The postpartum period can be a transformative, beautiful experience for new parents, however, it is not without a dark side for many. I personally experienced both the euphoric stage of new motherhood, as well as the anxious and depressed state that many women experience.
Perinatal/postpartum mood and anxiety disorders (PMAD) affect approximately 15 to 20% of new mothers. This may underestimate the prevalence of PMAD; the signs and symptoms may be missed and attributed to being a ‘normal’ part of motherhood, or, mothers may resist acknowledging the signs because of stigma or societal pressures.
If prolonged and untreated, PMAD’s can be detrimental to maternal health and the child’s development. As such, is important that we work to improve our screening/identification and treatment approaches for this group of women.
Naturopathic Medicine, with its emphasis on treating root causes and viewing health more holistically, is well suited to support women with PMAD’s. There are many factors or root causes that may be involved in the development of a PMAD, including but not limited to the following: personal history, family history, social support, birth experiences/trauma, stressors, nutritional status, and thyroid/hormonal factors.
In my experience, the most overlooked factors are nutritional status, stress levels, and thyroid/hormonal imbalances. First, is not uncommon for women to be undernourished during their pregnancy and when a new baby enters the picture. She may have forgotten to take her prenatal multivitamin, have pre-existing nutrient deficiencies, or feel like she doesn’t have the time or energy to nourish herself properly.
Elevated stress hormones are also common in this group of women. The stress hormone, cortisol, may high be due a variety of factors, including but not limited to: birth trauma, lack of support, financial challenges, relationship stress, and lack of sleep.
Further, the risk for developing hypothyroidism (an under active thyroid) is greater in the postpartum period. Hypothyroidism may develop due to nutrient deficiencies, prolonged elevation in cortisol levels, and hormonal and immune system changes associated with pregnancy and postpartum. Hypothyroidism is a common cause of depression, anxiety, and fatigue, and must be ruled out in all cases of PMAD.
In my opinion, the treatment approach to PMAD should be collaborative in most cases. Involvement of the woman’s G.P., a Psychologist or Social Worker, and an N.D. would address several facets of the PMAD. In moderate to severe cases medication may be necessary for a period of time. Counselling or CBT is also important to develop healthy coping strategies and to re-frame negative thought patterns.
My approach as a Naturopathic Doctor would begin with a comprehensive screening of thyroid tests and nutrient levels (ie. Vitamin B12, Iron status, Vitamin D3) in these women in order to better identify and treat any possible physiological underpinnings. Following a careful assessment of patient history and blood work, I work with women to optimize their nutritional status and provide dietary counselling, I encourage healthy lifestyle factors such as exercise, self-care, and mindfulness practices, and provide individualized nutritional or herbal supplement recommendations.
As an ND who has seen many women with PMAD, in addition to my personal experience, I have developed a deep understanding and empathy for this group of women. They deserve a thorough assessment of their physical, mental, and emotional health, as well as an individualized treatment plan to help them cope, overcome their PMAD’s, and improve their well-being so that they can be more present mothers for their babies and be their best selves.
By Anna Totzke, Registered Acupuncturist
Tuina is a type of bodywork based on Traditional Chinese Medicine principles. Tuina focuses on the pathways in the body called meridians to help encourage circulation in the body. Acupressure is also applied to acupuncture points to promote healing. Depending on the client’s constitution and concern, various Tuina techniques are used to help the body to heal by either: unblocking, nourishing, warming/cooling, dispersing/gathering, stimulating/calming, and helping with circulation throughout the body.
I enjoy applying Tuina along with cupping, acupuncture, or moxibustion but is a wonderful and effective treatment on its own. Tuina is also a great option for people that would prefer a needle-less treatment or a more hands-on approach.
Tuina Can Help With:
Muscle and Joint Pain and Weakness: Back pain, frozen shoulder, tennis elbow, cervical spondylosis, wry neck, chronic neck and shoulder tension, back pain, sciatica, leg pain, hip pain
Menstrual / Fertility: PMS and menstrual problems, painful periods, irregular menstruation, amenorrhea, fibroids, infertility
Digestive: Digestive & inflammatory bowel conditions (IBS, colitis, constipation, diarrhoea, Indigestion, poor appetite, epigastric pain, abdominal pain)
Head / Sinus Issues: Headaches and migraines, Sinusitis, allergic rhinitis, facial paralysis, toothache, teeth grinding, TMJ issues
Respiratory / Chest: Palpitations, angina, cough and asthma, plumstone throat, rib tightness
Emotional / Mental: Stress, depression, anxiety, insomnia
By Jill Jackson CNP, NNCP
If you are a Canadian citizen, chances are high that you have been taught to follow or at the very least, seen Canada’s Food Guide at some point in your life. I vividly remember being taught to follow it in school, even starting as early as grade 7 and 8. From a young age, I questioned the lack of individuality the food guide had to offer. How could a food guide really work for all Canadians who varied in age, genetic predispositions, weight, gender and so many other differentiating factors?
