Why it's best to not just let it all hang out post pregnancy....

Why it's best to not just let it all hang out post pregnancy....

The care that we give our post pregnancy body is just as important as the care which we provide for ourselves during the 9 months. During the 9 months of pregnancy our abdominal region stretches to make way for the growing foetus. Once a woman gives birth the organs, ligaments, muscles etc remain in those locations. Our body is not like a lacky band whereby we stretch it, let go and it goes back to the original form.

There are a few things that we can do to assist our post baby belly heal and return the items back to where they were pre-pregnancy. 

1) Coupled with moderate cardio, a postpartum workout should focus on building up the muscles of your torso (which took a beating when you were pregnant). Every new mum can benefit from core strengthening. “The rectus abdominal muscles are stretched during pregnancy in a way that makes it impossible to exercise them during that time." Some women also experience a separation of the abdominal wall muscles, which is called rectus abdominis diastasis. Exercises that target this condition can bring the muscles back together again and a woman's physio is a great port of call to get the low down.

2) A postpartum belly band, wrap or our supportive leggings band (folded) is sometimes recommended, since they can help your C-section incision heal. But you may have seen women with vaginal deliveries touting the benefits of these products as well.

While postpartum belly wraps won’t actually cause weight loss, they may provide some benefits. They help tighten your stomach after pregnancy, improve circulation, reduce swelling through compression, and support the abdomen and lower back. What’s more, these postpartum belly bands may be especially helpful for those with diastasis recti. 

Ask your doctor or woman's physio if you want to use a belly band and remember, you still need a healthy balanced eating and exercise plan to help your body heal...

Getting the 'C' Jab in Pregnancy

Getting the 'C' Jab in Pregnancy

There has been a big push from the government to get Pregnant woman vaccinated for COVID-19. So why has the advise changed? Pregnant women have a higher risk of severe illness from COVID-19 and their babies have a higher risk of being born prematurely. Vaccination is the best way to reduce these risks. 

"Pregnant women were not included in the first clinical trials for COVID-19 vaccines, so at the time of initial guidance there was limited evidence confirming the safety of COVID-19 vaccines during pregnancy. The initial advice from immunisation expert groups was therefore cautious, and COVID-19 vaccines were not routinely recommended in pregnancy. Over time, ‘real-world’ evidence from other countries has accumulated and reports show that COVID-19 vaccines, such as Comirnaty, are safe to use in pregnant women. Emerging research also demonstrates that pregnant women have a similar immune response to mRNA vaccines compared to non-pregnant women, and are therefore likely to have similar protection against COVID-19. Furthermore, research shows that the antibodies produced by vaccination cross the placenta and may provide some protection to newborn babies." (health.gov.au). Pregnant woman especially in at risk groups like over 35, health conditions, from indigenous decent etc should know the risks are even greater for them.

Here are the facts of Pregnant woman Vs Non pregnant woman:

  • They have about 5 times higher risk of needing admission to hospital.
  • They are about 2-3 times higher chance of needing admission to an intensive care unit
  • About 3 times higher need of needing invasive ventilation (breathing life support)

COVID-19 during pregnancy also increases the risk of complications for the newborn, including:

  • A slightly increased risk (about 1.5 times higher) of being born prematurely (before 37 weeks of pregnancy) or at a higher risk of stillbirth
  • An increased risk (about 3 times higher) of needing admission to a hospital newborn care unit.

We all know that the information and advice surrounding COVID-19 keeps changing and what is said today may be different tomorrow, though for now it seems like the evidence supports Mums to be getting vaccinated to protect themselves and their unborn baby- so 'Roll Up your Sleeve'! The earlier the better and also the research shows that it does not affect fertility.

CBS News released this article on the 18th August 2021.

'Let the blood flow'- the increase in blood flow during pregnancy.

'Let the blood flow'- the increase in blood flow during pregnancy.

Why all of a sudden do you feel like it is 3 x harder to walk up a hill or a stairwell, or why has your iron levels dropped?

Blood volume increases significantly within the first few weeks of gestation and increases progressively throughout the pregnancy. The total blood volume increase varies from 20% to 100% above pre-pregnancy levels, usually close to 45% of average woman. 

"A healthy woman bearing a normal sized foetus, with an average birth weight of about 3.3 kg, will increase her plasma volume by an average of about 1250 ml, a little under 50% of the average non-pregnant volume for white European women of about 2600 ml. There is little increase during the first trimester, followed by a progressive rise to a maximum at about 34-36 weeks, after which little or no further increase occurs." (National Library of Medicine) A non-pregnant woman has about 100ml of blood per minute flowing through the uterine artery, but in early pregnancy this increases to about 120 ml per minute. Once a woman is close to her due date, the blood flow has increased to about 350 ml per minute.

Interestingly enough the research shows that physically active women possess significantly greater vascular volumes than their sedentary counterparts.

WHY DO WE GET AN INCREASE

Pregnancy requires dramatic changes in blood flow, the most obvious being that which occurs in the uterus and the development of the placenta to make a baby grow.

WHAT OTHER THINGS HAPPEN AS A RESULT OF THIS INCREASE?

  • Blood flow to the skin increases, making a newly pregnant woman feel warmer and perhaps sweat more, particularly from her hands and feet.
  • The increase boosts the body metabolism by about 20%, creating more body heat and making pregnant women less likely to feel the cold the body temperature will often rise to about 37.8 C degrees. (Normally 37)

So if you are feeling light headed, having nose bleeds or bleeding gums there could be a very likely reason....THE BLOOD FLOW has INCREASED..

 

B-BB-BOUNCE: Running and Sports Bras why Invest???

B-BB-BOUNCE: Running and Sports Bras why Invest???

