nutrition

Postpartum Nutrition From a Traditional Chinese Medicine Perspective

This blog was originally shared on www.birthfit.com.

According to Traditional Chinese Medicine, childbirth leaves a woman’s body weakened at a time when she is continuing to be the primary source of nourishment for her new baby.  It is important for the new mother to nourish herself with food, rest, warmth, and support so that she is able to continue to care for her child.

Before discussing postpartum nutrition, it is important to touch on common postpartum states according to Chinese Medicine to better understand how nutrition supports them.

Qi and blood deficiency

o  Mom is qi (energy) and blood deficient postpartum because during childbirth she lost blood and energy.  She is also continuing to lose blood (lochia) and use energy as she is caring for a newborn and likely not getting adequate sleep.  In TCM, breastmilk is made from blood which is causing mom to be even more deficient.

Spleen qi deficiency

o   It is the spleen’s job is to hold everything up and in.  Near the end of pregnancy, moms SP qi becomes weaker to allow her baby to descend and exit the uterus.  If the spleen is not strong postpartum, we can find prolapses such as hemorrhoids and prolapsed uterus.

Yin and blood deficiency

o   Pregnancy is a very yin state and the mother is often deficient after childbirth.  This can manifest as constipation, headaches, difficulty sleeping, and anxiety.

Cold in the uterus

o   During pregnancy the womb is filled with the love and warmth of the mother’s baby; after childbirth, it is empty and cold.

Cold in the uterus can lead to blood stasis in lower jao

  • Blood stasis can be a cause of postpartum depression in Traditional Chinese Medicine.

Blood deficiency and qi deficiency almost always coincide because qi moves blood and blood reinforces qi.  Foods that will build qi and blood include red meats, organ meats, fish, eggs, collagen, greens, beets, soups, and bone broth.  All foods should be organic and free-range if possible.

According to Chinese medicine, it is the spleen’s job to transform and transport foods and fluids to aid in digestion.  During the postpartum period when our spleen and stomach are weak, we need to consume foods that are easier to digest. It is recommended to drink a cup of tea, warm water, or bone broth with each meal and eat warm, cooked foods, as these are easier to digest.  Use warm spices such as ginger, cinnamon, black pepper, fennel, garlic, and nutmeg when cooking. Avoid cold foods and drinks as these are more difficult for the stomach and spleen to digest. Dairy can weaken the spleen and should be avoided. Butter from grass-fed sources is the only recommended dairy product.  Eat small meals every few hours as large meals can be difficult for the stomach and spleen to digest.

Yin is one of the two universal energies in Chinese medicine, yang being the other.  Yin is more earthy, dark, female, and restful. In your body, yin is below your waist, interior, and is the blood and bodily fluids.  One can see how childbirth would leave a woman yin deficient. Foods to tonify yin include barley, millet, rice, wheat, quinoa, amaranth, seaweeds, string beans, kidney beans, animal proteins, beets, grapes, banana, and soups.

Nutrition is not only about the foods you are consuming.  Nourishing your body through rest and warmth is pertinent to restoring balance during the postpartum period.  The uterus is considered cold and “empty” in the immediate postpartum.  If the abdomen is not kept warm, cold and wind can invade the uterus leading to blood stasis.  This can manifest in clots, slowing of lochia, low back pain, and problems in the future with menstruation and future pregnancies.  The postpartum woman should always be covered and kept warm.

It is often recommended to spend two weeks in the bed, two weeks on the bed, and two weeks around the bed.  The fourth trimester can be filled with an array of emotions. Healing your body with food, warmth, rest, and support will begin to re-establish balance while your body continues to nourish your new baby.  

Candace R Gesicki, DC

BIRTHFIT Cleveland @birthfitcleveland

What is the Glucola Test and are there any alternatives?

This post was originally shared on www.birthfit.com.

The glucola test, or oral glucose challenge screen/test, is a prenatal test typically given around 24-28 weeks of pregnancy.   The purpose of this test is to provide a preliminary screen for gestational diabetes. Women who test positive to this will be asked to take the oral glucose tolerance test.

