Healthy Pregnancy

Markers of Ovarian Reserve Viewed Through the Lens of Chinese Medicine

Estradiol   FSH – Follicle Stimulating Hormone

Inhibin B   AMH – Antimullerian Hormone

“Ovarian reserve” testing can be intimidating and daunting. The results often feel like a fertility death sentence. When viewed through the eyes of Chinese medicine, however, these laboratory markers of ovarian potential can actually make diagnostic sense, and help determine the best natural therapeutic course for you.

It will be helpful to understand a little reproductive physiology first.

Brain Hormones:

The pituitary gland, which sits behind your eyebrows, emits FSH (follicle stimulating hormone) in response to messages translated by the hypothalamus, which secretes Gonadotropic releasing hormone (GnRH) in response to the hormone levels in your blood, and your emotional response to your environment. This hormonal command post, like all of the hormones in your body, responds to internal chemical messages conveyed through the blood, and emotional interpretations of your external environment.

These external and internal messages determine how the pituitary hormones interact with and are able to communicate with your ovaries, and how the ovarian output communicates back to the hypothalamus and pituitary gland.

Ovarian Hormones:

Activin and Inhibin B are protein complexes within the ovarian follicule. Activin enhances FSH secretion, cellular proliferation and plays a role in menstrual regulation. Inhibin B, on the other hand, down regulates and inhibits GnRH from the hypothalamus, and FSH secretion from the pituitary gland.

When the system is in sync, the hypothalamus secretes GnRH to trigger the pituitary gland to release small amounts of FSH during the last few days of the previous menstrual cycle, which rise until the beginning of the next follicular phase. FSH recruits Graafian (or antral) follicles, which have been growing within the ovary for the better part of a year.  Around three months before these follicles are ovulated, they enter the tonic growth phase, where protein synthesis occurs.  Follicles that have interacted optimally with the internal environment have the potential to become dominant follicles, primed by FSH. They then secrete estrogen, and express LH receptors, which allow the chosen dominant follicle to mature and become capable of ovulation.

Higher levels of Inhibin B indicate that the ovarian follicle is doing its job of putting out adequate estradiol. Inhibin B provides negative feedback to the hypothalamus and pituitary gland to let them know to turn down the GnRH and FSH, as output is sufficient.

The Fertile Soul Method ® is proven to maximize your reproductive potential. Most of our patients are 40 or over; most have high FSH, low AMH, other hormonal abnormalities, or have been diagnosed with poor ovarian reserve, poor egg quality, endometriosis, or recurrent miscarriages. Most have not found their answers solely within Western reproductive medicine. Most have been able to rectify their internal energetic imbalances through our program, and produce new life.

Dr. Randine Lewis is the founder of The Fertile Soul, the president of the Continuing Excellence in Fertility Professionals, the author of The Infertility Cure, and The Way of the Fertile Soul. Find out more about Dr. Lewis’ retreats at www.thefertilesoul.com.

Infant mammals have one thing in common. They all breastfeed. In addition, they are all equipped to squirm, crawl or swim to the breast and latch and happily suckle without the help of their mothers.

But human babies are different than other mammals, right? Don’t they need someone to “latch them on”?

Yes, human babies ARE different from other mammals. They are smarter and even more capable than their furry counterparts. After some help to get to mom’s torso, a newborn will have no trouble finding the breast and suckling comfortably. You have probably noticed that when your baby is ready to breastfeed, she turns her head back and forth on your chest and moves her body toward one breast or another while her mouth is wide open. She may also bob up and down on your chest with an open mouth. When your baby does those things, she is looking for your breast.

If your baby has been having trouble with breastfeeding, you might want to try letting her take the lead. Sit in a semi-reclined position bare from the waist up. Place your baby (also shirtless) on your chest facing you. Keep your hands close by to protect her from falling—otherwise, let her move her way. Notice how she uses her chin, cheeks and mouth to find the breast, then the nipple. When she gets close enough, she will anchor her chin to the underside of your breast, throw her head back, open her mouth wide and latch on. It may take her a few tries to get it right. You can help her by lifting the breast if necessary.

Letting your baby show you how she wants to postion herself can help you understand how best to help her–even when it’s not practical to remove your shirt!

