Whether a mom is a first-time mom or a fifth-time mother, the postpartum period can be a challenging time. Hidden behind the late nights, early mornings, diaper creams, loads of laundry, and a plethora of toys scattered around the house is a woman who is trying to recover from the previous ten months of growing and then birthing a little human! Conventional medicine’s idea of postpartum recovery includes, as is usually limited to, a six week-postpartum visit. This, however, leaves many women struggling with symptoms to fall through the cracks. This is where integrative medicine can step in and shine, providing testing that can help assess the status of the mom’s health and then using results to create a personalized treatment plan tailored to their needs, so they can be their best selves while caring not only for them but for the precious gift of life that they just brought into the world.
This article will discuss what the postpartum recovery period is, common medical issues that may arise, and how integrative medicine can help. We’ll then discuss functional medicine labs that can benefit postpartum moms and integrative treatments that can be used to formulate a well-rounded treatment plan.
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What is The Postpartum Recovery Period?
The postpartum recovery period is defined as the year after giving birth. However, this is a debated definition; sometimes, the postpartum period extends beyond one year and should be determined on a woman-to-woman basis, as bodies are different and the return to a pre-pregnancy state will vary.
Common Medical Issues During The Postpartum Recovery Period for New Mothers?
A mother's first year after giving birth can be a wild ride for many. Nighttime wakings, crying, blowout diapers, teething, the introduction of real foods, tantrums, smiles, first words, and first steps; so many events and activities are packed into those first 365 days! Symptoms commonly seen during the postpartum period can include fatigue, loss of sleep, stress, and constipation; these symptoms may be glaringly obvious. However, other symptoms, including anxiety, depression, and hair loss, may be masked or simply ignored.
How Can Integrative Medicine Help New Mothers During The Postpartum Recovery Period
Integrative medicine provides both traditional and conventional medicine options, with a focus on the physical, mental, emotional, and spiritual health of the person. With that being said, integrative medicine offers many modalities for new mothers in the postpartum recovery period, including lifestyle counseling such as diet and sleep help, herbs, supplements, pharmaceuticals, and more.
Common Functional Medicine Labs Ran During The Postpartum Recovery Period to Help Individualize Treatment Options
Functional medicine labs can help to assess many attributing factors to a mom’s postpartum symptoms. Here are a few common functional medicine labs utilized for postpartum patients.
Micronutrient Testing
The body requires small amounts of micronutrients like vitamins, minerals, and fatty acids. Pregnancy requires higher amounts of many vitamins and minerals and may lead to deficiencies in them. Lactating mothers will also have higher nutritional needs that continue until she is done breastfeeding. Examples of micronutrients that have higher recommended dietary allowances (RDAs) during pregnancy and lactation include iron, folate, and vitamins C, B12, B1, B2, B3, B5, and B6. Additionally, stress, as often found in postpartum moms, can also cause nutrient deficiencies as your body utilizes more nutrients to make hormones to combat the stress. Micronutrient deficiencies can lead to further problems, including hormone and neurotransmitter imbalances, further lack of energy and sleep, and more. The Spectracell Micronutrient Panel assesses 31 micronutrients which the practitioner can then use to make dietary recommendations, including eating foods that are higher in the depleted nutrients and supplementing with them when necessary.
Sex Hormone & Stress Testing
Hormone fluctuations during the postpartum period can be intense. Directly after childbirth, levels of both estradiol and progesterone plummet. Prolactin, the hormone responsible for milk production, surges, as does oxytocin, the hormone that facilitates bonding between mom and baby. Estradiol and progesterone levels usually do not regulate until, at the earliest, three months postpartum. However, breastfeeding, stress, lack of sleep, and other factors can contribute to these hormones being out of balance for longer. The DUTCH Complete test by Precision Analytical is a wonderful choice for the postpartum mom with symptoms that include hormonal imbalance symptoms such as irregular menstruation, heavy periods, mood swings, and more. This test assesses urine metabolites of hormones to show not only the hormone levels but also how the hormones are being broken down. Additionally, this test checks cortisol levels throughout the day. Cortisol is a primary stress hormones in the body and also one of the primary hormones that control our circadian rhythm, or sleep-wake cycle. When cortisol levels are out of range, it can lead to and/or exacerbate symptoms of fatigue, sleeplessness, brain fog, and more. Melatonin is also checked alongside cortisol. Melatonin is our sleep hormone, but it can also impact our sex hormone production. Lastly, this test ends with an organic acid test that assesses urine metabolites for a few neurotransmitters that can affect mood and micronutrients that may impact hormones.
