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No Housework And Regular Massage: Postnatal Traditions From Around The World.

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postnatal traditions recovery fitness

I have some vivid and precious memories from the first few months after my sons were born, despite being in a bit of a daze at the time. It’s such a special time, and one of enormous transition: physically there’s a lot of healing needs to take place, there are hormonal changes, bonding, learning to breastfeed, and relationships adjust.

And I can’t help but feel we don’t honour this time as we should. We’re pretty good about pregnancy, but once baby arrives, the mum doesn’t always get so much attention anymore. And with paediatrician appointments,  endless nappies to change, baby clothes to wash and visitors to see baby, self-care can take a back seat.

 postnatal recovery traditions

But is this good for our recovery?

In a word: no. Which made me wonder- do other cultures take better care of new mums than we do?

Confinement.

Many countries have confinement practices where the new mum stays at home, with no visitors except close family until the confinement period is over. For Malaysian women this usually lasts for 42 to 44 days, for an Indian mum, it’s about 40.

Wouldn’t it be wonderful if we could follow a similar practise in the UK, treating the postpartum period as a time to cherish and give mum extra care? Unfortunately it is just not practical for most of us: how many have family members who can tend to us for that long? There is the option of hiring a doula though, who often provide support beyond the birth itself and can advise on self-care and even help with household chores, or postnatal support from someone like Karen at Parents & Co, who can provide overnight care too.

No washing your hair!

This is a Chinese one, and linked to an overall practise of staying warm, because loss of blood and energy is thought to make mum ‘cold’: in Vietnam they practise nam lua (‘mother-roasting) where a fire keeps the mother warm for a month.

Other warming practises include bathing in warm, herb infused water- I don’t think any of us want cold baths or showers, so this one is pretty easy to follow!

postnatal traditions

Is this a valid concern though? Apparently so! One study found people who dipped their feet in icy water for 20 minutes were more likely to develop a cold than those who didn’t.

Given that new mums often experience increased sweating (getting rid of the extra water retained during pregnancy) these warming traditions do seem like a good idea!

No TV or reading!

Ok, I would have struggled with this one. I get the reasoning- strain on the eyes and potentially tiring- but I’m not sure I could stay in the house for that long without books. Unless I ran up a MAHOOSIVE bill at audible.com. Is it acceptable to ask for itunes vouchers instead of baby clothes as a gift?

Other activities considered to be stressful and avoided include shouting, crying, and too much conversation. I may have struggled with the crying (hormones!), however talking to fewer people may have helped…

No housework

Awesome. Also, no bending at the waist to prevent back injuries. In India new mums are sometimes helped by a dia (or even a maid) who will help with cooking, laundry, and bathing the baby.

In some cases, where the birth has been particularly difficult and there may be problems such as a prolapse, this is great advice. In others, it may feel impractical: bending over baby to play, for example.

Also, whilst I’m all for rest, some exercise, such as gentle walking, can be really beneficial in encouraging the core to repair. It will increase circulation which will increase the nutrients being delivered to mums muscles, aiding her at a cellular level.

However, there’s something else that aids circulation…

Massage.

postpartum traditions healing massage

Also awesome. In India the dia will do this too (maybe even daily), or in Malaysia a bidan massages the abdomen. Pregnancy and the strains of a new baby can leave mum with tight areas, and  a tight spot pulling you out of alignment can affect posture, and therefore abdominal healing (diastasis recti).

Release work doesn’t have to be done with massage, I give clients techniques they can use at home for this, but massage would be my method of choice!

Abdominal binding.

Many cultures practise some form of belly wrapping to aid with healing the core. In Malaysia they use a special postnatal corset (bengkung), and India a long cloth to bind it. They can give extra support to weakened abdominal muscles, reduce postnatal swelling, and encourage them to close back together.

In the UK Physiotherapists can recommend abdominal support for women who are having trouble healing. But whereas across the pond in France new mums see a Women’s Health Physio as standard, subsidised by the government, here you have to be referred by your GP if, or search for a private one. The difference this would make to recovery, and incidences of pelvic floor disorders such as incontinence and prolapse, is immense.

