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Katya's Doula Notes

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congenital hypothyroidism Jan. 16th, 2007 @ 12:39 am
Congenital hypothyroidism is one of the inborn errors of the metabolism that is tested at birth, along with PKU, galactosemia, etc. I have recently encountered 2 families that experienced a false positive result on that test, and I put together a little note on this test. Read more...Collapse )

Epidurals and c-section rate May. 29th, 2006 @ 05:32 pm
A contraversial topic, research articles go here.

Epidural and fetal distress May. 29th, 2006 @ 03:26 pm
This is a topic to collect research articles as well as useful reviews relating to fetal distress following epidural administration to the birthing mom.

Cervical length and preterm labor May. 18th, 2006 @ 08:23 pm
This is a post on cervical length measurements, predictive values of 2nd and 3rd trimester findings, incidence of preterm labor, effectiveness of cerclage and/or drugs in helping prevent preterm labor, etc.
Current Mood: working

Induction May. 3rd, 2006 @ 02:57 pm
Notes on inductions (protocols, personal stories, thoughts) go here.
Other entries
» Acid reflux in late pregnancy
Here are some tables of "safe" and "avoid" foods:

Safe foods: http://heartburn.about.com/cs/dietfood/a/heartburnfoods3.htm
Avoid foods: http://heartburn.about.com/cs/dietfood/a/heartburnfoods1.htm

Some of it is going to be individual - for example, banana is listed in the "safe" table, and yet I could not eat one without suffering from heartburn for a couple of hours after the meal, but the overall trends are there.

Finding a way to work the snacks into your day, and therefore decrease the three main meals, is probably a better idea then relying on medication to keep the acid down.

Another suggestion from an obgyn is chewing gum:

If you are interested in natural remedies, here are several fruit extracts you can try - these assist in food digestion and help the food to be moved along more swiftly. These include papaya extract and orange peel extract, available in most natural food stores. Fresh papaya may be even better, although it tends to be pricy around here. Since pineapples are in season, you can eat those instead! Here is some info on these:


Also, some moms find small amounts of active-culture yogurt (consider Dannon Activa, it has a good variety of lactobacteria, or else one of the organic yogurt brands from Trader Joe's) before sleep to be very helpful.
» Edema
Some notes on non-preeclamptic edema:

(A) Evening Primrose Oil (EPO) and water retention (edema). It actually seems that in population EPO fights both pre-eclampsia and edema:

1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1492408&dopt=Abstract
Here is a clinical trial on using EPO to fight preeclampsia. Here is what the authors find:
"Compared to the Placebo group (29%), the group receiving the mixture of evening primrose oil and fish oil containing Gamma-linolenic acid (GLA), Eicosapentaenoic acid (EPA), and Docosahexaenoic acid (DHA) had a significantly lower incidence of edema (13%, p = 0.004)"
(placebo means that the women in that group received a pill without any EPO, for example their pill had olive oil in it)

2. http://www.uspharmacist.com/oldformat.asp?url=newlook/files/Alte/ACF301B.cfm&pub_id=8&article_id=147
It looks like one component of EPO has been proven to reduce edema in arthritic rats.
"When compared with the anti-arthritic drugs indomethacin and methotrexate, amyrin esters (a component of EPO seeds) caused considerable reduction in carrageenin-induced rat pedal edema."

(B) Here are some more natural ways to fight edema:

1. Elevate your feet when sitting or resting (or sleeping in a recliner, as you have been doing)
2. Drink enough water so that your body is not tempted to "hoard" it
3. Eat fish
4. http://wwwumm.edu/altmed/ConsConditions/Edemacc.html - there is a whole list of recommendations there, but I kept the ones that may be relevant to you:

· Eliminating food allergens from your diet decreases inflammation.

· A low-salt, high-protein diet may help edema. (However, you should not eat a high-protein diet if you have kidney disease.) You should also reduce your intake of sugar and refined carbohydrates.

· Add more potassium (i.e. banana a day) to your diet.

· Natural diuretics: asparagus, parsley, beets, grapes, green beans, leafy greens, pineapple, pumpkin, onion, leeks, and garlic.
There are also some suggestions on vitamins in that link, but I would ask your doctor first to make sure she's OK with that.

· Vitamin B6 (50 to 100 mg per day) is a diuretic. The B vitamin thiamine may be supplemented (200 mg per day).

