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Exercise Guidelines For Pregnancy

By: Paige Wyatt

Living a health lifestyle has never been more important than while you’re pregnant. Not only are you now responsible for your overall health and well being, but also that of your unborn baby. What we eat, how much we sleep, how much water we drink, our mental and emotional stress, as well as how much we exercise need to be taken into consideration for a healthy pregnancy.

The new 2019 Canadian Guidelines for Physical Activity Throughout Pregnancy has shed a new light on recommendations for prenatal physical activity. Not only can we help to reduce complications during pregnancy but it can also optimize health and wellbeing for both mother and child.

Previous concerns over fetal health during pregnancy have long been a deterrent for prenatal physical activity. The thought of exerting ourselves and potentially increasing our chances of miscarriage, stunting gestational growth, inducing preterm labour, and harming the fetus has caused a lot of expecting mothers to reduce and stop their exercise program. Less than 15% of women are engaging in the recommended prenatal exercise.

But, here’s the truth; these concerns have never been proven by research. Instead we’ve seen a rise in pregnancy complications such as gestational diabetes, preeclampsia, gestational hypertension and large for date babies, which may be the cause of rising maternal obesity.
Physical activity is now being looked at as a preventative and therapeutic measure to reduce pregnancy complications.

WHAT DO THEY RECOMMEND?

• All women without contraindications should be physically active throughout pregnancy
• 150 minutes of moderate-intensity physical activity per week
• Physical activity should be accumulated over a minimum of 3 days per week
• Aerobic and resistance training achieved greater benefits
• Pelvic floor muscle training (eg. Kegels) may be performed on a daily basis to prevent urinary incontinence
• Exercises should be modified to reduce supine position

WHAT ARE THE BENEFITS?

Women who exercise during pregnancy have a reduced chance of gestational diabetes, preeclampsia, gestational hypertension, cesarean delivery and operative vaginal delivery. Exercising while pregnant can also help reduce post partum recovery time, decrease depression and stress levels, as well as overall weight gain.

IS EXERCISE FOR EVERYONE?

No. These guidelines are intended for women who do not have any pregnancy complications. Although exercise exhibits many health benefits there are certain conditions that are considered absolute contraindications. EVERYONE should be thoroughly evaluated by their OBGYN before beginning an exercise program to ensure there are no medical conditions.
Absolute contraindications are as follows:
• Ruptured membranes, premature labour
• Unexplained persistent vaginal bleeding
• Placenta previa after 28 weeks gestation
• Preeclampsia
• Incompetent cervix
• Intrauterine growth restriction
• High-order multiple pregnancy (eg., triplets)
• Uncontrolled type 1 diabetes, uncontrolled hypertension, or uncontrolled thyroid disease
• Other serious cardiovascular, respiratory or systemic disorder

HOW TO START BEING PHYSICALLY ACTIVE DURING PREGNANCY?

According to the new guidelines there is never a better time to start exercising than the PRESENT. Even if you have never exercised before it is recommended to start. If you’ve never exercised, starting gradually and slowly increasing your intensity and frequency is recommended.
Although the more activity you do, the greater the benefit, even small amounts of physical activity have been proven to be beneficial. Exercise can be for everybody! Take a prenatal yoga class, go for a brisk walk, go for a swim, take an aerobics class or get your sweat on by stationary cycling.
Keep in mind that there may be periods of fatigue and discomfort as your body changes throughout pregnancy, and certain activities may need to be modified as pregnancy progresses. Remember, IT’S OKAY TO REST!

