Birth and Bowel Movements: Tips for the first BM after delivery

Bowel movements?!?  Really?!?  You want to talk about bowel movements?  

Yes. Yes, I do.  

This is one thing I certainly never expected or cared to research when I was having kids.  I was just focused on gearing up to get the baby out - I didn’t think so much about after the fact!  One would think that a bowel movement would be nothing in comparison to pushing out an 8 pound baby, no?!? Well…

Many women don’t anticipate this being an issue after delivery, especially if you’ve never had issues with constipation before.  However, a multitude of factors can throw things off and leave you feeling all “backed-up”.  Medications, prolonged sedentary positions and/or an altered diet are just a couple of potential culprits. Regardless of the reason(s), it makes for a less than ideal experience when the time comes to void those bowels.  Your healthcare provider will most likely be asking you and keeping track of how this process is going.  However, if you are having trouble in this department after giving birth, don’t be afraid to ask for help so they can set you up with a variety of resources like stool softeners and enemas to help move things along.  

Here are some additional tips that you can do yourself should you find you’re in the situation of dreading bowel movements after giving birth.  (These tips also work great for general constipation too).  

  1. Relax - Way easier said than done especially if you’ve had any type of tearing, an episiotomy, a C-Section or are just dreading having to “push” one more time!  Pelvic floor muscles relax and open much more easily when you are not stressing about it or anticipating pain.  How do you relax the pelvic floor specifically? One way is to use your breathing - inhale and simultaneously visualize opening the anus.  Sometimes it works well for people to visualize widening the SITs bones away from each other as you inhale (the “SITZ bones” are the two boney points you feel in your backside when sitting in a chair).  This relaxing or opening should NOT feel like you are pushing downwards, it’s simply a reflexive response to the breath. If you’re having trouble getting this down, ask for some help from one of our amazing physiotherapists.  
  2. Don’t clench your jaw - Also, if you’re having trouble relaxing the pelvic floor, check and make sure you aren’t clenching your teeth.  Strangely enough, keeping this area relaxed can also help relax the pelvic floor.
  3. Knees higher than hips - Those fancy commodes are handy so you don’t have to squat down so low, but sitting high doesn’t do much for optimizing the position of the rectum when trying to void those bowels.  Grab a stool or improvise with a garbage can (preferably empty!) tipped on its side.  Place feet up on something secure so your knees are higher than your hips and legs are supported and relaxed.  This can help align things more optimally for faecal evacuation.
  4. Position some more - Lean forward and rest elbows on your knees. This allows for further relaxation.  Let the tailbone untuck slightly to allow for easier passage of stool pass this area.  
  5. C-Section? Splint lower abdomen - If you’ve had a C-section, place a towel or your hands between thighs and lower abdomen for added support at the incision site.  Try not to block your belly totally however as forward movement of the abdomen can further help the muscles surrounding the anus to relax.  I know it’s going to feel like things will burst wide open if you strain too hard, but keep in mind that the surgeon stitches you up with the goal of keeping you closed.  If they thought the forces generated by pooping were going to be a hazard, they would tell you not to poop for 6 weeks or something crazy like that until things are all healed up.  Plus, after reading this article, you now have some strategies to minimize that horrible feeling of pain/pressure/pulling at the incision site! Ready for some more awkward suggestions??  I’m just warming up!
  6. “Moo”, “Grr”, “Hiss” or pretend to “Blow through a very small straw” - Ummm, WHAT?!??! If you didn’t already think I was crazy, I realize I just tipped the scale.  Please, bear with me (no pun intended).  Using your breath or vocalizations on the exhale can help modulate intra-abdominal pressure and act as an effective tool for assisting with a less strenuous bowel movement.  It can help you avoid the Valsalva Maneuvre (breath holding) that can increase downward pressure on the pelvic floor and/or the outward pressure on the C-Section incision site (if you have one).  Try all four sounds out - see which one feels like it opens the anus the most.  Generally speaking, half of these vocalizations will feel like they make you tighten at the anus, and the other half will create an opening effect.  However, which one is most effective will vary from person to person.  When you find one that feels like it creates the greatest opening effect (eg. “Moo”), use that as your go-to vocalization when on the toilet.  If you are having trouble finding one that works, make sure you try again using a low-pitched voice versus a high-pitched voice.  In attempts to try and redeem myself, I’m going to throw in here that you don’t actually have to make the sound so they can hear you at the nurses’ station (although that would be entertaining).  Simply causing that air movement with a whispered “Moo” can be just as helpful.  

