The birth of a baby is a joyous occasion. However, in the postpartum period the new mother may face a host of potential problems. These include the physical problems of fatigue, anemia, pain (from the episiotomy or Caesarean section), and breast soreness. Mental disturbances such as the “blues” or postpartum depression are also well-recognized.
These complications usually occur soon after the baby is born, and by the third month after delivery most women are feeling well. Unfortunately, that is not always the case and some women do not enjoy a rapid return to good health. In the past few years, it has become apparent that some of these women are ill because of postpartum thyroid disease, and may be helped to feel better with proper treatment.
A new Center for Disease Control report finds that an estimated 375,000 babies being born each year at risk of neurological problems due to exposure to mercury in the womb. The Mercury Policy Project report indicates that at least 10% of women of childbearing age have levels of mercury in their bodies that exceed what the U.S. Environmental Protection Agency considers acceptable – this translates to nearly six million women. In addition, the FDA has issued advice on mercury in fish bought from stores and restaurants, which includes ocean and coastal fish as well as other types of commercial fish. Women who are pregnant or could become pregnant, nursing mothers and young children should not eat swordfish/marlin, Ahi, king mackerel, shark (often sold as imitation crab), or tilefish.
Cows’ Milk, Lactose Intolerance
Since lactose is found in mother’s milk, almost all infants of nursing age are able to digest it. But past weaning and with increasing age, progressively fewer children retain this ability. One study of black children found lactose intolerance in 11% of four- to five-year-olds, 50% of six- to seven-year-olds, and 72% of eight- to nine-year-olds. It is usually rare among North American white children under six years of age, but increases to 30% in adolescents.
“Most formula-fed infants developed symptoms of allergic rejection to cow milk proteins before one month of age. About 50-70% experienced rashes or other skin symptoms, 50-60% gastrointestinal symptoms, and 20-30% respiratory symptoms. The recommended therapy is to avoid cow’s milk.”
“Those who consumed cows milk were fourteen times more likely to die from diarrhea-related complications and four times more likely to die of pneumonia than were breast-fed babies. Intolerance and allergy to cow’s milk products is a factor in sudden infant death syndrome.”
Infrequently, severe cases of lactose intolerance in children have been shown to cause damage to the lining of the intestine and severe diarrhea.
Milk Production
Most problems with insufficient milk supply result from issues with breastfeeding during the first six weeks, when a mother’s milk supply is being established. A reduced milk supply may result from an insufficient number of feedings, limiting length of feedings, or improper positioning at the breast.
There are also maternal factors that have been associated with insufficient milk supply. Some medications, such as birth control pills, antihistamines and sedatives may decrease the milk supply. Smoking, excessive caffeine intake (more than 5 cups per day), hormonal problems and fatigue have also been associated with poor milk ejection reflex.
Although uncommon, a mother may be born with insufficient glandular tissue. Breast surgery, especially breast reduction, can have a similar effect.
Babies themselves can also play a part in insufficient milk supply. A baby with a tight or short frenulum (tissue anchoring the tongue to the floor of the mouth) may not be able to nurse properly, unless it is clipped.
Weight loss after pregnancy
It can be difficult to loss weight if there was too much weight gain during pregnancy. Fat deposits,during pregnancy, can increase by more than a third of the total amount a woman had before she became pregnant. If the weight gain was normal, most women lose this extra weight in the birth process and in the weeks and months after birth. Breastfeeding helps to deplete the fat deposited during pregnancy. A woman who breastfeeds expends at least 500 more calories than one who doesn’t. The woman who nurses her baby also has increased needs for specific nutrients, and should not be on a weight loss diet.
Should you breastfeed while pregnant?
As a general rule, if it’s safe for you to have sex, it’s safe for you to breastfeed. There are, of course, legitimate reasons why certain mothers may be advised to wean — and abstain from sex — when they become pregnant (such as those with a history of preterm labor, premature delivery, or miscarriage, women who experience uterine pain or bleeding, and others with the potential for higher-risk pregnancies). But for most mothers, breastfeeding while pregnant is perfectly safe. In fact, in many regions of the world, women routinely breastfeed one child while pregnant with the next.