First, let’s have a quick history lesson. Where did this food guide originate? It was first released to the public in 1942 with the title “Canada’s Official Food Rules”. It was originally intended to assist with wartime nutrition and food rationing during a time when poverty overtook many areas of the country. There was 6 initial food groups: milk, fruit, vegetables, cereals & bread, meat & fish and eggs. Despite being made by the Nutrition Division of the Federal Government and the Canadian Council on Nutrition, it was evident that war time efficiency was of top priority, rightfully so. However, suggestions such as 4-6 slices of bread and only 1-2 servings of vegetables a day are hard to see as a nutritionist!
There were a few small changes and revisions made along the way. The guide continued to use emphasize food preservation/rationing and the term “Food Rules” was continued until 1949 when it changed to “A Pattern for Meals”. Providing an example of a “idealistic” breakfast, lunch and dinner, with bread and processed margarine still being a main staple.
Revisions continued to become more specific. Finally, in 1977 terms such as “Meat and Alternatives” were introduced, at last giving an alternative option to those who wished to get protein elsewhere. In 1992, there was a large change in how the guide was presented. There were more suggestions, and it was appealing to the eye, getting Canadians excited about nutrition. It even recognized nutrition changes based on age and activity level and increased the suggested serving of fruits and vegetables jumped to 5-10. Unfortunately, the “grains” category still remained the biggest food group with the suggestion of a whopping 10-12 servings daily!
Finally, in 2007 there was a huge revision that took into account gender and age! Fruit and veggies remained a prominent category, oils were considered, dairy alternatives were considered and suggestions for including exercise were given as part of a healthy lifestyle. It was translated into many languages as Canada continued to grow to be a multicultural country. In my opinion, this was a great step! This is the guide I remember growing up with.
Now the current 2019 food guide is part of the Government of Canada website. The main page shows a picture of a portioned plate with a variety of foods within each portion. From a far, the plate looks fairly well rounded. Half the plate is filled with different fruits and vegetables, a quarter of the plate filled with meat and alternatives and a quarter filled with various grains. The main written suggestions on this picture simply state the following;
- Have plenty of fruits and vegetables
- Eat protein foods
- Make water your drink of choice
- Choose whole grains
The next sliding page goes on to state a few more helpful suggestions with linked articles as to how to carry through with them.
So the big question you have all been waiting for…
IS THIS HEALTHY?
My answer…it depends.
Here’s what is positive about it: It looks pretty, a bonus for drawing the reader’s attention towards nutrition. It is definitely is more diverse than it used to be. It also provides a wonderful amount of links for further reading! It caters to First Nations and Indigenous people. Also, I never thought the Canadian Food Guide would be suggesting mindful eating practices, but it does and that’s awesome! It’s translated into more languages than ever before, as Canadas diversity continues to grow. And last but not least, most importantly, it is emphasizing fruits and vegetables as half your plate, making it the predominant food choice.
Unfortunately, I still feel there are a long list of cons. I will just name a few as to not keep you reading all day.
- It has reverted back to taking away gender, age and food groups making it less specific. I understand the attempt to make nutrition less confusing, but diet is not a one-size-fits-all situation and people should be given that disclaimer front and center.
- Food groups have now disappeared on the main page. It is replaced with the saying “eat a variety of foods each day.” I know what this saying is referring to (as a trained nutritionist) however, the average person may be eating a variety of different processed foods or a variety of foods all within one food group and still consider that “a variety”. Though the picture is great, the comments on the main page have become extremely vague. Unless people are clicking on the links a page over, I feel it leaves much for incorrect interpretation.
- It still is heavily influenced by conventional dairy and meat products which do not always need to be essential in a healthy diet and in many instances can cause health issues. In the 6 recipes given as suggestions I still found ingredients such as conventional low fat yogurt, margarine, and light mayo. There is now so much science and research showing how these foods can be damaging to the human body! It has me scratching my head as to why they are still included.
- Common allergens such as gluten, dairy and eggs are not overly taken into account. It leaves limited options for those suffering from all to common allergies and intolerances.
- There is a more in-depth guideline under the websites subheading “For Professionals”. It has further explanation and evidence. I feel this information should be front and center for all to read. It would limit confusion and give people the information they need to feel impowered to eat better. Nutrition is so important, it is literally what keeps us living on a day to day basis!! Information such as this should not be marketed to professionals only.
In conclusion, I hope you take the Canadian Food Guide with a grain of salt. Clearly, suggestions from the Canadian Food Guide have not always worked as a majority of Canadians still walk around overweight, underweight, sick, or nearly dead! If you have never considered nutrition before, it may be a good place to begin, but please also consider what has been stated above. Always remember that no two people are the same, therefore, no two diets should be either.
I could ramble about this interesting topic for days, so if you have questions or any opinions to add please feel free to leave a comment or shoot me an email! I would love to hear from you.