Time and time again we see woman hitting the pavement with bras that offer zero support. When they start moving they are lucky that they don’t lose an eye as there is so much action going on under the top....so why do they invest in other things and not in supporting the girls when they run or even walk 🤷‍♀️

Unlike other muscles in the body, once the supportive tissues in the breasts stretch, they cannot revert back to their original position. However avoiding irreversible sagging is easier than it sounds.

Norris and her colleagues have found that breasts move in a figure eight pattern. Not just up and down—that vertical movement is what most runners think of—but side to side and forward and backward as well. “[Breast is] just a mass of tissue, not a muscle,” Norris says. “It is not rigid structure. It can move in all three dimensions when we run.” And it does.

When you add all that movement in three planes together, Norris says, breasts—unsupported—move about 15 centimeters during running. (Different labs report different numbers, depending on the cup size of the cohort they’re testing.) About 50 percent of the movement is in the vertical, and then 25 percent is side to side movement, and the other 25 percent is anterior-posterior motion.

 

Portsmouth University’s Research Group in Breast Health (RGBH) calculated that the breasts can move 15cm during a run.

“According to the NHS website, research suggests 70% of women are wearing the wrong bra size. What’s more, as the breasts are composed of fat and fibrous tissues, as you eat better and exercise more, your breasts may decrease in size, meaning your sports bra might not be supporting them as well as it once did. Your sports bra also loses it's support overtime, with experts recommending you change it after 30-40 washes.....

Comfort and support are foremost but also Is Breathability.

To keep you cool when you start sweating, most sports bras are made from blends of moisture-wicking fabrics. Materials like nylon, spandex, and polyester fare better than standard cotton, which gets heavy and takes a while to dry. Plus, many brands have even implemented ionized and UPF fabrics for odor control and UV-ray sun protection. Outside of fabrics, keep an eye out for bras with mesh panels or keyhole cutouts. These features do a great job at ventilating sweat to keep you cool and comfortable. At MUMMACTIV we get specific fabric that is moisture wicking, breathable, quick dry, 4 way stretch and is a nylon/spandex combo making them a great choice. 

Did you also know that in a 2014 study showed running beats walking for breast cancer survival rates....(An interesting finding) Vigorous exercise was better than moderate exercise for the women in the study. Breastfeeding also reduces her risk of breast cancer by 4.3% for every 12 months a woman breastfed.The study compared mothers who breastfed to those who didn't. (Study conducted by the Collaborative Group on Hormonal Factors in Breast Cancer)

All the more reason to hit the road—with a good bra, of course.

 

Prolapse and Exercise - so what is to know?

Prolapse and Exercise - so what is to know?

What is Vaginal Prolapse?

Usually our pelvic organs (bladder, uterus and bowel) are supported by a hammock of connective tissue and muscles. If this support system isn’t working as it should, it can lead to one or more of these organs descending into the vagina, which is called a ‘vaginal prolapse’. 

A prolapse can be categorized into different types – a front (or anterior) wall prolapse, which is the bladder or urethra coming down, a back (or posterior) wall prolapse, which is the rectum or small bowel coming down, or a uterine prolapse, which is the womb dropping down. It is still possible for the top of the vagina to drop down if someone has had a hysterectomy. 

It often seems to be assumed that it’s the uterus that most commonly drops down, but actually the front wall of the vagina is the most common type of prolapse to occur. 

Prolapses can also be divided into ‘stages’, depending on how far down the lowest part descends when you do a maximal downward strain:

  • A stage 1 prolapse means that the lowest part of the wall/organ is still more than 1cm inside the vagina 
  • A stage 2 prolapse means that the lowest part of the wall/organ is between 1cm inside and 1cm outside the vaginal opening. This stage of prolapse, when the organ descends to the opening, is often when women become aware of their prolapse for the first time. 
  • A stage 3 prolapse means that the lowest part of the wall/organ is more than 1cm outside the vaginal opening
  • A stage 4 prolapse means that essentially the whole organ has come outside the body – this is relatively rare. 

 

How do I know if I have a Vaginal Prolapse?

The symptoms of a vaginal prolapse are different in everyone, and it’s important to note that sometimes people with mild to moderate prolapses don’t have any symptoms. 

The most common symptoms are:

  • A bulging sensation (or being able to see a bulge) or a feeling of ‘something being there’ in the vagina
  • A feeling of not being able to completely empty the bladder or the bowel (usually because the prolapse is causing a sort of ‘pocketing’ making it difficult to evacuate).
  • Lower back or lower abdominal ‘dragging’ pain

Sometimes women can complain of a ‘heaviness’ or ‘pressure’, but this needs to be confirmed on diagnosis as this can also be a symptom of over-worked, tired pelvic floor muscles. 

Sometimes prolapse can be associated with discomfort with sex, and sometimes with bladder or bowel leakage, but again – this isn’t always the case and should be confirmed on a physical examination, because there are many people who have these symptoms without having a prolapse. 

The health professionals who work specifically in the area of Women’s Health are best placed to make this diagnosis – gynaecologists, Women’s Health & Continence Physiotherapists, or Continence Nurses. However, your GP is a good place to start and many GP’s will have a vast degree of experience in diagnosing and staging prolapses, and can then refer on to one of the aforementioned professionals for further management. 

 

How common is a Vaginal Prolapse?

Unfortunately, it’s very common for women to experience vaginal prolapse, mainly due to our anatomy. We are animals that stand upright, and have a large proportion of our body weight going through our pelvis, but we also need a wide pelvic opening to be able to birth very large offspring through!

That mix of a large pelvic opening with a heavy load on top of it is unfortunately not ideal for supporting pelvic organs.

Studies have shown that up to 50% of women who have given birth will have some degree of prolapse, with other research showing that 1 in 3 women will have a prolapse that extends at or beyond the vaginal entrance (ie a stage 2 or more prolapse). 

Unfortunately, there is a high proportion of women who will require surgery for either prolapse or stress urinary incontinence. Statistics show that 1 in 9 women will undergo one of these surgeries, which are not without risks and have relatively high recurrence rates. 

