Meg 'the Paleo Midwife's' guide to Coffee, Tea and other Primal Brews in Pregnancy: Part 1 Herbal Tea

Wake up, do some yoga stretches, turn on the kettle and make your morning warm cup-a-goodness….wait….now that you’re pregnant, is this lovely morning ritual still okay?  What’s safe, what’s not? Here’s one Paleo Midwife’s take on the whole situation around tea and coffee in your paleo pregnancy.

Herbal Tea

Beneficial teas:

Red Raspberry Leaf:

- Acts as a natural uterine tonic. It won't put you into labour, but helps encourage the upper and lower uterine segments to learn to work together, which they need to do efficiently during labour. Think of it as a WOD for your uterus.

- When taken during pregnancy, red raspberry leaf is also believed to support your   immune system, ease morning sickness and promote better circulation, as well as assist with breast milk supply.

- One Study has shown that women who take red raspberry leaf have reduced incidence of birth interventions. Women who drink red raspberry leaf tea regularly towards the end of their pregnancies also have a shorter second stage of labour than those who don’t (after baby before the placenta) .

- The taste of raspberry leaf is a kind of ‘hay like’ or bitter, so you may want to sweeten it with some honey.  You can also buy it in premade bags. Yogi tea and Traditional Medicinal's both make good blends.  If you’re in your first trimester, one cup per day is great to drink. Aim to slowly increase amounts until you are in your third trimester, when I recommend up to 4-5 cups daily.

Ginger: May help combat nausea and can aid in digestion.

Nettle: Nettle will support kidneys, ease leg cramps and muscle spasms, reduce hemorrhoids and increase richness and amount of breast milk. Nettle also prevents kidney and bladder infections, aids in iron absorption and reduces blood sugar. Nettles are high in vitamins A, C, K, calcium, potassium, and iron. Use in smaller amounts during pregnancy.

Dandelion: Helps with fluid retention, aids in liver detoxification and support. Again, this tea is recommended in small amounts, please drink occasionally.

Peppermint: Great for nausea and digestion. May make GERD a bit worse in some women. Consume as much as you like.

Lemon/Lemon Balm: May help ease anxiety and is great when blended into another flavor of tea. 

Rooibos aka Red Tea: Full of antioxidants and may help with GERD/reflux. Consume as much as you enjoy.  Makes a great “latte” and Red Espresso can be made in an espresso maker. I swear by this product www.redespresso.com As a former coffee snob, this tea blend creates a crema similar to a fine espresso. 

Teas Avoid

Licorice:  May raise blood pressure and contribute to fluid retention. A little bit in a blend is okay but don't drink it on it's own. 

Chamomile:  Chamomile has such powerful anti-inflammatory properties that regular consumption may result in a serious fetal heart problem, premature constriction of the fetal ductus arteriosus. This is the same reason why NSAIDS are to be avoided in pregnancy.

Senna: Is a natural laxative that can increase prostaglandin levels putting you at risk for preterm labour in addition to causing the runs and resulting dehydration and that's kind of a 'crappy' situation :) 

‘Meg the Midwife’s’ Pregnancy brew

Raspberry leaf 4 parts

Peppermint: 1 part

Nettle: 1 part

Third trimester: Dandelion 1 part

Blend these dried herbs and make a strong tea in a large glass jar by letting it sit overnight. Strain, and keep iced in the fridge.

Don’t have time to make my witches brew? Wanna buy it ?

Check out your local artisan tea makers, they often have great blends that are local and may be able to be customized. Otherwise, these are all good and tasty blends and available across North America. 

http://www.traditionalmedicinals.com/product/pregnancy-reg-tea

http://www.yogiproducts.com/products/details/womans-mother-to-be/


Stay tuned for my next post where I'll look at caffeinated beverages like coffee and tea...what's safe? What's not? Do you drink caffeine during your pregnancy? 