See also, “Let Your Baby Take the Lead”

Written by Renee Beebe, M.Ed., IBCLC. Renee is a lactation consultant in private practice in Seattle, Washington. She is available for home/hospital visits and phone consultations. Renee can be reached at www.second9months.com

As a mother, you want to help your baby breastfeed. But many times our well-intentioned “help” confuses the baby and results in uncomfortable, ineffective breastfeeding.

To let your baby use her instincts, position her on your lap so her head is slightly under your right breast. Your right hand can support your breast. Your baby’s top lip will be lined up with your nipple and her head will be tipped back slightly. Support her with your left hand just behind her ears, at the base of her neck. Your hand should be between her shoulder blades. Do not touch the back of her head. Lift her so her chin touches your breast. Her nose should be away from your breast. If she’s interested in nursing, she will tip her head back and open her mouth wide. At that moment you can lift her torso slightly so she can latch on. Her upper lip will barely cover the nipple. Avoid pushing her nose to the breast. Do not try to center the nipple in your baby’s mouth.

You can also try positioning your baby on your lap, supporting her so that her left cheek rests on top of your right breast. Hold her so that her head can move freely and the nipple is just out of reach. She will open her mouth and turn her head to find your nipple and begin breastfeeding.

If your baby is latched on correctly, it will be comfortable for both of you. Her nose should be tipped away from the breast and her chin and chest tucked in firmly against your body. You will hear rhythmic swallowing.

See also, “Your Baby is a Mammal!”

Written by Renee Beebe, M.Ed., IBCLC. Renee is a lactation consultant in private practice in Seattle, Washington. She is available for home/hospital visits and phone consultations. Renee can be reached at www.second9months.com

We all love tight arms! Looking good in a tank top, short-sleeved shirt, or swimsuit means having tight arms. But what exercises really tone the biceps and triceps? According to the National Academy of Sports Medicine, focusing a weights workout on biceps and triceps is unnecessary when lifting for the chest and back muscle groups.

How is that possible? When you’re doing a chest press, the triceps are stimulated, and when you’re doing a back pull, your biceps are stimulated. Think of it as multi-tasking. So, don’t feel guilty about cutting out the specific arm exercises. Your arms will become toned as you lift properly. The key is lifting enough weight during your chest and back exercises to reach fatigue at about 15 repetitions. Give it a try. Your arms will feel it!

When my friend Heather got pregnant she experienced morning sickness like few I have known. And I really do think that it’s one of those things you have to experience to understand: a myriad of joy mixed with the deep desire to stay in bed until week 12 is long gone. We have all heard how important protein is during pregnancy. Cells are replicating, your baby needs nutrients and so do you. But what to do when nothing is appealing and even worse: nothing stays down?

Heather actually lost four pounds and was at a loss for what to eat, until her husband Michael discovered the magical pregnancy protein shake. It’s actually quite a simple, nutrient dense concoction that helped her to begin to stomach food throughout the day. To create a pregnancy smoothie at home use a blender to mix together:

1 cup of organic greek yogurt (choose a brand with a high protein content- Heather found one with 24 grams, whereas the one I originally used had 4 grams)
1 cup of your favorite berries (frozen or seasonal)
1/2 cup whole fat milk or dairy alternative
1 banana (optional)
1 scoop of whey protein (find a low sugar variety- less than 2 grams)

Everyone wants great hair. The health of your hair is a direct reflection of your nutrition and lifestyle habits. My friend Amanda recently wrote a great blog about pregnancy and hair care. She was surprised by how much her hair changed when she got pregnant. While we usually shed an average 50-100 hairs per day, pregnancy is considered a resting stage and hair loss decreases, causing hair to thicken. The thickening is attributed to the increase in estrogen which promotes beautiful skin and hair versus high levels of testosterone that promote baldness. Hair is actually thickest in your 20 and 30’s when estrogen levels are peaking. During this time 70-90% of hair is in a growth phase compared to 30 % in your 40’s.

Knowing that your DNA and basic genetics can predetermine graying and balding, here are some tips to help you improve the health of your hair:

Medication

There are certain medications that can impact the health of your hair. Birth controls containing progesterone can shut down hair follicle production, as can thyroid problems, antidepressants and some acne medications. If you are required to take a medication that impacts your hair growth it would be important to follow some of the stress reduction guidelines and dietary recommendations to help counteract the effect.

