Post Natal Health

An area of female health that often gets overlooked, is that of postnatal health and wellbeing. Traditionally, fertility, pregnancy itself and breastfeeding has always been and is becoming still more focused on in female health and for good reason. These stages of life, are of course crucial to the health of a female who would like children. The ‘Fourth Trimester’, a term coined by US pediatrician Harvey Karp, which is traditionally seen as the first 12 weeks after a baby is born, now also receives some attention from health professionals. This is an adjustment period for both baby and mother, as many women attend postnatal clinics and GP postnatal checks, where they receive a physical and to some extent mental health check. This is again, a very essential part of the overall experience of having a baby and can be where serious conditions such as Postnatal depression can be picked up on, as well as physical complaints such as episiotomy or

C-Section issues.

However, this ‘Fourth Trimester’, in reality, can extend well past the first 12 weeks, up until a year and even beyond for some women. An Australian research article highlighted this in a study, showing that the incidence of postnatal depression occurred at its highest rate when a child reached the aged of 4. There can be many reasons for this to have occurred so far after birth, including a younger age of conception eg 25 years old, low income, intimate partner abuse and experiencing multiple life stresses (Brown & Woolhouse). Another key factor many naturopathic medical professionals such as Dr. Oscar Serrallach are seeing in their clinics, is postnatal depletion from poor nutrition along with lack of sleep and a perceived societal pressure to jump back on the career ladder and deal without the support of ‘A village’. Centuries ago, when traditionally we lived closer together with our families and in communities, this ‘village’ was an important part of our motherhood journey, to not travel it alone with just our partners (who may also be struggling with the transition to parenthood) for support or alone as many single mothers

This concept of the ‘Fourth Trimester’ in many cultures is a very important and protected part of the motherhood journey. The concept is often called ‘Lying in’ or In China, it is called Zuo Yuezi “the sitting month”, in Japan it’s “Sango no hidachi“, in Latin American countries it’s known as “la cuarentena”– forty days. This practice can include among others, a focus on nourishing nutrition, sitz baths using essential oils and healing herbs to help gently heal birth tears, keeping stimuli like lighting and noise low and dim, family, particularly the new mothers own mother, may come to stay and support (Eberhard-Gran et al, 2010) Many of these customs have now decreased since the 1950’s in these cultures, but the concept still exists in a modified way in some countries.

These practices may not be practical or suit every new mother in our modern fast paced world, where logistics of family spread across the globe and the need for brightly lit and noisy modern technology helps to keep us connected. However, elements such as good nourishing nutrition, support from the wider community to lighten the load, as well as good sleep hygiene practices and being given some quality time away from baby to engage in healthy lifestyle practices such as yoga and meditation, certainly are still suited to modern life. These focuses are important in the weeks and months following the traditional 4th trimester and perhaps even more so to help avoid the risk of postnatal depletion and depression in the years post birth.

An element that I feel is at the crux of this this postnatal depletion is good nutrition. This is as important in the postnatal period as when trying to conceive and during pregnancy itself. The path for nutritional depletion in the postnatal period, is set up during pregnancy, where a female body can be, as the saying goes ‘eating for two’. What this really means, is that all the nutrients a woman is eating, has to be shared between her own body and that of the baby through the placenta and certain nutrients are used up very quickly during pregnancy, Our body has a higher requirement for Vitamin D and A, calcium, magnesium, Folic acid, zinc, iron and essential fatty acids to name a few. However, all nutrients can potentially become depleted post birth, especially during breastfeeding. Often women are told that during breastfeeding we should increase our calories, however this can often mean we tend to splurge during this often arduous and tiring period and eat what we like. When we are tired and a bit low in mood, we tend to crave the carby and sweet foods to give us immediate energy and a happy serotonin boost for our mood. In moderation there is nothing wrong with eating the occasional sweet treat or our favourite sandwich as part of a balanced healthy approach to eating. However, when this tumbles into multiple times a day, it means we often start to miss out on the key nutrients which are essential to give us true sustained energy, happy mood boosts, and promote good restorative sleep even if its short stretches. Particular nutrients I'd like to mention among the many which can help prevent the risk of post-natal depletion and depression are firstly:

• Magnesium, is such a key nutrient for many systems in the body. We need it to help us manage stressful and often nerve-wracking situations (Kirkland, et al, 2018) and it often gets depleted during these periods.....cue Motherhood!! It is also crucial for hormone balancing, which our bodies are naturally reaching for post pregnancy when our periods finally return and help us ride the hormonal rollercoaster of PMS (Quaranta et al., 2007). Magnesium also regulates the hormone melatonin, which controls our sleep wake cycles (Durlach, et al, 2002). Good levels of energy rely heavily on magnesium as an essential nutrient (Jahnen-Dechent & Ketteler, 2012) alongside others including B vitamins

• Great sources of Magnesium include dark green leafy veg such as kale, spinach, collard greens (wilting not boiling is key to retaining the mineral content), Avocado, nuts, seeds and wholegrains (osiecki, 2010)

• Iron. Many women become iron deficient during pregnancy as the foetus demands a large amount for growth and if this is not picked up during, it can worsen in the postnatal period. Common symptoms of low iron status can include fatigue, restless legs, frequent infections, low mood and anxiety, pale nails and inner eyelids. Aside from the importance for the foetus, it is also essential for our own health from optimal brain function (Murray-Kolb & Beard, 2007) bye bye brain fog!, energy production (Houston et al., 2018) and immune health. (Cassat & Skaar, 2013)

• Good sources can include, beans, lentils and pulses, spinach and sesame seeds, organic liver (osiecki, 2010)

• Zinc, promotes digestive health, keeps immune system strong, helps make the brains neurotransmitters and regulates hormones (osiecki, 2010) all aspects of health that are at risk during postnatal recovery.

• High amounts in pumpkin seeds, nuts such as cashews, liver, wholegrains, sea food and eggs. (osiecki, 2010

• Essential Fatty acids. There is considerable demand on a mother to supply DHA – an essential fatty acid to her child during pregnancy and lactation and thus can become very depleted herself. Further pregnancies following your first can deplete this nutrient further. This can have a significant effect on the risk of developing postnatal depression. (Levant, 2011). Other effects of EFA depletion can also include poor memory and concentration (Glick and Fischer, 2013) which can affect our confidence on returning to work after maternity leave, where before we felt sharper and more focused.

• These essential fatty acids are often found most commonly in oily small fish like Mackerel, sardines, salmon, herring and anchovies but also in flax seed. (Levant, 2011) and it is a good idea to increase your intake or supplement during pregnancy to ensure good levels in your body in the postnatal period.

These are just a few of the nutrients which can affect a woman in the years post pregnancy and if not corrected through dietary input and in some cases supplementation, post-natal depletion can affect many areas of her life.

As a qualified Naturopathic Nutritional therapist, I seek to help women in all stages of reproductive health, whether that’s fertility, pregnancy, the postnatal period or menopause. I first and foremost treat the body as a whole rather than on a symptom basis, taking an in-depth health and lifestyle history, recommending any relevant testing, creating a nutrition and lifestyle plan to support replenishment and repair for each stage you are in and offering you coaching and support on your journey to and past motherhood to help marry the woman you are now with the woman you once were.

I offer a variety of ways to support you from group online workshops to 1:1 packages, so if you would like to find out how I can help you regain control over your health symptoms and bring your body and mind back to balance at whatever life stage you are in, click the link below to book your free 30 minute health review with me today

https://my.practicebetter.io/#/6053af492a832607e0c6b3c9/bookings