Mind Pump: Raw Fitness Truth - 1060: Stephanie Greunke of the Whole Mamas Podcast

Episode Date: June 24, 2019

In this episode, Sal, Adam, and Justin speak with Stephanie Greunke of the Whole Mamas Podcast about health and nutrition pre, mid and post pregnancy. Why she created the Whole Mamas Club? (2:40) The... misinformation surrounding pregnancy in our current culture. (5:21) How we are NOT eating in a way that is optimal for our health and fertility. (7:52) What are the common nutrition issues, she sees, with women NOT able to get pregnant? (10:14) What foods support healthy pre-conception pregnancy and post-partum? (12:00) The first trimester: What to look out for and expect. (16:54) The importance of sunlight pre and post pregnancy. (19:22) Why you SHOULD exercise while pregnant. (21:19) The fears surrounding birth. (27:47) The microbiome, probiotics, and birth. (35:19) The changes of nutrition pre, during and post pregnancy + the mysteries surrounding cravings. (38:35) Why she is an advocate of ‘maternal mental health’. (44:45) The ‘Four R Approach’ to mental health post-partum. (48:23) What can you do to set yourself up for success pre-baby? (54:40) Exercise recommendations post-partum. (58:34) The benefits and struggles surrounding breastfeeding + alternatives to breastmilk. (1:01:42) What are the best things a father can do to support this process? (1:12:44) Gestational diabetes and when/what to test for. (1:14:45) Featured Guest/People Mentioned Steph Greunke, MS, RD, PMH-C (@stephgreunke)  Instagram Website Whole Mamas (@wholemamasclub)  Instagram Website Podcast Melissa Hartwig Urban (@melissa_hartwig)  Instagram Related Links/Products Mentioned June Promotion: MAPS Strong ½ off!! **Code “STRONG50” at checkout** Exercise in pregnancy! Aerobic exercise during pregnancy influences infant heart rate variability at one month of age. Episode #62: Birth Traumas with Dr. Pauline Dillard, Ph.D. Meal Train | Meal Calendar for New Parents, Surgery, Illness, and More Mothers' Milk Bank | Get Breast Milk For Your Baby | Saving Infant Lives Goat Milk Formula | KABRITA USA Maternal Gatekeeping & Why It Matters for Children Five Questions With: A Gestational Diabetes Nutrition Expert

Transcript
Discussion (0)
Starting point is 00:00:00 If you want to pump your body and expand your mind, there's only one place to go. Mite, ob-mite, up with your hosts. Salda Stefano, Adam Schaefer, and Justin Andrews. Man, I am a... I'm in full daddy mode getting prepped to be a father. Yeah, I enjoyed this episode with Stephanie. She talked a lot about nutrition, pregnancy, nutrition, pre, during, and then post pregnancy nutrition. Love this.
Starting point is 00:00:31 Yeah, there was a lot of great information and insight. And Stephanie Grunk, I hope I'm saying her name right, she has a podcast called Whole Mamas podcast. And it's all about like healthy eating. It's connected to the whole 30 if I'm not mistaken, right? Yep, she's connected to them. She's also good friends with our other two doctors that we had just recently on the show, so they were all kind of in the same circle. And I actually didn't find that out till later,
Starting point is 00:00:52 till we actually had each of them on the show and then started to talk to them. Oh yeah, I know each of them. Yeah, they all know each other. No, this is a great episode in regards to nutrition, especially for women, and especially in regards to things like pregnancy. So we know you're gonna enjoy this episode.
Starting point is 00:01:09 You can find Stephanie at WholeMama's Club. You can also find her online at Stephanie at Whole30.com30 is 3-0, not spelled out. And then the website, of course, I mentioned already was WholeMama's podcast. Now before we get going, I do want to tell everybody that maps strong is still 50% off. It's the month of June after this month, this program will not be on sale again. Map Strong is one of our best muscle-building metabolism-boosting programs. Here's what you do to get the 50% off. Go to mapsstrong.com, M-A-P-S-S-T-R-O-N-G.
Starting point is 00:01:50 And use the code strong50, S-T-R-L-N-G, 50 for the discount. So that's it, without any further ado, here we are talking to Stephanie Grunkey. All right, well, step, I'm excited to have you on the show. I think we connected about, I wanna say about six months ago, when we first started talking, is that right? Yeah.
Starting point is 00:02:09 The sound about right? Which is right around the same time that Katrina and I got pregnant, why me, she got pregnant. Is that right? Is that politically correct when you say that? I think you didn't, yeah, you can tell. Am I allowed yourself, am I allowed to say that? You're involved in it too.
Starting point is 00:02:21 Yeah, yeah, I felt like I was involved in it. So I think, I think I can say that. But I really wanted to have you on the show. I know that you're part of the whole 30 group, is that correct? Yeah, I am the program director for a whole Momma's Club, which is the motherhood arm of the whole 30. OK, so let's talk a little bit about how that evolved first, and then we'll get kind of into your personal story.
Starting point is 00:02:42 Yeah, sure. So I am a registered dietitian. When I became pregnant, I saw that there was a lack of great information out there about pregnancy. There's a lot of fear mongering. There's a lot of controversial topics. And so even as a dietitian who had been helping women through the pregnancy process, I did really stop and look at the literature and figure things out
Starting point is 00:03:05 for myself. And I have a lot of friends and colleagues that are in the field that understand pregnancy. And even with all of that information, I was still a little bit confused at what I could believe in in such a vulnerable time like your pregnancy. You want to make sure you do it right. And so I actually talked to Melissa Hartwig, who is the co-creator of the whole 30, her and I have been friends for a while, and she had a similar experience. She got so much different information about her pregnancy, and she wanted to make sure that she was using the most evidence-based information. And so we thought, why don't we create something that is like that, a one-stop shop where women can come and get everything that they need to know about pregnancy
Starting point is 00:03:48 and they can dive in as deeper as, you know, as shallow as they want to with information and talk about things like pregnancy exercise, the nutrition and supplements in lab testing and what to do with your partner when you have this new baby and just really get the woman ready in this time where she may not have the greatest information available. So yeah, we decided to come up with this program originally it was a webinar, but as I was putting together the information, it was pretty much a book. And so we decided to create a pregnancy program that really gave women all the tools that they needed from a non-judgmental non-fear-based perspective
Starting point is 00:04:26 so that they could make a decision based on what they learned for themselves and decide what was best for themselves in their family. Now, you guys also have a private forum too, right? How does that work? Yeah, so with the purchase of the program, they can get access to a private Facebook group. And it's moderated by myself and other health professionals like OBGYNs.
Starting point is 00:04:46 We have registered nurses in there. We have IBCLCs. And so they come, they can join our private Facebook group. They can talk about things that they don't feel comfortable talking about with maybe their friends or having that, they have a screen in front of them, not a person in front of them allows them to be a little bit more vulnerable with things. Also, if they are experiencing loss, if they are just newly pregnant, and they want to tell somebody, but they're not quite 12 weeks yet,
Starting point is 00:05:13 they can come in, it's a safe space where really everybody gets to know each other, and there's no shame, and that's really hard to find these days. Stephanie, if you wouldn't mind, could you talk a little bit about some of the contradicting or misinformation that we tend to see a lot, especially in modern societies, because I recently had my mind blown with the whole pregnancy and birthing process. I had one of our listeners actually challenged a statement I had made on a earlier podcast where I had said that for, you know, I was mistaken and I said, yeah, having a child is one of the most dangerous things you could do in terms
Starting point is 00:05:50 of, you know, birth and this person was a midwife and she contacted me and she's like, actually, that's totally wrong. Set me all this literature. I read it and my mind was blown. Could you mind going over some of the contradicting or just some of the wrong stuff that we tend to believe in societies like ours? Yeah, I mean, we're doing a start. There is lots of misinformation about gestational diabetes. There's lots of information about what a healthy prenatal diet looks like. And then like you just said, there's a lot of misinformation, a lot of fear among what labor and delivery looks like and how we are in this like very vulnerable period of time and we're open to things that can go wrong in the
Starting point is 00:06:32 medical field. And I think that is emphasized by the fact that people that share about their birth stories often share what went wrong and the bad things that happened to them. And that's what sticks out in people's mind, even if they heard 10 stories and eight of them were good, they're going to remember those two where something went wrong. And so I think we're going into labor and delivery with this fear already there. We are going into bright lights in a hospital setting
Starting point is 00:06:59 and we don't really know what to do. So we leave our control at the door when we enter that hospital. And we put it in the hands of providers that really do want to keep us safe. But they may not be giving us all of the information that we need to make the best decision when we're in labor. And what I like to tell people is that the same conditions that get your baby inside of you,
Starting point is 00:07:21 that calm, that safe, that dark, that really just feeling of being in control and being intimate are the exact opposite of what you're going to find at the hospital setting, the bright lights, the new people coming in, the shift changes, and what helps baby get out is the same thing that gets baby in. And so if we can really reduce the fear, really feel in control, really have the information that we need, we are going to be able to birth in a more safe and more effective way. Can we start at the beginning then at prenatal nutrition and activity? You know, I was for a long time, I thought, you had
Starting point is 00:08:00 to treat, you know, pregnant women like they could break. And so you had to be very, very careful with certain things. And as I started training women, especially fit women who exercised before they got pregnant, I realized that they were incredibly capable of great physical pursuits. And these were women who already fit, by the way. And I was always blown away at how fast they recovered.