THINGS TO CONSIDER

  1. 1. Take it easy! A good indication that you are not overdoing your workouts is by using the “Talk Test.” If you are able to carry on a conversation while exercising it is likely that you are not overexerting yourself.
  2. 2. Always make sure you maintain adequate hydration- drink water before, during and after exercise.
  3. 3. Avoid physical activity in excessive heat and humidity (eg. hot yoga). A thermo-neutral environment is recommended.
  4. 4. Avoid activities that involve a risk of falling, or physical contact that may induce risk of fetal injury (eg. horse back riding, non-stationary cycling, extreme hiking)
  5. 5. No scuba diving.
  6. 6. No high altitudes.
  7. 7. Seek obstetric advice if considering exercising above the recommended guidelines.
  8. 8. Listen to your body and if you experience any symptoms while exercising such as persistent shortness of breath, severe chest pain, regular and painful uterine contractions, vaginal bleeding, persistent loss of fluid from the vagina, persistent dizziness, and faintness that does not resolve with rest STOP physical activity and consult a health care provider.

In summary the new 2019 Canadian Guidelines for Physical Activity Throughout Pregnancy has recommended moderate-intensity exercise during pregnancy to help reduce pregnancy complications and optimize health for both mother and baby.

https://els-jbs-prod-cdn.literatumonline.com/pb/assets/raw/Health%20Advance/journals/jogc/JOGC908_LR-1539864964137.pdf

https://sogc.org/news-items/index.html?id=229

https://www.acog.org/Clinical-Guidance-and-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Physical-Activity-and-Exercise-During-Pregnancy-and-the-Postpartum-Period

My Favorite Resource For Pregnant Mothers To Be

By Christina Pistotnik

The time between that positive pregnancy test and holding your newborn in your hands can be filled with a mixture of emotions. On one hand you are so excited that you are going to be a mother but on the other hand you can’t help but feel anxious because it is hard to know what you can and cannot do. Some of you invested time, energy, and financial contributions in order to get to this place, and of course you want to do everything you can to safely maintain this pregnancy.

One of my favorite resources that I refer to and suggest to newly expectant mothers is called Motherisk. It is a Canadian site and program facilitated by the Toronto Hospital for Sick Children and they provide evidence-based information about what is and is not safe during pregnancy. I really enjoy it because it is easy to use and contains a vast array of information all on one site. Plus they have a toll free number (1-877-439-2744 ) that you can call and speak directly to a nurse that will help you out with any concerns you may have.

Having reliable resources and specialists to support you during pregnancy is important because it can help ease uncertainty surrounding an important time in your life.

What about acupuncture, is it safe during pregnancy?

Since the majority of my patients start seeing me while in the process of trying to conceive, I get this question quite a lot in my practice and the answer is; Yes, acupuncture is a safe and effective form of treatment in pregnancy. This is because it utilizes the body’s own healing process to help maintain pregnancy by keeping the uterus calm and stabilizing progesterone which keeps the lining secure until the placenta takes over. Plus it helps to minimize uncomfortable pregnancy symptoms which include; nausea and vomiting, aches/ pains, insomnia, and energy issues.
Plus, an added bonus when receiving acupuncture treatments is that it has a very calming affect on the body. Therefor, it can help with stress and anxiety that you may be experiencing during this time.

As an acupuncturist specializing in fertility and pregnancy, I am happy to safely treat you for any of your pregnancy concerns. Call Whole Family Health to book your appointment today!

Moving Forward From Pregnancy Loss: 4 Things That Help

October is Pregnancy and Infancy Loss Awareness Month, and in honor of heartbroken parents, blessed little lost ones, and all dear folk touched by this grief, we recognize this all too commonly shared experience.

We all process this kind of loss in our own way, and in our own time. One of life’s humbling mysteries – sometimes there is an explanation, and other times there is not. Either way, we are left to grapple with that which we don’t have control over, and to practice with somehow making peace with it, while sorting out how to move forward.

Often losses can be isolating, held close and private, locked in the silent hope of the first trimester. Hopefully to be spoken of later, perhaps when a little less emotionally raw.

While later term losses or stillbirths may be collectively grieved; empty-armed parents, navigating how to move forward at the mercy of often unpredictable waves of emotion. Moving through a life unchanged and yet forever changed – buoyed or sunken by the community’s varying depth of understanding and expectation.

It is said that 1 in 4 pregnancies end in miscarriage by age 35, and once we start talking about it, we realize that everyone knows at least one person who has suffered a loss- if they haven’t experienced one themselves.

