(Written by Karla Rice, RN, BScN, C.H.N.C.)
“Mom and babe are doing great, and we will update you all with a name!” We hear this blanket announcement often when a new baby is born. But after this announcement is made, it is often the last we hear about how mama is doing. The focus becomes the baby and the mama’s health and wellness is often overlooked.
Why is that?
It’s not seen all over the world, but many cultures perform special rituals that are believed to enhance healing and postpartum wellness for mamas after giving birth (14, 19). However, here in Western society, we often praise women who are able to “bounce” right back up after giving birth. Without realizing it, we might even encourage them to get back to their “pre-pregnancy” body and tasks as quickly as possible.
Do we do this knowingly or unknowingly – and why?
It has a lot to do with the social culture and support system beliefs that we can find embedded all throughout Western society (19).
Why can this be detrimental for the health and wellness of a new mom during the postpartum period?
During pregnancy, the focus is on the health of the expectant mama because her health is the life source of that tiny little human that she is marvelously growing inside her uterus. After the birth of the baby, we often shift the focus solely towards the baby, while the health of the mother falls to the wayside. A baby certainly needs a lot of nourishment through nutrition, love, and affection but so does his/her mama. Expecting mamas to bounce back and reinforcing this through a lack of appropriate social support can push new mothers into survival mode – they often feel alone and fearful. Eventually, these feelings can lead to burnout. Pair this phenomenon with depleted nutrient reserves from pregnancy and the excitement of becoming a new mom can further push the mental load and increase the risk of developing a perinatal mood and anxiety disorder (replacing the common postpartum depression term).
The postpartum period places a tremendous nutritional demand on a mother and restoring her nutritional stores is vital for her postpartum health as she continues her journey into motherhood (10). While it is well documented that nutrients have the ability to alter mood and affect mental functioning, most of these studies have excluded pregnant women (11). In a review of the literature, however, it is probable that nutrient intake can affect the susceptibility and increase the vulnerability of mamas developing perinatal depression (11). This warrants the need for more longitudinal studies to confirm the link between postnatal depletion, maternal burnout, and perinatal anxiety and mood disorders (11).
“Women are particularly vulnerable to the adverse effects of poor nutrition on mood because pregnancy and lactation increase nutrient requirements” (Leung & Kaplan, 2009).
Optimizing maternal mental health and avoiding postnatal burnout requires the need for a new integrative approach that includes nutrition, social support, and lifestyle education. It is known that prolonged and/or excessive stress has a multitude of effects on our emotional and cognitive functioning (9). It is also known that early exposure to stress can disrupt the formation of functional brain pathways (7). So, by nourishing mamas in all aspects of health (mind, body, and spirit), we are also encouraging the development of proper coping brain mechanisms in her children, as she is much more likely to avoid burnout and a perinatal mood or anxiety disorder. These disorders can have negative consequences for both the mother and the baby. We are essentially optimizing the health and wellness of generations by nourishing postpartum mamas.
Bringing awareness of the risks associated with postpartum nutrition is only one pivotal step in working to ensure that all new mothers receive the nutrition that they require. Several studies have linked an increased risk of postpartum depression with lower levels of omega 3 fatty acids(13,16,18). The fact that postpartum mamas are deficient in this important healthy fat shouldn’t come as a surprise because in utero, the baby will pull this fatty tissue from his/her mama’s brain (14, 16, 21). Furthermore, breastfeeding will continue to demand high amounts of this fatty acid for proper brain development for the infant (14, 21). In animal studies, it has been discovered that after one reproductive cycle (pregnancy), DHA levels in the brain have declined by 18% (12). This same phenomena is believed to occur in humans as well (12). Another study found that the risk of developing postpartum depression is related to slower improvement in DHA levels (18). Low levels of DHA will affect a mama’s ability to cope with stress among other important functions (19). This essential fatty acid (meaning it must be obtained from the diet) is vital for the health of a postpartum mama, as we all know too well just how much our stress levels can increase when we bring a new a new baby into our life.
Establishing optimal levels of this nutrient will help mamas cope and potentially avoid the “survival mode” mentality in the fourth trimester and beyond because low levels in the brain contribute to “baby brain” and postnatal anxiety (19). Although determining optimal levels is crucial, the timing of supplementation may also play a role in the outcome for the fetus which is why education on this essential fatty acid is necessary (1).
Magnesium is a mineral that many mamas probably want to have on board for several different reasons. First, magnesium is known as the anti-stress mineral and it is involved in over 300 biochemical reactions that take place all throughout the body (5,19). Magnesium is required for the maintenance of bone health, along with nervous system functioning, blood sugar metabolism, and immune support (too name a few) (19). However, it is also easily depleted under stress and we cannot hold onto it very well in the body. Coffee also readily flushes out this mineral (hello coffee-drinking mamas!). So, without a doubt, many moms can be supported with additional supplementation of magnesium, on top of eating a diet rich in magnesium through foods like dark, leafy greens, nuts, and seeds for example (3). This mineral can definitely help a new mother avoid postnatal burnout. An animal study actually found that magnesium exhibited anti-depressant effects on animals, which is something that may also occur in humans (20).