Starting point is 00:08:23 Can we start at the beginning, I guess, before pregnancy? How do we create the, because when I look at statistics today, and I don't know what those numbers are today, but an incredible, maybe alarming amount of women now are needing medical intervention to get pregnant today. Something that's, you know, such a natural thing that we've almost had for most human history, we've kind of been afraid of, oh my gosh, it's so easy to get pregnant now. It's like we're spending all this money on hormones and things to make this process happen. What's going on there? What do you think's happening? I think there are a lot of things going on. I think when we
Starting point is 00:08:58 look at our nutrition, we are not eating in a way that is optimally healthy for not only our overall health, but our fertility specifically. We are really stressed. We have so much stress, whether that is external, whether it's our job, whether it is the environmental toxins, whether it is the fact that we're eating inflammatory foods that are causing that inflammation or system. So we've got a lot of inflammation, a lot of stress, a lot of nutrient deficiencies.
Starting point is 00:09:28 We are more overweight and obese than ever. And I think it's hard to pinpoint one thing of why we're dealing with a such high cases of infertility and IVF, but there is so much that we can do based on how we're eating, moving, thinking, and feeling that can lead to better outcomes. And it's not just the female that's involved. It's also making sure that we get the male on board. And the man having a BMI within a healthy range and the man taking control over their health,
Starting point is 00:10:02 really looking at drug and alcohol use and exposure to environmental contaminants themselves, because it really is, we're looking at like 50, 50 picture male and female. So what are the more common things that you see where, you know, woman comes to you and they're like, I haven't been able to get pregnant. We've been trying. Yeah. I seem otherwise healthy, but it's just not working.
Starting point is 00:10:24 What are the common things that you see tend to be the issues, maybe with nutrition, for example? Yeah, well, one of the common things that I see with nutrition, for example, is looking at how mom is consuming folate or folic acid in her diet. So there is a genetic mutation called the MTHFR, which up to 60% of women have. And if they don't consume enough fully in the form that their body responds to, they
Starting point is 00:10:50 are going to have a hard to harder time getting pregnant and sustaining the pregnancy. So that is one thing we want to do. So I'm genetic testing things like their thyroid levels. So making sure that they have optimal TSH, making sure that there is low to no antibodies that are there that could be preventing the pregnancy. Because we know that there is a huge demand on mom's thyroid when she becomes pregnant because baby requires mom's thyroid hormones to carry them through the first trimester. And then the baby can start making their own in the second trimester.
Starting point is 00:11:23 So looking at mom's thyroid health, looking at moms, nutrient status making sure she's got sufficient levels of folate. And what's really interesting is that the nutrients that help moms conceive and help carry her through that first trimester are ones that often the birth control pill are pulling. One's that stress are pulling from us. And so I really like to get mom as soon as possible when she's thinking about conceiving so that she can be on a prenatal vitamin and she can start replenishing some of those deficiencies that the birth control pill or stress or a lack of it in the diet has
Starting point is 00:11:59 cost. What are good natural sources of some of the most important nutrients that she may need? Yeah. So a couple of my favorite foods that really support healthy preconception, pregnancy and postpartum are ones that include like iron, B12, folate, omega-3s, colon, and these foods are a lot of animal-based. I was just going to say you're not going to find a lot of those in vegan diets, are you? Yeah, so eggs are one of my favorite foods. They contain so many nutrients that are supportive
Starting point is 00:12:31 for a healthy pregnancy and pre-conception period. I love salmon. Salmon is really, it's one of those things where women are told to fear fatty fish. They're told to fear for a fish in general because of the mercury. And I think was something like that. Our fear of these foods is preventing us from eating them and preventing us from getting the array of nutrients that they're providing. And so women are told to fear mercury,
Starting point is 00:12:57 but they're not told about how important DHA is. And so they're limiting these foods that are really supportive for their baby's brain development, nervous system development. Later in life, they're IQ memory and for mom's mental health too. So eggs, salmon, leafy greens, natural source of folate. Again, we want folate and not folic acid and pregnancy. Things like liver, another controversial food, and it's not that we need a ton of it, we don't need a ton of liver.
Starting point is 00:13:30 You know, there is concerns over vitamin A toxicity, but actually pregnant women and infants really need that vitamin A for healthy immune system function and lung function and to support the facial formation. And it's just, it's unfortunate that some of these foods that we're afraid of are actually the most nutrient dense foods. So the eggs, salmon, liver, leafy greens, bone broth, is really supportive if you think about all of the tissue, the connective tissues, and all the growth that's happening,
Starting point is 00:14:03 and the bones and skins and skin and teeth, we really need that bone broth and that collagen and that glycine to help build not only mom's growing body but baby's growing body. So I love bone broth. No, I know it's kind of a generic question to ask you this because I know there's such an individual variance between everybody. But what would you say is a good amount of these foods that you should have in the diet? What would be pretty low or very low? Then what would be maybe the extreme where that's more than enough?
Starting point is 00:14:30 Maybe give me a range. Yeah, so let's talk about eggs for instance. With eggs, what we are looking for, one of the biggest things in eggs that we are often missing is colon. Colin supports placental function, colon supports memory, colon supports learning, and just a lot of nervous system, brain system growth. And in one egg, we're looking at about 150 milligrams of colon. What is recommended for pregnancy is about 450 milligrams. But when you're looking at the research and what supports optimal outcomes, the amount of cooling that's actually beneficial is about 930 milligrams.
Starting point is 00:15:08 Oh, wow. So you're doing like eight, nine eggs a day. And these are, and this is in the yolk, right? The yolk is what contains, that's important to know. Which is what people are feared, you're not afraid of. Yeah. Yeah. So, you know, I think when it comes to the RDA standards, they're to prevent deficiency or
Starting point is 00:15:24 prevent a disease state. They're not necessarily to prevent, or to boost the outcome of mom and baby. And I think that's important to note because if we're looking at the RDA, a lot of these are actually based on adult men. And then they figure out what pregnant needs are by these complex formulas that may or may not be accurate.
Starting point is 00:15:44 And in a lot of cases, we see the RDA for vitamin B12 is three times lower than what it actually should be. DHA and EPA, 300 milligrams of DHA and EPA is a great place to start, but that's really a minimum. You want to be shooting for more like one to two grams a day, it would be better. So in your experience, do you see people grossly under-consuming these foods? Like how often do you even see somebody over it? Sounds like it'd be tough to even over eat.
Starting point is 00:16:13 Yeah. And when you think about eggs, for example, most women are having what? Two eggs. It's very rare when you see women eating three or four eggs, which is what I like to do. And so back to your question, it's not that we should be eating eggs necessarily, because that's a lot of eggs. Colleen comes from egg yolks, like we were talking about an also liver, but women aren't often eating liver.
Starting point is 00:16:34 And so what I like to do is try to fill in the gap by having them eat the egg yolks, but also having them have a prenatal vitamin that has Colleen in it. And that can help make sure that mom is getting what we, she needs, for example, if she's in the first trimester and eggs are the last thing in the world that she wants, that would help support her through that. Well, let's talk about the first trimester.
Starting point is 00:16:55 Now, some of the things that I noticed and maybe, and I'd like to hear you, maybe revisit you, grazed over, glazed over the thyroid. Katrina, I remember would be so tired. Like around five, six o'clock, she would just like pass out on the couch, which she never did that before. So what are some of the things to look out for
Starting point is 00:17:15 in the first trimester and what to expect, both not just nutritionally, but also physically what's probably going on with her? Yeah, so I wouldn't say that. She had a low thyroid status or anything like that if she was tired. It's very common around week six to eight. There is a lot of development that's happening
Starting point is 00:17:33 and that's causing mom to just naturally be tired and slow down. And if you think about it, that's really beneficial for the baby because the more that mom slows down, the more that the baby can stay safe in the first trimester as they're developing. And it is a huge energy demand. So women will feel tired.
Starting point is 00:17:51 That's for sure. Nausea is so common, 80% of women experience some form of nausea and vomiting. And there's different degrees. There is just the morning sickness and then there's also all day sickness. And there are people that actually have a condition called hyper-emissive gravaderum. And that's up to 3% of the population. And that is when they need to be hospitalized because they are extremely dehydrated. They can't even brush their teeth a lot of times. They just have to take tiny little sips of water. They can't fathom eating anything. And that is a different case. But so those
Starting point is 00:18:27 are very common. You know, you see this represented in the gym too. I know one of the first things that made me think, well, maybe I'm pregnant is my gym performance just tanked because I was so tired. And I remember beating myself up before I knew I was pregnant because I'm like, why am I so tired? Why is this? Why is this?? My trainers knew I had a competitive spirit, so they kept kind of trying to push me, but my body was telling me to slow down. So those are some really common things that will happen. Now, when we were talking about nutrition earlier, these are the same kinds of things you'd want to continue eating throughout your pregnancy, correct? You got it. Yeah, absolutely.