Strange tips, I know, but these simple things can make a huge difference in keeping that first bowel movement or two after delivery a much less torturous experience.

If you have any questions about pelvic floor physiotherapy or preparing for birth, please call Rebirth Wellness Centre at, 226-663-3243, or email us at info@rebirthwellness.ca.

Jaclyn Seebach, PT ~ Certified Pelvic Health Physiotherapist

Well Parent: Nutrition While Pregnant & Breast/Chestfeeding

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Well Parent Nutrition While Pregnant

Healthy eating is an important part of good health, and an integral part of disease prevention and immune system support.  It is important that you eat healthy to ensure you are at optimal health to grow and care for your baby.

During pregnancy and while breast/chest-feeding your body provides all the nutrients a baby requires, often at the sacrifice of the parents needs. Good nutrition is important to help you keep your energy, and replenish reduced nutrient stores so that you are feeling great while growing, caring for and feeding your baby. Eating a well balanced diet filled with vegetables and good protein is the best way to achieve this.

Healthy oils such as raw olive oil, coconut oil and other unsaturated fats. Raw nuts are an excellent source of healthy oils, and a great source of protein and other micronutrients

Protein is an important part of good health. When choosing plant sources, be diverse! Mix and match! By eating a variety of legumes, nuts and grains  every day your are providing all the building blocks for healthy bodies and brains

Complex carbohydrates These can include beans and legumes, whole grains, rice, quinoa, fruits and vegetables. But beware the easy trap of pre-made simple carbs such as pastas, breads, and crackers…although they do have *some* nutritional merit, and are a wonderful addition to the diet in small quantities, they don't offer the biggest bang for your buck for nutrient needs, and can fill you up quickly

Vegetables and fruits Eat lots! They are excellent sources for micronutrients, vitamins and minerals. Don't forget the dark leafy greens, which are excellent sources of iron and folate: Spinach, Kale, collard greens…

Well Parent Nutrition While Breast/Chestfeeding

The beauty of breast/chest-feeding is that the nutritional content of breastmilk will always be exactly what your baby needs, but it is important to eat well so that you are getting exactly what you need.  

Many parents are often concerned about the nutritional content of their breastmilk, and worry that their babies are not getting what they need. Your body is made to breastfeed, and it will ensure that  your milk is filled with everything it needs for baby's growth and development. It will use all its resources to stockpile breast milk, regardless of parental nutrient levels. If your baby is eating well, and gaining well then your baby is very well fed.

All in all, parental diet has little impact on breast milk nutritional content (breast milk will always have the right stuff in it) (1).  However, there are a few exceptions:

Fat   Fats are incredibly important in brain development and growth, and although the amount of fats you consume has minimal impact on the amount of fat in breast milk, the type of fats that you eat IS important (1, 2). If you are eating the 'not so healthy' fats found in deep fried foods, potato chips and french fries the composition of those fats will be the composition of the fat in your breast milk. But if you are eating healthy fats such as avocados, nuts and olive or coconut oil then the fats in your breast milk will be that of the healthy fats. How neat is that?

Water soluble vitamins    The amount of water soluble vitamins (Vitamin C, B complex vitamins) found in breast milk depends greatly on maternal intake (2). These vitamins are not stored in the body, so both mother and babe are dependent on food to provide these vitamins (3). This is why it is important to eat a healthy well rounded diet so that both babe and mom are getting the vitamins they need. So, where can you get these important vitamins? You guessed it…Veggies! All those bright colourful veggies like red and yellow peppers, brussels sprouts, and dark leafy greens are rich in those C and B vitamins. B12 seems to be the tricky one, most sources of B12 are derived from animal products, however alternative sources include nutritional yeast (I’ve got a great recipe for nutritional yeast popcorn..yum yum yum), fortified tofus and soy products.

