Postpartum Tummy Skin, Helping get it back.

Before

 After

( Notice the skin about the belly button getting smoother)

After you have had a baby,  not only do you have to work out and get your abs tight again, but the skin on the stomach itself has broken down the collagen during the pregnancy. As we age,  the collagen continues to break down leaving the skin looking altered and may not go back to its former glory.
I will tell you that my own skin, while I was blessed with no stretch marks due to my heritage, I do now have altered collagen around my belly button. I have been testing a product called Regenemax, which is largely made of choline which is a macronutrient that aids in connective tissue regeneration which also includes our stomachs, facial wrinkles and breasts.  So what I am really saying is that this is my vanity supplement and this is what I am taking and trying to get my body back.

I am going to do it and show you a picture, because I started this as an experiment on my abs specifically and I am still testing it. So far, it appears to be working on my abs, but not on the eye bags yet unfortunately.  So here is my abdominal photo and the product I am testing which is pharmaceutical grade Regenemax  (choline).

I don't like Breast-Feeding, a story about some womens journeys.

In my practice, I run into women of all kinds who either love or hate breast-feeding. Most new mom’s start breast-feeding and experience some mild breast tenderness and a little bit of anxiety but are overall successful. Many enjoy breast-feeding and all the things that it entails like bonding and spending time with a new baby.

I have started coming across a group of women that I think need a voice that we often don’t acknowledge or recognize.  It’s women who want to breast-feed but don’t enjoy it because it ‘s painful, or the sensation of nursing doesn’t agree with them in some way.  While still other’s wanted to nurse their babies but have rigid work schedules that do not allow for the baby to nurse longer when they needed to.

Prior to having my baby, I was a very rigid no nipple-shield person and tried not to pump. This had been my philosophy.  But since seeing more moms and all the lifestyles that they live in, I have since realized that not everyone likes breast-feeding, they don’t love it but don’t hate it.I found myself to be one that just liked breast-feeding but didn’t love it.

With my first child, I thought that I had somehow missed something and the hormones that a mom normally got which made you love breast feeding had missed me. Also because I worked and was away from my baby for several hours at a time, and sometimes I had to rush my babies along, I would pump instead. I was grateful to be able to nurse but never found in myself the love of nursing.

Please forgive me all my wonderful lactation consultants but my thoughts on breast-feeding have changed to do whatever keeps you breast-feeding. Whether it’s pumping or even using a nipple-shield, I would encourage the mom to continue breastfeeding so the baby gets the nutrients (remember this-without nursing directly you don’t get the babies saliva to change the antibodies in mom though). If it means pumping the entire 1st year of life than switching to formula - do it - it is worth it.

So I give a huge shout of admiration to all the mom’s and women who nurse or use a pump even if it doesn’t give them the satisfaction that so many of their counterparts got. We know every woman has a different experience with breast feeding.

Postpartum Pregnancy Massage

Postpartum is hard on the body and mind.  Often, you are exhausted and you are building your baby holding muscles up by lifting your new heavy bundle of joy.  The physical act of holding your new born especially if you are breast feeding  can cause any mom to start having shoulder and neck pain that will often result in a headache.

At In Health Clinic, we offer a postpartum check up for mothers. A common complaint we hear every time is how stiff their shoulders and neck are.  The bad news is that baby only gets heavier, but the good news is you are helping your child grow bigger.
What can mom do to help keep herself healthy so she can continue to care for her little one and entire family?  I find myself struggling with these very same problems as I have had 2 beautiful girls in the last couple of years and my recommendation to new mom’s and dads has always been get a postpartum massage or muscle work.  This may sound decadent,  but if you are like me you start getting significant amounts of headaches and neck pain that won’t go away which makes caring for a new baby even harder.  This is definitely a time in your life that postpartum massage work is tied very closely to your health in general.  I have also found that new mom’s rarely give themselves permission to go get a massage because they guilty. I now suggest that dad’s or partners should be the one to schedule it for them.  The new mom will be very grateful that they taking care of them.

With my pregnancies, I was sent by my husband to get a massage and both cases I was so glad because I was starting to get headaches from nursing and staring at my beautiful baby. Going a few times postpartum helps relax the body, alleviate the soreness, and get the blood flowing to the muscles.  The baby continues to grow and moms body needs help accommodating to it’s new job as mom (compare it to starting a new work out routine).
 So I can say with 100% certainty that this has saved me and below you will see the people I have gone to and recommend.

