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Postnatal Period


When I coached my clients I got these questions a lot: "Do I really need to take supplements?" or "I eat a healthy diet, why do I need to supplement?" I don't blame them because before I became a nutritionist, I was thinking the same thing!


While eating nutrient-dense foods is always the best way to get your daily nutrients, this is most often not enough. Especially considering how being a mother impacts your nutrient stores and ability to replenish them. It is extremely difficult for the average mother to be able to plan, cook, and eat perfectly balanced, nutrient-rich meals every single day. Having that expectation is simply unrealistic, and places an unnecessary burden on ourselves and mothers in general. After extensive research on the nutritional status of mothers before, during, and after pregnancy, it is clear that mothers need more than just "healthy food." That is why I created my line of supplements, probiotics, and superfoods so that mothers can get help replenishing their depleted nutrient stores and can feel better and not have the nagging worry that they are not "getting enough" to provide for their babies and themselves.


When people ask me why they should take a supplement, I usually respond with these reasons:


1. Mothers go through incredible physical, emotional, and mental transformations during pregnancy that leaves them nutritionally depleted. 


In fact, over 80% of mothers are considered to be nutrient depleted as a result of pregnancy, birth, and lactation. It's no surprise that as a woman grows an ENTIRE little human (sometimes more than one!) inside of her body, she needs many more nutrients compared to the pre-pregnancy period. It takes a LOT of energy to not only grow a baby, but also to birth a baby and create breast milk to nourish your baby and to reverse all the changes of pregnancy back to a non-pregnant state. While many pregnant and postpartum women try their best to eat nutritious foods, unfortunately, the vast majority of people are unable to meet the nutritional demands of pregnancy and lactation without supplemental support. Take iron, for example. In the U.S., over 24% of women experience anemia during pregnancy, often due to the fact that many women have insufficient stores even before their pregnancy begins (WHO, 2010, Turner, 2003). An iron-deficient diet, an increase of 50% in iron needs, poor iron absorption in the gut, and blood loss from menstruation before pregnancy are some common reasons why women can't keep up with the increase in demand for iron during pregnancy (Abbaspour, 2014). 


Another example is folate, an essential nutrient required for cell division during pregnancy and the synthesis and secretion of breast milk during postpartum, which leads to a decline in its concentration from mid-pregnancy until 3-6 months after birth. In fact, 20% of women in developed countries have been reported to have low serum folate levels 6 months after delivery (King, 2003).


Like iron and folate, many of the nutrients required for pregnancy and lactation are mobilized from maternal stores. So when you start from an already depleted state, it becomes nearly impossible to increase your nutrient intake without taking supplements, especially as the nutritional demands increase throughout your pregnancy and continue to remain high during lactation. 



The changes that occur to your body during and after birth can also contribute to your nutrient depletion. Your entire digestive system shifts and as a result, your microbiome is affected and the digestive process (and therefore the absorption of nutrients in your gut) can be slow and inefficient. While many people view the postpartum period to sometimes be as short as 6 weeks after delivery, the truth is, nutrient depletion can last for much longer. A study by Janet King concluded that it takes approximately 18 months to replete nutrient stores after pregnancy and therefore that mothers with closely-spaced pregnancies are at increased risk of adverse maternal and baby outcomes (King, 2003). 


Pregnancy and postpartum is a truly unique time that places extra stress on your body, so you want to make sure that you are getting the most important nutrients to support your pregnancy and birth, including folate, vitamin D, omega-3 fatty acids, choline, B-vitamins, iron, and collagen. Taking a multivitamin in addition to single nutrient supplements is often the best way to meet the elevated nutritional requirements during this time.


2. Many health issues are linked to nutrient deficiencies.

When we don't have the necessary vitamins, minerals, and other nutrients that our body needs, the biochemical processes in our bodies are unable to work efficiently, which applies chronic stress on our bodies. For example, we all know that omega-3s are key in baby's brain development, but it does a lot more than that. Deficiencies in omega-3 fatty acids like DHA have been linked to auto-immune conditions, postpartum depression, anxiety, and pregnancy complications like preterm labor and hypertension. Low folate during pregnancy has been linked to higher risks of neural tube-related birth defects. Vitamin D deficiency has been linked to osteoporosis, pregnancy complications like gestational diabetes, pre-eclampsia, preterm birth, and data from the CDC Nutrition Report shows that almost 90 million people do not meet the standard required levels of vitamin D (Serrallach, 2018, Nichols, 2018, CDC). Vitamin B12 deficiency, which has been reported in 3.4 million women in the U.S., can lead to anemia, depression, nerve damage, dementia, and increased risks for neural tube birth defects, preterm delivery, and miscarriage (Nichols, 2018, CDC).