 

What factors increase your risk of Vaginal Prolapse?

The main risk factor for prolapse is having had one or more vaginal births, with specific risk factors including:

  • Forceps deliveries
  • Giving birth to a baby over 4kg (9 pounds)

Prolapse is not limited to only those who have delivered babies vaginally, however, with other risk factors including:

  • Pregnancy
  • Family history of prolapse
  • Increasing age
  • Increasing BMI
  • Constipation
  • Chronic Cough
  • Heavy lifting

The main reason that pregnancy and vaginal childbirth are risk factors is because of their effect on what is called the ‘levator hiatus’. This is the name for the space in the pelvis between the two sides of the pelvic floor, and is essentially ‘the gap into which things can fall’. 

Studies on women who have recently given birth show that this ‘gap’ in usually increased from normal for up to 4-12 months after having a baby. This is one of the main things that Women’s Health Physiotherapists will assess for when doing a vaginal examination at a postnatal assessment, because it helps to determine your individual risk for prolapse occurring or worsening with return to higher load or impact activities. 

This ‘gap’ would be increased more significantly, and more permanently, if the woman experienced a birth injury called a ‘levator avulsion’. This means one or both sides of the pelvic floor muscle having a partial or full tear away from the pelvis bone. This can also be assessed for with a vaginal examination. 

 

How is Vaginal Prolapse managed without surgery?

Pelvic Floor Muscle training, under the guidance of a physiotherapist with post graduate qualifications, is recommended as the first line of treatment for vaginal prolapse. 

We probably assume that this training is all about improving the strength of the pelvic floor muscles (measured out of 5), but studies have shown only a minimal link between a woman’s maximal squeeze pressure improving and prolapse improving. 

This makes sense, because a vaginal prolapse needs to be supported all throughout the day while you’re in an upright position, but we probably only maximally squeeze our pelvic floor muscles for 1% of the day – at times like in response to a big sneeze or lifting something that’s heavy. 

Instead, it is more likely that pelvic floor muscle training helps to decrease prolapse signs and symptoms because it improves the ‘stiffness’ and support of the area, and it decreases the ‘gap into which things can fall’ (the levator hiatus) both at rest and under load. 

Other management strategies would include:

  • Teaching women how to empty their bladder and bowels effectively and without straining
  • Determining if symptoms can be improved by incorporating rest periods in ‘anti-gravity’ positions throughout the day
  • Weight loss 
  • Exercise modification
  • Use of support pessaries

 

What is a Vaginal Support Pessary?

Vaginal pessaries are devices worn inside the vagina that help to give support to the vaginal walls. If fit properly, they should give symptom relief, be comfortable and should stop a prolapse from descending. 

They can be a huge help for women with prolapse who wish to remain active or become more active. Pelvic Floor Muscle Training, while essential in the overall management of prolapse, can take a long time for symptoms to improve. Pessaries could be used in a ‘stop gap’ role to prevent further descent, and possibly give feedback on what types of things cause descent to occur, while concurrently working on pelvic floor training.

 

 

What exercise should I avoid if I have a Vaginal Prolapse?

Now this is an interesting one… and if you’re after a list of Do’s and Do Not’s, I’m sorry… it’s not coming from me!

Let’s start with what the recommendations are for exercise for general health. The Australian Government’s “Physical Activity Guidelines for Adults” states that we should participate in:

Cardio exercise:

  • >150 minutes of moderate intensity activity/week
  • OR 75 minutes of vigorous activity/week (or a mixture)

Resistance exercise:

  • >2 days/week 
  • >1 set of 8-12 reps per area
  • Maximum health benefits are gained when you would struggle to do another set

And recommendations for Bone Density and prevention/management of Osteoporosis:

  • Regularly doing a combination of resistance training and moderate to high impact weight-bearing activities

But historically (and I’m not talking that far in the past either) the recommendations for anyone diagnosed with, or at risk of, vaginal prolapse were:

  • Minimise weights
  • Keep all exercise low impact

But although well-intentioned, how evidence-based was this blanket recommendation?  And by giving this advice, are we compromising overall health (in particular our heart and bones) for the health of the vagina? 

Recent studies have looked a lot more into the pressures created in the abdomen, and more specifically in the vagina, during different types of exercise and although we can extrapolate some general information, the main message that comes out is “It’s not what you do, it’s how you do it”. 

If you give the same exercise to a variety of different women, then their individual anatomy, injuries, technique etc will mean that the way they perform that exercise results in a wide variety of different effects to their pelvic floor muscles and vaginal walls. 

It’s highly recommended that in order to tell a woman what exercise they should and shouldn’t do, we should understand:

  1. Their individual risk profile for prolapse occurring or worsening
  2. Whether a certain exercise is likely to be on the higher or lower end of the ‘risk’ spectrum

 

How do I know which risk category I fall into for Vaginal Prolapse?

A Pelvic Health Physiotherapist is a physio who has done a huge amount of extra training in Women’s Health and Pelvic Floor Health. They can do vaginal examinations to check a number of things such as:

  • The Pelvic Floor Muscle function
  • The structural support of the vaginal walls both at rest and on straining (and very important to assess this in standing too!)

There’s a specific test that we can do called ‘GH+PB’, which measures the amount of movement of the tissues at the opening of the vagina when you strain. This measurement, taken externally, has been proven to be a good indicator of what’s happening internally to the size of the space into which our organs could potentially descend. The larger the GH+PB measurement is (in cm) the higher the risk is that a prolapse could occur or worsen when the area is put under strain. 

Some important points to note:

  • It’s important to check if you currently have a prolapse (it’s not always symptomatic) but it’s just as important to pick up those who don’t currently have a prolapse but are at high risk of it developing
  • Pelvic floor muscle exercises are important but there’s a lot more to it than just getting the best maximal squeeze possible, especially for endurance activities like running and playing a game of sport (because when you think about it… how much help is a grade 5/5 squeeze going to be during a run if you’re not squeezing maximally while you’re running?)