What does life after loss look like? There is no right or wrong way to grieve, we all do it in our own way and in our own time. Some of us are de-railed for a short time, and others of us never quite ‘get over it.’ Some of us need potato chips, while some of us need long walks, or both. Whatever it may be, allow the time and space to be with it in whatever way works best.

Here are some things that will help in the wake of pregnancy loss:

1. Breathe. Studies show that Mindful breathing exercises shift us out of fight or flight and activate our pre-frontal cortex- which is responsible for higher executive functioning. This supports our recovery from traumatic events and helps us to be present with and to integrate these experiences in a healthy way.

Mindfulness allows us to have the perspective we need to see our way through difficult times, without avoiding or being completely high-jacked by the negative impacts of the associated stress. Accessing resources like a Mindfulness class or a Mindfulness App like Headspace have far-reaching benefits.

2. Nourish and renew. Pregnancy loss and stillbirth can be draining both physically and emotionally. Eat replenishing foods, that are nutrient-rich and tonifying. Try to stay away from refined and processed foods, while gravitating toward a whole foods diet.

Stick to warm and cooked meals, especially in the colder seasons. These are more easily digested, and your body doesn’t have to work as hard to metabolize them. Bone broths, which are rich in amino acids, vitamins and minerals are easily absorbed, rehydrating, and fortifying.

3. Follow up. Follow up with your doctor. Especially if bleeding or pain persists or if your energy levels are slow to recover. Your doctor can run standard blood-work to check on hormone and iron levels after a loss. He or she can also determine if there is any indication for ultrasound imaging to ensure that no pregnancy products remain and/or that healing from any procedure is going smoothly.

If you have had more than one loss, your doctor will likely want to run a Recurrent Pregnancy Loss Panel, to rule out any potential contributing physiological factors.

4. Acupuncture. Acupuncture promotes blood flow, regulates inflammation, supports hormone balance, and decreases stress. It helps with recovery from both spontaneous miscarriage, procedures and stillbirths, as well as supports regulation of your cycle after loss.

Treatment plans are individualized, based on factors relevant to your particular case, and can include regular acupuncture, customized Chinese herbs, and a review of recommended supplements, diet and exercise.

If a Western diagnosis has been identified, and/or Western Medical treatment is necessary, we make modifications to support this process. The primary aim is to help your body re-set. Should you plan to create and carry another healthy pregnancy, then we also help to prepare for this, while supporting the mental-emotional process and doing what we can to prevent another loss.

Pregnancy and infancy loss is not uncommon, and the more we speak to it, the better
we are able to understand and support one another. Bless the hearts of those who know
this kind of loss first-hand and bless the hearts of those who love and support them.

 

Dr. Alda Ngo

For more information on how we can support recovery and prevention of pregnancy
loss, please feel free to contact us for a free 15-minute phone consultation.

How to Safely Vaccinate Your Child

At Whole Family Health, our team of acupuncturists and massage therapists work in conjunction with MDs every day. We recognize the need to combine Chinese medicine with Western care, especially when it comes to vaccinations.

Did you know that Chinese medicine has been using inoculations since the 10th century? Chinese doctors used to scrape small pox lesions and collect the resulting scabs to be made into a powder. This powder was then snorted up a child’s nose as an early form of vaccination.

Many parents have a fear of vaccinations, most commonly from being misinformed by celebrities that vaccines cause Autism or other adverse reactions. It is our goal at Whole Family health to walk our patients down a path of understanding vaccines, the role they play in overall health, and how Chinese medicine can be used to help safely vaccinate your child.

Vaccinations are not perfect, in fact we have worked with many people whose children have had adverse reactions that range from minor to life altering. Whether it was a result of vaccine agents, their carriers, or severe sensitivity, we strongly feel these reactions can be minimized with Chinese medicine. From our point of view, the primary concern with immunization isn’t the vaccination itself, but how it is given and how our patients are taken care of afterwards.