Starting point is 00:19:03 And then even into your postpartum, which that's a really interesting time a lot of times, we'll stop our prenatal vitamin. We will eat the casseroles and the cookies and the things that come to us from while meeting friends. And we will be so focused on taking care of the baby that we don't take care of ourselves and we aren't nourishing our own.
Starting point is 00:19:21 I have a question for you. What role would sunlight play in all of this? I've recently been reading quite a bit about the impact of just getting out in the sun and health. How important is getting out and getting exposure to the sun's rays, pre and during pregnancy? Oh, I think it's really important. So when we're looking at the vitamin D needs us
Starting point is 00:19:42 and now they're really interesting when you're talking about how much you about like how much You needed how much is recommended and so for pregnancy 600 I use of vitamin D is recommended when the leading researchers in vitamin D Think it should actually be 6000 I use a 10 times more and when you're looking at how much is in a prenatal. You're getting maybe 400 IU, 600 IU. So significantly less. And so getting out in the sun is really important to help mom produce vitamin D.
Starting point is 00:20:12 90% of the vitamin D that comes in is either through sunlight or synthetic. We barely get any from foods. Yeah. So a couple of tips. There's a couple hacks you can do, and I don't know if you've tried this before and I think these are important for people because People don't like the taste of organ meats. We don't eat them that much in modern societies So one thing I like to do is I'll take like a liver and I'll ground it ground it up and I'll mix it in with some ground beef Or some ground lamb and make patties and I'll even throw in some yolks in there. And then you get your yolks, you get your colon,
Starting point is 00:20:47 you get your vitamin A. In organ meats, you can also cod liver oils, a great source of vitamin D. So sometimes for supplementing, if you wanna get more omega-3s, cod liver oil will give you the D with the three as well. But what's interesting about all of this is, when we talk about what we're finding
Starting point is 00:21:03 to be the best thing, it all brings it back to, I guess, kind of how we evolved. Really, I mean, lots of vitamin D. Well, yeah, we were on the sun all the time. And all these organ meats and whatnot, these are the foods that we probably prized the most, which brings me to activity. I think for a long time, we've been led to believe that, or at least it's been insinuated that pre- and during pregnancy, that we need to not move and treat ourselves very carefully, but I can't imagine that being how humans evolved while going for most of human history. How do we look at activity with all of this? Yeah, I'm glad you brought that up because I feel like we're, the tides are turning when
Starting point is 00:21:46 it comes to physical activity. We used to think that pregnant women shouldn't move that they are in a very vulnerable position and really keep them safe. And I know my mom was still not exercise during her pregnancy and my grandma. And you still in some cultures have that belief that exercise during pregnancy is somehow harmful. And the fears are usually circulating around restricted blood flow to the fetus, so you're reducing the oxygen and you're also reducing the nutrients.
Starting point is 00:22:11 And so there might be a little birth weight concerns or preterm delivery. But when you're looking at what the organizations recommend, so American College of Obstetricians and Gynecologists, which is the leading board, and common sense, would tell you that exercise during pregnancy is not only safe and very beneficial, and there's there's no question that it's beneficial for both mom and baby. And so when it comes to looking at why it would be important for mom, we want to really reduce the risk of pre-clampsia and gestational diabetes as much as possible. And we know that exercise exercise has a strong influence on that. We want to make mom feel very confident and comfortable during her pregnancy, especially as she's changing her weight and her body composition is adjusting to the pregnancy.
Starting point is 00:23:06 We want to reduce pain, and so if we can strengthen mom's back and really help with the increase in her breast and her belly, you know, it's not uncommon for a woman to go from like a size B cup to a double D cup or beyond during pregnancy. So you have that extreme growth, and so you need to make sure that you're supporting that. And then also supporting the lower back with exercises that really help with the glutes and help kind of pull that belly back. And so, mom is in more alignment. So that's for sure a benefit. And, you know, we do see that there is a reduced risk or reduced evidence of cesarean bursts in moms at exercise.
Starting point is 00:23:43 We see that they tolerate the contractions and the labor a lot more because they're used to that like on and off of exercise. And I think that's something that you won't read in the research, but it's very true, is if you think about, I like to say, you know, when you are mentally preparing for labor, it is as mentally and emotionally challenging
Starting point is 00:24:04 as it is physically, too, because you just don't know. You're scared. You're trying to really fight through the contractions. And so I like to say that the four more sets in the weight room equates to four more pushes in the delivery room. You're able to kind of push yourself through it and feel motivated and confident that you have that. And so if we can even do, you know, for resting in between sets at the gym with weight training or if we are doing some cardio and we're having that rest, that replicates what's going on in labor and delivery because you're having that strong contraction and then you're having that relaxation and that strong contraction, that relaxation.
Starting point is 00:24:39 So being able to kind of power through that mentally is really important. As far as babies go, we know that moms who exercise have babies with better heart rate variability. That's really important. We know that that can lead to lasting impacts on the baby as far as their verbal skills and their efforts in school, their performance in school. So, babies for sure benefit, babies are getting, if you think about with exercise, exercises bringing more nutrients and blood into the baby. So, babies really getting nourished. Yeah, the way I see it is funny, because there was a study a long time ago that people used to defend why we should say that they that pregnant women
Starting point is 00:25:26 shouldn't exercise and the studies show that women who exercised regularly during pregnancy had average lower birth weight children. So everybody's like, oh, there you go. There's your evidence right there. But then when you look deeper, you find that the babies were the same length, same heads or conference. They were leaner. And there's other studies that show that things that the mother may eat or experience, that the child's genes almost are primed to bring them into this new life or new world. So if the mother's active, it's more likely, it makes sense that the baby, the baby's genes are going to be more primed for a more active lifestyle, kind of prepare the baby. What does that look like for a mother
Starting point is 00:26:05 who, or an expecting mother who doesn't really exercise and who's just like trying to do the best, they can to get into the actual labor and delivery of it, but maybe now is like trying to make this something that's in her lifestyle. Yeah, I think it's good to define exercise as more of movement during pregnancy. So we're not talking about doing your hardest workout, your hardest high-intensity course. I'm not going to name names, but it's not talking about going there.
Starting point is 00:26:37 It's talking about just moving your body on a daily basis, getting up instead of just sitting all day, getting up and taking a little bit of a walk. And so it's not that it's all or nothing when it comes sex or size. If we can just be moving, getting our heart rate up, however that looks, whether that is taking a walk or going on the elliptical or doing a Zoom class, we're gonna see benefits.
Starting point is 00:26:59 Yeah, the way I would always explain it and correct me if I'm wrong, staff is, I would tell people to not work out any harder than they had been. So ideally, you'd want to work out before you got pregnant and then just kind of maintain your fitness. You're not trying to get in shape when you get pregnant. But at one point you made that I think is really,
Starting point is 00:27:18 really important that needs to be reiterated is, because I've seen two childbirths and I've had lots of clients have babies, I've had a few of them do it naturally. It's a, it's a bit of a marathon. It requires a level of fitness, like it's not easy giving birth. And so if you go into it totally out of shape, I can obviously the odds that you're going to need medical intervention are going to go up because you don't have the strength to
Starting point is 00:27:43 get your body through that process. You have two children. How did that go for you? Yeah, it takes a lot of mental and emotional resilience when you're in labor for sure. You just have no idea how long it's going to take. You are in so much pain. You don't know if it's going to be an hour or 10 hours.
Starting point is 00:28:01 I mean, the average first birth is 12, 16 hours plus. So that's a really long time. That's you are in labor and it might not be strong contractions the whole time, but if you think about it, I mean, just the emotional load of knowing that a baby is coming and it's going to come out of you and it might be eight or nine pounds is really taxing. So yeah, I had two kids. I decided to have home bursts with both of them, actually. So I have a four and a half year old, and the two and a half year old. And my four and a half year old, when I got pregnant with him,
Starting point is 00:28:31 I just, I never liked being in the hospital setting. And that's why, as when I became a registered dietitian, I knew that that wasn't the kind of work that I was gonna do. I needed to go into private practice because I didn't wanna be in a hospital. So right there was in my inclination that maybe a hospital birth isn't right for me because
Starting point is 00:28:47 I just don't like the smell and the lights and all the people and I didn't want to be like moaning and screaming with a bunch of other people around me. And so I decided to have, I thought I was going to either have a home birth or a birth center birth. And I chose to do a home birth just because I didn't want to leave the house. And actually my husband was in favor of it too because he didn't want to have to leave the house. He wouldn't just be able to like rust in his bed and all of that and watch shows. Well, I was in birth, so in labor.
Starting point is 00:29:12 So yeah, I had a home birth. My first one was six and a half hours, which is pretty short for a first birth. And this is what the man was. Yeah, and did you use water? Yeah, I was in a tub. Yeah, so I did use water or? Okay. I was in a tub, yes. So I did a water birth, which, man, if you're interested in it, I highly recommend it. And I will talk to you all about it
Starting point is 00:29:31 because it was really, it really relieved a lot of the pressure when I got into the water. And I was able to just really focus and not have, you know, all these lights on me and people distracting me and do my thing in the tub. And my second was also a home water birth and he was born in two and a half hours. My son, my fort where he was two at the time, he was sleeping in the room next to us the whole time. And so I share that story not to like brag about my home birth or say that that's how it always is,
Starting point is 00:30:02 but I think there is a lot of fear when it comes to birth. And I think it's important to share really happy, good stories in addition to really understanding the risks that are out there as well. Well, when you, we treat birth like a medical emergency for this, because so both of my kids were born in the hospital. And I didn't know any better, but you walk in, and it's like, what's going on?