 

Which exercises are likely to be higher risk?

There are lots of unknowns here, and we don’t know what the ‘safe’ level of intra-abdominal pressure is for preventing prolapse. We also don’t know, without individual assessment, how different women respond to the same exercise. 

But we can understand generally which exercises tend to come out as creating higher intra-abdominal pressure and perhaps these can be the ones that are more closely tested and monitored. 

Things we can assume about strength and resistance exercise:

 

  • Standing exercises have higher pressure than sitting, and both of these have higher pressures than lying down. On this note – abdominal crunches and lying down abdominal exercises usually come out as one of the ‘lowest risk’ exercises in the studies that have been done, although traditionally these have been amongst those that were the most highly cautioned against. 
  • Increasing weights and resistance increases intra-abdominal or intra-vaginal pressure

Things we can assume about aerobic exercise (note that this is probably the hardest type of exercise to investigate, but there is some exciting current research happening in this area):

 

  • Running, jogging, skipping etc are likely to be high risk due to the fact that they have an endurance nature to them, they’re always done in upright positions, and there are ground reaction forces involved.

Things we can assume about Crossfit-style exercise:

 

  • In low risk women (those who are young and have never had children), there is unlikely to be a negative impact on prolapse between those who choose to do Crossfit compared to those who choose to do ‘gentle’ exercise (but there are likely to be many benefits in other areas of health)
  • There is limited/no research on prolapse risk in women who are considered ‘high risk’

Things we can assume about pilates exercise:

 

  • Most pilates mat and reformer exercises are considered low risk and are unlikely to increase intra-abdominal or intra-vaginal pressures significantly (many are performed in lying down and with relatively low resistance)
  • There are lots of benefits to pilates but in isolation it doesn’t meet the guidelines mentioned previously about Disease Control and Prevention and needs to be considered in conjunction with other forms of exercise. 

 

How can a Women’s Health Physio give you individualized information about the type of exercise you should consider?

A Women’s Health Physio should be able to put all of this together and come up with a plan that suits you regarding an exercise regime. 

They might assess you and find that you’re very low risk for prolapse occurrence or worsening, and then you can work out together whether any monitoring needs to occur as you increase your load and intensity in your workouts. 

They might assess you and find that you’re currently in a high risk category and they can help you to work on a pelvic floor program (and possibly a pessary fitting) to allow you to gradually return to the exercise you love with close monitoring. 

They might assess you and find that you fit somewhere in the middle. Perhaps there are certain things that either make your prolapse symptomatic, or that cause vaginal wall descent without you realizing. Rather than advising you to stop exercising completely, they should be able to help you to come up with regressions or variations of these movements, and perhaps supplement them with other forms of exercise that you enjoy to allow you to still meet the health guidelines. 

 

Some final points to remember about Prolapse and Exercise…

  • Exercise is vital to overall health, and women unfortunately often decrease exercise due to fear of worsening a prolapse. 
  • Remember that a large number of exercises that were previously suggested to be ‘not pelvic floor safe’ don’t actually have much evidence to back that up (and might be really good for overall health)
  • Individual assessment and reassessment is key – and remember that you can’t assess prolapse or risk of prolapse with only an external examination. So if you’ve only had a real time ultrasound screening assessment on your abdomen, this isn’t able to be used to determine your risk profile. 

If you’d like to see a specialist physiotherapist in Western Australia, there’s online Directory for both private and public referrals:

Also, if you live in Perth or Mandurah, we have compiled a list of post-graduate trained physiotherapists who are particularly good with pregnancy, postpartum and exercise – see the FitRight website!

And remember – the whole aim of FitRight is to keep you moving, even if you do have a vaginal prolapse. Chances are that multiple women if every one of our classes are managing a prolapse and the instructors will be aware of this and know how to modify the classes to suit individual needs. 

Whether you’re pregnant, early postnatal, a Mum of young children or heading into peri-menopause, we have classes to suit you!

 

Article was written by Taryn Watson owner of FIT Right. She holds a 

Those bits that affect just under 1% of pregnancies that no one really talks about....

Those bits that affect just under 1% of pregnancies that no one really talks about....

We have all heard of a placenta but many have never heard about the condition PLACENTA PREVIA. It may sound like a horrible breakfast cereal but to those pregnancies which it affects its an awful reality.

It occurs when a baby's placenta partially or totally covers the mother's cervix — the outlet for the uterus. Placenta previa can cause severe bleeding during pregnancy and delivery. If you have placenta previa, you might bleed throughout your pregnancy and during your delivery. With it afffecting approximately 0.5% of pregnancies, it is the most common cause of bleeding in the third trimester.

 

So you may ask why is this a problem in a pregnancy? Well as the cervix thins and dialates- (getting ready for labour) and the placenta is attached the blood vessels tear and result in bleeding. The lower uterus is less able to contract and restrict (stop) the bleeding in this area resulting in uncontrolled bleeding.

The advanced age of a mother, a smoker or multiple babies are the main risk factors for this to occur. But also a woman who has had multiple pregnancies, a previous previa, previous uterine or cervical surgery or a cocaine user.

With Placenta Previa there are three catergories: marginal, partial or complete. Most diagnosed in the second trimester resolve themselves especially if they are not major. (84% complete and 98% of marginal will have resolved by 28 weeks).

Most woman diagnosed with this will endure an ultrasound with some getting put on bed rest ,for extreme cases, or Pelvic Rest (NO hanky panky). The biggest risk comes from the onset of labour. Many with moderate to severe previa will have to undergo a routine cesarean also if there is blood loss, foetal distress or evidence for preterm labour. 

So Placenta Previa is no walk in the park and there is no direct correlation between anything in particular-some pregnancies it just happens even if you didn't have it previously.

PUMP it Louder...

PUMP it Louder...