 

Balanced Bites Guest Post

Check out my guest post over on the Balanced Bites site, where I discuss solutions to help trouble shoot common digestive problems during pregnancy!  

If you aren't already familiar with the Balanced Bites site, you need to have a peak. Diane is not only terribly cute but is also a wealth of great information. Her book Practical Paleo is among one of my favourite health and wellness books of all time. It's beautifully written, colourful, creative and is an excellent guide to a balanced paleo diet and lifestyle. I recommend it to all of my clients who are being introduced to the paleo diet for the first time. Diane and her friend Liz Wolfe also host an awesome and sometimes hilarious Podcast  where they offer up great paleo friendly tips, answer listener questions about paleo living and fill your ear buds with hilarious banter about everything from Liz's adventures in homesteading, to the latest New Girl episodes to what was on their plate for dinner last night.  She's also getting ready to launch her 21 day Sugar Detox book, which I'm anxiously awaiting. 

Thanks again to the Balanced Bites team! I hope to continue to collaborate with them as I start this crazy journey into the world of blogging and information sharing :)  

 

Supplementing your Paleo Pregnancy

My post this week was inspired by a question from a reader wondering what supplements she should take during her Paleo pregnancy.  As always, I'm happy to answer questions and sometimes, like today, even elaborate a bit further. I hope you enjoy!

 

Does your supplement basket overfloweth??

More is not always better!

I do a comprehensive health history with every woman I see. Part of this process is asking what supplements she's taking.  I often see women with a laundry list of supplements a mile long! It seems both insane and totally overwhelming to both them and me! Unlike with chocolate, when more is always better, supplementing with high doses of vitamins and herbs is not always the best approach.

If you have a care provider than can test your levels of certain vitamins and minerals such as Vit C, zinc, Vit D, calcium ect then you will have a pretty good guideline on what and how much and what you need to supplement.

Vit D serves as a pretty good example. For the past 5 years, I’ve universally been recommending that all pregnant women should supplement with a minimum of 5000IU of Vit D. I frequently test women’s levels at the beginning of pregnancy; many are deficient, according to the lab reference ranges, which has supported my recommendation. However, new research suggests that optimal vit D levels may be much less than what was previously thought and may fall within the lower limit of the reference ranges.  In response to this, I now base my supplementation guidelines on a client's individual levels, exposure to sunlight, risk for type 2 diabetes, dietary consumption of vit K/A/D and cultural practices (is her face or body covered  for most of the year). Chris Kresser has a great podcast episode summarizing some of these new Vit D guidelines that's worth a listen. 

You are only as good as what you can absorb

Even if you consume a balanced Paleo diet of nutrient dense foods, we are only as good as what we absorb. Stress, sub-optimal sleep, poor digestion and inflammation can all affect the absorption of nutrients from our healthy diets. You can supplement all you like but if you don’t absorb what your taking in it’s literally like throwing money down the pipes. You can from your diet and your supplements:

Here are a few tips to ensure you’re maximizing nutrient absorption:

  • Take iron supplements like Floridix or Inate Iron Response with a food-containing vitamin C. Berries, colourful peppers or cauliflower are great choices. Take away from anything containing calcium such as dairy. Calcium blocks the absorption of iron.
  • Consume fat-soluble vitamins with some fat.
  • Consume vitamins/minerals with food and amino acids or probiotics on an empty stomach.
  • Ensure your digestion is at its best. Chew your food slowly and consider a high potency probiotic or consume grass-fed Kefir daily to help your gut flora flourish.

Try to get the bulk of your nutrients from whole food sources

  • Vit A/B’s - Organ meats like grass-fed beef or lambs liver 1/ wk.
  • Vit E- Organic Red Palm oil 3 times/wk.
  • Choline/Vit D- Egg yolks daily
  • Calcium/Vit D/omega 3- Sardines or other fatty bony fish 3/wk.