Calorie counting? Often new parents find that they have increased hunger. The caloric need of a breast/chest-feeding parent has increased with the increased demand from breast/chest-feeding, this makes it so important that you listen to your body. Every person is different, and as a result what every person needs is different. The same goes for thirst; while breast/chest-feeding, a lot of the water consumed will be used to produce milk, and many parents often feel an increase in thirst. My advice? Drink when you are thirsty! Water, coconut water or natural fruit juices are great ways to hydrate. Eat when you are hungry! Or do both at once with a smoothie!

Well Parent Smoothie.png

It all comes down to the basics when growing and breastfeeding your baby…take care of you and your body will take care of baby.

If you are interested in learning more about eating well while pregnant or  breastfeeding, or looking for tips on how to manage feeding a baby while feeding yourself...give us a call at Rebirth Wellness Centre! We would love to have a chat with you about how we can get you feeling and being well.

xo Rebecca

References:

1.    Fraser, Diane, Cooper, Margaret. (2009). Myles Textbook for Midwives, fifteenth edition. Elsevier Limited

2.    Park, Eileen. 2012. Class notes-Nutrition and Biochemistry

3.    Baby Center  www.babycenter.ca

Rebecca Robertson, Breastfeeding Counsellor, Doula, Childbirth Educator

I am a birth advocate, a breastfeeding educator, and especially an advocate for mothers and the choices they make. As a doula my main role is to support mothers and partners to ensure a satisfying and positive birth experience. I am trained in providing emotional and spiritual support, as well as physical comfort during labor. I completed a DONA training course in 2009 and it sparked my love for supporting laboring women. Since then I have been inspired to continue my learning to provide the best support I can with additional studies in lactation and natural medicine. Some of the things in my tool kit include massage, acupressure, and items to help with visualization and relaxation.  I am trained in different stretches and birthing positions to improve pain tolerance and pushing efficacy, as well I give lots of encouragement! In 2012 I enrolled in a Lactation Medicine Program at the Centre for Breastfeeding Education. There I was instilled with this goal "To enable the mother to manage her own breastfeeding experience, so she will be empowered to achieve her own breastfeeding goals." I accumulated over 90 hours in lactation specific education, as well as hours in observation at their breastfeeding clinic. Since that time I have been supporting new moms as they transition to motherhood and begin the breastfeeding relationship. During my time studying Naturopathic medicine, I was fortunate to expand on my knowledge on lactation medicine as well as how naturopathic medicine can play a role in the perinatal care of women and their new babes. I am passionate about my job, and I bring lots of enthusiasm and love for what I do.  

The Top 5 Foods to Make More Milk

Isn't it amazing how quickly the boob obsession can take over your life as a new parent? Am I making enough? Did they drink enough? Is the milk good enough? Are they getting the hind milk? What is hind milk?….? Thats the thing about breast/chest-feeding, it’s a little unnerving not knowing how much your baby is drinking. But here's the thing about that thing (too many things?), you don't need to measure the volume of breastmilk your baby is drinking to know if they are getting enough. The key is to look and listen to what your baby is telling you.

Look and listen to baby.png

Revolutionary thinking, I know.

When you are able to look and listen to your baby, and decode what it is that they are telling you, you learn so much.  If you are struggling to decode the mysterious signals your baby is sending in relation to hunger, drinking and satiety then let's chat in person. Once you have someone guide you to see the simple cues baby sends, it can change how you feel!

Also, I have a confession.  I have you here under a ruse...I've mislead you to believe that we are going to talk about how to increase your milk supply through food. And we WILL get to that...but first let me say this: the NUMBER ONE way to increase milk supply is to have a great latch, with baby draining the breast well.

Number 1 Way to Increase Milk Supply.png

If your baby is latching well (big wide mouth, asymmetric on the breast, full tongue mobility), and able to drain the breast well, this will be the absolute *best* way to continue to produce the milk that your baby needs. It is supply and demand, if your body gets a strong signal to make more milk, it will!

Sometimes the stars don’t alight for this process to run smoothly right from the beginning, and that is ok-and completely normal. But getting you back on track is without a doubt the best way to make more milk. Sometimes other factors, like mood, sleep and breast-chest feeding parent nutrient, come into play as well. Please, if you are struggling reach out, use your community, we want to support you.