Adeline Carlson  - a certified pre-natal and post-natal massage therapist  with Light and Joy Acupuncture 408-357-0295

Bridget Eding – Just B Massage 408-836-9259

Mom’s Emergency Kit

1.  Tampon - for period’s that can catch you off guard
2.  Tide to-go stick – for the messes that kids and you make while on the go
3.  Krazy glue – for cuts and injuries this glue was originally created for surgery
4.  Triple antibiotic plus ointment – this is for cuts and abrasions where infection is likely. Caution: do not over use.
5.  Barrette – For hair emergencies
6.  Pacifier – for melt downs and baby’s need for sleep
7.  Sunscreen – because sometimes you are out and forgot to bring sun prescriptions
8.  Benadryl – this is for allergic reactions and emergency reactions to foods, bee stings etc…
9.  Camilia Teething drops – For teething issues (starts around 7-8 months)
10.  Light day pads – for emergencies whether postpartum or periods that come unexpectantly
11.  Bandaids of various sizes – for injuries and pain.

This is my kit that I keep in the diaper bag at all times in a little bag. I check it frequently to make sure it is stocked.

Post Partum Depression

Before I was pregnant, I had volunteered at an event called Jenny’s Light and it is NOT named after me. It is a foundation created to bring awareness to postpartum depression something that effects 1 in 7 women and can range from very mild to very severe. In the case of Jenny, she took her own life and her family created a foundation to help prevent that from ever happening in anyone else’s family.

It’s important to recognize the signs in our friends and loved ones. It effects so many women. When a couple is in my office, I always make sure the significant other is aware of the signs. Often the new mom will not see the signs and know that it’s happening. See below for a basic list of the most common signs:

Mood swings
Anxiety
Sadness
Irritability
Feeling overwhelmed
Crying
Reduced concentration
Appetite problems
Trouble sleeping
Depressed mood or severe mood swings
Excessive crying
Difficulty bonding with the baby
Withdrawing from family and friends
Loss of appetite or eating much more than usual
Inability to sleep (insomnia) or sleeping too much
Overwhelming fatigue or loss of energy
Reduced interest and pleasure in activities usually enjoyed
Intense irritability and anger
Fear that you’re not a good mother
Feelings of worthlessness, shame, guilt or inadequacy
Diminished ability to think clearly, concentrate or make decisions
Severe anxiety and panic attacks
Thoughts of harming yourself or your baby
Recurrent thoughts of death or suicide

There are many resources to help with identifying postpartum depression:
One of my favorite quizzes that is one that the new mom can take or a partner can take for her is here: http://www.postpartumhealthalliance.org/screening-test

Help Resource guide: http://www.supportingmamas.org

Treatment options:

Medication
Acupuncture and herbs
Counseling
Support groups

Supporting the cause: http://jennyslight.org

This is a great cause that you can join and either donate, race or volunteer. Our office has a booth every year trying to help create awareness about this issue that can effect many women. Come and join us each May for the 5K race at Vasona Park in Los Gatos to help prevent future postpartum tragedies.

Postpartum Weight

What can you do postpartum to lose the weight you gained during pregnancy or should you lose the weight?

It is important to not push yourself to lose weight especially if you are breast feeding, but losing weight gradually is normal and to be expected. That’s why they say that breastfeeding is a great way to lose weight. Plus it’s a safe way to not damage your milk supply.  But let’s face it - we are still women and there is an element of vanity in our souls and we do read magazines that talk about models and actresses that get their bodies back in 1 month and we want an easy solution.  In our lives, we may work full time (and our job’s usually aren’t to look beautiful as a profession) or we already have children to care for leaving us with little time to have perfectly cooked dinners for weight loss plus we don’t have time for exercising hours a day to lose our love handles.  So what’s a hard working mom’s to do to lose weight? The following are healthy recommendations:

Mega-Former workout Coremocean
(start after 6 weeks only and maybe longer based on ab tearing called diastis recti).
Lower your carbohydrate consumption and eat more protein.
Regular meal consumption- the worst thing is skipping meals.
Sleeping when the baby sleeps - lack of sleep will cause your body to hold on to weight.
Protein shakes are a great way to always have an easy meal.
Walk with the kids in the stroller daily to burn off calories.
Weight lifting – you can do kid lifting if you do not have weights at home.
Squats and lunges are a great way to activate large muscle groups to help lose weight.

During my post-partum with both Zara and Allegra, I have done running and mega-former and lower carbohydrate consumption.  With Zara, I was able to lose the weight faster than with Allegra and this is a common phenomenon.  Second pregnancies are usually harder to lose the weight. It is also important to make sure that your thyroid function hasn’t been compromised which in my case was an issue making my metabolism slower.  With the help of herbal supplements, I was able to correct the problem.