Starting point is 00:30:22 What, you know, how dilated are, okay, we need to give you Patocin. This is not happening fast enough. Patocin is a, you know, it's, it makes the hormone that makes your body contract even more. Now it's even more painful. Oh my God, you can't bear it.
Starting point is 00:30:35 Let's give you, epidural. Epidural, okay. Now you're numb, everything feels good. Oh, the baby's not moving, you know, moving through properly, probably because you're numb from the epidural. Now we gotta do a C section and it's this whole kind of insane emergency process. And then I was really shocked to learn that the doctors that deliver babies aren't necessarily
Starting point is 00:30:55 birth experts, they're surgeons, they're experts at surgery, the people who are experts at delivering babies are midwives, totally different experience from what I've seen now through my own research. Yeah, no, that's true. You know, one of the things that I was taught during my child birth classes was that in OBGYN is trained in surgery, and he's very, or he or she is very good at that.
Starting point is 00:31:19 But they may have never seen a true physiological birth, meaning an unmedicated, an unbirth, no intervention. Yeah, that type of birth, which is really interesting. And it kind of just shows that, you know, midwives really understand the birth process on multiple levels. Some of them are moms themselves. They understand the pain. They understand the different stages of labor.
Starting point is 00:31:43 It's really interesting. They can actually tell the size of your baby. I feel like a lot better in the third trimester than an ultrasound will. Ultrasons are notoriously inaccurate in the third trimester. So yeah, midwives really just get it on an emotional level and a physical level. And they are able to offer other alternatives when it comes to pain.
Starting point is 00:32:08 Instead of saying, here's an epidural, like here, let's get into this position. Or let's try this like a homeopathy or an herb or some kind of herb to help. Yeah, now during your first birth, were you in BB honest? Were you ever in the middle of it going, okay, I want some drugs like this is, this is painful, so scared in the shadow me, or were you like, no, I'm good the whole time. Yeah, in the first I was for sure, because I had no idea, I mean, that's one of the reasons I wanted to have a birth at home to is
Starting point is 00:32:39 because I didn't have an option. Like, if I needed to tap out, like, I would have to go to the hospital. And so I kind of chose that to avoid my chance of, because I mean, it's so painful and you just don't know. And so if I was in the hospital who knows, I could have asked for an epidural at the time, but since I was at home, I wasn't. So yeah, it wasn't, it was so fast for one. But then I knew what the whole, I knew what the process looked like. I actually told my midwives where I was in the stages of labor because I was so connected with the baby.
Starting point is 00:33:15 And I understood that, yeah, it's painful, but babies do come out eventually. And there is an amazing prize at the end. Yeah, one experience. So my wife and I had a doula actually come with us, which I highly recommend if you are going to go into medical setting, just because ahead of time, she was able to really kind of keep within what we wanted to happen, because they were throwing all that at us and trying to get us to medicate and do things and not change positions and things like that. to medicate and do things and not change positions and things like that. So I definitely am glad that she was there to kind of vouch because I didn't know what's
Starting point is 00:33:49 going on. As a father either, doing my own research and everything, it's just like, you don't know what it looks like until it actually happens. Are there differences in the chemicals that are in the neurotransmitters and whatnot that are released after having a baby in a natural childbirth versus one that is maybe, you know, where you're using things like Potosan or C-section, for example, because I know that there's bonding chemicals that are released in both for mother and child. Are there differences? Do they have any studies that show that?
Starting point is 00:34:23 Yeah, well, if you are for pregnancy, for example, there is natural painkillers that are secreted. And that is part of the process and that's kind of what helps you get through the contractions. And even the types of contractions are different with if you have an epidural or a patosin, or I should say patosin and a natural birth because with a natural birth, you kind of have longer waves and then you have a rest period in between them with betosin that those waves are shorter and you have less time to rest so they feel more intense. So, yes, during pregnancy for sure, there is more of those natural pain killers that are released. And then after birth, I'm not quite sure the answer on that,
Starting point is 00:35:00 but you know, when you are giving any intervention, there are side effects that may come with that. And there are there is alterations and hormones that come with that. And I don't know that we don't all the exact details of it, but, you know, yeah, it is possible that could be. One thing that we've been talking quite a bit about recently is how babies are introduced to the mother's microbiome, both through the birth canal and then through breastfeeding. And so the question that I've gotten from people is, should I supplement with probiotics during pregnancy or should I? Is there anything
Starting point is 00:35:39 I can do to increase the diversity of my child's microbiome? Because now they're connecting it to food allergies and stuff like that. Do you have any recommendations along those lines? Yeah, actually, there's some evidence that babies exposed to mom's microbiome in utero. So they actually see, they thought that the amniotic sac was sterile and they're not seeing that. They're actually seeing there is microbiome or there is a microbiome in the placenta and in the amniotic fluid And so it's not just you know like we thought it's not that babies first exposed with the vaginal birth It's not throughout the the pregnancy and then for sure during birth then for sure with breastfeeding then for sure skin-to-skin Environment too when mom or dad is holding baby there being exposed. So yes, I do recommend probiotics, and I recommend them for a variety of reasons.
Starting point is 00:36:30 You do want to make sure that moms, not only her gut microbiome, but her vaginal microbiome is replete in the species that need to be there, like lactobacillus in the vaginal canal, and then the different species throughout the gut to prevent bacterial vaginosis. That happens more commonly in pregnancy with the change in hormones with UTIs to help prevent GBS, which is group B streptococcus. And that can happen in the third trimester. And so women are, it's a natural...
Starting point is 00:37:03 And they test for that, right, before the baby's born, because then otherwise they give them antibiotics or something. You got it. So yeah, in the late third trimester, you will do a swab, a vaginal swab, and that will see if there is the GBS culture, is if you test positive for GBS. And if you test positive for GBS,
Starting point is 00:37:20 what the protocol is, is they'll give you antibiotics in labor. And that will prevent any kind of issues in baby if baby is born vaginally and exposed to that GBS, which the side effects could be, in some cases, if they're exposed and infected, meningitis or sepsis. So there's early onset and late onset GBS. So giving moms probiotics throughout the pregnancy and the last trimester specifically can help prevent that. And that's one thing. Also, the amount
Starting point is 00:37:52 of antibiotics that are given during pregnancy as well. If you're random things, you know, like we talked about the different urinary tract infections and BV, or, you know, after birth, if mom needs antibiotics, if mom's doing a cesarean section, she needs antibiotics. There's a whole host of that. So we wanna make sure that we are replenishing mom's gut microbiome as much as possible. And we know that if mom's taking probiotics,
Starting point is 00:38:18 she will secrete those probiotics in her breast milk to her baby. And so her baby will be able to be exposed to a wide variety of probiotics that way. And interesting. Are there any nutrient, are there any changes in nutrient in food demands throughout the different trimesters? Because I know there's different developmental things that are happening in the first,
Starting point is 00:38:38 second, and third. Are there foods that you tend to recommend more in different parts or throughout the different parts of the day? Yeah, and I want to talk about cravings too, because like I know that there's some crazy ones out there and how much of them are actually like valid and how much of them are just like, you know, random cravings that they kind of feel and experience. Yeah, okay. Let's talk about both of them. They're both really good questions. So the changes in nutrition throughout the trimesters. So in the first trimester, there's really no need to increase calories above what mom was
Starting point is 00:39:08 typically consuming, if she was consuming a healthy level of calories for her. It's not until the second trimester where the calorie demands increased, about 300 grams or calories a day, and then 450 calories in the third trimester. And when mom's breastfeeding, the knees are actually higher than when she was pregnant. So they're about 500 calories for at least the first six months. This is why a lot of women actually lose weight when they're breastfeeding.
Starting point is 00:39:35 I know that I see a lot of clients where they'll actually reduce body fat relatively fast when they're breastfeeding. Yeah, yeah, I mean, yeah, the babies do suck a lot of the calories from you. And the life force out of you. That's you, yeah. My midwife called it liposuction for the breastfeeding.
Starting point is 00:39:54 But yeah, so the calorie needs increase. I would say, the main things to look at in the first trimester, you really want to emphasize that full eight. And so the full eight, the B12, the coli, and they all act very similarly, and they support that neural tube closure, neural tube development.
Starting point is 00:40:08 And so that's really important. And that actually is important, probably before the mom even realizes that she's pregnant, because that all takes place in the first couple of weeks. And so that's why I really recommend, as soon as you think about pregnancy or getting pregnant, get on your prenatal,
Starting point is 00:40:23 make sure you're eating a lot of leafy greens to support that process, to kind of jumpstart everything. And then in the third trimester, one of the big things is looking at EPA and DHA and the diet, so making sure you have enough of that fish oil and or the fatty fish what you're eating, because we know that babies pulling about 67 milligrams of DHA from mom each day.
Starting point is 00:40:46 And so if moms that were punishing it, babies taking it and that's gonna impact moms mental health, which I'm really big advocate of maternal mental health. And so making sure that that's not pulling too much from mom. And then also, you know, the amount and the type of fats that mom is eating during her pregnancy in late trimester. And while she's breastfeeding, the type in the amount of fats is going to be replicated in her breast milk.