Vaccinations
Whether to vaccinate or not is a controversial and complex subject. There are many websites dedicated to informing parents regarding this issue. Many states accept vaccination waivers based on religious grounds and samples of religious waivers are available on the Internet.
Here are some guidelines to assist you if planning to have your child vaccinated:
- The older the infant, the better. Delaying vaccination reduces the likelihood of negative consequences.
- The healthier the infant, the safer. Don’t vaccinate when the infant or child is ill.
- Blood type suggestions, for those interested in the “Blood Type Diet”:
- Blood Type O children: Be alert for any sign of inflammation (fever, joint pain). Avoid injectable polio and use the oral version instead since type Os seem to need a less potent form. Don’t give acetaminophen (Tylenol) for vaccine-related problems, as type O children seem to do poorly on it.
- Blood Type A and AB children: They respond well to vaccines and a full program should produce few side-effects. Use the injectable instead of the oral polio vaccine as digestive mucus does not react well to the oral vaccine in these blood types.
- Blood Type B children: Sometimes type Bs have neurological reactions that may occur as a result of cross-reactivity with the vaccine, resulting in the body attacking its own tissues. Be alert for any crawling or personality changes and make sure they are completely healthy before vaccination. As with type Os, use the oral polio vaccine.
- The likelihood of severe reactions can be reduced by giving 500mg of vitamin C just prior to the vaccination. If convulsions occur within a day or two after vaccination, Vitamin C should be given by injection.
Australian health professionals have raised concerns that controlled crying, also known as controlled comforting and sleep training, may have a negative impact on the emotional and psychological health of infants. Controlled crying involves leaving a crying baby for increasing periods of times before coming to comfort them in an attempt to teach them to put themselves to sleep and not cry out during the night. The researchers say that it is normal for babies and young children to not sleep through the night, and their crying is a sign of distress. Although controlled crying may teach children to stop crying, it may also teach them not to seek help when they are upset.
SIDS – Sudden Infant Death Syndrome
A study released this week (Oct 9, 2008) by the Archives of Pediatrics & Adolescent Medicine, found that having a fan going in the room where a baby sleeps decreases the chances of Sudden Infant Death Syndrome (SIDS) by a startling 72%.
Doctors reportedly don’t know all the reasons why this seems to work, except that improving circulation of the air in baby’s room (though not blowing directly on the child) is important since the infant’s neck muscles are not strong enough to always turn his head toward fresh air. Exhaled carbon dioxide can build up, says the study, between the baby’s face and the mattress, causing him to re-breathe that used air.
The research needs further study, says Marian Willinger of the National Institutes of Health, and she reiterates that putting a baby on her back to sleep is still the most important way to prevent SIDS.
Conditions that suggest Motherhood Issues
Zinc Requirement
If zinc intake is chronically low, breastfeeding further increases the risk of zinc deficiency in the mother due to the greater need for zinc during lactation.
Risk factors for Motherhood Issues
Vitamin A Requirement
See link between Female Infertility and Vitamin A Deficiency.
Motherhood Issues suggests the following may be present
Schizophrenia
A study released from Finland shows that baby boys given vitamin D supplements had a reduced risk of schizophrenia. This same benefit was not observed in the girls. The boys were given 2,000 units of vitamin D. Perhaps all children need vitamin D supplements if they are not exposed to sunshine, especially breast fed babies (there is little usable vitamin D in breast milk). [Schizophrenia Research April, 2004;67(2-3): pp.237-45]
Recommendations for Motherhood Issues
Fish Oil / Krill
In one study, participants were given 15gm flaxseed oil daily for 12 weeks. Quantities of EPA, DPA, DHA or total omega-3 fatty acids did not increase in plasma or erythrocytes. Moreover, after the flaxseed oil supplementation was stopped, ALA concentrations in the blood and breast milk reverted to the original concentrations. On the basis of this study, flaxseed oil is not an ideal source of fatty acids for breast-feeding mothers. Fish oil, containing preformed EPA and DHA, is a better source of these fatty acids than flaxseed oil for mothers breast-feeding their babies. [AJCN January 2003 77: pp.226-233]
Probiotics / Fermented Foods
Gastrointestinal alterations in bacterial flora are common in infants suffering from allergic disease or who will develop allergic disease later. Probiotic supplementation helps normalize and strengthen the lining of the GI tract in infants. Eczema symptoms have been reduced in infants when they were supplemented with probiotics. In addition, probiotic supplementation in mothers for 6 months before and after birth reduced the incidence of eczema in their children by 50%. [Brit J Nutr 2002 Sep; 88 Supp 1: pp. S19-27] Antibiotic use in early infancy has been associated with an increased risk of allergic disease in later childhood, which is in keeping with the understanding that a disturbed GI flora will contribute to an allergic tendency. A family history of atopic disorders like dermatitis further suggests that probiotic supplementation would be wise both pre- and postnatally.
