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mother feeding her baby in nature outdoors in the park

Engorgement and Mastitis

The breasts of women play a crucial role in life – it nourishes the infant shortly after birth and can make a difference in the growth, development and health of a baby. It is known that breastfeeding is the best means to nourish a newborn and today breastfeeding is once again becoming the preferred option among new mothers. However, there are two fairly common breast problems that can arise during lactation.

Firstly there is the situation where the breasts become overfilled with milk and painful. This is known as breast engorgement. The other problem that may be seen among breastfeeding women is an infection of a breast or even both breasts simultaneously. This is known as mastitis. Although both involve the breast during lactation, it is two very different conditions. However, engorgement may lead to mastitis.

Breast Overfilling

Breast milk production is a normal process that occurs shortly before giving birth and continues for as long as the infant is feeding. It can sometimes occur abnormally without pregnancy but milk production is usually very moderate in these cases. Some women produce more milk than others but the quantity of milk production is largely based on how frequently a baby feeds.

Milk production is fairly constant during lactation and regularly emptied by the feeding infant. Therefore the more a baby feeds, the more milk the breast produces. Milk production can occur indefinitely in this way. In breast engorgement the milk collects in the breast until it begins to exceed the maximum storage capacity of the breast. It leads to swollen and painful breasts.

Engorgement of the breasts is mainly due to a women stopping breastfeeding suddenly. Blockage of the milk ducts that carry milk out of the breast can worsen the condition but is usually not the sole cause. Contrary to popular belief, engorgement is unlikely to arise because the breasts are abnormally overactive in milk production.

Basically, if a lactating women expresses the milk regularly or allows the infant to feed more frequently, the breasts will not become overfilled. As the baby feeds less with supplementation of solid foods, the breast starts producing less milk and the chances of engorgement is unlikely. It is possible for engorgement to progress further and complicate into mastitis.

Breast Infection

Mastitis, in the true sense of the word, means inflammation of the breast. However, since the majority of cases are due to an infection, the term mastitis has become synonymous with a breast infection. Although mastitis can occur in any woman, it is more common during breastfeeding. Therefore the condition is more correctly known as lactation mastitis.

Breastfeeding is a time in a woman’s life when the breasts experience extensive trauma. However, breastfeeding is a natural process and the breasts are equipped to deal with it to a certain degree. The bacteria that cause mastitis exist naturally on the skin and within the baby’s mouth where it is not harmful. But when the bacteria enter the breast tissue, it can cause a serious infection.

Normally the breast can prevent bacteria from entering the breast tissue. However, when the nipples become chapped with breastfeeding, the bacteria may take the opportunity to infect the
breast. Mastitis can also occur when the milk ducts become blocked. This can lead to engorgement of the breasts as the milk is trapped but bacteria may also enter and infect the breast tissue.

Easing Early Labour Pains

Pregnancy, how to ease early labour pains

The start of labour pains does not necessarily mean that childbirth will occur soon thereafter. Some women may only be in labour for a few hours while for others the ordeal can last for one to two days. Labour pains are a natural part of childbirth but it is challenging for any women. Modern drugs have proven to be useful in this regard but it is not always advisable for a prolonged labour. Instead other measures to comfort the mother and ease the early labour pains should be considered.

Some women have a higher pain threshold and are able to contend with labour pain for a longer period without any intervention. For most women however, simple conservative measures may be sufficient until drugs are feasible to use. Easing early labour pains should involve the partner as simple reassurance and support may be sufficient to make the experience tolerable. Even soothing music may help some women stay calm and deal with the pain.

However, more definitive measures are required at some point before opting for drugs. Various techniques have been explored and while the results may vary, all of these measures are safe options for easing early labour pains. Breathing, massage and heat or cold therapy are some of the more widely preferred options. These non-invasive techniques do not pose any risk to the baby and may in fact be helpful – if the mother unable to handle the pain, the stress response can affect the baby.