It is expected that there will be some sort of reaction to a vaccine, most commonly a fever. Both Chinese and Western medicine recognize this as the body bringing its immune system into action. In conventional medicine a child would be given Tylenol to offset the fever, but Chinese medicine believes suppressing the fever may cause the immune system to become weak and dysfunctional. There is also growing evidence that decreasing the body’s reaction to a vaccine may actually reduce the immunity it is trying to create. With Chinese medicine we strive to support the body’s response to the vaccine (not suppress it) reducing the risk of long term immunological compromise.

We recommend the following tips for parents looking to immunize their children:

  • Have a conversation with your pediatrician as to which vaccines are critical
  • Prepare your child with acupuncture and herbs prior to the immunization
  • Separate combination vaccines (such as MMR) so they are administered one at a time
  • If your child is sick, reschedule your appointment
  • Follow up vaccinations with rest, even if your child appears to be unaffected
  • Egg or Gelatin allergy? Discuss these sensitivities with your pediatrician, as they will likely lead to adverse vaccine reactions

At Whole Family Health we strongly believe that Chinese medicine is NOT an alternative to life-saving immunizations. It is however an integral part to safely vaccinating your child.

Morning Sickness and Acupuncture

Morning sickness is one of the hallmark signs of pregnancy but for some women, it can be extremely debilitating.  (more…)

Mitigating the Harmful Effects of Stress

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4 Board Certified Fellows of the American Board of Oriental Reproductive Medicine at Whole Family Health

Congratulations to Christina Pistotnik RAc, DAc, HHP, FABORM and Monica Patt RAc, HHP, FABORM on your recent certification with ABORM! (more…)

Integrative Fertility Symposium 2016 Highlights

Our team just got home from the 2016 Integrative Fertility Symposium and wanted to share some highlights. (more…)

The Natural Path to Chronic Urinary Tract Infections (UTIs)

If you’re a woman, your chance of getting a urinary tract infection is extremely high and many can lead into chronic infections that are recurrent, sometimes for years. There are two types are UTIs, bladder infections (BIs) and kidney infections (KIs). I will be specifically chatting about BIs, since KIs should be treated promptly with antibiotics.

UTIs are bacterial infections that are not to be taken lightly. If you have had the joy of experiencing one…you know how incredibly debilitating they are. Common symptoms of a UTI are:

  • Frequent and/or intense urge to urinate
  • Burning sensation when urinating
  • Pain or pressure in the lower back or abdomen
  • Cloudy, dark, bloody, or strange-smelling urine
  • Symptoms of shaky or feeling tired
  • Fever or chills, nausea and vomiting (likely a sign that the infection has gone to the kidneys) 

If you suspect you have a UTI, it is imperative that you head to the medical doctor to get a urine sample to confirm. In younger, sexually active women, sudden onset of painful urination can also be due to chlamydia infection or gonorrhea (rarely), so getting a urine culture as well is beneficial. The majority of UTIs are bacterial in origin so medical doctor’s prescribe antibiotics during an acute episode. Some women who have chronic BIs are given long-term antibiotics for preventative measures. However, frequent antibiotic use, especially in women with chronic BIs, has been shown to alter intestinal and vaginal flora and increase the rate of antibiotic resistance.

Naturopathic approaches should be strongly considered in cases where chronic BIs are still a problem. Naturopathic doctors can treat acute, single episodes of BIs, but you want to be under the supervision of a doctor since these infections can quickly develop into kidney infections, which are very dangerous and can only be treated with antibiotics.

Housekeeping Rules for your lady parts:

  • If you were ever told to wipe from front to back after using the washroom, listen! This is a key factor in preventing recurrent BIs.  Since the urethra (where you pee) is located close to the anus in women, bacteria from the large intestine are in perfect position to escape the anus and invade the urethra. Some women have shorter urethras allowing bacteria to ascend more easily to the bladder, making them more prone to BIs.
  • Another housekeeping tip is to urinate after sex. Having sex can introduce bacteria into the urinary tract, again causing an infection in the urethra.
  • Avoid vaginal hygiene products (ie. douches), which can be irritating to the urethral area and alter the vaginal flora.
  • Research has shown that wearing cotton underwear can reduce the chance of UTIs since it is more breathable.

