The Tot Q&A: Postpartum Care With Josie Bouchier
When you’re swept up in the energy of having a newborn, it’s often easy to forget to look after yourself. Womens’ Wellness & TCM expert, Josie Bouchier answers questions on how to prepare for the first six weeks postpartum and how to take care of yourself while also looking after your baby.
Q: What breastfeeding-friendly herbs or nutrients would you recommend to support energy?
A: I highly recommend a good quality (pharmaceutical quality if you can) prenatal multivitamin and fish oil. A consistent vitamin regimen will help to replenish vital nutrients lost during labor and delivery can help maintain or enrich breast milk supply.
As for herbs, I typically prescribe an ancient Chinese medicine herbal formula called Ba Zhen Tang which tonifies Mama’s Qi (“chee,” aka energy) and Blood. No matter what kind of birth experience you have, you lose a tremendous amount of Qi and Blood during delivery, which directly effects your energy levels, hormone levels, mood and mental health. I also love to recommend Bach Flower Remedies to my postpartum (and pregnant) patients because they are so effective and have no interactions or contraindications during pregnancy or breastfeeding.
Q: Any tips on sleep and recovery with a newborn and an active toddler?
A: Postpartum recovery (and sleep) is a completely different journey when you also have a toddler at home. One of the most useful pieces of information I learned during that time came from a parenting method called Hand-in-Hand Parenting, which is based on child brain development. (You can check out their website handinhandparenting.org for more info.) I learned that toddlers do not need you to match their high energy levels, nor do they need to be out and about in the world until they are 7–10 years old. What toddlers need the most from you is your presence, your time, and your attention, which you can give them while resting on the couch and feeding your newborn. One of the ways I learned how to offer connection to my toddler while breastfeeding my newborn was to “follow the laughter.” This is a method they teach where you simply keep doing what makes the child laugh, and then you laugh yourself, too. Sometimes I would make a funny face or a noise over and over again, both of us laughing, for 15 or 20 minutes. Laughing together like that causes a bonding brain connection that fills the toddler’s emotional cup.
After this type of interaction, my daughter always felt content to play and entertain herself for awhile, which freed me up to rest and care for her baby sister and for myself. Win-win! The other piece of advice, and permission, I’d like to offer you is to ask for or hire help. No one was ever meant to care for their baby alone or to take care of themselves alone. Traditionally, we had a community of people around us to tend to our needs and our baby’s needs. One of the most nurturing things you can do for yourself is to create this community for yourself, or hire it if you have the means.
Q: What can you do for postpartum anxiety and emotional well-being that is safe while breastfeeding?
A: One of the best tricks you can do to nip anxiety in the bud, whether or not you are postpartum or breastfeeding, is to take deep belly breaths. This can be done anytime, anywhere, and it’s the single most effective thing you can do to flip the switch in your brain from “fight or flight” to “rest and relaxation.” Taking a couple minutes to breathe from your belly, as often as you can throughout the day, will have a profound impact on your level of anxiety and emotional well-being. I also highly recommend acupuncture for postpartum anxiety and emotional well-being because it is completely safe while breastfeeding and extremely effective.
Bach Flower Remedies are also wonderful because they are safe while breastfeeding, can be found at most health food stores, and they solely address emotional well-being. Additionally, make sure that you have a solid support system in place, whether it be a therapist our counselor and/or 1–2 close friends you can text or call when you are feeling at the end of your rope who will simply listen and let you vent and offer love and encouraging words. There is no shame in taking western prescribed anti-anxiety or antidepressant medications that are considered safe while breastfeeding if you need extra support. I don’t think all-natural approaches are always appropriate for everyone, especially in the acute phases of postpartum recovery. If your emotional well-being is at risk, don’t be afraid to reach out and ask for help. Every mama I’ve ever worked with struggles to some degree with postpartum recovery; it’s something that needs to be talked about more and brought into the awareness of everyone around us so that it’s no longer a taboo subject.
Q: Is there a way to prevent postpartum depression/baby blues?
A: Unfortunately, there is no surefire way to prevent postpartum depression, but there are many things you can do to lessen the odds, soften the impact of the postpartum phase, and set yourself up for a more successful experience. Consistent acupuncture throughout your pregnancy can help keep your hormones balanced, which can help prevent postpartum depression. Just make sure you find someone that specializes in women’s health and/or pregnancy, because there are certain acupuncture points that are contraindicated during pregnancy, and you want someone who knows what they’re doing.
Setting up a reliable support system and using it now, before you deliver, can do wonders for your mental-emotional state once baby is born. Whether this support system includes a therapist or counselor, or 1-2 close friends or family members, just make sure that any one of these people is only a phone call or text away at any given time. Eating a healthy diet and staying on a consistent vitamin regimen that includes a high quality (or pharmaceutical grade) prenatal multivitamin and fish oil, can lessen the depletion you’ll experience after giving birth. If you’re less depleted, you’re less likely to slip into postpartum depression.
Like I mentioned earlier, there is no shame in taking western prescribed anti-anxiety or antidepressant medications (that are considered safe while breastfeeding if you are breastfeeding) if you need extra support. I don’t think all-natural approaches are always appropriate for everyone, especially in the acute phases of postpartum recovery. If your emotional well-being is at risk, don’t be afraid to reach out and ask for help.