Back Pain in Pregnancy

Is it safe to use a wheat bag or heat pad during pregnancy?

Heat therapy has been used throughout time as a means of treating various ailments. It is safe to use in most instances and pregnancy is no different. Although expectant mothers are often afraid of utilising any drug or therapy while pregnant, heat therapy is relatively safe in this regard. If used appropriately, a wheat bag or heat pad can relieve discomfort, strain and pain during pregnancy.

Avoid Hot Water Baths

Not all forms of heat therapy may be safe. Immersing in a hot bath is one form of heat therapy but may not be suitable for pregnancy. Heat causes the blood vessels in the skin to dilate. This increases superficial blood flow. When heat therapy is used on a small area of the body like with a wheat bag or heat pad then it is not a problem.

However, immersing in a hot bath causes vasodilation (widening of the blood vessels) throughout most of the skin on the body. Blood rushes to the surface and this alters the blood pressure. It also means that normal internal blood flow to the baby can be affected which is not optimal during pregnancy. Therefore pregnant mothers who need to apply heat to an area should rather use a wheat bag or heat pad rather than soaking in a hot water bath.

Advantages of Wheat Bags and Heat Pads

A wheat bag or heat pad has distinct advantages over other forms of heat therapy. It does not become overheated like water or change form like when water converts into steam. It does not hold any risk in terms of electricity with the use of an electric heat pad. It can be easily placed and take the shape of any part of the body thereby focussing the heat on specific areas. However, no heat application, not even a wheat bag or heat pad, should be placed on the abdomen during pregnancy.

Mother and new born.

Shoulder Pain with Breastfeeding

Breastfeeding is one of the most emotionally fulfilling experiences for any mother. It is a time of bonding between mother and baby, and is equally important for the baby’s growth, development and health. However, breastfeeding is not always without some degree of discomfort and symptoms that arise at various parts of the body. Shoulder pain is one such symptom during breastfeeding.

Causes

The most natural position to breastfeed is to hold the baby up against the breast where the infant’s mouth can reach the nipple. It does however, cause significant strain on the muscles of the arm and upper body. Although babies are light in weight, the constant carrying during feeding can strain the muscles of the shoulder and neck in particular. Shoulder pain may therefore occur. Sometimes problems with the breast such as engorgement and mastitis may also cause referred pain to the shoulder.

Despite the best efforts of the mother, shoulder pain is a common consequence of muscle strain during breastfeeding. Shoulder pain in these instances may also occur when the mother feeds the infant in the sleeping position. Although it is not recommended to breastfeed while lying down, midnight feeds can be taxing on the mother and inadvertently lead to feeding on the bed. However, lying on one side in a position that will allow the infant to feed can also strain the muscles of the shoulder and neck.

Symptoms

Shoulder pain is a symptom on its own. When it occurs in breastfeeding, mothers may experience difficulty in moving the arm at the shoulder joint. Raising the arm above the head or rotating it at the shoulder joint tends to exacerbate the pain as does holding the infant to the breast. Neck pain often occurs simultaneously and many mothers experience significant stiffness of both the shoulder and neck.

Usually there are no other symptoms unless the shoulder pain is related to breast problems. Symptoms such as shoulder pain during breastfeeding should not detract mothers from breastfeeding. Extensive research has shown that opting to breastfeed can make a difference in the baby’s immune defences, with allergies and proper growth and development.

Treatment

Shoulder pain during breastfeeding is often seen as part of lactation and most mothers live with the pain and stiffness. As drugs may pass through the breast milk into the baby’s body, most mothers prefer to avoid painkillers and anti-inflammatory drugs that could ease the pain and stiffness. However, a few simple measures can help in managing shoulder pain during breastfeeding without opting for drugs.

Learning the proper technique to hold the baby during feeds while reducing the strain on the muscles of the upper body is important in preventing shoulder pain. Mothers should seek the advice of a medical doctor or paediatric nurse on the appropriate technique. Stretching exercises for the shoulder and neck muscles should be carried out several times a day to minimise the muscle strain.