Vitex
In one study of 100 nursing mothers, vitex was shown to significantly improve milk flow and milk-release when compared to placebo. Vitex is traditionally taken the first day after birth and continued for ten days. Vitex is only recommended if there are any problems with milk production.
Saw Palmetto (Serenoa repens)
Saw palmetto should not be taken by women who are pregnant, nursing or trying to conceive, because it affects sex hormone levels.
Caffeine/Coffee Avoidance
Coffee should absolutely be avoided during breast feeding. Fetuses and newborns cannot metabolize caffeine in their livers, so it remains in their bodies for up to four days, stimulating their nervous system the entire time, causing irritability and sleeping difficulty.
Grain-free / Low Starch Diet
Feeding infants cereal may be associated with an increased risk of developing type 1 diabetes mellitus autoantibodies, according to a study. [JAMA October 1, 2003;290(13): pp.1713-20] Children at an increased risk of type 1 diabetes who were fed cereals between the ages of 0 and 3 months and at age 7 months or older had an increased risk of developing type 1 diabetes later in life. The results suggest that exposing susceptible children to cereal during certain ages increases their risk of type 1 diabetes.
Weight Loss
Lots of new moms regain their figure within 8-12 months. The best time to start exercising (again) is about 5-6 weeks after the birth. Set little goals, like doing 10-minutes of exercise each day and then gradually increase it. Ideally, aim to achieve a regular 30 minutes exercise per day. Exercise brings physical and psychological benefits.
If you gained no more than the recommended 22-30 pounds, it should take you about 4-6 months to lose it. For extra weight gained, aim to lose an average of 1 pound per week with exercise. Weight loss dieting, if necessary, should be avoided, especially if breastfeeding.
Increased Fish Consumption
Based on the recommendations of the Environmental Working Group and the U.S. Public Interest Research Group, it is recommended that shark, swordfish, king mackerel and tilefish, tuna, sea bass, halibut, marlin, pike, Gulf coast oysters and white croaker not be eaten by pregnant women and women of childbearing age who might become pregnant due to mercury contamination. It also recommended that nursing mothers and young children steer clear of these fish. In addition, the report says canned tuna, mahi-mahi, cod and pollack should not be eaten more than once a month.
Melatonin
On the basis of theoretical ideas about how melatonin works, some authorities specifically recommend against using it for depression, schizophrenia, autoimmune diseases and other serious illnesses, and in pregnant or nursing women.
Reading List
Gut and Psychology Syndrome (GAPS) – Natural treatment for autism, ADHD/ADD, dyslexia, dyspraxia, depression and schizophrenia. Written by Natasha Campbell-McBride MD.
DHA (docosahexaenoic acid)
Despite a significant body of evidence that docosahexaenoic acid, or DHA, is the essential structural ingredient of breast milk lacking in infant formulas, the Food and Drug Administration banned its use in infant formulas in the U.S. as of 2001. A recent series of studies conducted worldwide indicate that breastfed babies have an IQ of 6-10 points higher than formula·fed babies. The FDA has finally allowed DHA to be added to infant formulas. Enfamil LIPIL was the first infant formula supplemented with DHA and ARA to be introduced in the United States. Others have followed suit, making their products also more like breast milk.
Scientists and nutritional experts attribute this to DHA, an essential structural component of the brain and retina, found naturally in mother’s milk. DHA has received glowing recommendations from the World Health Organization, the Food and Agricultural Organization of the United Nations and the National Institutes of Health.