Humidifiers for Babies

Humidifiers are a popular item on baby registries for very good reason, babies have much more sensitive skin than adults. With forced air heat in our homes in the winter, it can dry their sensitive skin out.



Not only do babies have sensitive skin but they also have delicate respiratory systems and low humidity homes can cause them to wheeze or cough or develop a rash.

Humidity drops to 10% in centralized heating homes which can allow viruses or other respiratory infections to take a hold in dry lungs.

Many of my first babies items have been passed down to my new little one, but there are some things that you need 2 of and a humidifier is one . Here are a few key reasons to have a humidifier in each child’s room:

Reduce the risk of illness
Soothe Cold and Flu symptoms
Preserve Vocal Cords
Protect Skin
Provide Warmth to Baby
Prevent Asthma

We have a blue humidifier for Zara and we have a White one for Allegra.  Based on its reviews, we purchased the Crane Drop Shape Ultrasonic Cool Mist Humidifier.
It’s small enough for the babies room and it was affordable.

Here are the top 5 best rated reviews:  http://bestreviews.com/5-best-humidifiers

When Things don’t go as planned, but they are still perfect.

I am a Family Practice Chiropractor and I know a lot about homeopathy, botanical medicine and optimizing the pelvis in preparation for labor. Chiropractic care during your pregnancy will shorten your labor time and reduce the chances for back labor and a mal-positioned baby. Homeopathy can reduce labor time and help with pain management and stalled labors. Taking uterine tonifying herbs can help with labor and also help post-partum.  Acupuncture can help your birth as well as help induce labor.

My births although good, were not within the perimeter of what they should have been even with all of this knowledge.
 
I tell patients all the time what the average patient experience should be and advise them what the research says so it improves their chances for a better birth outcome.  But I now know that these are only statistics and they don’t mean a thing when you are the out-lier.
 
My first labor was 60 hours and it stalled and my second was 17 hours and 43 minutes and it also stalled.  I was a week late for both my births ( I think this is how are family rolls).  I needed pitosin both times which is something I wanted to avoid.  After these experiences, I have learned that my birth was my own; it was not in my plan, but 2 healthy beautiful girls and the love and support of my family, doula and birth professionals made me love my story and be thankful for it.

The Birthing from Within was a class that helped prepare me to accept my story and make the correct decisions during my birth and not feel guilty about my decisions.

Plugged ducts

After both of my pregnancies, I have gotten plugged milk ducts and have been very uncomfortable. I had already tried the poke root, essential oil poke root, hot and cold therapy, massage, and lecithin orally.  I knew I was in need of a stronger remedy because I didn’t want to get mastitis.  I had that when I had Zara and it is not only painful but also very debilitating due to the high fever that can accompany it.  I went for a treatment that our acupuncturists in our office have been doing in our office, ultrasound.  I first noticed it when I could feel a plugged duct and everything else had failed.  It was getting so painful even to the touch on the breast that I was having a hard time massaging it out.  I did the ultrasound treatment and it was not anymore painful than the massage I had been doing; in fact it felt almost relaxing.  Afterwards, the pain wasn’t gone but it was 80% better.  I could even stand to massage the duct that night afterward and I didn’t get an infection in that duct.

I highly recommend if you are a mamma that is struggling with plugged ducts and the home remedies suggested in my previous blog (http://drwalkerpregnancy.blogspot.com/2013/09/breast-trouble.html ) don’t work then you may greatly benefit from an in-office breast ultrasound procedure that is safe for mom and baby and pretty affordable also.

My Birth Story Dr. Eugenie Giasson-Gomez

My due date was September 14, 2015; exactly ten years after I asked for my husband’s number. Although it would be a great story to tell should my baby come on that day, I was hoping the baby wouldn’t wait too long because I was ready to have my regular body back. My pregnancy went well overall but I wanted the heartburn to end and I missed being more active. At the clinic, our manager, Marj, would say, “as long as you don’t have the baby before September 1st.” That was the day that we would take our photo for the Holiday cards. That was a very busy day at the clinic and when I got home, I promptly took a three hour nap, which was much longer than my usual naps. An hour after I woke up, I began having some low back pain. I wanted to try to walk it out so I went for a walk with my husband and our dog. Whenever the dog would do her business, I would take the opportunity to do some squats and try to get my pelvis together. As we walked along, my husband and I took turns answering the question of what makes a good parent. We encountered a woman who asked when the baby was due. I replied “any day now” not realizing that the process had already begun. When we got home and a surge of back pain came back with a heaviness to the front of my pelvis, I said, “This back pain is weird. It comes and goes.” As soon as the words came out of my mouth, I knew that I had been actually experiencing contractions. My baby was coming!