Q: If I had trouble breastfeeding and pumping with my first because of low production, will I have trouble with my second?
A: Just because you had trouble with pumping and low production with your first pregnancy does not necessarily mean you will have trouble with your second. According to Chinese medicine, the two most important factors to keep your milk production levels high and easily flowing are adequate nutrition (and digestion to absorb and assimilate the nutrients you put in your body), and low stress levels. In Chinese medicine, breast milk comes from transformed food, so make sure you’re eating a nourishing, balanced diet and consistently taking your prenatal vitamins. Additionally, be sure to include foods that are “galactagogues,” which means that they promote breast milk production. Galactagogues include whole grains, dark leafy greens, fennel, garlic, chickpeas, nuts, seeds, ginger, papaya, and spices like cumin, anise, fennel, and turmeric.
When we’re emotionally stressed, our Liver Qi (energy) constricts, especially in our chest area. When our energy is constricted, this can stop or greatly hinder the flow of breast milk. Massaging the breasts in a clockwise circular motion can help restore the energy, blood, and milk flow. You can use a small amount of coconut or sesame oil to make it easier to massage, and you may also want to use a heating pad to warm the area.
Q: What are some healthy foods to have on hand for quick snacking while taking care of baby?
Some of my favorite go-to, one-handed snacks are: veggies with hummus and olive oil, mashed canned sardines in marinara sauce with whole grain crackers, apple with almond butter, mozzarella cheese sticks with whole grain crackers, turkey slices with veggies, sprouted grain toast with mashed avocado, salt and pepper. I also find it useful to make big batches of soups, stews, or broths that can be easily portioned and quickly heated up in a mug in the microwave, or on the stovetop. Sipping on broth throughout the day is a wonderful way to nourish the body when you don’t have the time or energy to make a complete snack. You can also buy miso paste and simply stir a couple spoonfuls in hot water to make a yummy miso soup. In Chinese medicine, it’s important not to put out your “digestive fire” by consuming too much cold or raw food. Balancing uncooked snacks, like those mentioned above, with warm soups, broths, and teas will help to nourish and strengthen your digestion after giving birth.
Q: What are some ways to not feel so isolated when stuck inside so much caring for them?
A: Caring for small ones can feel extremely isolating in today’s modern parenting culture. When I was home all the time with my daughters, I relied heavily on social media to feel connected to the outside world. I also fell in love with an app called Yoga Glo because it had guided meditations and yoga classes for every ability level and time commitment. Whether you have 5 minutes or 50 minutes, you can log in and choose a guided meditation (there are several specifically aimed at parents) or a yoga session and it’s just you and the instructor for that amount of time. I always ended the class or meditation feeling renewed and centered, and most importantly, like I just had an interaction with another adult. I’m sure there are several apps that exist like this one, but that was the one I loved. It was a life saver! I also recommend FaceTime or talking on the phone with one adult per day, whether it’s a friend, family member, counselor or therapist. Plan on it, even if it’s just for 5-10 minutes. It can make a world of difference.
Q: Any big nutrition don’ts while breastfeeding?
A: Luckily, there aren’t any major dietary “don’ts” while breastfeeding. However, avoiding contaminated food is probably the best thing you can do for your health and your baby’s health while breastfeeding. The best way to find up-to-date information on mercury toxicity in seafood, and pesticide toxicity in produce, is to check the Environmental Working Group’s website periodically. You might even want to keep a copy handy of the Dirty Dozen and the Clean Fifteen while grocery shopping so you know which produce to buy organic, and which produce is ok to eat even if it’s conventionally grown.
Additionally, caffeine and alcohol are best consumed mindfully and in moderation since baby will experience some residual effects from both. Try to time your consumption just after you’ve nursed or pumped, which will give your body some time to process the caffeine or alcohol and it will be much lower concentration, if any, at baby’s next feeding. A good rule of thumb is if you don’t feel the effects anymore, neither will your baby. The other thing to watch out for nutritionally while breastfeeding will be different for every mama and baby are food sensitivities or allergies. Signs that your baby might be sensitive or allergic to a certain food or foods can include eczema, rashes, increased fussiness, gas, diarrhea, congestion, and vomiting. Keeping a food journal can help to make correlations between symptoms and foods.
Q: What’s a good prenatal routine you would recommend if you only have 15 minutes every day? Postpartum?
A: Hands down it would be pelvic floor strengthening, both during pregnancy and postpartum. During pregnancy, I would seek out a prenatal pilates instructor and have them teach you a 15 minute routine to do daily at home. That way, they can customize your routine for where you are in your pregnancy and account for any possible physical limitations and medical history. Once you are in the postpartum phase, I highly recommend an online program by Wendy Powell called MuTu. As part of the program, she gives you a 15 minute daily exercise routine that you can do anytime, anywhere at home and it works wonders! She offers much more extensive workouts as part of her program, but I only did the 15 minute daily routine and noticed a huge difference in my postpartum recovery. She also takes into account where you are in your postpartum recovery and you can start out slow and simple and then get more advanced.
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