) decoction, peppermint of spearmint tea, alfalfa (Medicago sativa) tea for B vitamins

Varicose veins/Hemorrhoids: 1-2 cups daily of Oatstraw tea, 1-2 cups of nettles tea, raw parsley (Petroselinum sativum) in salads, witch hazel (topically)

Anemia: 1 TBS Yellow dock (Rumex Crispus) decoction per day.  Can also try teas of Dandelion root (Taraxacum off), Parsley, and Nettles.

Heartburn/Indigestion: Anise or Fennel seed tea for after meals, Papaya enzymes, raw almonds, Slippery Elm (Ulmus fulva)

Bladder Infections: unsweetened cranberry juice, Uva Ursi leaves infuse for 8 hours, then drink one cup every 12 hours.  Can add yarrow (Achillea millefoilium) if not clear with just Uva ursi.

Hypertension: garlic, cucumbers, Hops (humulus lupulus)—only during 3rd trimester, Passionflower tincture (15 drops per day), Skullcap (Scutellaria off.) 1-2 cups per day, Hawthorn berries (Crataegus off.)

Late Pregnancy uterine tonics: Black and Blue Cohosh (Cimicifuga racemosa and Caullophyllum thalictroides), Squawvine (Mitchella repens)

*Please consult a helath care practitioner before beginning any new herbal or nutritional regimen