ENDS TONIGHT: FREE LOCKDOWN SHIPPING to SA, VIC, NSW and QLD....or spend over $89 for FREE SHIPPING ANYWHERE
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 

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

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 10, 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!

 

 

Can you smell that?

Can you smell that?

The sense of smell is very important. Did you know that this sense often gets affected due to depression? Many observe during pregnancy that their sense of smell heightens often making nausea worse so why is it that many suffer a loss of smell in the postanatal stage due to postnatal depression or other mental illness post baby?

"Personally, my husband did not believe me that my sense of smell had gotten so bad due to my postnatal depression and anxiety. Unfortunately now many smells go unnoticed or the degree of the smell needs to be greater in order to sense it..."

So here is why?

Depression, schizophrenia and seasonal affective disorder all suppress the sense of smell. The olfactory bulbs is the part of the brain that gives us our sense of smell. Researchers have found that the more severely depressed a person was, the smaller their olfactory bulb.  Therefore this suggests that depression may cloud, but not damage, a person's sense of smell. The reduced brain response to odours found in depressed persons may be tied to problems in two closely connected parts of the brain that play an important role in processing emotional information and smell, known as the orbitofrontal cortex and amygdala.

The effects were present whether or not an individual was taking antidepressant drugs.

It has also been noted that once the depression has been successfully treated the sense of smell/response to smells returned back to their normal levels.

CON-VID19 and Breastfeeding- what is the low down

CON-VID19 and Breastfeeding- what is the low down

The World Health Organisations are continuing to learn about the deadly CON-VID19 virus. Like many we are trying to stay abreast of the changing developments to help us to make informed decisions about our health and the families health. Due to this being so new we have a lot to learn and the effect on some/implications is unknown.

One of those areas of the flow on effect is with breastfeeding mothers. What we do know from previous studies is that breastmilk is like liquid gold and helps with the babies immunity- like almost putting a protective bubble around them.

The Centre for Disease Control and Protection outlined the following:

Transmission of COVID-19 through breast milk

Much is unknown about how CONVID-19 is spread. Person-to-person spread is thought to occur mainly via respiratory droplets produced when an infected person coughs or sneezes, similar to how influenza (flu) and other respiratory pathogens spread. In limited studies on women with COVID-19 and another coronavirus infection, Severe Acute Respiratory Syndrome (SARS-CoV), the virus has not been detected in breast milk; however we do not know whether mothers with COVID-19 can transmit the virus via breast milk.

CDC breastfeeding guidance for other infectious illnesses

Breast milk provides protection against many illnesses. There are rare exceptions when breastfeeding or  feeding expressed breast milk is not recommended. CDC has no specific guidance for breastfeeding during infection with similar viruses like SARS-CoV or Middle Eastern Respiratory Syndrome (MERS-CoV).

Outside of the immediate postpartum setting, CDC recommends that a mother with flu continue breastfeeding or feeding expressed breast milk to her infant while taking precautions to avoid spreading the virus to her infant.

Guidance on breastfeeding for mothers with confirmed COVID-19 or under investigation for COVID-19

Breast milk is the best source of nutrition for most infants. However, much is unknown about COVID-19. Whether and how to start or continue breastfeeding should be determined by the mother in coordination with her family and healthcare providers.  A mother with confirmed COVID-19 or who is a symptomatic PUI should take all possible precautions to avoid spreading the virus to her infant, including washing her hands before touching the infant and wearing a face mask, if possible, while feeding at the breast.  If expressing breast milk with a manual or electric breast pump, the mother should wash her hands before touching any pump or bottle parts and follow recommendation for proper pump cleaning after each use. If possible, consider having someone who is well feed the expressed breast milk to the infant.

So in a time like this it is probably more advantageous then ever to keep breastfeeding babies to give them some immunity to this pandemic.

What to do to INCREASE the flow...

What to do to INCREASE the flow...

Many woman struggle in the first few weeks/months of breastfeeding until they establish their supply and/or get the hang of it. A number of lactating woman also feel that they are not producing enough in order to meet the demands of a newborn baby. This can often be the thought due to having a screaming baby, one that keeps searching for a suck, poor weight gain etc, not thriving etc etc. 