Stress

The hair follicles are surrounded by stress hormone receptors and are vastly impacted by cortisol and adrenaline. Stress impacts the growth of your hair and can lead to thinning or even balding. Luckily we know that there are ways to reduce stress by making the relaxation response part of your daily routine. Learning to unwind and take some down time not only improves the health of your hair but also your nervous system, metabolism and mood. In Chinese Medicine the hair and bones are related to the kidney energies, our deepest reserves that we trade on a daily basis to fuel our activities. Working too hard, not sleeping enough and failing to eat a healthy diet all contribute to a acceleration of stress and the aging process.

Diet

It is important to eat a healthy diet for obvious reasons including hair health. In fact, depriving yourself of nutrients and vitamins will wreak havoc causing dullness, thinning and split ends. To strengthen hair include lots of antioxidant in fresh fruits and vegetables along with the following nutrients:

Protein is the building block of your hair

Zinc supports natural oils and contributes to shiny hair. Foods with high zinc content include liver, beef, lamb, venison, sesame seeds, pumpkin seeds, green peas, shrimp and mushrooms.

B vitamins support cell growth for regenerating hair follicles. Include fermented products, seaweeds and algae in your diet.

Iron fuels the enzymes that support hair growth (consume with Vitamin C (citrus) to improve absorption). Iron rich foods: liver, lean red meats,seafood, black beans, lentils, dark leafy greens, chicken, turkey, molasses, nuts and egg yolks.

Vitamin E helps with circulation which gives fresh blood supply to hair follicles. Vitamin E foods include: sunflower seeds, safflower oil, peanuts, spinach, broccoli, kiwi and mango.

Vitamin A keeps the hair root lubricated to support healthy hair. Vitamin A rich foods include: liver, sweet potatos, carrots, mangoes, spinach, cantaloupe, dried apricots, milk, egg yolks and mozzarella cheese.

Why do some mothers seem to be overflowing with milk and others barely keep up with their babies? The answer to that questions remains a mystery. We do know, however, which practices enhance milk production and what may decrease milk supply.

Newborns need to eat frequently. All that early suckling before your milk “comes in” helps set the tone for later milk production. Think of as your baby placing an order to be filled at a later date. On the other hand, restricting breastfeeding in the first few days may lead to decreased milk production overall.

You’ve probably heard that milk production is based on supply and demand. That means that the more milk that is removed from your breasts, the more milk you will produce. If more milk is consistently removed from your right breast, your right breast will consistently make more milk than your left. If baby regularly sleeps from 10pm to 4 am, but breastfeeds every 2 hours during the day, you will eventually have less milk in the middle of the night than during the day.

How do your breasts know that your baby is growing and needs more milk? Very simply; the baby asks for it! Your baby will breastfeed more frequently when he needs more milk. After a few days of what may seem to be constant eating, your breasts catch up and all is well. When your baby gets older and doesn’t need to breastfeed as often, your milk supply will naturally decrease.

So let your baby be your guide and your milk supply will take care of itself!

See also: “How do I Increase my Milk Supply?“

Written by Renee Beebe, M.Ed., IBCLC. Renee is a lactation consultant in private practice in Seattle, Washington. She is available for home/hospital visits and phone consultations. Renee can be reached at www.second9months.com

Now that you’ve made the commitment to breastfeed your baby AND you’re going back to work, you may be wondering…how do mom’s really do this?

Here are some tips from experienced breastfeeding moms who have learned how to make every second count!

The night before:

Label bottles of milk with the date and your baby’s name.

Lay out your baby’s clothes and yours. Better yet, dress your baby in the next day’s clothes and forget about jammies!

Keep the pump bag, diaper bag and your charging phone by your purse or briefcase.

Ask your partner to pack your food for the day—lunch and a couple of snacks. You will probably be surprised and delighted at the quantity of food he thinks you should eat!

Add baby supplies to the diaper bag.

In the morning:

Add ice and pumped milk to daycare bag. A little cooler specifically for baby bottles is great for this purpose.

Breastfeed baby one more time before going out the door. Or leave a little early and breastfeed at the day care. That will mean less milk that you will have to pump!

General tips:

Wear clothes that give you easy access to your breasts. You shouldn’t have to take off your shirt or dress in order to pump or breastfeed. Check out www.hadleystilwell.com for professional nursing/pumping clothing.