I emailed my midwife and went to bed so that I would be well-rested on labor day. However, the back pain paired with my excitement kept me from sleeping until 8:30am the next morning. When I woke up two hours later, the contractions were not coming regularly anymore and I was exhausted. I called the clinic and they moved my appointments to Dr. Ho’s schedule and I was scheduled to be seen by Dr. Walker and Yoevita. I did not intend to have “back labor.”  After their treatments, I felt relaxed. The back pain was gone and the contractions were coming at regular intervals again. That night I slept as the contractions came and went. 

Thursday morning, the 3rd of September, I woke up and knew that it was going to be labor day. I was going to have my baby! I had no appetite at all but managed to eat an egg and a potato anyway because I knew I would need the energy.  For the rest of the day, I had broth and chlorophyll in water while I labored. When the contractions started getting more uncomfortable, my husband helped me with the tools he learned from Patricia Madden’s class called “Tips and Tools for an Active Birth.” Around 4:30pm, his help with the contractions was not enough and I asked him to fill the birthing tub. At 4:45, I asked him to call Hope, our midwife. When she arrived, I had been in the tub for a few minutes and got tremendous relief from it. I was so happy to have it and the idea of being in a hot tub in my living room was really fun for me. My contractions were still coming regularly so I was confident that I wasn’t relaxed to the point of stalling my labor. The tub put me in such a good mood that my midwife was a little doubtful that the baby was coming soon rather than later. 

The contractions were gradually getting closer. Hope would check on baby’s heart beat periodically and when the contractions were about a minute and a half apart, the baby’s heart rate was elevated to 180-190. She asked me to get out of the tub. The baby’s heart rate was still elevated. She was getting concerned and said we may have to transfer to the hospital. I didn’t answer. I was hoping the baby’s heart rate would normalize at any moment. She had me lie down and checked dilation. She also took my vitals. There was no sign of infection and the heart beat was steady and not decelerating. Decelerations would indicate that the heart was failing. There was no perceptible reason as to why my baby’s heart was beating was so fast. It was as if he was getting a workout. Somehow I felt calm and that everything would be ok. 

“We might have to go in,” she said. I was trying to visualize grabbing the packed bag and my wallet. Trying to see myself step into the night air and going to the car. Trying to accept the possibility of leaving. I wasn’t going to move in that direction until my midwife said we had to. I started praying over and over again. Laying on my back and on my side was very uncomfortable and practically intolerable so I changed positions. On my knees, I hoped that this position would help my baby’s state. Still high. I cried out, “Why?”.  My husband and my sister came to me and laid their hands on me and prayed. Hope was monitoring the baby’s heart rate and it started to go down though it was still too high. After another contraction, Hope asked me how I felt and what my intuition or gut feeling was. I said I felt fine. I got up and took a few steps. Then she said, “You’re so close. I feel like you could have the baby right here.” That was a ray of hope and I ran with it. I felt hot so I stepped outside and came right back in for another contraction. The cool fresh air felt wonderful though and I felt better. The next time she checked the heart rate it was just above normal. I was so incredibly relieved I almost wanted to cry. My water broke shortly after that and when she checked the heart rate it was calm and healthy! Back on track!

Labor was gradually getting more intense all the while and I was starting to be ready for it to be over. My husband’s love and support nourished me. This experience was making our bond even stronger. Throughout the labor, Hope was never more than an ear shot away. She was never overbearing and let me be free to listen to my body. She gave me guidance and I felt secure with her nearby. 

After what felt like a lot of pushing, I was on my hands and knees when our baby was born at 10:35 pm. It’s a boy!  

The moment that I had my son is the single most joyous and beautiful experience of my life. 

The memory of it fills me with such gratitude. Though my husband was a little skeptical of a home birth in the beginning, he now says that he can’t picture it any other way. We don’t want to leave the area now until we’re done having babies with the hope that they can all be delivered by our midwife Hope, into the serene and loving space of our home.

Why I choose a Home Birth, Our Doctor's Journey.

 I knew that I wanted a home birth when a midwife guest lectured in one of my classes in college when I was 21 years old. She taught us about the hormones involved in labor and how they can be altered by the mother’s state of mind and environment during labor. She then explained that once one intervention is introduced into the woman’s system, it triggers a snowball effect that could require more interventions. A Certified Professional Midwife (CPM) is the professional of uncomplicated natural births, which means they recognize immediately when something is awry because it is amiss of the process they are so familiar with. Ninety percent of births are uncomplicated and for that ten percent that is complicated, they will know early and take proper action before an emergency arises.

