Pregnancy Nutrition

Before we dive into pregnancy nutrition, let’s look at the general nutrition status for Aussies – according to research only 4% of Aussies eat the recommended 5 serves of veggies a day, and it’s estimated that up to 80% of Aussies have a nutritional deficiency, such as iron and Vitamin D deficiencies


You can see why during periods when your body requires additional macronutrients, vitamins, and minerals, including preconception planning, pregnancy, and postpartum, it adds another layer of complexity to your health goals.

Now, it’s said it takes two years to nutritionally recover from a pregnancy! Just take that in for a second.  Doesn’t it make sense that we should focus on preconception planning and pregnancy so you don’t just survive the pregnancy and first year with your new baby, but that you THRIVE?!

Art and Image by Olga Murasev

Many common pregnancy-related conditions are caused or worsened by nutritional deficiencies or imbalances, some of these include fatigue, headaches, iron deficiency anemia, gestational diabetes, and also birth complications, including underweight babies.

Getting the right nutrition during the preconception stage and pregnancy is one of the best ways to give your baby a head start in life – and it can make pregnancy safer and more comfortable for you too.

So let’s discuss the do’s and don’ts of nutrition in your pregnancy


Do:

  • Focus on eating a wholefood diet; that is, eating food that’s natural, seasonal and undergone minimal food processing. Enjoy quick and easy, nutritious foods, including vegetables, fruits, eggs, olive oil, nuts, seeds, legumes, oily fish, seafood, organic meat & whole grains.
  • Eat protein with every meal, and snack, to keep you fuller for longer, stabilise blood sugar levels and manage morning sickness.
  • Eat small, regular meals.  Try to eat every few hours. Your pregnant body is a bit like a newborn; it thrives on routine & consistency. Small, frequent meals are the most effective way to stabilise blood glucose levels, reduce nausea & heartburn, regulate energy levels & reduce sugar cravings.
  • Include a good quality pregnancy multivitamin that contains bioavailable vitamins, especially B vitamins such as activate folate, which supports healthy cell division, development of the foetus & prevents neural tube defects.
    • Up to 30% of women have an MTHFR gene mutation, which means the body has an issue absorbing Vitamin B9 (folate) even when you eat all the ‘right’ B-vitamin rich foods, like veggies, and take folate supplements.  For this reason you want a highly absorbable, active form of folate, called  5-methyltetrahydrofolate (5-MTHF).
  • Do a full blood test at each trimester to identify any nutrient deficiencies or imbalances.  Include full iron studies, folate, B12, zinc, Vitamin D, full thyroid studies, zinc and insulin levels in your regular blood test.
  • Include an iron supplement, if necessary. From the second trimester there’s a 50% increase in blood volume, which is why women start to experience declining iron levels and may experience iron deficiency at this stage in pregnancy. Please note: only 25% of iron supplements are actually absorbed, so you want to work with a practitioner to select the right supplement to suit your needs, and avoid ones that can clog you up and cause bloating and constipation.
  • Include fibre in your diet to reduce constipation, a common side effect of pregnancy.Fibre also supports bowel health, detoxification pathways and promotes healthy hormones. Include oats, quinoa, cacao, corn, green leafy vegetables, berries, beans and chia seeds.
  • Increase your intake of foods naturally high in probiotics, which supports good gut bacteria and support the natural digestive juices & enzymes that keep your gastrointestinal tract healthy. Since over 70% of your immune cells reside in your gut and your gut health is the seat of your immunity, it’s a simple way to support healthy immune function. These foods include sauerkraut, olives, miso soup, tempeh, kefir, kombucha & full-fat natural Greek yoghurt or coconut yoghurt.
  • Eat walnuts, flaxseed oil and oily fish such as sardines & wild salmon, for their omega 3 fatty acids, which support healthy immune function, reduce inflammation, promote cardiovascular health and support the growth & development of the baby’s brain.  Alternatively, opt for a good-quality fish oil supplement, with 3 grams per day of EPA and DHA.