Consider supplementing wisely

  •  Fermented Cod Liver Oil or even better, if dairy is tollerated, Cod liver oil butter oil blend
  • Vit K2
  • High quality Probiotic like Inate Women's balance
  • A clean, high quality prenatal vitamin with folate. Watch for “folate” or “tetrahydrofolate not “folic acid”, which is an artificial chemical that can be converted by the body to folate.  Always read the labels and ensure that your vitamins are sourced from real foods and contain enzymes to aid in absorption and assimilation.
  • Extra Vit B6 if you are experiencing nausea
  •  Floridix or Inate Iron Response anemic or at risk for anemia (carrying twins or still breastfeeding)  

Have more questions…feel free to send me a question! Always happy to help you navigate your healthy Paleo Pregnancy.

 

Weight Gain during your Paleo Pregnancy

I'm just going to get right into it this week .... here we go !

I see women in my office all the time that are terrorized by the scale and their changing bodies. We live in a weight-obsessed society which supports the illusion that happiness is found in a certain shape, weight or dress size.  This belief system contributes to a feeling of extreme anxiety about the natural weight-gain associated with a healthy pregnancy. 

The Paleo and Primal communities are not immune to this quest for the ‘perfect’ uber lean female form.  I’ve witnessed it in many crossfit gyms, trail running circles and climbing communities. Women restrict carbohydrates, overtrain and beat themselves up about minor variances in daily macronutrient percentages and body fat compositions. It breaks my heart! We all struggle with body image issues in one form or another. Body image during pregnancy will be the topic of a future post but, while that's in development, Melissa over at Whole 9 has a great article all about pregnancy and body image that's worth checking out. 

pregnancy scale.jpeg

Pregnancy is a time to celebrate your body and honor its' wondrous adaptations. It’s also an ideal time to let go of any limiting mindsets and punitive thought patterns you might carry with you.  Take time to connect with your true self and authentic female form. Nurturing a balanced mind and body, as you journey into parenthood, will help your physical self thrive and lay a strong foundation for becoming a wonderful Cavemama to your little paleo babies.

This post is a launching pad for women with questions about weight gain in your paleo pregnancy.


"How much weight should I gain anyway?"

 

First you need to know your BMI. I know, I know, BMI is controversial. The BMI has been labeled by many as a really crummy measure of body mass. However, it’s all we’ve got and in my clinical experience, for most people, it is a pretty darn accurate measure of a healthy weight status.

How much you should gain based on your BMI

“Normal”: 18.5-24.9: 24-35lbs

“Overweight”: 25-29.9: 15-25lbs

“Underweight”: <18.5: 25-40 lbs.

“Obese”: 0-15lbs

Carrying Twins? 35-45lbs

Not sure what your BMI is? The Google machine will help you find out. Pregnant and wondering where you fit in? Health Canada has a handy online calculator that will give you guidelines for how much weight you should gain during your pregnancy.


Where does all that weight come from?

 

Baby: 7-8 pounds

Placenta: 1-2 pounds

Amniotic fluid: 2 pounds

Uterus: 2 pounds

Maternal breast tissue (awesome btw): 2 pounds

Maternal blood: 4 pounds

Fluid Retention: 4 pounds

Maternal fat and nutrient stores required for breastfeeding: 7 pounds

Most women can expect to gain about 2 to 4 lbs in the first trimester and continue to gradually gain during the second and third trimesters. A sudden peak in weight gain during the second trimester is not unusual, as maternal blood volumes have done a lot of rapid expansion. If you see this happening, it’s nothing to freak out about, take a chill pill, this is totally normal.

 


 “If I don’t gain much weight during my pregnancy then I won’t have much to lose it after the baby arrives.”

 

I hear statements like this far too frequently. They are abundant on web forms, in office waiting rooms and even in prenatal classes.  Honestly, restriction of calories before and during pregnancy and even during breastfeeding is never a good idea. Period. 