Starting point is 00:41:15 And so, if mom is eating a lot of these healthy fats, the DHA, the EPA, the avocado, the olives, the coconut, those kind of fats, that's going to show up and create healthier milk for the baby. And the amount of EPA and DHA and breast milk can vary like 10 fold, which is a different mom. So it's really important that she's getting enough throughout the entire journey, but for sure in the third trimester. Wow, that's huge. 10 fold. So if your diet is high in heavily processed vegetable oils,
Starting point is 00:41:47 and you're like, oh, I'm eating enough fat, your breast milk could be unhealthy in comparison to where it could be. Well, we don't want to ever say breast milk is unhealthy because it really is a beautiful food. And if mom, yeah, if mom, it's hard to talk about. And I think the reason we haven't talked about is about what mom eats and how it shows up in the breast milk is because we don't want moms
Starting point is 00:42:08 to fear breastfeeding anymore than they do or cause any more barriers because it really is hard. It's a beautiful thing, but it's not easy at all to do. So yes, your breast milk is going to be wonderful, but regardless, but if you can support it by continuing on your prenatal vitamin and having that fish oil or making sure that you're eating a fatty fish, that's going to just create even more superpower of breast milk. And then to just this question about cravings, like, have they found, we found a link to the cravings
Starting point is 00:42:40 in terms of like, you maybe need these nutrients. Right, you're deficient or why pickles and peanut butter. Right. Yeah. Yeah. You're a pica eating, what's that? Yeah, it's interesting. Well, yeah, there could be some nutritional deficiencies there with pica, pica, iron, for sure, is one of them.
Starting point is 00:42:57 But cravings are interesting. So when you think about the first trimester, a lot of times the foods that don't sound good to pregnant women are the foods that are going to be the most susceptible to food born illness. So we're thinking about meats and produce. And so a lot of women want to go nowhere near a salad, want to go nowhere near eggs or meat in the first trimester.
Starting point is 00:43:18 And what they do crave is the foods that are the most safe, you know, the carbohydrates, foods, the processed foods, which have a lower susceptibility to foodborne illness. Also you're tired, like we were talking about, like you're just fatigued and you just want something to boost your energy. And so you're going to be craving something like that. If you're nauseous, you're going to be craving something that's more plain and, you know, just chips, you know, we all have experienced food poisoning or nausea or diarrhea. And you don't want to be eating a salad and eggs.
Starting point is 00:43:48 You want to be eating something that's really quick to process and easy to digest. And so I think the cravings come from a lot of different sources. But yeah, they're definitely a real thing. And I didn't have a whole lot of strong cravings during my pregnancies. I loved fruit. But I almost thought it was't a thing until I,
Starting point is 00:44:07 I was talking to a couple of my friends, I have even strict or diets in I do, and they had so many cravings. So it isn't, I know, the perception is like, well, maybe they're just like eating whatever they want because they're pregnant, but there are some really strong pulls to these foods. Yeah, and that makes a lot of sense
Starting point is 00:44:21 because if you really look at everything on a scale, the worst, the highest risk or the thing you should worry about the most would be food-borne illness. And then down the scale would be okay, nutrient-dance food. It's like, because if you could get one terrible food-borne illness and that could stop the whole thing. So that makes perfect sense. I've never heard that worded that way, but that makes a lot of sense. Now, you made a statement about maternal mental health, and you said
Starting point is 00:44:50 you're really big on that. Can you explain that? Yeah. So I actually had postpartum anxiety with my first, and I had no idea what was happening. I just thought I was being too wearing too much, or too anxious, and there really wasn't a whole lot of information out there about it circulating and celebrities hadn't come out about their post-partum depression and anxiety when I had my first about almost five years ago now. And so I'm passionate about it because I have experienced a pregnancy without it and a motherhood without it and one with it. And so I know the difference. And I know that there's a lot of misconceptions and stigma that are preventing women from getting the support that they need. And to really define it, what we're looking at, sometimes it's called postpartum or sometimes
Starting point is 00:45:36 it's called postpartum depression. But truly, when we're talking about maternal mental health, we're talking about perinatal, mood and anxiety disorders. And this is ranges from postpartum depression, to postpartum anxiety, to postpartum OCD, to postpartum traumatic stress disorder, to all the way on the far end of the range, which is postpartum psychosis.
Starting point is 00:45:58 And that happens in one out of every 1,000 bursts, but that's one where that's sometimes what people think about when they think about post-prime depression And that is the mom that's jumping out the window or that's the mom that you know she She Commits like in thanticide or neonaticide and and so these things where That's so rare that that's the case It's usually more towards the way other end of the spectrum where mom is just Experiencing a whole lot of overwhelm. She is very anxious. She might be counting the amount of diapers that are in her diaper
Starting point is 00:46:32 Be she might be watching the baby breathing at whenever they sleep and not able to sleep herself. She may be Just who I had that and I wasn't even the one that had the baby. Yeah So it's a great it's a great point because it can happen in partners too. And so with women, it's one out of every five to seven depending on what's just as to stick you're looking at. I think it's really hard to figure out how many women are experiencing this because so many just don't share it or don't get diagnosed. But with partners, it's one in every 10 dads, also
Starting point is 00:47:05 experience it. And how they experience it is very different than how a woman does. And so, you know, I kind of like to joke like how men experience it is, they look like assholes. Like they engage in dopamine and they're dopamine and they're active. You've been practicing that a long time. That's true. So the amazing guy like, he's acting normal. You've been practicing it a long time. That's true. So they're amazing.
Starting point is 00:47:25 Should be like, he's acting normal. Yeah, so they may take up like gambling or they may, you know, take up alcohol like these kind of things for the first time where they may engage in it more. They may like be doing video games or whatever. They may be just connecting from the family. They may doing doing their own thing, they may shout out in anger bursts. They just, that's how it's represented in their body as they just feel this loss of control.
Starting point is 00:47:51 They don't know what to do. They may not have seen father figures in their life or they may have, you know, just that the amount of the transition is just, it's a lot to take in for both partners. So it's really something to be looking at. We're not screening for it nearly enough. We're not talking about it nearly enough. And there is so much that we can do to support moms and their partners
Starting point is 00:48:17 when they do have a baby to prevent some of these things. Well, let's talk about some of those practices actually. I'd like to hear some things that you could give someone like even like me who's heading into this and to help prevent some of this. Yeah, because I was always, uh, for a long time, I thought that the postpartum condition was due to changes in hormones and chemicals, but I'm starting to realize that it's, you have a, if you go from zero to a baby, you went from no responsibility for any human
Starting point is 00:48:48 other than yourself and maybe your dog or whatever. Now you've got a new human, it's way more stuff, way more stuff you got to do, your schedule's totally different, your sleep is off. I'm starting to think it probably doesn't have a whole lot to do with the changes in chemicals or hormones and just a complete change in lifestyle. So what are the practices revolve around?
Starting point is 00:49:07 How can we work on this? Yeah, absolutely. Yeah, it used to be thought, like they called it the monoamine theory of depression, which is that there is the lack of serotonin, and that's what was causing the depression. And what we're finding now is that, yeah, serotonin does play a role, but there are a host of other reasons why we may be experiencing depression in general and then depression or depression in the postpartum period.
Starting point is 00:49:31 And one of the major findings that we're looking at now is the amount of neuroinflammation and the amount of inflammation, not just systemically, but in the brain. And there's a whole host of reasons that we may be experiencing more inflammation. And we kind of talked about those with preconception, but looking at diet and deficiencies and our lifestyle and our stressors. And so inflammation is definitely at the root of it. We also know that gut health plays a role.
Starting point is 00:49:57 And I'm sure you've talked about the gut brain access on other podcasts and how central that is to overall health. And when we're looking at the gut changes that happened during pregnancy and the exposure to antibiotics and really just depleting all of that. And then combine that with nutrient deficiencies that happen because baby is pulling all of mom's stores. And that's during pregnancy and then during breastfeeding.
Starting point is 00:50:24 And so what we really want to do, and I talk about this, mom stores and that's during pregnancy and then during breast feeding. So what we really want to do, and I call it a four hour approach because I think it just helps us center on what the main components are that we want to be looking at in depression and in postpartum depression. The first would be making sure that our blood sugar is regulated. This is something that in pregnancy, we may be struggling with it, with if we have gestational diabetes, but then again, in the postpartum period, we may be struggling with it because we're snacking throughout the day, and we're not sitting
Starting point is 00:50:54 down to full meals, or we are eating foods that are rich in carbohydrates, and we're not balancing it with protein and fat, or snack, you know, just the quality of foods that we're eating. So if we, we've seen a bidirectional relationship between depression and mood disorders. And so if we can really focus on what does that blood sugar look like and how do we keep it stable throughout the day, that is one way that we can really stabilize our mental health. And you know, we all know how that feels if we skip a meal and we're hangry and we're irritable, and that if that's just happening over and over again,
Starting point is 00:51:30 that adds up. So the first thing is looking at balanced meals. The second thing I talk about is reducing that inflammation systemically through choosing more whole foods, skipping some of the processed and refined foods, and really just looking at things like DHA and mom's body. And then looking at replenishing what was lost. So that's the third R.