Don’t:

  • Drink alcohol, as it interferes with the digestion, metabolism and excretion of nutrients and has toxic effects on foetal development.
  • Eat undercooked or raw meat, including runny egg yolk, raw meat, raw fish, raw milk, soft cheeses, etc.
  • Consume foods with chemicals, additives & preservatives, as they can deplete your body of key nutrients needed in pregnancy and contribute to headaches, skin issues and allergies.
  • Eat refined sugar & sweeteners. Amongst other things, refined sugar directly depletes white blood cells, which can lower your immunity & contribute to digestive dysfunction.

If you’d like to organise a full blood test as part of your preconception planning or during pregnancy to see if you have pregnancy-related deficiencies/imbalances and you’d like a personalised naturopathic approach you can book a consultation with Olivia at the clinic.


Dry Needling vs Acupuncture

What is it and what is the difference?


You may have heard the terms ‘Dry Needling’ and ‘Acupuncture’ used interchangeably; and while they both involve inserting very thin needles into specific locations, the theory underpinning each practice is vastly different.

Acupuncture is a type of Traditional Chinese Medicine (TCM), and is focused on facilitating the flow of the body’s innate energy. In TCM this energy is called Qi (pronounced ‘Chee’), and it flows through meridians (or pathways) of the body, helping the body to exist in harmony with itself, and the wider world. When these meridians become blocked, it is believed that the Qi stagnates, and may be the cause for many different signs and symptoms for a variety of conditions.

Acupuncture needles are inserted into specific meridians identified by your Acupuncturist, to help return the flow of Qi, and thus help the body return to harmony.


Dry needling is based on a more western concept of illness. Through controlled stimulation of the natural anti-inflammatory processes of the body.

Inserting very thin needles into certain soft tissues (muscle, fascia, tendons, or ligaments) creates a small amount of controlled, localised microtrauma.

Press HERE to read our Healthy Living Blog post “Dry Needling – (Part One)”


The physical act of microtrauma helps to break up scarring and adhesions, stimulating healing on a structural level of the tissue. Additionally, controlled microtrauma stimulates the body’s chemical healing response through activation of the body’s natural anti-inflammatory cascade.  This stimulates an increase in blood flow in the region, facilitating the release of several naturally produced chemicals with anti-inflammatory and pain-relieving properties.

Both of these processes are thought to help the body accelerate its healing response.


References:

What else should you know about dry needling? Please read here

Chiropractic Care – should it be part of your pregnancy plan?

Pregnancy is a time of massive change – mentally, emotionally, hormonally, and biomechanically.


It is also a time when many women look for other options to manage various health challenges during their pregnancy. Chiropractic care rates among the many that women choose during this time. The great thing about chiropractic care is that it is safe, gentle, and drug-free – things we all want in any intervention while pregnant.

As a chiropractor, it is both a responsibility and a privilege to care for increasing numbers of pregnant women as more and more of them seek out chiropractic care as part of their pregnancy plans.

This article explores some new research around the possible benefits of chiropractic care for pregnant women and offers a brief review of the broader picture of chiropractic care in this area.


Lower back pain

Lower back pain is common in pregnancy and pregnant women are known to seek chiropractic care for pregnancy-related lower back pain.

A survey of South Australian Women reported 35.5% of women experienced moderate to severe lower back pain during their pregnancy. A whopping two-thirds of this group reported persistence with that pain after their pregnancy.1

In one report, 75% of pregnant patients who received chiropractic care reported that they experienced relief2 and in another review, there was a rate of relief from back pain of 84%3.

A study that measured pelvic floor function found that there was relaxation of the pelvic floor muscles. We know that the pelvic floor and co-activation of transverse abdominus muscle are important in lower back pain.4

Photo credit: iStock.com / Martinan

Reduction in labour pain and duration

I can hear you all shouting YES PLEASE!

Women who undergo spinal manipulation prior to labour reported less back pain or ‘back labour’ during delivery3. (Back labour is an acute, lower back pain felt during labour that can be treated with sterile water injections)

Women who seek chiropractic care during their first pregnancy have been reported to have an average reduction in labour times of 25%, while those on subsequent pregnancies have been reported to experience reductions averaging 31%.5,6


Other possible benefits

There are some areas that chiropractic care MAY help with. The research in these areas is still being developed.