The midwife also retold stories of women giving birth standing. For example, the woman who crossed the border of Mexico into a clinic in Texas and shed a single tear as her baby entered the world. Then there was the story of an indigenous Brazilian woman who squat down as she caught her own baby and walked on. These stories were nothing like the images of birth that I had seen in the media and heard about from people I knew who birthed in the hospital.

The midwife showed us that the way we experience pain is very much a cultural thing. Pain is then a perception which means that I can I have some degree of control over how I experience it. After that realization, I enjoyed letting my optimism get ahead of me to paint me as that woman who would take birth standing. The experiences that she shared that day combined with my history of traumatic sport injuries prevented me from ever fearing the pain of labor. I was no stranger to pain and I would bend it. I am a woman and women have babies. My friends would shake their heads and laugh as I would demonstrate how I too would squat down and catch my baby when the day came.

A common response to hearing that I chose a home birth is “You’re brave!” My response to that is, I didn’t make that choice to be brave. I chose it because it makes me feel safer actually. I want to have the freedom of movement and the freedom to trust and listen to my body. People also ask, “what if something goes wrong?” or “what if you want an epidural?” These types of questions come from a fear of an emergency situation or a fear of pain. I already discussed those issues above. It was an easy choice for me and I chose out of love, not out of fear.  I am willing to experience the intensity of labor. I want to embrace this unique experience of bringing a person into the world. It is the highest honor. I should feel something. I should feel the impact of this act.  It will impact the world too in some way.

With a healthy pregnancy, a wise midwife, and the best husband, I felt excited and eager to meet my baby at home.

Check out the South Bay Homebirth collective at:  Southbayhomebirthcollective

Dr Walker is going on Maternity Leave - Guest Writer

I am on maternity leave and my next blog will let you know the baby is here but during my absence from the blog, we will have a very special guest writer, Dr. Eugenie Giasson-Gomez. She will be talking about her Home birth experience and how it is to be a new mom - so look for her upcoming blogs.

Dr. Walker and Dr. Ho's Daughter was Born

Dr. Walker and Dr. Ho's daughter was born on January 16, 2016 at 10:43 am in Santa Clara California.  Both mommy and baby are doing well.

Allegra Grace Ho
8 lbs 2.2 oz
20 inches

Induction Techniques for Labor: Natural to Forceful

So what happens when your pregnancy is 40 weeks and 2 days like mine and no signs of baby coming.  So induction techniques are plentiful with some being more scientific than others and they range from very gentle to very forceful.  I want to share with you the range of options then let you know which ones are my go to and let you decide what is best for you and baby.  As always please consult your mid-wife or OB/GYN before selecting any of the more forceful options. 

Meditation/Deep breathing                                                Least forceful

Raspberry Leaf Tea/ Herbs

Eat Dates

Spicy Food/ Curry

Sex

Nipple Stimulation

Evening Primrose oil for cervical softening

Induction Massage

Acupressure

Chiropractic induction

Acupuncture

Membrane Sweeping or Stripping

Break Water

Misoprostol

Pitocin

C-section                                                                    Most Forceful (Ultimate induction)

So During my first pregnancy I used raspberry leaf tea, massage, acupuncture, sex, spicy food, nipple stimulation and chiropractic induction.  During my current pregnancy I am doing acupuncture, sex and spicy food, prayer and chiropractic induction.  Please remember that certain herbs and techniques must be supervised by your mid-wife or OB especially in cases such as a VBAC, pre-eclampsia and gestational diabetes.   

Group Streptococcus B (GBS) Testing and how to improve your chances for being negative

At around week 35-36 in a woman’s pregnancy, there is a test for Streptococcus which is done by swabbing the perianal area of the body.    The bacterium comes from the bodies’ intestinal tract and can be transferred to the vaginal area of the body.  This bacterium is normally harmless in most adults except in diabetics or those with liver disease. In a new born, it can cause serious problems.  If a woman is found to be positive for GBS, they will receive antibiotics at labor usually in an IV to prevent the infant from getting infected.

If a baby is infected, most are fine but there are some that get GBS disease and these are the following symptoms:

Lethargy
Fever
Difficulty feeding
Irritability
Difficulty breathing

One of the signs that you may have GBS is present is that you may have diarrhea or constipation; or basically a non-working digestive tract.  One of the ways I have already tried to prevent being positive for GBS is doing citrus seed and probiotic for 1 month prior to the testing.  This doesn’t mean I won’t be negative during testing but it has worked with both pregnancies so far!