Starting point is 00:51:53 And in the postpartum period, when it comes to mental health, we're looking at B12, we're looking at iron, we're looking at coal, we're looking at zinc, we're looking at vitamin D and EPA and DHA. These are essential for mental health, and these are often ones where baby is pulling and we're also not getting enough of in the diet. So that's a huge component. So making sure that we have replenished those deficiencies because those deficiencies
Starting point is 00:52:19 can present as, you know, mental health conditions and depression and anxiety being two of them. And then the fourth would be replenishing the gut to support that brain access. And so that is looking like making sure we are going on a probiotic, one specifically to address whatever we're dealing with, whether that is antibiotic exposure or just supporting mental health.
Starting point is 00:52:41 There's a lot of different strains that are out there to support that. And then I think the other really big thing that's not talked about is just how do we create this plan for the postpartum to support this major life transition? A lot of times we're focused on the birth and the pregnancy and we forget that the, it doesn't end when the baby is born. It's just that's the beginning.
Starting point is 00:53:07 That's kind of our approach and we spend so much time making sure that the baby room is beautiful and that we've got a newborn photographer lined up and we spend more time doing that stuff and really sitting down with our partner and saying, hey, look, this is what it's going to look like. Here are my current rules right now. Here are my current rules right now. Here are your current rules right now. How can we meet in the middle and make sure that these things get met?
Starting point is 00:53:30 Do we need to hire out? Do we need to delegate this somewhere? Do we need to think about handing things, delegate to other people that are your hiring or delegate to your partner? How do we set up our environment at large to support this major life transition? And one of the things I know you talked about Adam
Starting point is 00:53:50 and one of your previous podcasts is that you were hiring like a dog walker. Like, and I just loved when you said that because I think it's these things that we don't think about that can really make our break our experience as parents is gonna be overwhelming, but the more that we can have structures set up before babies born, the more we're gonna be able to thrive.
Starting point is 00:54:09 It was one of the best advice, it was funny because I've got, I continue every time I hang out with a buddy of mine that has already had a kid. I love asking, you know, like, what's one thing if you could go back and do it over again that you would do different or what did you learn from it? And when he gave me the advice about the dogs, it was just like this aha moment for me.
Starting point is 00:54:29 Like, wow, I didn't even, I wasn't even, my mind wasn't even there, but I could totally see like, oh, what a headache that could become because I wasn't prepared for that. So what are some other things like that? Have you that you have found that people just kind of don't really think about and it's like,
Starting point is 00:54:44 man, if you would have spent the time maybe one having a conversation about that or two, if you're in a position like where I am where I potentially could hire some people out to assist me, what are some areas you think that I should look into? Yeah. Well, I, so as a dietician, I look at food as like a huge component of what I do. And so I think we can do a lot before baby comes, set ourselves up for being able to reach and get a really high quality Nutri-Sho snack or meal, then just whatever is fast and convenient. And one of the things that I talk about doing is, you know, in your third trimester,
Starting point is 00:55:14 so when you are cooking a meal, cook double what you're gonna make, and then freeze that, or make triple. So I know- You do the food saver thing. Yeah. You vacuum seal it, throw it in a freezer? Absolutely. Yeah, so the more that you can start thinking about doing that, I know some do the food saver thing. Yeah, you vacuum seal it, throw it in the freezer. Absolutely. Yeah, so the more that you can start thinking about doing that, I know some women will do it. They'll do a weekend full of just huge batch cooking for their deep freezer, but when you're
Starting point is 00:55:34 in your third trimester, you're going to be tired and you may not want to stand for hours in your kitchen meal prepping. So if you can just do it a little bit at a time and to create this really great supply of already frozen meals, that's huge. I actually would I do for my friends that have baby showers, is I will bring them a gift for mom after birth. So maybe that's like a nice lotion for her
Starting point is 00:55:55 and then a meal for her. So I'll make a frozen meal and that's what it'll give to her because like we were talking about, you don't need more baby stuff. Like you're usually set with baby stuff, but we needed to think about is, everybody wants to hold the baby, but who's gonna hold the mom in the postpartum period?
Starting point is 00:56:10 And so really supporting that. So frozen meals, I think are huge, getting a meal train set up, so that people can bring you fresh hot meals right after you have your baby is another thing. And there's lots of free services that are out there that will do it, like meal train. And what this looks like is you just, if your friends gonna have a baby, you set up a meal train for them or you can set
Starting point is 00:56:30 up one for yourself. There's no shame in that. And you can also list the preferences. So if you want gluten free or dairy free or soy free or whatever it is, you can stay on the meal train. And then people will go on their calendar. They'll pick a time to bring you a meal. And that is so helpful because it's nice and fresh and hot, and you also get that connection with another person if you want to, and it's just easy, they come to you. And what I like to tell moms is, you know, let them know. You may not want to see them, and that's okay too. If somebody brings you a meal, you're not obligated to hang out with them and to entertain them.
Starting point is 00:57:03 They can leave it at a door in a freezer. You can put something outside that they can set the meal in and then just let them know, like, hey, I'll hang out with you in a couple of weeks. And this is also common in the winter when people are bringing colds and flusin. You may not want guests or family to come anywhere near you and your little baby.
Starting point is 00:57:19 So that's another thing. I think we are blessed to live in a day where we can have grocery deliveries come to our house and drop-off groceries. We have lots of meal delivery services that can bring anywhere from full meals to meals that you cook yourself. So I think that is an option. And then we have a lot of really healthy package foods that are out there from grass-fed jerky to, you know, nut butter packets, two things that you can eat with one hand when you're nursing. And so just making sure that your pantry and your kitchen is set and ready to go before baby comes. One just one other final thing that I found really helpful to is if you have a couple of restaurants around you and you have your
Starting point is 00:58:01 favorite foods from those restaurants that make you feel good, you can,. You can make a list and put the number of the restaurant on. So if people come to visit you and they're like, are you hungry? You know, they know, okay, that's exactly what she wants. That's the restaurant that she wants it from. And they can order something that really makes you feel good and nourished. And you called the meal train. I've never heard of that before. So that's like a site or an app or something?
Starting point is 00:58:20 Yeah, there's a couple of them out there. If you Google meal train, you'll find a bunch of them. But yeah, it's free and it's something that you can do and it's the best gift ever. I would rather have that over, baby gifts any day. Interesting. Now, what about any specific exercises post pregnancy to work or strengthen the areas that may have either atrophied during the pregnancy process, pelvic floor movements, or what are some common exercises you like to recommend?
Starting point is 00:58:49 Yeah, and I think it's really interesting because in the postpartum period, I think we overestimate what we can do and underestimate how much healing needs to take place. I remember even two weeks postpartum, I was like, I'm gonna go for a walk and even just a five minute walk, I'm like, I need to turn around and really go back. And so I think the key with postpartum, I was like, I'm gonna go for a walk and even just a five minute walk. I'm like, I need to turn around and really go back. And so, I think the key with postpartum
Starting point is 00:59:09 is to really give yourself time. It can be hard, I mean, if we have personal trainers that work with athletes or women that like to show up in the gym, they're gonna wanna show up either right before or right at that six week mark where there will be gives them the clearance to go and exercise, but I like to kind of give the frame that if you push too hard now, it's going to affect you for a longer time. So if
Starting point is 00:59:34 you can arrest as much as you can, those first six plus weeks postpartum, you're going to be able to get back into your routine, you know, better and earlier and safer later on. So when it comes to postpartum, I think about rehabbing, resting, and retraining the muscles. You're relearning your body. Your body has completely changed. There are things, conditions that can happen like diastasis, recti, and prolapse. And we want to make sure that we aren't causing more
Starting point is 01:00:04 intra-abdom abdominal pressure than what's needed because again, we didn't talk about diastasis rough diet but I think your listeners probably have heard of this before and that's- We get questions on that all the time. Yeah, yeah. And so it's common to have that separation during pregnancy. Most women do because it allows for a baby to be able to fit properly, the tissues need to stretch. And so, it's not that we don't want to have
Starting point is 01:00:29 diastasis recti, but it is unnatural and it is causing issues for the mom. And it's not just the size of the gap, but also the tension and the function of that container. So the abdominals. And so that's something we want to keep in Iowa in postpartum is if you're doing any exercises that cause that doming or cause that bulging
Starting point is 01:00:56 or cause that pain, you definitely want to stop. And I think before we even get into exercise, what other countries will do? France, for example, every postpartum woman gets a visit with a pelvic floor therapist, or physiotherapist. And we don't do that in the U.S. You have to really ask for it at your six-week checkup. And I think that's what I think all postpartum women should do that even before they get into
Starting point is 01:01:20 exercise is to make sure that everything looks good down there and understand what they need to retranspacifically for them depending on whether they had a cesarean birth or a vaginal birth with maybe a tear. So before even thinking about exercise, I think we should go and see somebody that can help us really relearn our body and prevent any damages or injury from happening. Well, something we also kind of glazed over was the whole breastfeeding process. And I know it's kind of a controversial topic now for some reason, but can you go over the benefits
Starting point is 01:01:52 and kind of highlight those as well as what a struggle it is sometimes? It's really hard. I think we have this vision of it being natural and we may have seen videos where the baby just crawls up to the breast and they figure it out. But it is really difficult to figure out the rhythm. I call it a dance between the baby and the mom. And you both have never done this before and you're both sleep deprived and you both may
Starting point is 01:02:17 really want this to work. So the pressure is on and you want to be able to feed your baby and not being able to feed your baby or questioning whether you're feeding your baby is so hard for a new mom because I mean, that's like, that's your job and you really want to do it. You want to make sure that your baby is safe. And what can happen is a woman can be trying to breastfeed and have issues with the latch. And she may try to reach out to a lactation consultant, but she may not jive with that lactation consultant.