Breech Presentation

Following a study published in the Lancet in the year 2000, Caesareans became the most popular medical intervention for a breech presentation. In fact, while the rate of caesarean delivery for breech presentations in the United States was 14% in 1970, it is currently 90-95% and in some institutions 100%7.

A case series was published in Journal Pediatric, Maternal and Family Health in 2019 that showed resolution of breech presentation babies in 5 women using the Webster Technique7.

The Webster Technique has long been associated with chiropractic care during pregnancy. Combining sacral analysis and diversified adjustment, the aim of this technique is to “reduce the effects of sacral subluxation / SI joint dysfunction,” and in doing so, to facilitate “neuro-biomechanical function in the pelvis.


Chiropractic techniques have been shown to be safe and effective and are modified for the pregnant patient.

If you aren’t sure if chiropractic is right for you during your pregnancy, then call or drop into your local chiro for a chat to see if they may be the right fit for you. 

Many chiropractors have had extra training in pregnancy care and finding one of these is invaluable. Talk to other mums and health care providers about who they recommend or contact us @ Caring Hands Chiropractic and we can give you a referral to someone in your area.

If you would like any more information, please contact me @ Caring Hands Chiropractic (02) 4861 7718 or check out the website caringhandschiropractic.com.au


A little bit about us

My name is Sarah Worthington and have been a chiropractor and director of Caring Hands Chiropractic in Bowral since 2011. I discovered chiropractic at a young age and saw first-hand the health benefits it had for my family, which is what drove me to pursue chiropractic as a career path. I now have a family of my own, including my husband, our 1-year-old son, and our fur daughter. 

In addition to my degrees, I have completed my certification in SOT and am currently completing my certification in Webster Technique. I also participate in table educating for SOT seminars when time allows. I have done studies in the areas of applied kinesiology, nutrition, pediatrics, pregnancy, and women’s health and retained primitive reflexes.


References:

[1] Stapleton DB, MacLennan AH, Kristiansson P. The prevalence of recalled low back pain during and after pregnancy: a South Australian population survey. The Australian & New Zealand journal of obstetrics & gynaecology. 2002 Nov;42(5):482-5. PubMed PMID: 12495090. Epub 2002/12/24. eng.

[2] Shaw G. When to adjust: chiropractic and pregnancy. J Am Chiropr Assoc. 2003;40(11):8-16.

[3] Diakow PR, Gadsby TA, Gadsby JB, Gleddie JG, Leprich DJ, Scales AM. Back pain during pregnancy and labor. J Manipulative Physiol Ther. 1991 Feb;14(2):116-8. PubMed PMID: 1826921. Epub 1991/02/01. eng.

[4] Haavik H, Murphy BA, Kruger J. Effect of Spinal Manipulation on Pelvic Floor Functional Changes in Pregnant and Nonpregnant Women: A Preliminary Study. Journal of Manipulative and Physiological Therapeutics. 2016 2016/06/01/;39(5):339-47.

[5] Borggren CL. Pregnancy and chiropractic: a narrative review of the literature. Journal of Chiropractic Medicine. 2007 6//;6(2):70-4.

[6] Fallon JM. Textbook on chiropractic & pregnancy: International Chiropractors Association; 1994.

[7] Muclahy R, Mayo E (2019), “Resolution of Breech Presentations Confirmed by Ultrasound Following Chiropractic Care using Webster Technique in Five Women: A Case Series,” Journal Pediatric, Maternal and Family Health, pp. 19-27

Dry Needling (Part One)

Dry Needling appointments now available with Catherine.


Sounds confronting? Don’t worry, it’s nothing like a medical injection!

Those hypodermic needles can be >2mm wide (thicker than the average earring post), while the needles Catherine uses are only 0.3mm wide (twice the thickness of human hair).


Dry needling treatment can be virtually painless!

The majority of the time there is no sensation after the first second or so, but sometimes it can feel like a muscle ache (similar to pushing on a knot in the muscles during a massage); the good news is that you’re in control of the intensity! Catherine’s aim is to find the minimal amount of treatment and the least intense that your body needs.


