We put so much focus on pre-natal care, but how are you managing in the weeks and months following?
This interview was first published on the Mother And Luxe website in May 2015.
Why do so many women seem to struggle with health issues after childbirth and breastfeeding? I have come across so many women, whose health may have previously been good, who are now dealing with things like oestrogen dominance, auto immune illnesses, thyroid issues, adrenal fatigue, food sensitivities etc. in the months and years following childbirth. What sorts of changes are happening in the body during and after pregnancy and childbirth that can cause conditions like these to arise/flare up?
You have to remember what an incredible stress pregnancy and birth is on the body. The body is in a state of rapid cellular growth, turnover and repair. Hormones are constantly adjusting in support of creating new life, preparing for birth, birthing, bonding and ensuring varying nutritional content of milk supply over the course of breastfeeding. And all the while metabolism is trying to keep up with constant increased energy demands.
And then there’s the physical stress on the body whilst carrying, with the added likelihood of impaired sleep and increased cortisol keeping insulin levels high. This can then increase fat storage, which cycles to increased oestrogen levels and a potential oestrogen imbalance or insulin resistance.
It’s estimated that only 5-25% of illness is determined by genes. What that means is up to 95% of DNA changes are attributed to our environment, i.e. our thoughts, beliefs and physical, chemical and emotional stress. So it is understandable that an event such as pregnancy/birth and the stress following can impact DNA expression and methylation. And impaired methylation is linked to a number of imbalances, including oestrogen dominance, autoimmunity, mood shifts and food sensitivities. It’s a big topic but if you’d like to know more, you can read about it here: Methylation
As a naturopath, what sort of illnesses/vitamin deficiencies/complaints do you commonly see among mothers?
Well, the most common are infertility on one side and mood, fatigue, irregular cycles and subclinical thyroiditis or Hashimotos (autoimmune hypothyroidism) on the other.
Looking at the issues of infertility and history of miscarriage, my number one step is to get synthetic folic acid out of the diet and replace with natural folate or methylfolate (active B9).
Now we all know the link between folate and neural tube defects. Mandatory fortification of synthetic folic acid in foods plus a push for high dose synthetic folic acid in prenatal supplements can often show RBC folate pathology well above range. This is not necessarily a good thing though. The problem is the results don’t indicate how much of the folate is getting into the cells where it’s needed.
One of the hottest health topics at the moment involves gene function and one of the most researched genes is the one responsible for folate metabolism, Methylenetetrahydrofolate reductase, or MTHFR. Around 50% of the community have some form of mutation in this gene meaning folate isn’t being converted efficiently. Loading huge amounts of synthetic folic acid into your system often results in unmetabolised folic acid (UMFA) circulating in the blood stream. Increased UMFA has been shown to decrease Natural Killer Cell activity impacting overall immunity. There is also a link to higher rates of miscarriage with the MTHFR gene mutation. If you want to know more, you can read more here: MTHFR and Folate vs Folic Acid
Regarding fatigue, well thyroid could definitely be an issue, but there may be more obvious things at play. For example, lack of sleep. Or iron stores may be low, especially if there was haemorrhaging, which can knock our energy reserves for a six, as does low B12 and magnesium.
Magnesium is essential for energy, sleep, thyroid hormone production, balancing sugar levels and keeping us calm. During stressful periods, we lose magnesium stores very quickly via our urine, so for me, it’s an essential mineral requiring supplementation during this time. Look for glycinate, bisglycinate or citrate forms for optimal absorption and anti-anxiety effects.
Vit D is often low in new mums and is essential for immune health, especially in autoimmunity pictures. For Vit D synthesis, we need healthy liver and kidney function, both of which are needed for conversion from 7-dehydrocholesterol in the skin through to the active 1,25 dihydroxycholecalciferol via the kidneys.
And if thyroid is found to be part of the fatigue picture, I’d be removing gluten and wheat which have been linked to increased thyroid antibodies and autoimmune thyroiditis.
Pyroluria can also show up post-pregnancy. A condition of disordered haemoglobin metabolism and synthesis, its metabolites (pyrroles) impact the absorption of zinc and B6. Often triggered by stress, it may show as symptoms of depression, allergies, migraines, low libido, anger, anxiety, memory loss and mood swings (sound familiar?) A simple urine test can determine the condition and supplemental treatment can usually yield results within days to weeks.
