5 Top Tips for Surviving the Fourth Trimester

If you are on my e-mail list you have already met the newest addition to our family, Jack! He is 6 months old and loving eat solids (check out my starting solids course here), playing with his brother’s toys, and watching the kitties. Here I share some of my favorite tried and true tips for making it through those first three months postpartum. These tips are a little more lifestyle based, future blog posts will cover other natural recommendations for healing in the postpartum period.

Meal train

Have a friend or family member set up a meal train. This is super easy to do - you just need to collect e-mail addresses and share them with the person in charge of organizing your meal train. This website is free and easy to use. I would recommend encouraging people to bring you warm foods, like soups, stews, curries, etc… These types of foods are nourishing in those first few months postpartum and beyond. No meal train is too small! Never underestimate the benefit of getting a meal delivered - I know the meals that we had delivered seemed to come at just the right time.

Fancy jammies

Get yourself some special jammies or loungewear. You are likely just going to be switching from day jammies to night jammies for at least the first two months, so have something that you enjoy wearing and makes you feel special. If you plan on nursing or pumping make sure that the tops are easy access - buttons are ok, but snaps are even easier. I really enjoyed this nightgown for the snaps!

Tea instead of coffee

Switch from coffee to a cup of nourishing tea for at least the first month postpartum. I live in Seattle, so coffee is basically life here. I was surprised to notice that a cup of mineral rich tea gave me a similar energy boost! Caffeine can be stimulating and anxiety producing and this is not helpful in the postpartum period. I really loved the Nutritive Tea that we sell at Neighborhood Naturopathic. It contains nettles, red raspberry leaf, spearmint, lemon balm, dandelion leaf, oat straw, alfalfa, and ginger.

Netflix

Find yourself a guilty pleasure to watch at 2AM when you are up with baby. Babies take at least 6 weeks to find their circadian rhythm and produce melatonin, so it is normal for them to be awake for hours in the middle of the night and sleep for hours during the day. Expect this to happen. And having something fun to watch makes those middle of the night parties fun! I really liked Workin’ Mom’s because the episodes were short and funny, but find something that provides you with some entertainment!

Stretching

This is oh so important and easy to skip. Carrying and feeding a baby can cause some significant strain to your neck and upper back muscles, so make it a habit to do 5-10 minutes of stretching those muscles on a daily basis. Doing some gentle neck circles, doorway stretch (google it!), and cat/cow daily can help to prevent muscle strain.

These simple tips can go a long way in making your postpartum experience an enjoyable one!

Probiotics can help treat postpartum anxiety and depression

Postpartum mood disorders are common

Did you know that depression is the most common complication of childbirth? Postpartum mood disorders (like anxiety and depression) affect one out of every seven women and one out of every 10 men.

A variety of factors can lead to postpartum mood disorders

Postpartum mood disorders are likely due to a combination of the following factors:

• Sensitivities to hormonal changes - this includes the hormonal changes that normally happen after childbirth and also the shifts in hormones due to lack of sleep. Some people are super sensitive to this changes, which can result in depression and/or anxiety.

• Genetic predisposition - some people have mental health disorders that run in their family, so this makes them more vulnerable to mood disorders at times of change, especially in the postpartum period.

• Psychological sensitivities - this might include rocky relationships with parents or partner, perhaps this was an unplanned pregnancy, or self-image or perfectionism is involved. These factors can lead to postpartum mood disorders.

• Social factors - if there is poor social support of the family or friends, institutional/structural racism, social media, all of these factors can contribute.

Treatment options

Treatment for postpartum mood disorders ranges from counseling/therapy, prescription medications, and if you are working with a naturopathic doctor (like me!) herbal medicine and other nutritional supplements are part of the treatment plan.

How probiotics help

There is growing research that connects gut bacteria (probiotics) to brain chemistry and behavior via multiple pathways, called the “microbiome-gut-brain-axis”. One study showed that women who supplemented with probiotics, specifically lactobacillus rhamnosus, had fewer symptoms of postnatal anxiety and depression. This is consistent with other studies using different types of probiotics.

We know that postpartum depression can be associated with a sensitivity to changing levels of hormones, like estrogen and progesterone. The probiotics that live in the digestive tract are associated with estrogen levels. Some probiotics help to change estrogens into their most active form, which would impact low estrogen levels in that postpartum period. So, it is thought that supplementing with probiotics can help support mood in the postpartum period by helping to balance hormones, so to say.

Probiotics have also been shown to play a role in the hypothalamic-pituitary-adrenal axis (HPA axis). This axis is our stress response and probiotics help to make this system more flexible. This stress system is definitely activated in the postpartum period and probiotics might help to make this system more flexible in times of change.

Where to go from here?

There is growing research that shows that probiotics can be beneficial to help prevent postpartum depression and anxiety. Probiotics are safe to take during pregnancy as long as you check with your doctor or prenatal provider first. It will be interesting to see how research regarding probiotics and the postpartum period will evolve.

References:

Rackers HS, Thomas S, Williamson K, Posey R, Kimmel MC. Emerging literature in the Microbiota-Brain Axis and Perinatal Mood and Anxiety Disorders. Psychoneuroendocrinology. 2018 Sep;95:86-96. doi: 10.1016/j.psyneuen.2018.05.020. Epub 2018 May 17. PMID: 29807325; PMCID: PMC6348074.

Sanders A, Rackers H, Kimmel M. A role for the microbiome in mother-infant interaction and perinatal depression. Int Rev Psychiatry. 2019 May;31(3):280-294. doi: 10.1080/09540261.2018.1548431. Epub 2019 Feb 20. PMID: 30784334.

Slykerman RF, Hood F, Wickens K, et al. Effect of Lactobacillus rhamnosus HN001 in Pregnancy on Postpartum Symptoms of Depression and Anxiety: A Randomised Double-blind Placebo-controlled Trial. EBioMedicine. 2017;24:159-165.