Remember you don’t need to wash the pump parts after each pumping. Just keep them in a cooler (with ice) or a refrigerator and they’ll be ready to go for the next pumping.

Some moms love to pump hands free. There are bras and other devices that hold the pump flanges in place so you can multi-task.

Invest in extra pump parts—including bottles and caps—and keep extra at work just in case.

Take advantage of oxytocin coursing through your bloodstream. It will help you relax and enhance your creativity.

See also: “Working and Breastfeeding” and “Working and Breastfeeding: A Checklist.”

Written by Renee Beebe, M.Ed., IBCLC. Renee is a lactation consultant in private practice in Seattle, Washington. She is available for home/hospital visits and phone consultations. Renee can be reached at www.second9months.com

Women have been combining work with motherhood for thousands of years. Since babies get their nutrition directly from their mothers, society expected moms and babies to be literally joined at the hip for the first year or more. It’s only been in recent history that “going back to work” has been a potential roadblock to continuing to breastfeed. Although it is normal to work while caring for baby, our modern world and societal expectations often requires moms to be separate from baby while working.

So, is it really possible to continue breastfeeding while working away from baby?Absolutely! It takes some planning and commitment, but as a mother , you’re already committed to your baby and you’re probably a master planner and multi-tasker! Just make sure you have the tools and information you need to be successful.

If you are working more than 20 hours a week, you will need a professional-grade breastpump that is designed to be used every day, several times a day for a year or more. Expect to pay 200 to 300 dollars. Some very good brands include: Medela, Hygeia and Ameda.  (Hygeia is a brand new company.  Check them out at www.hygeiababy.com)

Talk to you employer and colleagues about your plan to continue breastfeeding while working. Find other mothers in your workplace who have pumped at work. Determine where you will pump.

Before you return to work, make sure your baby knows how to take your milk from a bottle or cup or even a spoon.   Give your baby at least 2 weeks to learn this new skill.

Store a few bottles of milk in the freezer just in case! Accidents happen—milk gets spilled, milk gets left at work, etc. You don’t need a whole freezer full of milk! Remember you’ll be replacing what your baby drinks every day!

If possible, visit your baby at lunch. Or arrange for your baby to be brought to you. Mothers who have access to their babies breastfeed longer.

Most importantly, take care of yourself. Learn to delegate! Make sure you eat well and sleep whenever you can. Remember, you have two jobs now!

See related article:  Working and Breastfeeding:  A Checklist.

Written by Renee Beebe, M.Ed., IBCLC. Renee is a lactation consultant in private practice in Seattle, Washington. She is available for home/hospital visits and phone consultations. Renee can be reached at www.second9months.com

One of my closest friends, who is pregnant for the first time, called me the other day in a panic to let me know she was experiencing spotting in her second trimester. Since her doctor’s office was closed, she made the good decision to go to her local emergency room and find out what was going on. The doctor did an ultrasound which revealed placenta previa, and ordered her to bed rest at least until the bleeding subsides. In this case relaxation on bed rest is the key, and perhaps one of the biggest challenges for women who are used to being on the move.

Though initially she was extremely concerned, she has an amazing doctor who talked her through the facts about placenta previa. What we know is that placenta previa is a condition in pregnancy where the placenta (the organ that supplies nutrition to the baby) lies low in uterus, sometimes covering part or all of the cervix. Placenta previa impacts approximately 1 in every 200 pregnant women and it is often, as it was in this case, diagnosed by ultrasound during the second trimester. The condition may be caused by an abnormally shaped uterus, previous pelvic surgery, scarring in the endometrium or a large placenta due to multiples (twins or more). Almost 90% of placenta previa cases will resolve themselves before delivery as the placenta often migrates upwards in the uterus between the second and third trimester.

If an ultrasound reveals that the placenta previa is persisting, you may be asked to remain on bed rest and avoid any strenuous activity. It is also important to avoid unnecessary pelvic exams and intercourse until your doctor says otherwise. In the case of ongoing bleeding or contractions you may be kept in the hospital and monitored in an attempt to prevent a preterm birth. Women who have placenta previa into the third trimester will have their babies delivered by c-section because the placenta is actually blocking the babies exit from the womb.