Here are a few tips to maybe get things flowing:

  1. Allow lots of sucking:Breastmilk is produced on demand, and the sucking stimulates your body thinking there is more demand for milk.
  2. Pump between feeds: This will also trigger the supply-and-demand cycle in your body to produce more milk.
  3. Lots of skin to skin contact: This will release a hormone called prolactin. Prolactin stimulates oxytocin (the feel good hormone). Both prolactin and oxytocin can help stimulate breast milk production.
  4. Drink more water: to avoid dehydration. Institute of Medicine recommends arounds 3.1 L compared to 2.2 L in non breastfeeding mothers.(This changes according to activity levels/environmental needs etc)
  5. Manage stress when possible: Outsource tasks if they are becoming too overwhelming. Listen to relaxing music during nursing sessions. 
  6. Empty breasts during feeding: The more milk that is removed the more you will make.
  7. Consider fenugreek tea: Fenugreek is one of a few herbs that has data to support its use as a galactagogue (substance to help increase milk supply).
  8. Make sure you are getting the additional 500 calories (a day) to help aid the increase in nutritional demands.

For further assistance see your local Lactation consultant or call the Australian Breastfeeding Association.

Spicy 🌶 Breastmilk?!?!?

Spicy 🌶 Breastmilk?!?!?

Spicy food is one of those general words that gets thrown around when a Mum is breastfeeding and her baby is unsettled. Many then ask should I avoid the spice while breastfeeding? Here is what we found...

 

It’s fine to eat spicy food while you're breastfeeding. Traces of what you eat enter your milk, but it shouldn't unsettle your baby if you eat spicy food. In fact, it may benefit your baby. ... If your breastfed baby seems upset or irritable, you could try eating a milder diet to see if makes a difference.

 

Generally, the dominant flavors of your diet – whether soy sauce or chili peppers – were in your amniotic fluid during pregnancy.

Fetuses swallow a fair amount of amniotic fluid before birth, so when they taste those flavors again in their mother's breast milk, they're already accustomed to them.

 

Parents.com verdict:

 

Verdict: Safe

“Nursing moms don't need to be scared of spicy foods, says Paula Meier, Ph.D, director for clinical research and lactation in the Neonatal Intensive Care Unit at Rush University Medical Center in Chicago, and president of the International Society for Research in Human Milk and Lactation.

 

By the time the baby is breastfeeding, Dr. Meier says, she is accustomed to the flavors Mom eats. "If a mother has eaten a whole array of different foods during pregnancy, that changes the taste and smell of amniotic fluid that the baby is exposed to and is smelling in utero," she says. "And, basically, the breastfeeding is the next step going from the amniotic fluid into the breast milk."

 

In fact, some items that mothers choose to avoid while breastfeeding, such as spices and spicy foods, are actually enticing to babies. In the early '90s, researchers Julie Mennella and Gary Beauchamp performed a study in which mothers breastfeeding their babies were given a garlic pill while others were given a placebo. The babies nursed longer, sucked harder, and drank more garlic-scented milk than those who had no garlic exposure.

 

Moms will restrict their diet if they suspect a correlation between something they ate and the child's behavior — gassy, cranky, etc. But while that cause-and-effect might seem enough for a mom, Dr. Meier says she would want to see more direct evidence before making any diagnosis.

"To truly say that a baby had something that was milk-related, I would want to see issues with the stools not being normal. It's very, very rare that a baby would have something that would truly be a contraindication to the mother's breastfeeding.”

Mindfulness Helping In The Fight Against Anxiety

Mindfulness Helping In The Fight Against Anxiety

Mindfulness is a process that leads to a mental state characterized by nonjudgmental awareness of the present experiences, such as sensations, thoughts, bodily states, and the environment. It enables us to distance ourselves from our thoughts and feelings without labeling them as good or bad.

 

Anxiety is the mind and body's reaction to stressful, dangerous, or unfamiliar situations. It's the sense of uneasiness, distress, or dread you feel before a significant event. A certain level of anxiety helps us stay alert and aware, but for those suffering from an anxiety disorder, it feels far from normal - it can be completely debilitating.