Dietary recommendations:

  • Increase your intake of water to ensure you are peeing regularly to flush out bacteria and prevent their adherence to the urethra.
  • Add in some UNSWEETENED PURE cranberry juice (not the Welch’s cranberry or any “cranberry cocktail” drinks). It is a known anti-adhesion agent, meaning it can prevent the bacteria from setting up shop in your urethra. It can be found in different forms: juice, tablets or capsules. You want to be drinking about 250-300ml/day, which you can dilute in some water since the pure cranberry juice can be quite tart. Cranberry juice is also safe and effective for the prevention of UTI’s in pregnancy, which is important since they tend to be more common.
  • Your GUT and VAGINAL flora are key players in preventing recurrent BIs, therefore keep your diet low in sugar and high in fiber, specifically from dark leafy greens.
  • To reduce the susceptibility to bladder infections it may be necessary to address and remove food sensitivities.

Supplement Recommendations:

  • Probiotics: can help keep the vaginal and gut flora balanced. You want to make sure the probiotics specifically contain the Lactobacillus species. One of my favorites is the UltraFlora’s Women’s by Metagenics that contains a 50:50 blend of Lactobacillus rhamnosus and Lactobacillus reuteri, once/day. This targets healthy vaginal flora by increasing the number of beneficial lactobacilli. Lactobacillus generates an acidic vaginal pH and interferes with the adhesion of common urinary bacteria. Vaginal probiotic suppositories have been used weekly and shown to reduce the incidence of UTIs after 12 months.
  • D-Mannose: a simple sugar that acts similarly to cranberry in that is prevents the adherence of bacteria. It can be used for treating acute BIs and for prophylaxis in women prone to recurrent infections. It has been shown to be more or just as effective as antibiotics when used for chronic BIs but with a much lower incidence of side effects. A general dose is around 2 grams of powder/day during an acute infection.
  • A healthy immune system can help the body resist infections. Specific vitamins I recommend are Vitamin C. Studies have shown that it increases the release of nitric oxide in the urine, which acts as a bacterial killing agent against the most common bacteria that causes UTIs, E.Coli. General dose is around 1-2grams/day. Vitamin A and Zinc are other common recommendations for supporting the immune system.

Herbal Recommendations:

  • For acute bladder infections, berberine extracts (found in various plants – Hydrastis Canadensis and Berberis vulgaris) have significant antimicrobial activity. It inhibits the growth of several bacteria, including resistant E.Coli (common in chronic BI patients). Berberine can also act as an antimicrobial to treat dysbiosis (altered bacterial flora in the gut), which can indirectly reduce the occurrence of BIs since dysbiosis can increase the incidence of BIs.
  • Other great anti-septics used in acute cases are: Uva Ursi and Yarrow. Can be done as an infusion/tea so they can be flushed through the urinary tract. The addition of marshmallow root can be added if symptoms of burning are present. These preparations can also be taken in capsule form.
  • If stress is associated with your chronic BI, it is beneficial to incorporate herbs that specifically work at supporting your stress response while ensuring your immune system stays in check.
  • Just a note: recurrent bladder infections are common in postmenopausal women due to the decrease in estrogen and its role in maintaining healthy vaginal flora and mucosa. There are many herbal recommendations that can help support this hormone imbalance and important to address these changes to reduce the reoccurrence of UTIs.

This information given is not to discourage antibiotic use, since in some cases it is absolutely necessary. It is to provide you with more preventative strategies and other naturopathic alternatives for treating chronic UTIs, all of which have much lower side effects compared to long-term antibiotics.

If you have any questions or would like to schedule an appointment at Whole Family Health, please contact us today!