Starting point is 01:02:50 I personally had to go through a couple because some of them were a little bit harsh than I wanted to, or they pushed the baby into positions versus letting me have it. And so I think one of the things that, when we're talking about building this postpartum plan is interviewing lactation consultants to find one that works for you because it's a very intimate thing when you're feeding your baby and you want to make sure that you
Starting point is 01:03:12 feel like you have rapport with that person who is going to be helping you feed your baby. And so if you can interview a couple of lactation consultants ahead of time, you're going to be given lactation consultants at the hospital, but if you can interview one and have bring them to the hospital to help you out, even like proactively going to a breastfeeding class before you have your baby because there are many women who have never seen what breastfeeding looks like up and close. And so now they're expected to not only figure it out with their baby, but to figure something out that they've never seen before. So I think, yeah, just,
Starting point is 01:03:46 we can do a lot proactively of finding somebody to help us support that process. You know, we can read as much as we want, but it's not until you actually get the hands on experience that you can decide for yourself what you need to do. And some babies latch easier than others. There are tongue and lip ties
Starting point is 01:04:03 that can make it more difficult. So. Now, as far as breast milk is concerned, that's now being widely considered as the healthiest, one of the healthiest foods, you can give your baby, but let's say that doesn't work for you. Let's say either you're not producing enough milk
Starting point is 01:04:17 or maybe you choose not to breastfeed, what are some of the better alternatives? We're just some of the better formulas or things you can give your baby besides breast milk? Yeah, it's a good question. So yeah, definitely if the goal is to breastfeed, it can be hard to supplement, but there are really great options that are out there.
Starting point is 01:04:36 Some women will choose to use milk from a friend or somebody that they know. And that breast milk is considered raw. It's not pasteurized at all. It's not screened. So there are risks with that. But some women, if you know the person well and you know that they are healthy, they choose to go that route. You can do a breast milk bank where the milk is screened and it is pasteurized for safety. And so that is an option. And some nick useUs will have that available for the babies that are in the hospital, but you may need to search out these things for yourself. There are other kinds of formulas that are out there.
Starting point is 01:05:14 So there is, if you want to avoid cow's milk for whatever reason, maybe you just personally want to avoid it, or you know that your baby doesn't tolerate it well, because you've tried it and they have reflux and all these kind of gastrointestinal issues, stool changes, you could do goat milk. And so goat milk, what's interesting is that there's no infant approved goat milk formula in the US. And so a lot of moms that I talked to, they prefer to purchase goat milk from a couple of brands overseas and have it imported
Starting point is 01:05:44 because it's really, it's a great option. There is a company called Cabrita that is trying to bring the first ever in thin goat milk formula to the US. And that will be a game changer that allow moms to just be able to pick it up at the store. Now this is interesting.
Starting point is 01:05:58 The breast milk bank thing is really interesting to me because my buddy who just had a kid a year ago, he said that one of the most challenging times they had was the first couple days of his wife starting to actually produce enough milk. And he said during that time, his hunter or his baby was just crying like crazy. And once they were able to give him the milk, he was still good to the point where he's like on number two here, he's just a, we're bringing formula to the, to the hospital. So I can give it to him right away. I didn't even know that this was an option.
Starting point is 01:06:35 So this is something that I can look into ahead of time and have it prepared that in case Katrina doesn't start to produce the milk, I can already have some of this milk readily available for us to use. Yeah, you can also, you can bring formula to the hospital if you're choosing. If you don't want to use what they have available, you can bring, there are companies that are doing grass fed and they're doing organic. And they're really looking at that formulation and making it as easily digestible as possible for the baby. So for example, looking at the type of sugar that's in the formula, lactose is what babies will get through breast milk and it's something that they can digest more easy than other types of sugar that may be added
Starting point is 01:07:17 to the formula. And so it's more expensive. Companies aren't doing it because of that reason, but there are some really great formulas that are out there that have it. So yes, you can bring it into the hospital and... No, my question is I, because I absolutely do not want to use formula. Yeah. And our goal is 100% breast milk, but he was the one that made me realize like, oh, what if, like, so what do I do if that happens?
Starting point is 01:07:41 If I'm somebody who's very adamant about feeding Maximus breast milk, and I'm in a similar situation where she's just not producing it yet or fast enough or enough, what would you suggest to me as the next best alternative if I'm if I'm really adamant about breast feeding? Yeah, so I think I would have a different opinion on that and my it's very similar to what we're talking about with the epidural It's like not having it as an option made me really like I didn't have a choice and so yeah There may be families that feel more comfortable doing that, but I also You know sometimes if formula is there it can
Starting point is 01:08:20 You just like I were talking about you want a breastfeed so bad and sometimes if that easier option is there It can prevent you from really getting the help that you need through a lactation consultant and when you do supplement with formula It can be harder to really regulate mom's milk supply and to make that breastfeeding relationship like a lasting one So I would kind of caution from bringing it in just in case and really looking at your support team and making sure that she has enough support to breastfeed if possible because there's a lot of tweaks where just even adjusting mom's position or looking at How baby is latching can make that breastfeeding relationship work and so Yeah, I mean there are options that are available if she wants to go the the breast milk route through dough and don't don't don't her milk or through friends, but maybe a little bit too tempting to have it there. No, I know I like this advice and I know you're trying to I know I can see you skirting around being politically correct right now and not offending people because I and I know this is a sense of talk, but I'm very interested in this and I know that.
Starting point is 01:09:24 and I know that Katrina and I both really, really want to breastfeed at all cost. But then I just never thought that there's a potential chance that she may not be even producing enough milk in the first day or two. Is that possible? Or is it more likely that babies having a harder time watching on? What is more likely to happen?
Starting point is 01:09:39 Yeah, so in the first day or two, what's happening is mom is secreting colostrum. And so when we're thinking about baby breastfeeding, a lot of times we're thinking about baby glugging, like glug glug glug getting all this milk. And in fact, the colostrum, the first milk, they're just getting little drips of it. And so it can appear that baby's not getting a whole lot of milk.
Starting point is 01:10:00 And it can be really hard for a mom to think that her baby is not getting enough milk. And so that that's kind of a misconception. So the true milk doesn't come in until a couple of days after baby is born. And that's when you'll start seeing babies taken down more milk. And you'll start seeing that glug. And you'll start seeing them, you know, fill up and be content with milk versus in the beginning, they just constantly want to be on the boob and milkly and not be streaming out like what you would imagine it being. It isn't normal for them to lose a little bit of weight anyways.
Starting point is 01:10:32 They do. At first. Yeah. And the classroom has got its own immune boosting effects. It's different than the regular. So I feel like what you're saying to me without trying to offend everybody else that what the opposite route is do my best to tough it out during that time and and push through and try and get him to latch on or get him to eventually get more of it. And it's okay that I mean, I'm beginning this tons of rush of milk at first because there's other benefits to what's going on. You got it.
Starting point is 01:11:02 Okay. I've listened to your podcast before and I know you guys are, you guys are very PC about how you do everything is I know this is such a sensitive area and people get offended so quick. The cool part is you're talking to mind pump and the three of us we're not going to get offended. I'd rather I you're on here because I respect your opinion and I'm okay that it's your opinion whether it everybody's gonna agree with it or not.
Starting point is 01:11:27 It's also such an, you know, like anything, like when we talk about exercise, it's gotta be so individual from person to person. So, well, maybe ideal for, you know, 80% of people may not be ideal for 20%. So, and you work with so many people, I'm sure you find that happen quite a bit. Yeah, and I think with breastfeeding, my thoughts on it have changed
Starting point is 01:11:49 ever since I started to really dive into the maternal mental health realm because I've seen women who are, they are trying really hard to breastfeed and that can come at the expense of their mental health. So I would never want to tell somebody to like push through it. If it really is compromising their quality of life in another hand. And so, you know, in the beginning, I think it's a different scenario because you just don't know and like there's just so much that is going through your head and the hormones and you just want to feed this baby. And so I would say kind of push through it in that sense because and push through it, not like you are struggling and the
Starting point is 01:12:22 latch is painful. Like the latch shouldn't be painful. It shouldn't be hard. It shouldn't be, she shouldn't be like curling her toes in pain with breastfeeding. That's a poor latch, but kind of pushing through the fact that it's not gonna, the latch isn't gonna be perfect right away. It's gonna take time to develop that dance. I think just being patient with yourself, right?