Diet: warming ginger, good; windy onion, bad.

The keeping warm theme continues here, as in many countries (including China, India and Malaysia) some foods, such as ginger, are believed to promote better blood circulation and strengthen the joints, while other cooling foods are avoided. Cucumber, cabbage, young coconut and pineapple fall into this catagory, the ‘cooling’ elements thought to cause rheumatism, arthritis and weak joints in a mother.

I’m not at all convinced by this, and would have recommended pineapple myself, as the enzyme bromelain in it is thought to aid digestion! However other advise I came across, such avoiding ‘windy’ foods like as onions and jackfruit, seems pretty wise! And bone broth/ soup is a staple of the postpartum diet in many cultures, which is great for recovery.

nutrition postpartum tradition soup

Not all these practises are followed rigidly; even for the confinement, some mums will end early if they feel they need to. I don’t think I would: the prospect of a month of massage and having my meals cooked is almost enough to make me want another baby!

If you’re struggling with your diastasis recti find out about my postnatal personal training packages here.

References

http://www.hyphenmagazine.com/magazine/issue-23-bittersweet/motherhood-rooted

http://www.babycenter.com.my/a1021145/confinement-practices-an-overview
http://www.babycenter.com.my/a1042118/indian-confinement-practices#ixzz3ZlkB5GUy

http://www.babycenter.com/0_postpartum-sweating_11720.bc

 

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Recipe: Beef Broth.

Bone Broth is becoming quite trendy at the moment! The benefits are being touted all over the place.place. I’ve talked before about the benefits of broth here and here, but even so, let’s not go overboard! There is little evidence to back the claims up, and studies that have been done are using nutrients from the broth in a supplement, so not the same (read here for more info).

Nonetheless, I love it. For the simple fact that it’s cheap (unless you buy it out, then it’s suddenly not anymore!) and lets me add extra protein to other dishes such as soups, I like making it. And although I’m sure a lot of the claims are over-hyped (you probably won’t look 21 again from drinking collagen!) it doesn’t mean there’s not some wisdom in it: many cultures give new mums bone broth as part of their post natal diet, and I’m sure they have their reasons.

So, my recipe. I always do broth in my slow cooker, as I leave it overnight and my stove switches itself off, but you can do it in a stock pot on the hob. Just bear in mind you need to leave it for a while: I aim for 24 hours with bones this big (smaller bones like chicken don’t need as long).

First, I put this bone, which was £1.50 from the local butcher, into the oven for about 40 mins on 180 degrees. This is for 2 reasons: first, it gives the broth a much nicer flavour (and smells lovely!); second, roasting the bone helps it to break down so you get more nutrients in your stock.

This is a marrow bone, which is nutrient dense and has a great flavour, but you can use any bones you like. Bones like hooves or knuckles are more gelatin rich, and have more collagen and glucosamine in them, so great for joints and postnatal recovery.

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Then I put it in the slow cooker (or stock pot), cover it with water and add about a tablespoon of cider vinegar or lemon juice (again this helps to break the bone down), and I also add a tablespoon of orange juice. I read somewhere that this helps with drawing out nutrients too, and I got a really nice flavour when I tried it so have stuck with using it!

In the slow cooker you just leave it on low, otherwise bring to the boil then reduce to a simmer. Over the first few hours you can get some scum rising to the top; just scrape this off. (OK, confession- I never do this. I just always read that you should. I’ve never found this scum, although I do sometimes find there’s sediment in the finished broth that I throw away.)

For the last few hours of cooking I add a few vegetables; usually whatever I have lying around. Here I’ve chopped up 2 carrots, an onion, some old celery (soup or juicing is a great way to use up fruit and veg past it’s best)  a clove of garlic (which I smashed open to help the flavour), and a couple of bay leaves:

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Depending on what you’re using it for and how strong you like it, you can take the lid off and reduce it down when you’ve finished. I like to do this and get a ricker flavour. Then just cool and drain through a sieve.

You can change the concentration of the gelatin in there, which is visible on the consistency when the broth is chilled, by decreasing the ratio of water to bones. Less water and more bones will result in a higher concentration of gelatin, so the broth will be more jelly-like when cold. Sometimes I return the broth to the heat once I’ve drained it and reduce it down to get a stronger flavour.