For mothers, many of these health risks can have serious consequences for their health and the health of their babies. Conditions like postpartum depression, which is diagnosed in 10-15% of mothers, can be especially crippling (NIMH). While there are many factors that result in mental health struggles, for many mothers, there's often a nutritional component that compounds the issue. Aside from Omega 3's, deficiencies in vitamin D, calcium, iron, selenium, and zinc have also been linked to negative impacts on mood (Leung, 2009).


Addressing nutrient deficiencies through supplementation can be the first step towards feeling better, both physically and mentally.

It makes sense, doesn't it? The more nutrients we can fuel our body with, the more enzymatic processes go smoothly, and the more energy we can get and have.  


3. The nutrient content of the soil in the U.S. has declined greatly over the last few decades. 



Due to modern farming practices, which greatly impacts the soil's natural processes, the soil in the U.S. has lost almost half of its original mineral and vitamin content over the last few decades. A 2004 study which looked at over 40 crops from 1950-1999 found that nutrients including protein, calcium, potassium, iron, vitamin C and riboflavin have all declined significantly, some by up to 38% (Davis, 2004). The decline in nutrient-dense soil has a negative impact on the nutrient content of food, which decreases the amount of bioavailable nutrients for us to absorb into our bodies.

That means that compared to a decade ago, the same vegetables are providing us with less nutrients, so we need to get the extra nutrients elsewhere to make up for it. 


4. The longer you supplement, the better your long term health is. 


One study comparing supplementation of mothers for 2 months vs. 5-7 months after birth between consecutive pregnancies concluded that the group that supplemented for longer had a higher mean hemoblogin status at the onset of their second pregnancies. Their babies also had higher birth weights and lengths and a lower risk of low birth weight compared to the 0-2 month supplementation group, demonstrating that longer supplementation periods between pregnancies can improve the outcome of subsequent pregnancies even among reasonably well-nourished women. We also have to keep in mind that as we age, our bodies naturally decline in nutrient stores. This is especially true for collagen, which declines to about 50% by the time we are 40. While many consider collagen to be helpful for skin health, it is also an important nutrient for your pelvic floor, gut, joints and scar healing.


5. Your babies benefit from your supplementation


You're not the only one who benefits from the nutrients your body absorbs from supplementation, especially if you breastfeed your baby. In a 2012 study on probiotic supplementation, women who were given probiotics during the last 4 weeks of pregnancy and throughout lactation produced breastmilk with double the levels of immunoprotective

compounds. The rate of eczema in their infants during the first 2 years of life was also

decreased for that group of women (15%) compared to 47% for those who did not receive the probiotic supplement (Pelucchi, 2012). Other studies have shown that probiotic supplementation can protect against infant colic, spitting up and overall digestive discomfort. (Nichols, Lily. 2018).


The effects of Omega 3 supplementation in breastfeeding mothers' babies has been studied in depth. Getting enough DHA during pregnancy and lactation can improve behavior, attention, focus, and learning in children. Other benefits that have been found by having adequate DHA during pregnancy is a reduced risk of allergies in infants and a positive influence on immune development.


It's clear that to support the high nutritional demands of pregnancy, birth, and lactation, and recovering postpartum, mothers need the help of supplements.


But knowing what kind of supplements to take can be incredibly overwhelming, especially in a market that is saturated with choices. 


Here are a few things to remember:

  • Getting your levels tested by your primary care doctor is crucial to knowing exactly which nutrients you are deficient in. Having hard data on how deficient you are can help you make decisions on what to supplement with.

  • What matters is the quality and form of the supplements, in addition to the dose. It is a waste to take supplements if they provide nutrients that are unable to be absorbed by our bodies. That is why looking at the specific forms of vitamins, minerals, and other nutrients is important and why all of our supplements were created using bioactive forms (like folate, D3, chelated iron) that are most easily absorbed by the body. Many of our supplements also include ingredients that enhance absorption, like our Organic Ashwagandha with black pepper, and our Vitamin D3 with K2. Sourcing from pasture-raised and organic animals also ensures that the nutrient content is as high as possible. 

  • In addition to single nutrient supplements, look for a multivitamin that contains vitamin A, all the B vitamins, vitamin C, vitamin D, vitamin E, vitamin K, Alpha Lipoic Acid, choline, inositol, boron, calcium, chromium, iodine, iron, magnesium, manganese, molybdenum, potassium, selenium, and zinc.







Not sure where to start?


Take our free Wellness Quiz to get a personalized nutrition report based on your answers about your pregnancies, diet, lifestyle, symptoms and other areas of concern. In your results, you will find out what supplements you could benefit from taking. 


For high-quality products that use the most bioavailable forms of nutrients, explore our online shop. You can find a wide range of products, from prenatal and postnatal multivitamins, potent probiotics for women, to a delicious golden milk mix with collagen (Golden Collagen)!




Did you take supplements during your pregnancy and postpartum? What was recommended to you to take? Tell me in the comments!