A breast pump becomes an accessory for every breastfeeding Mum. Many new Mums are often left confused/unsure as to what to look for and that is after you navigate the mindfield of terminology and gadgets. So lets break down some information relating to breast pumps to give you the best start of where to look.

Pumping can have a way of making us human mamas feel a little like milk machines. 

Even if you plan to exclusively breastfeed (often referred to as "EBF"), it is helpful to have a breast pump on hand. Why? It can help to increase your milk supply, especially in those early days. Breast milk is produced on a supply and demand basis, so pumping for a few minutes after nursing or adding in a pumping session an hour or so after baby finished can up your supply. Some woman have attachment issues or their newborn has difficulty feeding, or they are placed in a neonatal unit so it becomes necessary for the Mum to pump to generate a supply.

Having some expressed breastmilk on hand can also mean that someone else can do the feed giving Mum a break through the night or alternative an escape during the day- a breast pump gives you the freedom to do so.

Of course, if you’re planning on breastfeeding after returning to work, you’ll want a breast pump so you can keep your supply up, have a stash in your home freezer and relieve engorgement when you’re at the office.

There are basically four types of breast pumps:

  1. Double-electric breast pumps: These powerful electric models let you pump both breasts at once, important if speed is a concern.
  2. Single-electric breast pumps: You’ll only be able to pump one breast at a time, which can take longer. On the plus side, these cost less than a double-electric pump.
  3. Battery-operated breast pumps: These can be slower and run through batteries pretty quickly. The advantage of a battery-operated pump is that they're portable and helpful if you don’t have access to an electrical outlet (such as when you’re commuting to work or traveling).
  4. Manual breast pumps: These are lightweight, portable and inexpensive. The downside? You'll be doing a lot of the work yourself and you may not get as much milk as a result.

So the decision then comes down to answering these questions in relation to the pump and financial outlay:

          • Manual vs electric
          • How many hours a week do you think you'll be pumping? 
          • Weight
          • Sound
          • Will you be pumping occasionally or regularly, short-term or long-term?
          • Quality versus price
          • Suction and speed control
          • Product support and Warranties
          • Nipple Size
          • Ease of cleaning

 

Here are a few options to consider:

Best Breast Pump Overall: Medela Pump in Style Advanced

Most Efficient Breast Pump: Spectra S1 Plus Hospital Strength Breast Pump

Best Budget-Friendly Breast Pump: BellaBaby Double Electric Breast Pump

Best Breast Pump for Travel: Medela Freestyle Flex

Most Comfortable Breast Pump: Philips Avent Comfort

Best Single-Electric Breast Pump: Nuk Expressive

Best Manual Breast Pump: Lansinoh Manual

Best Hands-Free Breast Pump: Willow Wearable Breast Pump

Best Breast Pump for EBF Moms: Haakaa Silicone Breast Pump

Quietest Breast Pump: Spectra S2

For 1 in 8 it is not so easy to fall pregnant they instead have to endure rounds of hormone stimulation, injections and so much more.

For 1 in 8 it is not so easy to fall pregnant they instead have to endure rounds of hormone stimulation, injections and so much more.

Cassie Silver is one of those 1 in 8 who is struggling to conceive naturally. While some go down the negative spiral of ‘Why me’ and blaming lots on the universe she has chosen to put a positive spin on her experience and share hers plus many others journeys through her podcast: ‘What To Expect When You’re Injecting‘.


I haven’t
created a human yet, but the journey has made me a better one.
 

“I’m grateful this is happening to me”, are words I never thought I would say when it comes to reflecting on my journey so far in trying to conceive. Why would anyone want to go through the pain, grief and uncertainty that comes with IVF? Is it the need for attention as the woman putting her body and soul through so much? Or the quest for validation that I am working harder that other to become a mother? The truth is, I wouldn’t change the cards I have been dealt because it’s the journey so far has completely changed my outlook on life. I had the fairy-tale picture in my mind when I married my best friend years ago and came off the pill. I started talking about baby names, character traits and even forecasted what horoscope they would be and aligned the moon and starts perfectly. Just like my type A personality, I had planned to fall pregnant after my 30th birthday, soon after our wedding. Fast forward a few years and we’ve had multiple IVF and FET cycles without any success. So- in a nutshell. While we haven’t made a human yet, it’s made me a better one.

 

Living with PCOS, a high follicle count, the inability to ovulate, blocked tubes and my husband’s poor sperm motility means IVF is our best chance to have a family. I have been no stranger to the world of swaps, smears and stirrups; suffering from abnormal cells and having many laparoscopy procedures since I was 18 years old. But, unlike any challenge or milestone I have faced in life, making a family is the only hurdle I have no control over and feel I am failing at. I have spent more than a decade working in the Australian mediaindustry as a television journalist, producer, presenter and now the owner of a successful production business.  I am no stranger to the spotlight as a media identity in Perth and I’ve always made I my mission to life an authentic life. I have interviewed incredible individuals and travelled the world as a journalist, sharing their stories of success and struggle. While I have always been transparent, I never thought I would be sharing my own. If someone tells me I can’t do something, I fight for it even harder; I am a high achiever, I mean we collected 29 eggs at our last collection!

 

What started as a bruised ego is now a bruised belly, but Iwouldn’t change the cards I have been dealt. This journey has already made me a better friend, daughter, sister, colleague and wife. Ultimately, this is going to make me a better mother. A mother with a deep understanding of the value of empathy and the awareness of other people’s shit instead of suffocating in my own. I have cried through the park on my runs and walks as I fly by prams and mother’s groups feeling alone and lost. But it’s been the ability to change my internal language patterns and recognise self-sabotaging behaviour that’s made all the difference. Instead of wanting to run headfirst into prams and yell “F U”, I look at them and smile and say “that will be me very soon”. Yes, many strangers think I am a little creepy, but I am the only one who can control my emotions attached to infertility. I used to wish there was a different button to click other than “like” as people posted their baby announcements on social media. Maybe a “just a thumbs up” emoji will suffice my level of happiness for this Facebook acquaintance. Once again, there exciting news shouldn’t create a reaction of jealousy or anger, it should fuel hopefulness. I have run out of responses to comments like “everything happens for a reason” or “maybe a holiday will do you both some good.” For anyone who hasn’t experienced infertility, sometimes silence is the best support. One thing Ive learnt, is I may feel lonely- but I am not alone. Whether it’s an early miscarriage, unsuccessful implantation or the embryo didn’t survive thawing, I have experienced the loss and grief which comes from all of them and I’ve learnt not to measure it.