What’s the process?

Your practitioner at Caring Hands Chiropractic may suggest a dry needling appointment. Please advise our chiropractic assistant team at reception that a dry needling appointment with/or without an adjustment has been suggested. Either Toni or Shanna will provide you with a dry needling Consent Form to complete and return prior to your dry needling appointment.

On the day try to wear something that allows access to the skin of the area to be treated, if that’s not possible, no problem! We have gowns for you to change into.

Catherine will assess the region(s) to be treated, wipe the area with an alcohol solution to sterilise the skin, and then use sterile, single-use needles for your treatment.


Dry Needling (Part 2) will be out next Friday. Dry needling vs acupuncture, what is it, and what’s the difference?


References:

What else should you know about dry needling? Please read here

Calmbirth®

Prepares you emotionally, mentally, and physically for birth.


Calmbirth® is Australia’s leading and fastest-growing Childbirth Education Program.

Calmbirth® takes a very holistic and evidence-based approach to its education with the fundamental underpinning of the program being the Mind-Body-Birth Connection.

Pregnant couples and Birth workers alike are educated and reminded in Calmbirth® courses, of the resources the female body has to grow, nurture, and birth babies and the importance of acknowledging the role that our beliefs and emotions towards childbirth have, on not only the physical but also the emotional wellbeing of mothers and babies.


Calmbirth® has been changing the narrative of our birth culture for over 17 years since they first started educating and empowering pregnant couples with knowledge, confidence, and skills about birth. They have now seen over 45,000 couples and are in 8 major maternity hospitals in NSW.

Calmbirth® has led the way in changing birth culture and birth outcomes by normalising and enriching pregnant couples’ birth experiences.

  • By informing couples of their birth choices and rights and empowering them to birth with the support of their partners and caregivers.
  • By reframing birth and empowering women to work with their bodies, partners, and caregivers to create the best birth experience.
  • By learning how to retrain your response to stress by instilling confidence in yourself, so that you can work with birth on all levels. Calmbirth® teaches you to be proactive in your birth as opposed to reactive. The program includes fear release techniques through guided relaxation, to facilitate emotional subconscious healing of fear and anxiety about childbirth to help you move past any negative emotions around birth.
  • By learning complimentary therapies such as active birth positioning, accupressure points for pregnancy, labour and birth, massage techniques, Calmbirth® breathing techniques, visualisations and guided relaxations to help reduce pain naturally as well as getting you in the right head space.

Calmbirth® is now taking bookings for 2022. To find a Calmbirth® Educator near you or to book a Calmbirth® course please go to: calmbirth.com.au

Empower an expecting parent with the knowledge and confidence which comes from a Calmbirth® course. Gift vouchers are now available at their shop


Special thanks to author at Calmbirth®, Liz Uiana for this informative introduction to Calmbirth®.


Resolution Revolution

It’s that time of year where many people make resolutions for the new year. This may be joining a gym, eating better, losing weight, start meditating, doing yoga, or giving up smoking.


While New Years’ resolutions sound like an amazing idea, why is it that we find it so hard to stick to them? Is that they are too hard to achieve or is it that these resolutions don’t really align with our core values?


Humans are amazing creatures, we are constantly evolving and changing. Sometimes the best thing we can do is to let go of things that no longer serve us….’Marie Kondo’ your habits and choices – if they no longer bring you joy, then get rid of them. Sometimes I think we struggle with this concept because many of us define who we are by the habits we have.


Have you ever noticed that when we truly make up our mind to make a change nothing can stop us? Maybe we need to start the new year by identifying what our core values are, which will allow us to set goals and then break them down into achievable steps.

Things to consider when setting goals:

  • Does this align with my values?
  • Will this improve my life?
  • Is this achievable? For example: There is no point starting an eating plan with loads of legumes if you they make you sick or joining a gym challenge that requires a 5-hour commitment per week if you only have 3 hours available.
  • Will this bring me joy?
  • What will my life look like if I do this? What will my life look like if I don’t do this?
  • A contingency plan (guilt and shame free please!) if I start and don’t feel this is working in my best interest?