· Vitamins C (250 to 500 mg two times per day), E (400 to 800 IU per day), and coenzyme Q10 (50 to 100 mg two times per day)
Here are some physical things you can do daily:

* Dry skin brushing. Before bathing, briskly brush the entire skin surface with a rough washcloth, loofa, or soft brush. Begin at your feet and work up. Always stroke in the direction of your heart.
* Cold compresses made with yarrow tea.
* Contrast hydrotherapy involves alternating hot and cold applications. Alternate three minutes hot with one minute cold. Repeat three times to complete one set. Do two to three sets per day.
» Iron supplementation
Here is an excerpt from a letter I wrote to a client about iron supplementation:

"Here is the information on the iron supplementation. The articles I will site are well-referenced, and if you are curious about a particular article, let me know so that I can find it and give you a small review of the findings.

1. Here is the information from the Yale New Haven Natural Health. This is a pretty well written article, with good references. I dont' know who the original writers are as I have seen this in several places on the web, but this site is easy to read (for example, links to the articles are hyperlinked). Judging by how it's written, my guess is that it was a review for a scientific journal such as "New Scientist", with a large popular-reader base, that has been reprinted on the web over and over again without siting the author.

This jumps right to the "best form" section (bottom of the page), although you can read it all the way through if you like, it's well-written.


Which forms of supplemental iron are best?

All iron supplements are not the same. Ferrous iron (e.g. ferrous sulfate) is much better absorbed than ferric iron (e.g. ferric citrate). 13, 14 The most common form of iron supplement is ferrous sulfate, but it is known to produce intestinal side effects (such as constipation, nausea, and bloating) in many users. 15 Some forms of ferrous sulfate are enteric-coated to delay tablet dissolving and prevent some side effects, 16 but enteric-coated iron may not absorb as well as iron from standard supplements. 17, 18, 19 Other forms of iron supplements, such as ferrous fumarate, 20, 21 ferrous gluconate, 22 heme iron concentrate, 23, 24, 25, 26 and iron glycine amino acid chelate 27, 28 are readily absorbed and less likely to cause intestinal side effects.

As a summary - there are several other forms or iron supplements that are more bioavailable (i.e. more iron is actually absorbed by the body) AND give fewer side effects. You may want to ask your doctor to try some of them - I heard particularly good things about ferrous gluconate. Heme iron and the amino acid chelate are nice, but tend to be pricy.

I also like the section towards the bottom that lists the foods that inhibit iron absorption (i.e. would not be great to eat those and your iron supplement in the same meal):

Foods, beverages and supplements that interfere with iron absorption include


Green tea (Camellia sinensis). 51, 52, 53, 54 This effect may be desirable for people with iron overload diseases, such as hemochromatosis. The inhibitory effect of green tea on iron absorption was 26% in one study. 55

Coffee (Coffea arabica, C. robusta). 56, 57, 58

Red wine, particularly the polyphenol component (also found in tea). 59, 60 Since wine is also a dietary source of iron, it is not clear whether drinking red wine would lead to a deficiency of iron.

Phytate (phytic acid), found in unleavened wheat products such as matzoh, pita, and some rye crackers; in wheat germ, oats, nuts, cacao powder, vanilla extract, beans, and many other foods, and in IP-6 supplements. 61, 62, 63

Whole wheat bran, independent of its phytate content, has been shown to inhibit iron absorption. 64

Calcium from food and supplements interferes with heme-iron absorption. 65, 66

Soy protein. 67, 68

Eggs. 69, 70

2. Some of the best people to ask about diet influence on the iron bioavailability are the vegetarians. Here are some ways that the vegetarians structure their diets to improve their iron status:


See table #2 and table #3 for great and easy-to-follow guidelines. If you do that AND eat meat daily, trying for red meat 1-2 times a week at least, I think you will find your iron status improving greatly. However, that means no Coca-Cola at lunch time!
Probably one of the key things to to keep in mind is that calcium and iron taken together decrease the bioavailability of both. So whatever iron supplement and/or diet changes you end up choosing, it makes sense to take the iron pill about 12 hours apart from your prenatal vitamin (for example, take the prenatal vitamin in the morning and the iron supplement in the evening).

Best wishes!


» Nuchal cord
Collection of pertinent abstracts.

25%-35% of births feature a single nuchal cord
3%-5% of births have 2 or more loops

There is correlation with low heart tones and meconium, but no long term side effects statistically.
» Acupuncture

Large Intestine 4: Promotes Labour- on the top of the hand on the web; between thumb and index finger.

Bladder 60: Helps with Difficult Labour- LOCATION: Between the ankle bone on the out side of the leg and the tendon on top of the foot

GallBladder 21: Good for difficult labour, promotes lactation, helps with mastitis, postpardum hemorrhage and retention of placenta. LOCATION: on the highest point of the shoulder; between the neck and end of shoulder. ( do not use in 1 trimester)

Spleen 6: Ease labor pain and speed labour along LOCATION: fingerbreadths up from the inner ankle bone behind the tibia ( do not use unless in labour)

On each point press down from 5-20 seconds repeating as needed.
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