Anxiety Risking our Health and Happiness Part 3: Five Strategies for Coping with Anxiety and Stress

I know it may seem hard to believe but I am not always the most calm and collected individual, anxiety can hit me like a ton of bricks and trust me it can be hard to come out of. Here are some strategies that I’ve learned to help me cope:

  1. Regular Exercise
    This helps me to expel that extra pent up energy that can often turn into anxious type feelings. I’m not saying that you have to run five miles a day, but scheduling at least 30-60 min three times a week of moderate to intermediate physical activity will quell over whelming feelings of anxiety and stress. Plus getting the blood pumping and body moving enhances the release of endorphins which helps us feel happy.  Exercise also, benefits self-esteem by seeing physical results that may include less body fat, increased stamina, and muscle tone.
  2. Proper Eating Habits
    I know that if I let myself get too hungry I am not a happy camper (some people call it hangry) Therefore, it is important to be eating regular meals everyday in order to stabilize blood sugar. When blood sugar becomes too low it causes stress to the brain and can lead to anxiety becoming worse. This is because the body is not getting nutrients into the blood stream.The types of food that you put into your body also have an effect on anxiety. Feel good meals should include:
    -Foods high in Tryptophan (precursor to serotonin): Turkey, chicken, banana, oats, cheese, soy, nuts, and sesame seeds.
    – Vitamin B rich foods/supplements: Beef, chicken, pork, eggs, leafy greens, legumes, rice, oranges/citrus fruits, nuts, and whole grains
    -Omega 3 rich foods/supplements: Chia seeds, flax seeds/oil, salmon, tuna, lake trout, mackerel, sardines, and anchovies
    –  Foods high in Protein (stimulates production of norepinephrine and dopamine): Greek yogurt, lentils, beans, soy, nuts, cheese, eggs, and meat

    Foods that should be avoided that increase anxiety include:
    -Caffeinated and alcoholic drinks: both lead to dehydration, which increases chances of anxiety. Caffeine also suppresses brain serotonin and as we know this is a feel good hormone.
    -Foods high in sugar: The initial reaction to sugar may feel good at first but as the body releases insulin to counter balance that rush the body and mind are left feeling tired and in a low mood.
    -Processed foods (meats, high fat dairy, fried foods) A UK study found that people who consumed processed foods regularly were more prone to anxiety and depression (source).

  3. Breathing Exercises
    Sometimes I let my day get away from me and realize that I have not been taking full breaths and wonder why all of a sudden I’m feeling overwhelmed? Therefore I’ve been trying to make a conscious effort to take a few deep breaths every 30 min to help my mind and body feel more at ease.  Deep breathing gets more oxygen into our body that stimulates our calm at rest state of being also known as the Parasympathetic nervous system. Shallow breaths stimulate our fight or flight response or our sympathetic nervous system thus making us feel anxious and overwhelmed.
    One particularly easy breathing technique I like and can be done anywhere at anytime is called “Equal Breathing” Start by inhaling through your nose and count to four and be conscious that you are moving the air all the way down (your abdomen should inflate if you are doing it right) and then exhale through your nose for a count of four. I like to do this 2-3 times in a row to really get myself in a calmer state.
  4. Me Time
    Schedule at least thirty minutes to an hour to your own downtime every week is also important when managing anxiety and stress. Relishing in the things you like to do will help you to feel happy and grounded. These things can be as simple as taking a bath, reading a book, or listening to your favourite music.  Invest time in yourself, because you are worth it!
  5. Acupuncture
    As stated in my previous blogs regarding anxiety, acupuncture helps to reduce stress hormones in the body.  This is essential for the body to get to its state of rest and relaxation by inducing the parasympathetic nervous system to go into action. Another added bonus to acupuncture is that it can be counted as me time! How often do we get to just lay back and relax for 45 minutes without the world buzzing around us? When coming in for anxiety treatments, I suggest starting off with weekly appointments to monitor how you are coping and if things are going well then we taper the treatments off to twice a month then to once a month.

If you have any questions about how acupuncture and Chinese medicine can help your stress and anxiety, please do not hesitate to contact us today!

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