Jill Jackson CNP, NNCP
If you’re wanting to conceive this spring/summer, you’ve got just enough time to focus on your preconception health! Because it takes approximately 100 days to impact egg and sperm quality as they mature, I recommend that both partners begin their ‘trying’ journey by taking 3-4 months to prepare their bodies and minds.
As a women’s health, fertility, and perinatal care-focused ND, my goal is to help you achieve a healthy pregnancy and baby. I struggled with my own fertility and pregnancy issues, so I truly understand the emotional impact as well as the need for a more holistic and integrative approach to preconception healthcare and fertility.
Preconception healthcare can help treat the root cause of fertility issues, can reduce risk of miscarriage or pregnancy complications, and improve fertility treatment outcomes. It can also ensure the best possible start for your baby, as the beginning of a child’s life has been shown to influence his/her health as an adult.
A preconception healthcare approach with me includes the following: lab testing, diet and lifestyle modifications, stress reduction and mindfulness practices, and individualized supplementation protocols.
Lab tests are done to determine thyroid function, hormone levels, nutrient levels such as iron, B12, and vitamin D3, and more depending on my assessment of your current health and health history.
Individualized dietary and lifestyle modifications are essential: they set the foundation for optimal fertility! I help my patients establish a whole foods fertility diet and healthy lifestyle habits such as optimizing sleep and exercise. Stress reduction and mindfulness practices are woven into their plan as stress has a significant impact on fertility.
Finally, individualized supplementation protocols are provided to each of my patients. The supplements I select help to optimize preconception nutritional status, and treat any underlying disorders/imbalances that may impact fertility.
I find it truly amazing how getting diet, lifestyle, stress reduction/mindfulness practices, and supplementation right can make the world of a difference in fertility and pregnancy outcomes. If you or someone you know is beginning their journey, I would be so happy and honoured to help.
Water is one of the most vital things for human life. Without water we would all be dead within 4 days to a week. As morbid as that may be, it shows how essential it is for human life. Collectively the human body is between 60-66% water, that’s a pretty large percentage! This percentage is even larger when the human fetus is developing in the womb (up to 80%). Our bones contain about 30% water, and it is a main component of all fluids in our body.
Water is involved in many important functions such as:
- Body temperature regulation
- Elimination of waste
- Elimination of toxins
- Digestion and absorption
- The carrying of electrolytes
That’s just to name a few. In a 24 hour day we lose 1.5 liters of water through urine only. Also an additional 400ml through the breath, 150ml through feces and 750ml through our skin. That equals 2.8 liters of water loss every single day. The simple answer would be to say that 2.8 liters is the amount of water we should be drinking each day. However, the body can make a small amount of water by metabolizing certain nutrients and we also receive water directly from food. This still leaves us with an average of 1-1.5 liters of water that we need to get from elsewhere.
Why 6-8 glasses?
Why does this magic number ‘6-8’ appear everywhere? It’s because 6-8 cups are an estimated daily intake that stems back to a 1945 US Food and Nutrition Board recommendation. A little outdated if you ask me! Water intake will vary depending on your size, activity level, climate, and your diet. It should be completely individualized to you!
The consequences of not drinking enough water:
With all the functions adequate water consumption supports, there is bound to be a host of negative things that can happen to our bodies when we lack proper hydration. Dehydration can affect both our physical and mental health. Water protects our organs and digestive system. Dehydration can cause gastric ulcers, asthma, allergies, high blood pressure, irritation, migraines, lupus, light headedness, and chronic fatigue. It can even cause things like joint pain since cartilage cushioning requires water to remain fluid and function properly. A lot of these symptoms can be missed or be mistaken to be caused from other ailments.
Is there a maximum amount of water you should intake?
Drinking above around 2 liters daily can be harmful to your body. Too much water can be hard on your kidneys, causing over hydration. In severe cases, you can die. A few cases have been seen in marathon runners or people who take certain drugs, disturbing their thirst reflex. Keep in mind there has been far more people who have died from dehydration than over hydration. It is rare, but it can happen.
How should we get water into our diet?
We should get water from water, and we should never try to obtain hydration simply from sugary pops and coffee. Water is the simplest form of hydration. There is a ton of debate about what water is best. However, a high elevation spring water seems to be the cleanest and purest source but realistically it is not attainable for all. Tap or city water can contain a horrible amount of toxins. It can be hard to know what dangers can be found in our tap water, for this reason, I recommend water that has had some type of filtration. Installing a reverse osmosis tap would be a great option. Cost wise this may not be an option for many, in that case I recommend the Santevia jug filters. Any filtration is better than none!
In summary, water is absolutely life sustaining. Sadly, I feel that much of the world’s Western population lives day to day unknowingly dehydrated. If you haven’t already, add proper hydration to the top of your health goals and you will soon see the difference it can make in your daily life!
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