Once chilled it looked like this:

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mmmmm, yum. I scrape the fat off and you can see the consistency underneath:

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I often divide it up into 500ml containers and freeze some for stock. You can use it in casseroles, or for soup, or just heat and drink it. I know this doesn’t look hugely appealing, but once you’ve warmed it it’s runny again.

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My Number One Nutrition Tip For Healing Diastasis Recti.

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I don’t think it’s news to anyone that diet plays a vital role in overall health. There’s advice everywhere: what to eat to boost the immune system, boost energy, get healthier looking skin and hair…. I could go on.

Problem is, even though we know a nutrient-rich diet will help our recovery after giving birth, it’s easier said than done!

Yes we want to eat plenty of protein, fruit and veg, and home-made meals. But when I had my first and was exhausted, struggling to breastfeed, and generally overwhelmed, I found it very easy to reach for the biscuits! I had a lazy feeder who kept falling asleep on the boob and got told I had to pump to boost my milk supply. After every feed. In hindsight I’m not convinced this was necessary, or the fenugreek. Did anyone else take that? Seriously, I’ve never been so aware of my own stench before, the stuff oozes out of your pores. And just when your baby is learning to recognise mummy’s smell!

Anyway, up at 2am, feed for 30 minutes each side (as he was such a slow sucker) then pump. So back in bed at 4am, if I’m lucky, to get up again at 5 for a repeat… You’re damn right I had a packet of Cadbury’s Fingers next to me during those night time marathons!

Second time round I was better prepared with healthier snacks on hand, and if I did it again if be even more organised by filling my freezer with ready made bags like these.

But what specific diet tip would I give to new mums?

Bone broth.

Or just broth/ soup. Bone broth is trendier at the moment though (or at least calling it that seems to mean it costs more)!

Most women will get Diastasis Recti (DR) during their pregnancy, and while Mother Nature is fantastic, and it can heal on its own, poor sleep, nutrition, alignment and a lack of muscle tone beforehand can make it harder. For those who haven’t healed by 8 weeks post partum, it won’t heal without specific exercise/physiotherapy  intervention to help (Coldron et al 2008). But to get the best results possible you need to look at stress, sleep and nutrition too. And when I get a client who needs to work on repairing DR, my number 1 nutrition tip is bone broth.

The midline (called the linea alba), which has become stretched as the abdominal muscles have moved apart, is made of collagen. So you need to eat foods that encourage this collagen to repair. (As a bonus this will also let the pelvic floor recover, and let’s face it that’s taken some punishment too!)

The most efficient way to do this is from animal protein, specifically the skin, cartilage and bones, which is rich in gelatin, which is derived from collagen. Broth is the best source of this. It’s not as straight forward as eat collagen and your body will use it as collagen; we don’t absorb collagen whole. Your body will break it down and use it as it needs to. Bone broth has a different amino acid (the building blocks of protein) profile than muscle meat though, and is easily digested and anti-inflammatory. For any vegetarians- yes you can rebuild from plant sources, but the key word is‘efficient’.

The other benefit is that it hydrates you. Water is also an essential part of your recovery and tissue repair, and so many mums end up not drinking enough.

And remember, if you don’t like broth you can use it as a base for another soup, like tomato, or as stock, which is what I usually do, cooking rice in it or adding it to casseroles. Click here for my chicken stock/ soup recipe.

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When is a calorie not a calorie? When you have long intestines like a Russian!

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That may sound like a joke that my son made up, but it will make sense soon. Unlike my son’s jokes:

Him: What do you call a man flying?

Me: We don’t know

Him: Me don’t know

Me: ? But it’s your joke.

Him:………..

Me: Fred?

Him: Yes. What do you call a flower eating a flower?

This went on for a long time.