 

I have more patience for people in general and take time to listen to their problems instead of finding solutions. Someone wise once told me, “when you’re heard, you start to heal” and I truly believe in the magic behind the phrase. My marriage is stronger than it was when we decided to come off the pill and give natural conception a good crack. We both understand eachothers love language and appreciate what we have more than what we don’t. We have had the Carrie and Big from Sex & The City chat about, “will it just be us two?” and are we ok with that? I now have more honest and open conversations with my family instead of being a hero and projecting a persona of success. Going through IVF and running my own business has taught me the value of balance and priorities, I learnt how to say NO. My friendships have a focus on quality not quantity, a bit like my outlook now at egg collection. I have removed people from my life I probably wouldn’t have had the guts to do a few years ago and created new connections instead. Not only has my rollercoaster ride through infertility been a chance to overcome a horrific fear of needles, but it’s also allowed me to evaluate how I see my own self-worth and esteem as a woman. I have gratitude’s written on my bathroom wall which remind me every day that my body is doing incredible things, the process is incredible, I am worthy, and my journey is remarkable. There is nothing wrong with being your own cheerleader and it gives you a new meaning behind the word empathy too. It’s redefined my definition of failure and allowed me to use my media skills in a completely new light as the host of new podcast “What ToExpect When You’re Injecting”. I wanted to marry my skills and struggle together by producing an authentic and uncensored podcast, “What To Expect When You’re Injecting”, a candid and personal discussion on IVF and infertility. This project is allowing me to turn pain into purpose and fill my life with contribution and connection. So, for those on the journey, try to find the silver lining in it; somewhere, somehow. IVF has made me a better person, and while many would never wish is upon anyone, this is the only time I can truly believe in the saying “everything happens for a reason”, regardless of loss, heartache and pain. While some may say I’ll be able to translate the gratitude I have right now into motherhood; the truth is, I may never be a mother, so for now my greatest achievement is to be a good human regardless of if I make my own or not.


Check out @injecting_to_be_expecting

Written by @cassiesilver
What To Expect When You’re Injecting is available on Spotify and Apple Podcasts.

 

 

Getting our morning fix when BREASTFEEDING ☕️

Getting our morning fix when BREASTFEEDING ☕️

For a sleep deprived mother coffee becomes life...

The caffeine helps to get through the sleep deprived days. So the question often gets asked how much coffee is too much for the breastfeeding mum. 

Statistics show that nearly half (46%) of Australian’s drink coffee and that having children increased the weekly coffee consumption by 2.4 cups (7.2 v 9.6 cups per week).

Most breastfeeding mothers can consume a moderate amount of caffeine (eg a few cups of coffee or tea each day) without it affecting their babies. Caffeine does transfer to breast milk but in very low concentrations (0.06%-1.5% of 300mg of caffeine) Newborn babies however can be particularly sensitive to caffeine. This is because it can take a newborn baby a long time (ie half-life of 50–100 hours) to process caffeine. By 3–4 months, however, it takes a baby only about 3–7 hours. (According to ASN)

 Caffeine content in common drinks and food1,2

Drink/food

Caffeine level (mg)

Espresso coffee

145 mg/50 mL shot

Formulated caffeinated drinks / ‘Energy’ Drinks  

up to 80 mg/250 mL can

Instant coffee (1 teaspoon/cup)

60–80 mg/250mL cup

Tea

10–50 mg/250mL cup

Coca Cola

up to 54 mg/375 mL cup

Milk chocolate

20 mg/100 g bar

Takeaway coffee

51–332 mg/serving3

 

 

 

Tips to combine breastfeeding and coffee:

  • Pre term or ill infants may experience larger issues with metabolizing caffeine, you may want to limit caffeine intake during these times.
  • Studies have shown that ingesting less than 300mg/day of caffeine should not cause issues for infants. Be wary of what products contain caffeine, so you can track how much you have consumed. 
  • If caffeine affects your sleep, try not drinking any coffee after 2pm. Sleep is essential for health and wellbeing.
  • If you find caffeine intake effects your little one, but still need one, try having a coffee as soon as you breastfeed. This gives you the largest amount of time to process the caffeine before feeding again as peak levels occur about 60-120 mins after consumption.
  • If caffeine does have an effect on your child, try giving it a few weeks/months and trying again. The half life (time it takes for the body to get rid of half the dose) reduces significantly with age ( eg 97.5 hours for infants- 2.6 hours at 6 + months).

So the take away is you can still enjoy a cuppa but just be mindful of how much you are ingesting.

5 ways to steer yourself through procrastination

5 ways to steer yourself through procrastination

As a Mum, you have to juggle through a number of tasks every day. To you, every family member is like your child, whom you have to nourish and care for. So, you have loads of work to do every day and you frequently run out of time. But, do you ever wonder if there is something else contributing to your running out of time? How about procrastination? Maybe a yes or maybe a no, however, one thing is sure that you do wish to have a magic wand which could give you some extra time to finish your chores whenever you are falling short of time.

 

Now, here is good news for you as today we are going to give you the magic wand! Excited to know about the magic wand and how it works? So, let me disclose that you are yourself the magical wand, about whom we are talking about here. Don’t feel surprised! After all, you work wonders every day to keep your family happy despite falling short of time and that’s nothing short of magic! Thus, you have all the power and magic inside you only.