 

An anxious person will report an unreasonable exaggeration of threats, repetitive negative thinking, hyper-arousal, and a strong identification with fear. The fight-or-flight response kicks into overdrive.

By focusing our attention on the present moment, mindfulness counteracts rumination and worrying. Worrying about the future (e.g. I better remember to pay those bills and clean my house this weekend) and ruminating about the past (e.g., I should have done this rather than that) are generally maladaptive thinking processes. Mindfulness can be an important tool for helping us to better focus on the present moment.

 

Mindfulness helps us reduce anxiety and depression. Mindfulness teaches us how to respond to stress with awareness of what is happening in the present moment, rather than simply acting instinctively, unaware of what emotions or motives may be driving that decision. By teaching awareness for one's physical and mental state in the moment, mindfulness allows for more adaptive reactions to difficult situations.

 

 

Beyond Blue states:

 

“The research tells us that practising mindfulness does have some benefits for mental health wellbeing and for managing depression and anxiety. It is also helpful when it comes to managing some long-term physical conditions, helping the patient to better deal with pain or discomfort.

Many people who practise mindfulness report a number of tangible benefits, such as:

  • Improved memory
  • Better concentration
  • More flexibility in their thinking
  • Greater ability to focus
  • Less rumination (when the mind gets over chatty!)
  • Better stress management
  • Higher satisfaction with relationships and quality of life

 There has also been some research conducted linking the benefits of turmeric supplements by influencing the neurotransmitter balance in the brain and can be complimentary treatment.

 

Image: Heidi Forbes Oste
Why This Mum Is Not Rushing Back Into Fitness After Pregnancy....

Why This Mum Is Not Rushing Back Into Fitness After Pregnancy....

Nadine is a Brisbane Mum of two, a personal trainer, Emergency Military Nurse, blogger and a health and fitness enthusiast. Nadine has lived and breathed fitness for many years and was motivating the troops at F45 until she went on maternity leave.

 

During both pregnancies Nadine suffered from severe HG (Hyperemesis Gravidarum) or extreme morning sickness where she had to be hospitalised a number of times due to dehydration/monitoring. For those of you who know Nadine would appreciate that she gives everything 110% and will train anywhere/anytime. Due to unforeseen circumstances Nadine went into labour 6 weeks early and underwent an emergency caesarian. She then spent the next few weeks going back and forth to the special care nursery-pumping around the clock to nourish her little one.

 

For Nadine, exercise is like brushing her teeth, it is part of her day so when she made the conscious decision to NOT return to exercise postpartum it was a big thing. Listening to her inner dialogue and body is an important message for all Mums. Some tend to rush back into a regime which they may not be ready for mentally or physically- the fourth trimester is just as important as the first three…

 

“As you guys know I made the very conscious decision to NOT return to ‘Training’ at 6 weeks when I was cleared to begin ‘light’ exercise. Hear me out tho!! It’s interesting seeing me talk about my birth because birth trauma is REAL and what we experienced to bring Beckham here safely was incredibly scary for all involved but that is a story for another day perhaps, this is something I deal with everyday…. Anyhow this isn’t just about my birth experience….because….I hadn’t felt ready and I had to listen to that internal dialogue. I knew my recovery was going to be longer in duration due to what occurred physically and mentally for me and I know that i have had to be very meticulous, careful and very structured and progressive with my recovery. Slow and steady is absolutely what is needed for me and my body. Physically and mentally my mind and body have been through the wars. And my body has needed REST and a chance to do some internal repair on its own.-mind, body and soul without the additional stressors….Irrespective of my birth experience, I also DECIDED that the 4th trimester was something again that I wanted to immerse into, to truly soak in the time with my newborn and my family…time I’ll never get back, time to bond, time to find our groove. And without the added pressure or ‘postpartum bounce back’ that seems to be on the trend which I refuse to enter into….

 

Project ‘get my body back’, and some rapid postpartum mum bod has been so far out of my priorities it is not funny. That may seem interesting for someone whose life is revolved so heavily around health and fitness…(if your new to my page you may not know that I have a background in personal training, group coaching, have my online coaching and mentoring business, published fitness modelling and heavily involved in this industry) BUT  and that’s not to say others that return sooner are doing the wrong thing, I would hope we are all guided by the professional advice and pave our own path unique to our journey, but what I am saying is this is MY journey and my decision making and  SLOW RETURN is and has been my PRIORITY.