Starting point is 01:12:43 What are some of the best things that the father can do to support this whole process? From a pragmatic, realistically, what can we do to really help this process? I love that question. So I think really understanding what each other is doing is important because there's so many things that you go about your day and you do like take care of the credit card and you mock the dog and you wash the dishes and the other partner doesn't know that you're even doing it and there are some things that the woman may prefer to do like she may prefer to do her laundry because she doesn't want her yoga pants
Starting point is 01:13:22 shrinking or whatever it is so kind of creating a list of what you each do and then what the partner would feel comfortable giving up is really important, I think, in the pregnancy period too, so that you can say, hey, look, I see that you take out the garbage as one of your responsibilities, but that's something that I'm going to take on for you, something that she's willing to give up. I think also encouraging her to get out and to see friends and to leave the baby at home with you is really important because a lot of times women feel like they're inconveniencing you by even doing something healthy, like going to the gym
Starting point is 01:14:00 or going to meet up with a friend and letting your partner know that you want them to go out and play and be with other people. And you've got it. And it's a great opportunity for you to learn how to interact with the baby. When moms, there's a term called maternal gatekeeping where mom kind of leans over and is like, oh no, put the diaper on that way. Do something like that.
Starting point is 01:14:24 So it's just a really great opportunity for dad to bond with the baby if mom gets out of the house because if mom's in the house, chances are, baby, wants to be by. Yeah. I remember my mom left my dad alone with us and she comes back and my sister's diaper was on backwards. The rest of us were naked running around. She's like, what's going on? We're having fun.
Starting point is 01:14:43 We're having fun. We're having a good time. Now, when we were off air, I was sharing with you something that just recently happened to Katrina and I. So Katrina went in yesterday and got some of her tests done and completely just scared the hell out of her and it came, brought her home going like,
Starting point is 01:15:01 I don't understand, I don't get this because she's doing everything as far as the vitamins and we're eating really balanced, she's exercising, and the doctor says to her that she stuff came up that she may be pre-diabetic. And you said a term to me that I was unfamiliar with and that this is actually more common and sometimes the test can be wrong. Can you explain a little bit of this? Yeah, gestational diabetes is a really interesting one. So, when it comes to gestational diabetes, we actually should be screening in the first trimester because gestational diabetes could be,
Starting point is 01:15:38 actually, somebody that was undiagnosed with having pre-diabetes or type two diabetes before they became pregnant. So right now, we're screening in the second trimester when mom could be having, you know, dysregulated blood sugar in the first trimester as well. And it could not, it's maybe it's not gestational diabetes, it's actually prediabetes. And so when it comes to testing, what we should be doing is looking at mom's first trimester, hemoglobin A1C. Look at how she's been managing blood sugar the last three months.
Starting point is 01:16:11 Look at her fasting blood sugar. See where she's at to see if we can intervene early versus intervening in the second trimester. So in the second trimester is when you're going to see more insulin resistance, the most insulin resistance. So the theory is, let's test women's blood sugar in the second trimester. And what that looks like is around 24 weeks of pregnancy. In the U.S., we do a two-step way to test this.
Starting point is 01:16:38 So we do a screening with 50 grams of sugar. So it's just pure glucose. And a woman will drink that, and then she'll have her blood sugar tested about an hour after she drinks that solution. That's called glucola. And based on that, if mom's blood sugar is over 130, 140 milligrams per desolate at that screening,
Starting point is 01:16:59 then she has moved on to a three hour 100 gram glucose test. And she's tested at fasting, one, two, and three hours after she takes that. Then she has moved on to a three-hour 100 gram glucose test. And she's tested at fasting, one, two, and three hours after she takes that. And based on those results, if a certain number of those markers are elevated and that is up to the provider and the setting, then she can be considered gestational diabetic. So the first step, the 50 grams is a screening. The second test is a, a what how they can diagnose. And in some countries, I actually do 75 grams of sugar and then two hours. And that is actually more effective and
Starting point is 01:17:34 identifies more people that are at risk. Now how accurate is this and how much can this be manipulated by someone's diet? Because I would assume that I know that if I had somebody, and this is somebody that's not even pregnant, just a normal person who has been eating a low carbohydrate type of diet, and then I shoot 75 to 150 grams of carbs, they're extremely sensitive to that because they've been writing like a ketogenic type of diet,
Starting point is 01:18:00 which happens to be Katrina. So before she was pregnant, I introduced her to a ketogenic So before she was pregnant, I introduced her to ketogenic diet maybe two years ago. And even though she's not ketogenic, she did see a lot of benefits to running a lower type of carbohydrate diet. So we typically run a higher fat moderate protein and low carbohydrate diet for overall health for us and love to eat this way. And then now that she's pregnant, probably been increasing her carbohydrates significantly. Now, how much does that play a role here?
Starting point is 01:18:28 Yeah. So if a woman has been eating low, low glycemic, low carbohydrate for a certain time before taking the test, she can have a false positive. Because like you said, her body isn't used to 50 grams of straight up sugar hitting the bloodstream. And so the body is not going to respond well to that. She is going to show that she has elevated blood sugar just because her body is more as better at fat burning than sugar burning. So what some women will do, they have a couple of options. If they've been low carb going into the test, and this is when I say a low carb, it's usually under like 100 grams of carbs a day.
Starting point is 01:19:05 What they'll either do is they'll go ahead and take the test and know that they may have a false positive. They might increase their carbohydrates to like a hundred and twenty-one hundred and fifty grams before they take the test, at least like a couple of days before they take the test, to kind of transition out of that fat burning into give a more accurate result. Or they may choose to take a different type of test. And so what I did personally, I didn't take the glucose test because I knew I was like Katrina, I had a lower carbohydrate going into it because it was mostly like plants
Starting point is 01:19:39 and animal based, not a whole lot of grains. And I did my blood sugar testing at home. And providers are okay with that. You know, it's going to take more work on the woman to do it. But what you would do is for two weeks, you would monitor your blood sugar at home upon fasting and then one to two hours after your meals. And you would give those results to your provider. And then they would say, okay, yeah, you've got your blood sugar within range. And what I like about that approach is it's real life. It's what you're actually eating.
Starting point is 01:20:06 And it's great information because if you, you can see how that oatmeal at breakfast compares to those eggs at breakfast. And that can help you guide your choices. And it's really, you're more in control of what's going on and what it looks like versus taking a task which may make you nauseous and have headaches. And just you have to be at the doctor's office for that long.
Starting point is 01:20:25 Yeah, I would recommend that because how often does Katrina drink? Like never full sugar soda as it wants. Never, you know what I'm saying? I mean, her only real source of sugar like that is fruit. You know, the occasion. She's not pounding like a liter of fruit juice or no, she doesn't drink anything like that.
Starting point is 01:20:43 So I think that's what happened to her. And of course, you know, freaked her out and, you know, she was crying yesterday. And I was kind of piecing her back together and saying, relax, you know, just, I know she's going back to test again. But, you know, the thing I told her is she hasn't been tracking for me. And I said, if you're tracking for me, I can speak to this. I'm like, right now I'm trying to guess with you, but if we can track, I can get a pretty good idea, but what I'm guessing is because I do know how she typically eats, and she runs probably an under 100 grams of carbohydrate,
Starting point is 01:21:16 definitely under 150 a day, and not used to ever taking in 50 to 150 grams of sugar all in one shot, and I'm sure her body responded differently to the average. Did she tell you she got nauseous after drinking or anything like that? No, she didn't say that. She didn't say anything about feeling nauseous. She's, she's felt fine. One of the things that she realized early on in the pregnancy was if she made
Starting point is 01:21:40 sure that she got up early in the morning and eight as soon as her body told her to, she would never feel nauseous at all. So we actually really didn't even deal with any morning sickness or anything. She's been pretty good overall. This was the first, you know, scare or thing that she's happened that we've gone back and the doctor has said everything's perfect and healthy. And now she's looking back at me like, what the hell? Yeah.
Starting point is 01:22:01 Well, yeah, you can see it is really scary and nobody knows about this information about low carbohydrate diets going into. It's not something that provider talks to you about and says like, hey, look how's your diet been? Oh, okay, it's pretty low carb. We this may not be accurate. Like we just we don't know how that information. So you don't know you can't do anything with it. And also, you know, for the screening, it's whatever time of day, it's not considered fasting. And so what you eat before you take the test can influence your results, too, right? Like if you go and you have a pancake breakfast
Starting point is 01:22:33 before you take it, it's gonna respond differently if you have a good amount of protein. And so that's what I talked to my clients about, too, is before you take the test, let's make sure that you have something so substantial in your body. So it replicates more of a meal than just all of a sudden. Not really sure.
Starting point is 01:22:48 Just sugar in a lower. Right, interesting. That's exactly what I think has happened to her. Well, very cool. Yeah, we really appreciate you coming on. Thank you for having me. Yeah, this is really great because we get pregnancy questions quite a bit.
Starting point is 01:23:00 And we've all trained. We are not experts. Yeah, we've trained people pre-during and post-preg know, fitness wise, but by no means are we experts on the subject. And, you know, fitness and nutrition around that process is as important as it is outside of the process, if not more. So we really appreciate you coming on and illuminating some of this for us. Yeah, being here, you had great questions. Thank you very much. Thank you. Thank you for listening to Mind Pump. If your goal is to build and shape your body, dramatically improve your health and energy, and maximize your overall performance,
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