When a healthy woman restricts her calories in an attempt to hinder pregnancy associated weight gain, complications such as having a low-birth weight infant or premature delivery are more likely to occur. Babies who are born mothers that gain less than 20lbs are often considered small for gestational age (SGA), meaning they may have been essentially malnourished during pregnancy either by a malfunctioning placenta or due to inadequate maternal nutrition. These babies are born into an environment of perceived ‘famine’. This perception of chronic deprivation has been linked to numerous epigenetic alterations in metabolism, endocrine and nervous system development. This  sounds pretty bad, and it is, but the research is actually pretty cool. Or at least I think it is. I wish I had time to become a researcher and write a book about it!

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The epigenetic theory was first established in the early 1980’s when British scientist, David Barker, noticed a connection between low birth weight infants and elevated risk for heart disease later in life. Over the past 25 years, many researchers have replicated Barkers original results and today, epigenetic theory continues to reveal astonishing truths about how our genes are expressed and influenced by our environment. The epigenetic theory is explored and explained here by the ever articulate Chris Kresser.  

“The 9 months of pregnancy are the most consequential period of our lives, permanently influencing the wiring of the brain and the function of organs like the heart, liver and pancreas. They also suggest that the conditions we encounter in utero shape everything from our susceptibility to disease, to our appetite and metabolism, to our intelligence and temperament.”- Chris Kresser

“I’m gaining a TON of weight, what gives?”

Just as there are consequences for gaining too little during your pregnancy, there are also real consequences for gaining too much. Studies show that women who gain excessive amounts of weight during pregnancy may be at increased risk for preeclampsia, operative delivery and other less than desirable outcomes.  Epigenetic research (once again!) is providing us with some interesting evidence to support moderate weight gain in pregnancy.

One study found that women who gained > 45lbs in pregnancy had offspring that were predisposed to becoming obese when compared to women who gained the recommended 25-35lbs.  We are in the midst of a  “ Global obesity epidemic” and I believe that excessive weight gained in pregnancy is a real issue that contributes to future generations of overweight, obese children at risk for diabetes, heart disease and ill health. If you notice that your gaining a lot during pregnancy, take charge and have an honest look at your diet. Need more help? Send me a question and we can set up a private consultation.

Meg the Paleo Midwife's suggestions if you find yourself gaining a lot of weight:

  • Consider being tested for gestational diabetes by your midwife or doctor. Gestational diabetes can cause large, sudden spikes in weight gain starting at around 15-20 weeks. The Canadian standard of care for diabetes testing in low risk women is to offer a 50g Glucose Challenge Test at ~28 weeks gestation. If you find yourself gaining a lot before that, ask if the test can be done earlier.
  • Have your thyroid checked by your midwife or physician. Low thyroid levels can cause steady increases in weight gain as well as mood related changes that can put you at risk for postpartum depression. Low thyroid levels also contribute to low milk supply which can make breastfeeding (and your postpartum weight loss much more challenging).…that’s just a bummer.
  • Try doing a 7-day diet journal. Are you eating double portions, too many smoothies or fruit, excessive paleo treats or lots of nuts? Be honest with yourself
  • Are you rested? Chronic fatigue can lead to food cravings as the body attempts to fuel itself to stay awake! Perhaps you could benefit from an earlier bedtime or a nap.
  • Focus on clean Paleo eats.  Eat "twice as healthy", not "twice as much". You only require an additional 200 calories per day to fuel you pregnancy. Following a clean paleo diet with emphasis on nutrient dense foods like organ meats, well sourced proteins, healthy fats, egg yolks, leafy greens and colourful fruits and vegetables will see you through. Grassfed dairy is also excellent in moderation if that’s something you're into.