Approximately 60% of the human brain is composed of fatty material; 25% of that material is DHA. Since humans cannot produce it, they must consume it. Studies show that the DHA level of women in America today is comparable to that of women in Third World countries. This is attributed to the trend against eating DHA rich foods such as fish. Fish oil is the best source of DHA and EPA.
During the last trimester of a pregnancy the mother transfers to her fetus much of the DHA needed for the development of its brain and nervous system. The DHA content in the mother’s diet reflects the amount of DHA passed on to the baby. If the baby is not breastfed at all, it receives no subsequent DHA, thus hindering and impairing mental and visual acuity. DHA levels of premature infants are especially low since they miss much of that last trimester. Premature infants are also more likely to be bottlefed. If using infant formulas, make sure they contain DHA or use DHA supplementally.
In a dietary study of 119 pregnant or lactating women in the United States, the average intake of DHA was 54mg/day, only 18% of that recommended by experts. Less than 2% of these women met the FDA’s recommended DHA adequate intake of 300mg per day. [Obstet Gynecol, 2000;95(4 Suppl 1): pp.S77-S78]
Lecithin / Choline / GPC
According to a study, the important nutrient choline “super-charged the brain activity of animals in utero, which resulted in the creation of larger cells that were quicker at firing electrical “signals” that release memory-forming chemicals.
These significant changes in the brain could be used to explain how choline improved learning and memory in animals in earlier behavioral studies. Researchers said this data could mean boosting cognitive function, diminishing age-related memory decline and decreasing the brain’s vulnerability to toxic insults in children. This research has led to the decision to raise choline to the status of an essential nutrient, particularly for pregnant and nursing women.
Choline can be found as a naturally occurring nutrient in egg yolks, milk, nuts, fish, liver and human breast milk. [Journal of Neurophysiology April 2004;91(4): pp.1545-55]
Vitamin A
The risk of vitamin A deficiency is higher for young children whose mothers are vitamin A deficient. Maternal vitamin A deficiency results in reduced fetal stores and lower levels of vitamin A in breastmilk.
Infants and young children who are vitamin A deficient are at an increased risk of appetite loss, eye problems, lower resistance to infections, more frequent and severe episodes of diarrhea and measles, iron deficiency anemia, and growth failure. Infections and inflammation accelerate the use and loss of vitamin A.
The increased risk of illness leads to an increased risk of death. Studies show that in communities where vitamin A deficiency is prevalent, improving vitamin A status reduces child deaths by an average of 23%. Vitamin A is particularly protective against deaths due to diarrhea and measles and may reduce the severity of malaria symptoms.
In the first six months of life, breastmilk protects the infant against infectious diseases that can deplete vitamin A stores and interfere with vitamin A absorption. Vitamin A intake of a breastfed child depends on the vitamin A status of the mother, the stage of lactation, and the quantity of breastmilk consumed. From birth to about six months of life, frequent breastfeeding can provide the infant with all the vitamin A needed for optimal health, growth, and development. Breastmilk is generally higher in nutritional value than alternative foods and liquids fed to children in developing countries. Consumption of other foods decreases the amount of breastmilk consumed and may disrupt the infant’s absorption of vitamins and minerals from the breastmilk. Therefore, exclusive breastfeeding until six months of age helps ensure sufficient vitamin A intake.
Key
| Weak or unproven link |
| May do some good |
| Likely to help |
| Highly recommended |
| May have adverse consequences |
| Reasonably likely to cause problems |
| Avoid absolutely |
Glossary
Postpartum
After childbirth.
Anemia
A condition resulting from an unusually low number of red blood cells or too little hemoglobin in the red blood cells. The most common type is iron-deficiency anemia in which the red blood cells are reduced in size and number, and hemoglobin levels are low. Clinical symptoms include shortness of breath, lethargy and heart palpitations.
Postpartum Depression
The "baby blues" are a very frequent and completely normal consequence of childbirth, usually wearing off soon afterwards as hormonal and psychological systems get back to normal. Postpartum depression is a less common but severe depression that begins in the weeks following delivery. It impairs the ability of the mother to care for the child and fall in love with it. This makes her feel even more depressed and inadequate thinking that she can not be a good mother. At the extreme, postpartum depression may lead to dangerous delusions (for example, thinking the baby is in some way deformed or cursed) or hallucinations (that may command violent acts). This can occasionally result in a tragic episode of suicide and/or infanticide.