Now, let’s come straight to your problem of running short of time. So, Mum just do a little magic of honesty and introspectif you procrastinate? Your answer is most certainly yes because we all do! In fact, a little procrastination is okay.  But, when it starts preventing you from getting things done in time, it becomes problematic. In your attempt to do more in the less time left, you overexert yourself. Not only this, but your stress level also rises significantly, which is not at all good for you. Moreover, procrastination leads you to spend your whole day working for everyone else’s happiness but yours. You don’t find time for yourself.

Even when you are procrastinating on a task and relaxing on the couch,  you aren’t actually relaxing. In the back of your mind, you are still thinking about the dozens of pending tasks you have. So, it is crucial for you to steer yourself through procrastination. Now, let’s see how to do that:

1. Create your work schedule:

 

Yes, you have to create your work schedule. This has nothing to do with defining a fixed time for every task but at least you can fix the beginning and end of your work schedule. Let’s say that you can make it a routine to start working at 10 (after everyone has left for their destinations, work, school, etc.)and finish all your household chores by 3 or 4 in the afternoon. You can decide these limits according to your comfort level and the amount of work you have to do. Further, it is not compulsory to follow the same work schedule every day. Some days you might have some additional tasks to do like laundry. So, you can create a new work schedule for the new day every morning. Believe me, creating a work schedule will be really beneficial for you.  If you’ll have a fixed work schedule, you’ll be less likely to procrastinate and you’ll get everything done in time.  

2. Keep a check on yourself:

 

We all have our weaknesses and get carried away with them. For example, 5 minutes of Instagram often turns into an hour and we realize that only after we have lost plenty of our working time and you know what happens afterward! You work like a super speedy machine to get the things done before your children or family members return back home. Now, to get over this type of problem, you have to keep a constant check on yourself. If you feel the urge to use your favorite social media sites, go for it! But, not without setting a timer. You have to clearly set a limit on the time you’ll be devoting to your selected activity. Once the timer rings, just leave your smartphone right away and start working. This will help you get over procrastination to a large extent.

 

3. Set ‘No Procrastination’ reminders in your smartphone:

 

At times, you may forget all about overcoming procrastination. You may get drifted and start following your casual routine. So, it is always best to set ‘no procrastination’ reminders or alarms on your smartphone. You can set them to ring at regular intervals of time during your work schedule. For example, after every half an hour. This will help you not to get caught in the tight grip of procrastination.

 

4. Make use of the Pomodoro Technique:

 

Working continuously is definitely monotonous. This is one big reason why we procrastinate. So, if you break your work schedule into smaller segments, you’ll find it easy to overcome procrastination. Now, to break your work schedule into smaller segments, it is best to make use of the Pomodoro Technique. Given below are the simple steps by following which you can practice the Pomodoro Technique:

Select the task you want to do
Set a timer for 25 minutes
Start working in a focussed manner
Stop as soon as the timer rings
Take a break for 5 to 7 minutes
Get back to work after the break gets over
 
5. Allure yourself with exciting rewards:

When you are conscious that you are procrastinating, but still find it hard to get over it, then this is the best strategy to follow. You have to simply allure yourself with an exciting reward for completing the pending task. For example, you can give yourself a 30-minute relaxing nap as a reward, after completing your work schedule or you can cook your favorite snacks in the evening. These rewards will give you the power to overcome procrastination and focus your energy on work.

 

So magical Mum, now you know how to steer yourself through procrastination and not run out of time despite having to shoulder multiple responsibilities at home. Now, wishing you all the best and hoping that you’ll be able to set procrastination aside in your life.

 Written by 

Jessica Robinson
The Speaking Polymath
December 11, 2020 — Joanne Shepherd
Beating the Summer heat if you are Pregnant or Breastfeeding

Beating the Summer heat if you are Pregnant or Breastfeeding

SUMMER for many is their favourite season of the year...until they get PREGNANT and then it becomes uncomfortable!!! There are a few things to take note of as you brave the heat this summer.

PREGNANCY

It's not just that it's hotter outside, but pregnant women are hotter too: In the first trimester, the progesterone hormone increases body temperature. Pregnant woman's body temperature is already higher than normal so add in scorching summer temperatures and if you are not careful dehydration or other medical problems could arise.

Dehydration is common in the summer months. Did you also know pregnant woman is more prone to sunburn than non-pregnant woman? Other not so nice side effects of the summer heat is swelling, chaffing, 

 

Surviving the summer heat is necessary if you are pregnant and here are some tips:

1. Avoid direct sunlight.

Do outside activity early in the morning or after the sun sets. 

2. Stay hydrated.

Water intake should about eight to 10 glasses per day and should be more if you are exercising. Drink low-sugar electrolyte fluids, especially if you’re going to spend time outside. 

3. Dress for the heat.

Wear loose, breathable clothing and a hat to reduce sun exposure. 

4. Spritz water often.

Carry a spray bottle with you and spritz yourself with water to cool down your body temperature. 

5. Be smart about exercise.

Swimming is a terrific way to exercise and keep your body cool. Or stay inside and work out at the gym or walk laps at the mall. 

6. Wear sunscreen.

Be sure to reapply after sweating or swimming. Choose a brand with at least SPF 30 and make sure your face is protected. 

BREASTFEEDING

Newborn babies need extra care and attention when it becomes hot. Quite often they will want to breastfeed more reguarly, though become agitated due to the sweaty nature of skin to skin so might feed more less time.  

 

The Australian Breastfeeding Association reports the following:

"Most parents worry at some stage that their fully-breastfed baby may not be getting enough to drink in hot weather and they ask if they should give boiled water or fruit juice 'just in case'. The answer in most cases is that extra fluids are not required if your baby is breastfed whenever he needs and this may be more often than usual - just as you are drinking more often.