So, if you are reading this because you are struggling to produce enough milk for your babe, or your babe is gaining "slowly" then the number one way to boost that milk production is to consult a lactation consultant or breastfeeding professional. If you have and are still struggling, then see someone else.  The guidance you get can be invaluable for your breast/chest-feeding journey. There are so many ways that we can adjust latch and change breastmilk intake to help your baby and our body communicate effectively to get those mammary glands Rockin' and Rollin'.

Milk Boosting Foods

If the number one way to increase milk is to have a great latch, then what's the deal with milk boosting foods and teas?

Milk boosting foods are foods that will slightly increase the amount of water that is circulated to the mammary tissue.  When these foods do this it provides more water for your body to use to make milk. Being well hydrated is important for the galactogenisis process. These foods are high in protein, iron and B-vitamins, which provides some of the important building blocks for galactogenesis to occur, as well as supporting recovery in the post part period, and supporting overall wellness. Increased food intake and milk production go hand in hand. It is important to eat when hungry and drink when thirsty.

Having said all this, if you are looking for the top 5 foods to *support* the milk making process then here they are:

Adding these foods into your diet as a part of a healthy diet can help support the milk making process. And thereby slightly increase the amount of milk you make. Some breast/chest-feeding parents respond incredibly well and drastically increase production, others not so much. A simple way to add these to your diet is to start your day with a bowl of oatmeal, a handful of almonds, a spoonful of flax meal and Brewers yeast sprinkled on top, and a big glass of water.  For a more involved recipe here is my favourite Lactation smoothie recipe.

If you give it a try let me know what you think, or if you have any other questions send them my way. And as always, Nurse on!

~Rebecca

References: Compr Physiol. 2015 Jan;5(1):255-91.

Rebecca Robertson, Breastfeeding Counsellor, Doula, Childbirth Educator

I am a birth advocate, a breastfeeding educator, and especially an advocate for mothers and the choices they make. As a doula my main role is to support mothers and partners to ensure a satisfying and positive birth experience. I am trained in providing emotional and spiritual support, as well as physical comfort during labor. I completed a DONA training course in 2009 and it sparked my love for supporting laboring women. Since then I have been inspired to continue my learning to provide the best support I can with additional studies in lactation and natural medicine. Some of the things in my tool kit include massage, acupressure, and items to help with visualization and relaxation.  I am trained in different stretches and birthing positions to improve pain tolerance and pushing efficacy, as well I give lots of encouragement! In 2012 I enrolled in a Lactation Medicine Program at the Centre for Breastfeeding Education. There I was instilled with this goal "To enable the mother to manage her own breastfeeding experience, so she will be empowered to achieve her own breastfeeding goals." I accumulated over 90 hours in lactation specific education, as well as hours in observation at their breastfeeding clinic. Since that time I have been supporting new moms as they transition to motherhood and begin the breastfeeding relationship. During my time studying Naturopathic medicine, I was fortunate to expand on my knowledge on lactation medicine as well as how naturopathic medicine can play a role in the perinatal care of women and their new babes. I am passionate about my job, and I bring lots of enthusiasm and love for what I do.  

How to LOL Without Peeing Your Pants (Part 2) - Learn some MORE about your Pelvic Floor

How to LOL Without Peeing Your Pants (Part 2) - Learn some MORE about your Pelvic Floor

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Pelvic Health Physiotherapy is the assessment and treatment of a wide variety of issues pertaining primarily to the pelvis and pelvic floor muscles.  While pelvic health is largely concerned with this area of the body, it is by no means the only thing we care about.  Many other areas of the body, from head to toe, can influence how well the pelvic floor works and/or how well the pelvis moves and contributes to movement.

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Usually people avoid talking about the pelvic area because bodily functions here are considered personal and private.  Functions such as going to the bathroom aren’t talked about when they are working properly, let alone when they’re not.  Thank God for girlfriends though!  Girlfriends don't mind talking about personal things.  They’ll get that conversation started!  And it’s a good thing too or none of us would ever know that other people also have issues.

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