Before we start, I’ll admit now: I don’t like counting calories. This is in large part due to laziness. To accurately track calories I would need to:

  • Weigh every morsel of food I ate. And cooking changes the weight, so I’d have to weigh potatoes after boiling them, for example.
  • Let’s say I’m making a cottage pie. I’d have to weigh and calculate the calories in every ingredient, work out the total weight and calories, and then weigh my individual portion and calculate calories as a percentage.
  • I’d have to research the calories in everything.
  • What if I don’t finish eating my plate? I’d need to weigh the leftovers and recalculate.
  • I need to know my BMR (Basal Metabolic Rate) to know how many calories I burn at rest, and workout how many I need each day, depending on activity. To do this accurately I need to have the carbon dioxide and oxygen in my breath analysed. This seems a bit of a faff.

This is a lot of work, and I still wouldn’t be accurate with my numbers. Here’s why…

  • Sometimes a food has calories in it, but we can’t access those calories. For example we don’t seem to fully digest peanuts, pistachios and almonds. A study found that the “average” person receives just 128 calories per serving rather than the 170 calories “on the label.”
  • Some foods require more energy to digest them. Proteins can need 10-20 times as much energy as fats, but this loss of energy is not accounted for in food packaging.
  • Sometimes our immune system has to get involved to deal with potential pathogens. We don’t know how many calories this would involve, but the rarer the meat, for example, the more pathogens.

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  • The more processed the food is the easier it is to digest, so again we use fewer calories digesting it. People eating wholewheat bread received 10% fewer calories than people eating white bread in this study.
  • Genetic differences in us. If 2 people did manage to eat 2 identical potatoes, they wouldn’t get identical calories from them. Just like we vary on the outside, we vary on the inside. Russian intestines are 5ft longer than those of Italians. (I love this fact for some reason. I found it in this article, along with a lot of the other facts used in this blog.) In the same way we have different numbers of enzymes, and those with less lactase will extract fewer calories from milk than someone who isn’t deficient.

And our body’s handling of calories goes beyond digestion.

In The Lean Muscle Diet Alan Aragon writes: “a hungry guy might put away a million calories in a year. The daily average would be 2,750 calories, but nobody eats the exact same food every day. The number will probably fluctuate by a couple hundred calories a day, with a little more on weekends and holidays and a little less on weekdays. And yet, the average American gains less than a pound over the course of a year. Think about that: a million calories, spread over 365 days, and by the end of the year your body has probably stored just 2,000 of them. Your body is really good at keeping you in balance. The size and shape you are now is the exact size and shape you’ve conditioned your body to maintain.”

Put another way, Rudy Leibal, a leading obesity researcher, says “we don’t think body weight can be consciously regulated.”

In Diet Recovery Matt Stone agrees: “It can’t. In fact, a 70-year old person with 70 pounds of body fat has stored only one peanut per day more than they have burned. No one can control a process so precise. It’s like trying to increase your oxygen levels by breathing more.”

So, counting calories accurately is impossible, knowing your precise BMR is near impossible, and the body doesn’t allow you to control it that closely anyway as it’s trying to maintain your current weight.

And yet: counting calories works.

Weight Watchers, IIFYM, you name it. If you track the numbers and create a calorie deficit you will lose weight.

But what happens when you stop?

Some people may be happy to track every morsel of food that goes into their mouth for the rest of their life, but for most people, their diet has a finishing line, a weight loss target. And then they stop, and return to old habits, and I hear again and again, “I did a diet and it worked, but then I put the weight back on, so I’m going to do it again.”

A diet only has only worked if it has worked FOREVER! If you’ve regained the weight, then technically, in the long term, it hasn’t been successful.

Because people fall back in to their old habits. And that’s the key word here: habits.

If, instead of following a regime in the short term, you can successfully change habits for the long term, you will, gradually, lose weight and keep it off.

I’m not saying pay no attention to how much food you eat; portion control and selecting foods that make you feel more satisfied and so likely to eat less is one example of a way to monitor total calorie intake without calorie counting. I’m not even saying never count calories. I would happily support and help a client monitor their calories if this was the best way for them. Some people have no portion control and seeing the numbers can help bring that in to check. But there are other ways, and it must be done alongside efforts to change eating habits and restore a healthy relationship with food. Forever.

What’s that? Oh go on then, one more.

What do you call a man with a ladder? Ben.

If you have any comments or jokes for my son, I’d love to hear them.

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