Do you need more primal or paleo friendly help? Feel free to contact me

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To Crossfit or not to Crossfit: Part 2

“Meg the Midwife's” suggestions for working out ‘Paleo-styles’ during pregnancy

 

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1- Listen. Listen to your body’s wisdom…really listen…if you are unable to listen then stop doing crossfit. This sounds harsh but it’s important. There are so many of us  “A” types (I totally include myself in this group) running around doing burpees and pull-ups when pregnant. The name of the game during pregnancy is to grow a new life, not to expose a six-pack or set a new PR. Your healthy baby and chilled out body is your new PR. So please, if it hurts, don’t do it. If you’re really tired that day, take a break. Do some light yoga or meditate; you’re doing lots of hard work just growing a new life. This is especially important in the first trimester when your placenta is embedding itself into your uterine wall. As the placenta becomes established, it anchors itself with spiral arteries that connect it directly into your circulation. These arteries supply your baby with oxygen and nutrients. If your body is constantly moving blood away from the uterus to fuel your muscles for a 'Fran' workout , these vessels may not develop in the most optimal way. The take away message: A healthy placenta equals a healthy baby. 

2- Nourish your mind, not just your body: Ask yourself this question every day...."Is my workout nourishing my body AND mind ?" Are you stressed?  If so, take a break. Prolonged fetal exposure to high levels of maternal cortisol (the stress hormone) have been shown to affect a child’s IQ and cognitive performance. High levels of stress may also contribute to low progesterone levels. Low progesterone in the first trimester puts you at risk for miscarriage. Stefani Ruper from the Paleo for Women has a great post about stress induced low progesterone that's worth checking out! 

3-Scale: Be sure to properly scale your workouts. Check out crossfit mom for proper scaling suggestions. Join a crossfit mom’s group. No class at your gym, ask if you can start one! It’s a great way to connect with other pregnant and postpartum mom’s in a supportive environment. Balance your crossfit workouts with lots of long walks or hikes in nature. Being in nature has been shown to improve mood and overall wellbeing. Check out Mark's post here for more reasons why we should spend more time in nature. 

4- Chill out: Try to incorporate some sort of relaxation, meditation and muscle relaxing component to your workouts. Gentle restorative prenatal yoga and hypnobirthing meditations are great choices. Practice releasing, rather than engaging your pelvic floor muscles. The Spinning Babies site is one I recommend to many of my clients. The side-lying exercise found here, can be especially helpful if you're a crossfit athlete, runner or cyclist and may have some muscular imbalances in your pelvic floor.

5- Refuel:  If you're working out be sure to refuel your body with lots of filtered water (I like this filtration system) and healthy nutrient dense paleo or primal meals. 

 Recipe for a healthy Paleo Pregnancy Fitness Plan

2x Crossfit mom's/week

Lots of walks or hikes outside in nature

A healthy pinch of yoga

A sprinkle of daily meditation 

Remember, these are all just suggestions based on what I’ve learned from hundreds of women. You are your own best coach, so tap into your body’s inner wisdom and connect with what it needs. Happy trails!

 

To crossfit or not to crossfit? What's a pregnant woman to do? Part 1

A recent article in Paleo Magazine got me thinking about crossfit and other intense workouts during pregnancy. I’ve worked in many different communities and seen all sorts of variations in how women exercise. In the busy mountain town of Canmore Alberta,  I often had a caseload of Olympic level athletes, professional climbers, mountain guides and all sorts of fit active trail runners and crossfit gals. My mission in that town was to help women learn to SLOW DOWN and scale. This community had anecdotally higher rates of IUGR (intrauterine growth restriction) and difficult births. It was my theory that some, not all, but some, babies would become malpositioned, as a result of tight pelvic floor/hip muscles that just wouldn’t release. Many mama's also had a hard time letting go and allowing their minds to ‘relax’ so their bodies be primal and labour. 

 

My heart goes out to all my friends in Canmore who were devastated by flooding this week. Let the light shine and bring you hope as &nbsp;the massive clean up begins.

My heart goes out to all my friends in Canmore who were devastated by flooding this week. Let the light shine and bring you hope as  the massive clean up begins.