Thyroid Hormone Testing
Located in the neck, the thyroid produces thyroid hormones T4 and T3 that affect metabolism, body temperature, hormones, hair, skin, nails, and more. Thyroid hormones are essential during pregnancy as they affect the baby and mother. During pregnancy, thyroid hormone production increases, and they should return to normal after giving birth. However, about 5% of women will develop postpartum thyroiditis, a condition marked by inflammation of the thyroid gland. Initially, women with postpartum thyroiditis will have hyperthyroid symptoms of heart palpitations, anxiety, nervousness, problems focusing, hair loss, high body temperature, and weight loss. Eventually, a hypothyroid state occurs with symptoms that may include fatigue, weight gain, depression, memory loss, muscle pain, dry skin, and more. Postpartum thyroiditis usually resolves within 18 months of giving birth, but medications and treatments may be indicated while it's active. A full thyroid panel, such as the Thyroid Panel by Boston Heart Diagnostics, includes the thyroid hormones T4 and T3, as well as the hormone that controls their production, TSH. Additionally, this panel includes thyroid antibodies that are indicative of Hashimoto's thyroiditis, a condition that presents similarly to postpartum thyroiditis but is lifelong.
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Complementary and Integrative Medicine for Postpartum Recovery
Complementary and integrative medicine treatments may include acupuncture, pharmaceuticals, nutritional interventions, herbs and supplements.
Acupuncture
Acupuncture is a healing modality of traditional Chinese medicine. The process involves inserting small needles into the skin at specific points with the goal of moving “qi,” which in Chinese medicine is the body's vital life force. Acupuncture has been shown to effectively reduce stress and anxiety, two common symptoms in postpartum women.
Pharmaceuticals
Depending on the results of thyroid labs, thyroid medications may be a necessary addition to the treatment plan. Medications that can help suppress the thyroid gland would be needed in states of hyperthyroidism and include Methimazole and Propylthiouracil. In a hypothyroid state, medications that replace the thyroid hormones are used, the most common being synthetic T4 medications.
Integrative Nutrition Options For Postpartum Recovery
The postpartum recovery period should place a significant emphasis on healing the body. With that being said, the diet for the postpartum period should include healthy fats, proteins, and high amounts of micronutrients to aid in the healing process and also replenish levels of nutrients that may have been run down by pregnancy and the birthing process. This is also especially true for moms that are breastfeeding in the postpartum period since their nutrient requirements will be even higher than those not breastfeeding.
One diet that recommends an array of nutrients, fats, proteins, and healthy carbohydrates, and thus may be great for the postpartum period, is the Mediterranean diet. The Mediterranean diet places emphasis on eating fresh fruits, vegetables, herbs, spices, fatty fish, nuts, seeds, olive oil, and minimally processed whole grains. Many health benefits have been demonstrated when following a Mediterranean diet as this diet can help to balance mood, enhance brain functioning, stabilize blood sugar, improve immune function, and increase energy levels.
Supplements and Herbs That Are Helpful For Postpartum Recovery
Supplements and herbs that may be helpful for the postpartum recovery period include ashwagandha, prenatal vitamins, and GABA.
Ashwagandha
Ashwagandha is a botanical medicine that is referred to as an adaptogen. Adaptogens, as their name implies, help the body adapt to stress. A system review of ashwagandha found it was effective at reducing perceived stress and anxiety. Another study showed ashwagandha was able to lower levels of cortisol. Sleep quality improved by over 70% in another study, with participants supplementing with ashwagandha. Additionally, ashwagandha may be beneficial for the thyroid gland. A study showed improvements in thyroid blood markers TSH, T4, and T3 with Ashwagandha supplementation.
Dose: 300- 12,000 mg per day, depending on clinical goal and symptoms
Duration: Use of ashwagandha will also depend on symptom severity and improvement in lab markers.
Prenatal Vitamins
Due to the increased need for many micronutrients during pregnancy, as discussed above, micronutrient levels may not be adequate. Mothers who are breastfeeding continue to need higher levels of these micronutrients after pregnancy. Prenatal vitamins have been formulated with these increased nutritional needs in mind and thus have higher amounts of micronutrients than you would find in a typical multivitamin.
Dose: The dose will be dependent upon the brand of prenatal vitamin used.
Duration: Prenatal vitamins can be used through the postpartum period and/or until the baby stops breastfeeding.
GABA
GABA is an inhibitory neurotransmitter made in the brain that helps us to relax and calm down. Suppressed GABA levels have been associated with anxiety, irritability, depression, low-quality sleep, and restlessness. Taking a GABA supplement can help restore sleep and relieve stress.
*It's important to note: When taking a sleep supplement, the mother should ensure her partner, or someone in the house, is aware she is taking something for sleep so the other person knows it's their responsibility to monitor the baby at night.
Dose: 120 mg/day
Duration: 12 weeks
*If the mother is breastfeeding, all supplements should be discussed with their practitioner prior to beginning use, as they may or may not be appropriate, or other alternatives may be safer.
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Summary
The postpartum period is a critical time in a mom’s life. Her body is recovering from both creating a new life during pregnancy and then bringing that life into the world through childbirth. But rest doesn’t come easy during the postpartum period, as the baby’s demands can often trump the mother's needs, putting her health to the side. This is why many postpartum moms begin to develop symptoms. Functional medicine labs can help to find the root cause of these symptoms, which can then be treated with different integrative medicine modalities.
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