Zinc, Vitamin D and Selenium
Zinc is another mineral that is often depleted in mamas who have postnatal depletion, according to Dr. Oscar Serallach, who is board-certified functional medicine doctor specializing in postnatal well-being (19). It has many roles, like magnesium, but its role in immune function and digestive health makes neurotransmitters and regulating hormones the most important during the postpartum period (5, 19). In order to absorb zinc properly, you need enough hydrochloric acid in your stomach, which requires a healthy functioning digestive system (something that many of us, including mamas, need help restoring) (19). For these reasons, nutrient replenishment cannot be done without practicing healthy habits for digestive health to increase the likelihood of proper absorption.
A cohort study looking at the rate of postpartum depression and the role of micronutrients also noted a decline in postpartum depression with higher intake of selenium, vitamin D, and zinc (10). This is exciting research for new moms, because we can now determine new ways to optimize the life of new mothers during the postpartum period by recommending dietary and supplementation support for certain micronutrients that help combat the risk of developing postnatal burnout and depression.
Replenishing nutrient stores and eating a nutrient dense diet is the first step in nourishing a new mother. Furthermore, nutritional interventions as a treatment to depression may reduce the need for psychotropic drugs (16). However, in order to absorb these nutrients, mamas must be able to absorb them appropriately. Yes, it’s not just about what we can eat, but what we can absorb as well.
A healthy digestive system plays an active role in providing proper absorption and assimilation of nutrients (8). Poor sleep, stress, poor nutrition, medications, toxins, and hormones can all affect our gut health (1, 8). As a new mama, we are battling a few of these factors without much control, which is exactly why it is vital for mamas to have a village. A village can help support a mama by minimizing these negative consequences, while she establishes stress management techniques, nourishes herself with nutrition, optimizes her sleep as best as she can, and provides herself with copious amounts of self-love.
Simultaneously, when a mama can address her gut health, she is positively influencing her brain.
The Gut-Brain Axis
The gut-brain axis is emerging with supporting evidence that our gut health has a connection to our mental health. This phenomenon is actually quite old (dating back to the 18th century when it was discovered that the digestive system had its own separate nervous system) (2). Without going into grave detail about this exciting research, I cannot stress enough the importance for mamas to restore their gut health, replenish their vital nutrients, and effectively manage their stress levels to avoid postnatal burnout or what I call the gut, brain, and mom drain.
Simple suggestions such as mindful eating, not drinking with your meals, and taking deep breaths before eating to allow the parasympathetic nervous system to kick in rather than have our “fight or flight” mode on while we eat can help to improve digestion. We all know that it may be near impossible to eat a hot meal as a new mom, but ensuring that you are sitting down and in a relaxed state will aid in the digestion process and in the development of the gut-brain axis.
Stress activates the release of cortisol and other adrenal hormones, which initially can be a good thing as it is a coping mechanism (17). Prolonged release of cortisol, however, affects many aspects of our gut and mental health. One thing it will do is drive our blood sugar levels up, which can affect our mood (19) (let’s face it mamas; we need all the help we can get with avoiding mood swings with the amount of sleep that we lose on a nightly basis). Secondly, raised cortisol levels will decrease the flow of oxygen to our digestive organs (again, we want to optimize our gut health, not hinder it). Eventually, cortisol levels will start to under-produce and affect our sleep cycles and energy utilization, including the feeling of not being able to get up and the inability to sustain consistent energy levels throughout the day (19). So, reducing and managing stress is crucial in the postpartum period. Although more research is needed to draw causation, there is correlation to pre-existing inflammatory conditions associated with maternal mental health which is also another reason why managing stress and therefore reducing inflammatory markers is important (15).
How do we do this?
Eating nutrient-dense foods while practicing mindfulness and taking time to relax is not only vital, but I would argue that it is absolutely essential towards ensuring that you effectively manage your mental health and stress levels throughout the postpartum period. Research has linked increased incidence of perinatal depression and anxiety with a diet high in refined foods and sugary products (4).
We also need to bring back the village. One cohort study found that a positive correlation between social support and the development of postpartum depression (10). Connect with other mamas, family members, and/or friends that allow YOU to be YOU. Let that tribe relish you with kindness and provide you with support for your journey into motherhood, so you can live a beautiful and happy life while raising your children.
As a collective, it is not good enough to suggest self-care for mamas to promote postpartum well-being; they deserve nourishment too. All mothers deserve someone who can check in on them, bring them a meal, and ensure that they have what they need to feel whole – just like they do for their little ones. Let’s raise resilient and happy mamas together by empowering them with knowledge, encouragement, love, compassion, and support, so that they can raise the next generation of mothers and fill them with love and compassion. The world can truly flourish with so much nourishment and kindness.
*Addressing all of this may reduce the risk for postpartum mood and anxiety disorders. 1 in 5 or 1 in 7 (depending on the research) women develop postpartum depression. These rates are alarming and require attention and awareness. This is the number 1 medical complication related to childbearing (Perinatal support international). Maternal mental health complications such as postpartum depression can rob mamas from living a happy and healthy life. Of course, nutritional support is important along with lifestyle recommendation but this childbearing complication requires much more awareness and education for healthcare professionals, expectant and new mamas so we can all holistically provide essential, ethical and accurate care to mamas across the world.*
Written by Karla Rice, RN, BScN, C.H.N.C.
Nourishing You Kindly strives to encourage & empower mamas through holistic education, nutritional counselling and lifestyle recommendations while transitioning into motherhood by restoring nutrition and gut health, rebuilding the mama village and redefining happiness in motherhood. For full support please visit www.nourishingyoukindly.com and receive 20% off the 90 day nourishing mama program or 15% off the gut, brain and mom drain (must be purchased from January-April 2020 to qualify).