Considering these things allows us to make sustainable changes to our habits and lifestyle that fully align with our values. Remember there are loads of amazing resources out there to help you on your journey, after all, why reinvent the wheel?

Have a chat with your chiropractor or health practitioner if you need some help.


If you want a totally holistic (eat, move, think) reset, then consider the Wellness and Prevention 90 day lifestyle plan. If this seems too overwhelming then have a look at your Lifestyle Health Risk Assessment and start with something simple like drinking more water, eating more greens, or thinking of 3 things you are grateful for at the start and end of every day.


Whatever it is that you have resolved to do this year, be kind to yourself. Realise we are all on a journey toward health and self-discovery. Treat yourself with compassion and kindness, leave the guilt and shame at the door and watch for all the wonderful things that can happen.

Ice or heat? When and how to use them.

“Do I use ice or heat?”


This is one of the most common questions that I get asked in practice. I feel like there is a lot of confusion around what to use when. Below we discuss general rules on what to use when and how.

Please talk to your health provider before beginning any home treatments to make sure this is right for you and your circumstances.


Ice
Ice is typically used after an acute injury, for example, if we roll an ankle. Applying ice allows us to control the inflammation process by restricting blood flow and reducing pain signals which helps with pain and swelling.

Application
There are many types of ice packs on the market, however, a bag of peas will do fine if that’s all you’ve got. Make sure that whatever you use is wrapped in a tea towel or hand towel. DO NOT apply directly to the skin.

As a general rule apply ice for 10 minutes, then remove for 10 minutes, and then repeat the process 3 times.

In the initial stages of an injury (first 72hrs) you can apply ice every few hours.



Heat
Heat can be very helpful for muscle spasms and in ‘cold’ injuries like arthritis. Anyone who has arthritis I’m sure will be able to tell you how much they ache in the cold. Heat works by increasing circulation and blood flow which helps to relax muscles and potentially aid in healing.

There are lots of heat packs on the market. If you don’t have one, then a hot shower will often do the job. Again, make sure that whatever you use is not too hot as you do not want to burn the skin.

Application
Place heat pack or water stream onto the affected area for around 20mins. You can repeat as often as you feel is needed.


Heat and Ice Alternating

Sometimes your practitioner may suggest alternating heat and ice. This may be in the case of an injury or condition where there is also muscle spasm. Using heat and ice at the same time can be helpful for migraine headaches.

Application
Apply ice as above for 10 minutes then heat pack for 10 minutes. Repeat 3 times.

For migraines putting your feet in hot(not too hot) water with a heat pack on the back of the neck can be very effective for relieving some of the pain associated.

Chronic Stress: Is this the new normal?

Stress is something that we all talk about, however, I’m not sure we realise what a profound effect stress has on our health or hidden stress that we may not even consider.


Stress arises when environmental demands are perceived as taxing or potentially exceeding one’s own capacity or resources to adapt to them, and there is threat to well-being if coping responses do not satisfy such demands.1


Chronic stress has almost become a ‘normal’ part of life. I have noticed in the last 5 years that when I ask people how they are, they often reply with ‘I’ve been so busy!’

Have our lives become more complicated and busier or are we feeling like we need to fill our days more and more? Australians have had a lot of stress over the last 2 years. First, we had the devastating Black Summer bushfires, and then just a short time after COVID 19 hit our shores.

I know that personally when COVID 19 hit and we went into lockdown it really made me slow down and to be honest I haven’t returned to many of the activities I was previously doing. I am one of those people who pushes themselves and always overcommits and lockdown really made me look at what I was doing and change my behaviour which has allowed me to feel a lot more balanced in body and mind.