Thyroid
Thyroid Gland: An organ with many veins. It is at the front of the neck. It is essential to normal body growth in infancy and childhood. It releases thyroid hormones - iodine-containing compounds that increase the rate of metabolism, affect body temperature, regulate protein, fat, and carbohydrate catabolism in all cells. They keep up growth hormone release, skeletal maturation, and heart rate, force, and output. They promote central nervous system growth, stimulate the making of many enzymes, and are necessary for muscle tone and vigor.
FDA
The (American) Food and Drug Administration. It is the official government agency that is responsible for ensuring that what we put into our bodies - particularly food and drugs - is safe and effective.
Lactose Intolerance
A condition caused by a lack of an enzyme called lactase, which, in turn, causes the body to be unable to digest lactose, a sugar found in milk products. Common symptoms, which begin about 30 minutes to two hours after consuming foods or beverages containing lactose, may include: nausea, cramps, bloating, gas and/or diarrhea. The severity of symptoms varies depending on the amount of lactose consumed and the amount that an individual can tolerate.
Protein
Compounds composed of hydrogen, oxygen, and nitrogen present in the body and in foods that form complex combinations of amino acids. Protein is essential for life and is used for growth and repair. Foods that supply the body with protein include animal products, grains, legumes, and vegetables. Proteins from animal sources contain the essential amino acids. Proteins are changed to amino acids in the body.
Gastrointestinal
Pertaining to the stomach, small and large intestines, colon, rectum, liver, pancreas, and gallbladder.
Allergy
Hypersensitivity caused by exposure to a particular antigen (allergen), resulting in an increased reactivity to that antigen on subsequent exposure, sometimes with harmful immunologic consequences.
Diarrhea
Excessive discharge of contents of bowel.
Milligram
(mg): 1/1,000 of a gram by weight.
Vitamin C
Also known as ascorbic acid, Vitamin C is a water-soluble antioxidant vitamin essential to the body's health. When bound to other nutrients, for example calcium, it would be referred to as "calcium ascorbate". As an antioxidant, it inhibits the formation of nitrosamines (a suspected carcinogen). Vitamin C is important for maintenance of bones, teeth, collagen and blood vessels (capillaries), enhances iron absorption and red blood cell formation, helps in the utilization of carbohydrates and synthesis of fats and proteins, aids in fighting bacterial infections, and interacts with other nutrients. It is present in citrus fruits, tomatoes, berries, potatoes and fresh, green leafy vegetables.
Zinc
An essential trace mineral. The functions of zinc are enzymatic. There are over 70 metalloenzymes known to require zinc for their functions. The main biochemicals in which zinc has been found to be necessary include: enzymes and enzymatic function, protein synthesis and carbohydrate metabolism. Zinc is a constituent of insulin and male reproductive fluid. Zinc is necessary for the proper metabolism of alcohol, to get rid of the lactic acid that builds up in working muscles and to transfer it to the lungs. Zinc is involved in the health of the immune system, assists vitamin A utilization and is involved in the formation of bone and teeth.
Lactation
Production of milk; period after giving birth during which milk is secreted in the breasts.
Vitamin A
A fat-soluble vitamin essential to one's health. Plays an important part in the growth and repair of body tissue, protects epithelial tissue, helps maintain the skin and is necessary for night vision. It is also necessary for normal growth and formation of bones and teeth. For Vitamin A only, 1mg translates to 833 IU.
Vitamin D
A fat-soluble vitamin essential to one's health. Regulates the amount of calcium and phosphorus in the blood by improving their absorption and utilization. Necessary for normal growth and formation of bones and teeth. For Vitamin D only, 1mcg translates to 40 IU.
Schizophrenia
Any of a group of psychotic disorders usually characterized by withdrawal from reality, illogical patterns of thinking, delusions, and hallucinations, and accompanied in varying degrees by other emotional, behavioral, or intellectual disturbances. Schizophrenia is associated with dopamine imbalances in the brain and defects of the frontal lobe and is caused by genetic, other biological, and psychosocial factors.