Oral Glucose Challenge Test (Glucola Test):

This test involves ingesting 50g of glucose and having blood drawn one hour later.  It is now considered a standard test in the third trimester. The standard for the 50g of glucose is the glucola drink.

What’s in the glucola drink?

Water, dextrose (D-glucose from corn), citric acid, natural flavoring, food starch modified, glycerol ester of wood rosin, brominated soybean oil, food dye and coloring: Yellow #6, Sodium Hexametaphosphate, BHA, and .10% Sodium Benzoate (3).

Oral Glucose Tolerance Test:

This diagnostic test involves ingesting 150g of glucose and having blood drawn while fasting and at one, two, and three hours after consumption.  

Gestational Diabetes:

Gestational diabetes (GD) is a condition in which women without a history of diabetes have high blood glucose levels during pregnancy.  As high as 9.2% of pregnant women develop GD during pregnancy (1).

Treatment of gestational diabetes includes monitoring mom and baby, adjusting diet and monitoring glucose levels, and exercise.  If those do not manage glucose levels, insulin may be necessary. Gestational diabetes may increase your risk of preeclampsia, premature birth, birth injury due to increased birth weight, cesarean section, neonatal hypoglycemia, and fetal hyperinsulinemia.  For these reasons, managing GD is important.

Are there alternatives to the glucola drink?

It is common to hear from care providers that there is “no way around it.”  I have had conversations with OBs and midwives on why they say this and many believe there should not be an alternative to the glucola test because the values that are used to screen gestational diabetes were determined based on the glucola drink.  While studies looking at consuming the same amount of sugar have been done and theoretically allow the same results (see below) there is a chance the results could be misinterpreted since the test is standardized.

Many mamas may have hesitations with this test because of what is the drink contains (see above).  While you do have a right to determine what you put in your body and what kind of tests you have done to your body, if you do not want to take the glucose challenge test, I encourage you to investigate the alternatives, make an informed decision, and talk to your care provider about what you would like to do.  

Jelly beans: 28-jelly beans contain the equivalent amount of glucose as the glucola drink.  A study from 1999 looked at the efficacy of this as an alternative. The findings showed there were no significant differences between the two glucose sources and women reported less side effects with the jelly beans (2).  There are organic jelly beans and jelly beans with natural coloring that can be used as an alternative.

50g of sugar from other foods/drinks:  some care providers will let you consume a special meal that they approve as an alternative (some include juice, pancakes with maple syrup, or soda).  This varies by care provider and in some areas is becoming less popular as an alternative.

Two-week food diary + blood sugar test:  this alternative is one that I see many providers and their patients leaning towards.  Patients keep a food diary for two weeks and test their blood sugar using diabetes test strips when they wake up (fasted state) and two hours after each meal.  Some women enjoy this test because they’re interested in looking at the numbers themselves and others find this type of testing a nuisance.

Clear glucola drink: some women report that they get so much push back from their care providers regarding alternatives that they prefer to screen for gestational diabetes using the glucola test.  There is a clear glucola drink available that does not have the food dye and coloring. For some women, this makes them a bit more comfortable with the glucola drink.

Gestational diabetes can be an unwelcome diagnosis.  It is important to educate yourself on gestational diabetes, the risk factors, the tests, and any alternatives and discuss any questions and concerns with your care provider to make the best decision for you and your baby.

 

xoxo,

Candace R. Gesicki, DC

BIRTHFIT Cleveland

@birthfitcleveland

Citations:

1)  DeSisto CL, Kim SY, Sharma AJ. Prevalence Estimates of Gestational Diabetes Mellitus in the United States, Pregnancy Risk Assessment Monitoring System (PRAMS), 2007–2010. Prev Chronic Dis 2014;11:130415.

2) Lamar ME, et al.  Jelly beans as an alternative to a fifty-gram glucose beverage for gestational diabetes screening.  Am J Obstet Gynecol. 1999 Nov;181(5 Pt 1):1154-7.

3) Romm, Aviva.   2014 May 20. Gestational Diabetes: Please Don’t Drink the “Glucola” Without Reading the Label.  https://avivaromm.com/dont-drink-glucola-gestational-diabetes/