Today, I work with an urban population of ‘side-walk walkers’ and immigrant women. For many of these women, activity isn’t a valued part of their culture and they simply cannot afford the time to dedicate to exercise. Here, I see much higher rates of gestational diabetes and obesity. In this community, my mission is to get women moving.

So what’s a Paleo gal to do? Where’s the middle ground? If you’re a paleo-ista mama to be, what is the right thing to do when you are newly pregnant? Is crossfit okay? 

 

The honest truth is that we don’t really have any conclusive evidence to support or discourage vigorous exercise in pregnancy. Doing studies on pregnant women is unethical and as a result the AOCG and SOGC both give very vague guidelines in regards to exercise in pregnancy. The crossfit mom’s website does have a link to a study that looked at birth outcomes of 2 crossfit gals. This being said, a sample size of 2 isn’t research we can base a solid set of recommendations from. So what do we know for sure?

We know:

  • Women who stay fit and active during pregnancy are healthier, have easier labours, less chance of obstetrical complications and quicker recoveries.

 

  • Women who exercise report higher energy and lighter mood.

 

  • Women who stay active tend to not gain too much weight in pregnancy, which has been shown to increase the risk of complications.

 

  • Women report labour as being less painful and ‘easier’

 

  • So let’s start exploring this topic a bit more with some basic biology. Here’s what happens when a woman becomes pregnant.

Warning…this is about to get a bit nerdy.

Heart Rate:

As your blood plasma volume increases, the amount of blood the heart has to pump through your body, also increases. This causes a rise in your resting heart rate.

Breathing:

Pregnant women have a higher oxygen demand than their non-pregnant counterparts. Remember, you’re breathing for two! With mild exertion there is an increase in the number of breaths and amount of oxygen required to meet your greater demands. As exercise increases to moderate and maximal levels, however, you pregnant women do a funny thing. Your respiratory frequency and maximal oxygen consumption actually begin to decrease!  Say what?? The oxygen demand at high levels of activity (e.g. a hard WOD) appears to overwhelm the system. This may be partially due to the obstructive effect of enlarged uterus on the diaphragm making it mechanically difficult to get in deeper breaths. Theoretically, this could increase the risk of hypoxia to the baby. If done once or twice, while sprinting from a sabertooth tiger for instance, it’s likely okay, but theoretically, if done 4-5 times per week throughout the pregnancy, it could lend significant effects on your placental and fetal development.

Temperature Change:

Pregnant women are well known for being furnaces! That’s because there is a lot of metabolic activity going on inside that bountiful body. As you exercise, metabolism is further increased, resulting in higher core temperatures. Ensuring that you don’t overheat or dehydrate during exercise becomes critical in order to avoid fetal mid-line fetal defects in the first trimester and central nervous system effects in the second and third.  In my experience, mild dehydration can predispose you to uterine contractions and may put you at risk for preterm labour, not to mention make you feel terrible, so please drink up!

Musculoskeletal Change:

The chilled out hormone relaxin causes your joints and ligaments to become lax…get it… ‘relaxin’. This can predispose you to everything from tearing an ACL to misaligning your SI joints to spraining an ankle. Proper form when lifting and avoiding any sudden lateral movements becomes critical. With each subsequent pregnancy, your levels of relaxin appear to exert their effects earlier in pregnancy, so take care! Your growing belly can also send you a bit off kilter, which is why pregnant women are notorious for falling down or bumping into things. Watch your balance and your belly!

I don’t want to be an exercise ‘Debbie downer’ of sorts but let’s take a Primal approach... what a cavegirl would do?

She would:

- Walk a lot

- Lift and carry children

- Carrying water

- Prepare meals and gather berries (often while squatting)

Would they be doing pull-ups, burpees and clean and jerks? I’m not so sure of that.

Stay tuned for the second half of this two- part blog post where you'll hear 'Meg the Midwife's'   Paleo-friendly pregnancy workout tips. What do you do for exercise during pregnancy? Let me know, I'd love to hear back from you!