The problem with chronic stress is that something has to give eventually. For each person this is different and chronic stress symptoms can present in many different ways, including2:

  • irritability, which can be extreme
  • weight gain
  • fatigue
  • headaches
  • difficulty concentrating, or an inability to do so
  • rapid, disorganized thoughts
  • difficulty sleeping
  • digestive problems
  • changes in appetite
  • feeling helpless
  • a perceived loss of control
  • low self-esteem
  • loss of sexual desire
  • nervousness
  • frequent infections or illnesses

There are 3 main types of stress:

Physical – past traumas and injuries, poor posture, repetitive movements, sitting or standing for too long

Chemical – what we eat, breathe, drink and put on our bodies

Emotional – resentment, anger, grief, fear, frustrations, information overload, worry, anxiety.


Some things we know that can help to reduce stress on the body3 are as simple as:

If you are suffering from any or many of the above symptoms then it might be time to have a look at the stressors in your life and employ strategies to mitigate these.


If you aren’t sure where to start, have a chat with your health practitioner. There is also an amazing and comprehensive questionnaire called a Lifestyle Health Risk Assessment (LHRA) that can give you a great starting point by helping to identify the area you may need to address.

Contact us for more information.


References:

[1] https://www.sciencedirect.com/science/article/pii/B9780128009512000169

[2] https://www.medicalnewstoday.com/articles/323324#signs-and-symptoms

[3] Wellnessandprevention.com

Sleep Smart : Sleep posture matters!

Have you ever woken up from a great night’s sleep, and your body has felt stiff and awful?


It could have something to do with your posture while you sleep!

Unlike during the day, we don’t have active control of our posture during our sleep, so it is important to use a variety of tips and tricks to help maintain a neutral spine when sleeping.


What does a neutral spine look like when sleeping?

Very similar to standing upright.
3 smooth curves front to back, from base of head to top of buttocks; no side to side curves.

A neutral spine when laying on your back
A neutral spine when side laying

Should I sleep on my side or my back?

It doesn’t really matter providing you do it right!

When sleeping on your back:
2 pillows

A pillow under the head and neck (not under the shoulders).
It should be fat enough to support your head and neck, but thin enough not to bend your neck forward.

A pillow under the knees helps to support decrease the tension in the spine.

Arms comfortably by your sides, or resting on your tummy.


What about sleeping on my side?

When sleeping on your side:
3-4 pillows

A pillow under the head and neck (not under the shoulders).
It should be fat enough to support your head and neck, but thin enough so your neck doesn’t bend to the side.

A pillow between the knees.
It should be fat enough to keep your knees and feet hip width apart. This helps to decrease tension and twisting through the hips, pelvis and lumbar spine.

A pillow to stop you rolling over.
Hug a fat pillow – it helps to prevent twisting and tension through the shoulders, upper back and neck.
Prop a fat pillow behind your back, and rest onto it – it helps stop you rolling onto your back, and can help prevent tension in the mid-upper back and neck.


But I’m a tummy sleeper!

Tummy sleeping – it’s not ideal, but if it’s the only way you can sleep at the moment it will have to do!

Try sleeping with a pillow lengthwise under your chest, or horizontally under your tummy to help maintain a more neutral spine.

NO pillow under your head/face!!


Leave a question/comment on our socials; or at your next appointment, chat to your healthcare provider at Caring Hands Chiropractic. Wouldn’t you like to help your body feel more comfortable when sleeping by improving and finetuning your sleep posture, so you can wake up feeling good in the morning?

For more information on healthy sleep habits: https://www.metagenicsinstitute.com.au/blog-post/2020/improve-your-sleep-hygiene-for-a-great-sleep


References:

Cary D, Briffa K, McKenna L “Identifying relationships between sleep posture and non-specific spinal symptoms in adults: A scoping review” BMJ Open 2019;9:e027633 doi: 10.1136/bmjopen-2018-027633

“Chapter 28: Digital human modelling and ergonomic design of sleeping systems” R. Sironi, C.E. Standoli, P. Perego, and G. Andreoni; “DHM and Psoturography” Ed: S. Scataglini, P. Gunther; Elsevier, 2019, ISBN: 978-0-12-816713-7

Images courtesy of PhysioMed LTD, sourced and adapted from: PhysioMed LTD., 2021. [online] Physiomed.co.uk. Available at: https://www.physiomed.co.uk/uploads/guide/file/16/Physiomed_Sleeping_Posture_Digital.pdf