Other simple measures that can be equally effective are a gentle massage and heat therapy. While breastfeeding mothers are advised to seek physical therapy for their shoulder pain, heat therapy can be conducted at home. A hot water bottle or heat pad applied to the shoulder and neck area can help to reduce muscle pain and is equally effective in preventing pain.

Beautiful pregnant woman doing exercises.

Symphysis Pubis Dysfunction – Managing SPD During Pregnancy

Symphysis Pubis Dysfunction (SPD) occurs as a result of a hormone called relaxin (which also makes your feet bigger in pregnancy).  This hormone allows the usually taut ligaments that connect the three bones of your pelvis, to relax and make way for baby. While this added flexibility is useful during birthing, it can cause pain during pregnancy in the form of SPD.

Symptoms include pains or aches in the pelvic area that radiates to the lower back, hips, buttocks and down the legs.  You may also experience pain with movements  such as getting out of bed or a car and other positions where one leg drops down in a scissor-like movement. Walking and other weight-bearing activities can increase pain.

Self-Help Tips

Daily movement:

  • Stand symmetrically, with your weight evenly distributed through both legs.
  • Sit down to get dressed, especially when putting on underwear or trousers.
  • Keep your legs close together and move symmetrically and slowly.   Avoid “straddle” movements.
  • Swing your legs together as a unit when getting in and out of cars.  Use something slippery on the car seat e.g. bin liner,  to help you enter car backwards and then turn your legs as a unit.
  • Avoid heavy lifting or pushing.
  • When climbing stairs, step up with your best leg and then bring your other leg to meet it.

Therapies:

  • Acupuncture may reduce pain levels.
  • Movement and strengthening therapies like the Alexander Technique and Pilates may help. The Alexander Technique helps retrain more efficient and better muscle usage. Pilates works on strengthening the core muscle areas e.g. abs, back, etc.
  • Physiotherapy, osteopathy and chiropractic may help.

Bed:

  • Use a pillow between your legs when sleeping and/or use a pillow under baby.
  • Keep your legs and hips as symmetrical as possible when moving in bed.  You may find it helpful to have your partner stabilize your hips when adjusting position.
  • Silk/satin sheets and nighties may make it easier to turn over in bed.

Exercise:

  • Performing regular pelvic floor exercises and lower abdominal exercises can help to reduce pelvic strain. To perform a lower abdominal exercise, get down onto your hands and knees and level your back so that it is roughly flat. Breathe in and as you breathe out, perform a pelvic floor exercise and at the same time pull your belly button in and up. Hold this for 5-10 seconds without holding your breath and without moving your back. Relax the muscles slowly at the end of the exercise.
  • Back pain can be helped by resting backwards over a birth ball.
  • Water aerobics may be helpful.

 

Finally some general advice which might help.  Ask a partner to massage your lower back.  If their hands get tired, they could use a rolling pin or tennis ball.  If you prefer hard pressure on this area, get on your hands and knees and arch your back a bit, then have your partner put their elbow against the area and rub in small circles.

A chilled wheat bag may feel soothing and help reduce inflammation in the pubic area. Wheat bags warmed in the microwave before using, feel really nice on the back!

Back Pain in Pregnancy

Heat Therapy for Lower Back Pain in Pregnancy

There are many aches and pains in pregnancy. Lower back pain is by far one of the most common musculoskeletal ailments that most pregnant women will experience, particularly in the third trimester. However, in pregnancy it is not as simple a matter as popping an anti-inflammatory or painkiller to relieve pain and discomfort. With a growing baby, most pregnant women prefer to stay away from all drugs even if it is considered to be safe for use during pregnancy.

Fortunately modern drugs are not the only option for some of the common complaints of pregnancy. With lower back pain, simple manual therapies may be just as effective in offering pain relief. A gentle massage, proper stretching and the use of external heat may be sufficient to ease lower back pain and even prevent it to some degree.