 

But THIS to me is HEALTH! Its looking after ME in all life pillars- the physical sense, the emotional sense etc etc. I have had times where I’ve wanted to get back into it. Let’s not lie. BUT it was in those moments I reminded myself of THIS. Newborn life is fleeting and Ive focused my time and energy into my baby, my family and my WELLBEING OVERALL and gentle walks with Beckham a couple of days a week and that is it, focusing on nutrition especially when a prep baby is exclusively breastfed and that is my HEALTH, my body right now is still an extension to someone else aka BABY BECKS and will be for a while. These decisions have been easy to make-especially when it involves a MIRACLE baby that was born prematurely after a traumatic birth and him being in hospital in special care for the first few weeks of his life and heck a whirlwind pregnancy with trials along the way from the get-go, trust me when I say that we were a bees dick away from our birth being the catastrophic WORST day of our lives with the outcome being potentially VERY different…now as a result; my core and abdominals have needed and will be needing progressive rehab work just like anyone would need to; but perhaps on a grander scale due to what occurred that day. Which i too have been and will continue to be working on. My c-section fortunately and unfortunately had to be rapid, had to be severe, had to be rough and was complicated to say the VERY least. What happened had to happen in order to BRING our baby out alive.

 

Someone doesn’t recover from birth trauma overnight. Im a resiliant  person but Im not immune from that- it rocked me and Dane too- because our birthing partners experience it too lets not forget them. And it still does. It takes time. And I work on that in various ways everyday. We are appreciative and grateful with what eventuated in the end but it was a harrowing experience that perhaps I’ll share one day.

 

In a nutshell, taking this time slow but smart, meticulous and planned, progressive in nature and ensuring reassessment on all fonts along the way, but more importantly being discerning of where I focus my time and energy while I recover has been my priority.  I know where my body ‘can go’, what it ‘can’ look like, what it is ‘capable’ of doing and achieving. But doing that in record time would be foolish and detrimental long term. Pregnancy and birth is short term, my postpartum is FOREVER. AND I choose to honour and look after that!!!!!

 

I’m 4 months postpartum this weekend. I now move into a new phase of my rehab. Take note, in my opinion I started rehab day 1- it just looks different which is MY VARIATION OF NORMAL. And being in a ‘gym’ hasn’t been part of it until now. 4 months postpartum now involves a progressive program that I have taken time to develop with so much intention and will be assessing as I go, and with the necessary health professional checks and advice along the way with a women’s health physiology which also will be ongoing! This new phase isn’t some crazy step up, its simply simply the next part of my progressive step in my current rehab and restrengthening this mind and body. The bi-product of all of this of course will be some aesthetic change but again the focus isn’t that solely!! Im excited to be entering this phase and Ill be sharing it with you and I hope my journey will and can inspire others to also LOOK AFTER AND TAKE MUCH CARE IN THEIR POSTPARTUM JOURNEY……”

 

*Nadine has released her birth story on Dear Mama Project Podcast if you are interested in hearing more.

How Can You Make The Most Of Your Time?

How Can You Make The Most Of Your Time?

Mindfulness. Being present in the immediate. Slowing thoughts, breath and body to feel into all that is right now. This blissful, calm state is one that we’d all love in our classrooms a little more often, right? Incorporating mindfulness activities into your daily routine. Itis one way to incite this kind of calm.

Really read story time – unlike a sitting meditation, mindfulness can be done whilst you are doing anything, it’s just about being totally focussed on the task at hand. Reading the bedtime story is a great one. So many of us are reading the story on autopilot with our minds in our inbox, or planning dinner. Next time you read The Gruffalo, try totally focussing on the words, the images, the story. You might even get into it.

Don’t forget the endless benefits of mindfulness for Mums. Mindfulness training can help reduce symptoms of postpartum depression. According to Gannon, meditation can also help new mothers navigate feelings of uncertainty, cope with the stress of parenting, and even increase lactogenesis (a fancy word for “produce milk”) in mothers who are breastfeeding.

So why not stop and READ a book to your kids tonight!