Finally, sometimes it’s more acute care that’s required. If recovering from a C-section or perineal tears, increasing Vit C, silica, zinc and the herbs Centella asiatica and Calendula officinalis may be useful.
How do our hormones change after babies and how can postpartum and breastfeeding women best support their hormonal health?
Post-natal hormonal changes can be profound with swinging levels of oestrogen, progesterone, testosterone, cortisol, prolactin, oxytocin and serotonin impacting mood and post-natal depression.
Adequate nutrition is essential and supplemental support with Vitamin B6 and magnesium can be useful in supporting new mums through this time.
For those breastfeeding, including oats and flaxseed into the diet as well as herbs such as fennel, fenugreek and aniseed can help to encourage milk supply. Especially in those first few days, try this recipe for Barley and Fennel Tea: Simmer ½ cup pearl barley in 3 cups of water for 30 mins. Strain and put 1 teaspoon of fennel seeds per cup in the strained barley water to infuse for a further 10 mins. Alternatively, Weleda do a Nursing Tea including Fenugreek, Anise, Caraway, Fennel and Lemon Verbena. 3 cups per day of galactagogue herbs should result in improved breast milk within about 3 days. Dose can be reduced after around 2-3 weeks and continued for at least 6 weeks.
Pregnancy, birth and caring for small children is such a demanding and exhausting time in a woman’s life. How can women maintain their energy levels and avoid burnout (i.e. fatigue, anxiety, stress)?
Oh it really can be such a tumultuous time in a woman’s life. So much pressure, and after the hype has died down, they can be left feeling overwhelmed, inadequate and alone.
Pregnancy and those first years are not only a physical strain, but often expose issues around body-love, desirability, sexuality and normalcy, especially if they’ve previously been focused on their own business, career or social life. Depending on their birthing experience, the stress left on the physical and emotional body can be enormous. This is where Australian Bush Flower Essences are brilliant. They work on commonly-felt emotions such as shock, trauma, fear, exhaustion, overwhelm, abandonment, self-esteem and body acceptance and are great at helping these emotions quickly shift and release.
A wholefood diet is absolutely key and a lot of new mums don’t understand how essential nutrition is for everything from mood to energy to producing enough breast milk. It’s important new mums aren’t skipping meals and are getting enough healthy fats (olive and coconut oils, nuts and seeds, flaxseeds, avocado etc.), protein, carbohydrate and leafy green/multi-coloured veggies in their diet. Calorie intake needs to increase by about 500 calories p/d and water intake should increase to around 3 litres per day. Casseroles, bone broths and chicken or vegetable soups are great quality food options for quick and easy nourishment. And get others to help shop and cook – accept help wherever you can!
Of course, self-care is essential. Sleep is a massive issue so try to grab power naps where you can, let go of any perfectionism or guilt and start prioritising yourself. And if you need added support, please seek out a counsellor or therapist. Depression is more common than most would admit. The 2010 Australian National Infant Feeding Survey (AIHW) reports Perinatal depression occurs in 20% of women. It doesn’t mean you’re a failure, it means you are human. There is no shame in seeking help. Talk to your GP to discuss your options.
What are the blood tests every mother should have?
It would completely depend on the symptom picture. I think everyone should have a basic panel run including red and white cell counts, urinary/electrolytes, liver function test, fasting blood glucose, lipid studies and iron studies. Then depending on symptoms, useful tests may include a Thyroid Panel, including TSH, T4, T3 and rT3, TPO/Thyroid Antibodies, Vit D, B12 and Folate, Zinc, Copper, Pyrroles, Cortisol, Hormone Panel, DHEA, MTHFR or a full genetic panel.
Kate is a qualified naturopath who is passionate about helping women heal from hormonal havoc and inspiring women to know their own power, worth and wisdom.
Kate offers one-on-one Skype consults for irregular cycles, PMS and period pain, endometriosis, PCOS, peri-menopause, mood swings, fatigue and mental and emotional stress.
Simply drop me an email to see how I can help you!