Breastmilk contains a perfectly balanced ratio of food and water to meet all your baby's needs. It is a living fluid, ever-changing to suit your baby and even in response to the weather! The first milk your baby gets from a full breast has a low fat content and naturally quenches baby's thirst. Once the let-down has occurred, the fat content of the milk gradually increases as the breast softens. This later milk has a creamier appearance and satisfies baby's hunger. 

In hot weather a thirsty baby may want to breastfeed more frequently but for shorter periods. In this way he is getting more low-fat milk and so is satisfying his thirst. If you need to be away from your baby, it is preferable that he has your expressed breastmilk (EBM).

An older baby or toddler who is no longer exclusively breastfed may be encouraged to drink water between breastfeeds. You can also offer extra 'snack' breastfeeds to keep him well hydrated. Another refreshing idea for toddlers is to freeze fruit pieces, such as orange quarters, peeled banana or slices of pineapple - cooling and fun, just be prepared for the very sticky mess!

  • Some babies become sleepy travelling in hot weather. You may need to stop and wake your baby for feeds.
  • The effect of car airconditioners can cause some dehydration - so extra breastfeeds may be necessary on long trips, even if you are cool.
  • Prams that are enclosed are airless and can get very hot. An open-weave bassinette, cradle, layback stroller, baby hammock, cot or portable cot is probably cooler for your baby to sleep in."

As a result of Mum needing to feed more often and the heat making her dehydrated she needs to increase her water quantity. Signs of dehydration include irritability, headache, dry mouth, a feeling of thirst, and darker-than-usual urine. Prevent dehydration by carrying a refillable water bottle with you. It is suggested  drinking a glass of water every time baby drinks. If water’s not really your thing, eat more high-water-content fruit, like watermelon, as well as frozen fruit and other fresh fruits and vegetables.

 

Outfits should also be loose, comfortable and made from a performance/breathable fabric. You may also want to carry a bamboo/cotton sheet to place between yourself and the baby during a feed. Our new cotton breastfeeding tshirt is a great idea as the zip allows for easy discrete access and there is material that remains between you and bub.

 

Stay vigilant and HYDRATED this Summer!

 

 

So you are off to the Hospital to deliver you baby… what are the essential items to pack into the bag?

So you are off to the Hospital to deliver you baby… what are the essential items to pack into the bag?

Packing your pregnancy bag is a job you will either do too early or too late. It's never too early to gather together all the essentials you'll need during labour and birth, and for after your baby is born. Even if you're not planning to have your baby in a hospital or birth centre, you may need to go in unexpectedly, so try to have a bag packed by the time you're about 36 weeks pregnant.

Create a checklist and get ticking :)

 

What Mum needs for her hospital pregnancy bag:

  • Maternity bras
  • Nighties including an old one or a large t-shirt to wear in labour. It will probably get a bit messy, so don't buy anything special or tight to wear in hospital.
  • Dressing gown. This will be useful if you end up pacing hospital corridors in early labour. You'll probably also want one on the postnatal ward. Hospitals can be very warm, so a lightweight one may be better. A dark colour or busy pattern will help hide any stains.
  • Casual day clothes: include a pair of leggings that have supportive belly band with non intrusive seams. It helps with the repair of this area.
  • Slippers/shoes: Backless slippers that are easy to get on and off. Thongs work well, too.
  • Breast pads
  • Maternity pads plus lots and lots of undies
  • Heat packs. Many hospitals have a limited number of heat packs but are happy for you to bring your own. Check first, though, that your hospital allows microwaved heat packs (some have banned them), and has a microwave available so you can heat the packs.
  • Toothbrush, Toothpaste, Makeup, Hairbrush, Deodorant, Shampoo, Conditioner plus Hairbands, clips or a headband. If you have long hair, you may want it tied up or clipped back. And if your hair is shorter, you can keep it off your face with a soft headband especially during labour.
  • Lip balm: your lips can dry out quickly on a warm labour ward and from the air conditioner on the ward.
  • Any medications you have been taking (please bring the medication to the hospital to show your admitting doctor and arrange for this medication to be returned home)
  • Your Medicare card, details of your health insurance (if you have private insurance) and any hospital paperwork you need. Your birth plan (if you have one) and antenatal card, if you were given one.
  • Storage containers for glasses, contact lenses, hearing aids, or dentures. Note that your glasses may fog up when you're in the throes of labour, and you won’t be able to wear contacts if you're having a caesarean.
  • Things to help you relax or pass the time, such as books, magazines, games, knitting or a tablet. You may also want to download some fun and distracting apps on your phone to keep you occupied during early labour.
  • Music device, Phone and charger
  • Snacks and drinks for during and after the birth. Most women are able to eat and drink during labour and those early few days of breastfeeding when you can eat anything in sight. The hospital will have food and drink available, but you may prefer to pack a few things that you know you like. Great ideas are: Fruit, unsalted nuts, chips, muesli bars, honey sandwiches or and popcorn are all good options.

 

Some optional extras depending on the type of birth and/or what you have put into your birthing plan:

 

  • Massage oil or lotion if you'd like to be massaged during labour. You may also like to borrow or invest in a massage roller or similar aid, so your birth partner can massage you for longer.
  • Birth ball. This can help you find different positions of labour, and may also help you manage the pain of contractions. Check whether the hospital has the right size for you. If not, take your own. Remember to bring a pump so your birth partner can inflate it for you.
  • Oil burner, if you'd like to use aromatherapy oils. Check with your hospital because most have won't allow open flames, but you may be able to use an electric burner.

What baby needs:

 

  • Baby clothes and a blanket to take your baby home in
  • Newborn nappies and extra wipes (especially if you like a certain variety)
  • Dummy or pacifier if you choose to use one
  • Formula, bottles, teats and sterilising equipment, if you plan to formula feed
  • Olive, apricot, almond oil for coating baby's bottom before the first nappy goes to make cleaning easier