References

De Benoist B, McLean E, Egli I, Cogswell M, editors. Geneva: WHO Press, World Health Organization; 2008. WHO/CDC. Library Cataloguing-in-Publication Data. Worldwide prevalence of anaemia 1993-2005: WHO global database on anaemia; p. 40.


Turner RE, Langkamp-Henken B, Littell RC, Lukowski MJ, Suarez MF. Comparing nutrient intake from food to the estimated average requirements shows middle- to upper-income pregnant women lack iron and possibly magnesium. J Am Diet Assoc 2003;103:461–6 


Abbaspour N, Hurrell R, Kelishadi R. Review on iron and its importance for human health. J Res Med Sci. 2014;19(2):164–174.


King JC. The Risk of Maternal Nutritional Depletion and Poor Outcomes Increases in Early or Closely Spaced Pregnancies. The Journal of Nutrition. 2003;133.


Serrallach, O. (2018). The Postnatal Depletion Cure: A Complete Guide to Rebuilding Your Health and Reclaiming Your Energy for Mothers of Newborns, Toddlers, and Young Children. New York, NY: Grand Central Publishing.


Nichols, L. Real food for pregnancy: the science and wisdom of optimal prenatal nutrition. United States: Real food for Pregnancy; 2018.


Second Nutrition Report (2012) [Internet]. Centers for Disease Control and Prevention. Centers for Disease Control and Prevention; 2012. Available from: https://www.cdc.gov/nutritionreport/report_2012.html


Postpartum Depression Facts [Internet]. National Institute of Mental Health. U.S. Department of Health and Human Services; Available from: https://www.nimh.nih.gov/health/publications/postpartum-depression-facts/index.shtml


Leung BM, Kaplan BJ. Perinatal Depression: Prevalence, Risks, and the Nutrition Link—A Review of the Literature. Journal of the American Dietetic Association. 2009;109:1566–75.


Davis DR, Epp MD, Riordan HD. Changes in USDA Food Composition Data for 43 Garden Crops, 1950 to 1999. Journal of the American College of Nutrition. 2004;23:669–82.


Pelucchi C, Chatenoud L, Turati F, Galeone C, Moja L, Bach J-F, Vecchia CL. Probiotics Supplementation During Pregnancy or Infancy for the Prevention of Atopic Dermatitis. Epidemiology. 2012;23:402–14.


You may have heard of maternal depression, but what about maternal depletion? Maternal depletion describes the condition where mothers are unable to recover nutritionally, hormonally, and emotionally after birth. 50% or more of postpartum women are suspected to have nutrient deficiencies that contribute to this condition.  



Pregnancy takes a significant toll on your body.


A mother’s folate, zinc, vitamin B12, vitamin B9, iron, iodine, selenium stores are used throughout pregnancy to provide the necessary nutrition for her growing baby (Serralach, 2018, King, 2003).


By the end of pregnancy, the placenta passes a whopping 7 grams of fat a day to the developing baby, which leads to the progressing depletion of a mother’s essential fat stores.


Studies have indicated a link between low omega-3 essential fatty acid levels and higher incidences of maternal depression (Hibbeln, 2002). As a result, mothers are left feeling exhausted, fatigued, and with what many call “mommy brain” or “baby brain,” which describes the forgetfulness, poor concentration, and general fogginess that is associated with the postpartum period. 





A mother with maternal depletion may experience any of these symptoms:

  • Exhaustion

  • Fatigue

  • Falling asleep without meaning to

  • Not feeling rested after sleeping

  • Brain fog

  • Loss of self-esteem

  • Loss of libido

  • Feeling overwhelmed and unable to cope

  • Feeling guilt or shame



What are the causes?

A combination of factors contribute to maternal depletion:

  • Short intervals between pregnancies (less than 6 months) that do not allow enough time for recovery from birth and lactation have been linked to an increase in the risk of negative outcomes for both mom and baby (King, 2003, Hibbeln, 2002).

  • Chronic sleep deprivation from caring for a newborn. Many women also do not have the necessary support to engage in self-care.

  • The trend in delaying starting families has associated health risks, including a higher incidence of multiples, which places more burden on the mother’s body. 

  • Nutrient-poor food. Research indicates that the mineral content in U.S. soil has been significantly depleted due to modern farming practices. That means the food we eat is not as nutritious as it was generations ago. 

  • Lack of support for postpartum women. Mothers often suffer silently from postpartum depression, anxiety, and isolation because of high societal expectations to “do it all.”


How long does it last?

The length of time that mothers experience maternal depletion largely depends on their ability to replenish their nutrient stores and support themselves in the postpartum period.

Research has indicated that it can take up to 18 months for the body to restore its nutrients after birth (King, 2003).


Unfortunately, if maternal depletion isn’t addressed and a new mom isn’t allowed to fully recover from the demands of pregnancy and birth, the aftereffects can last for years (sometimes up to 10 years!) after a baby is born (Serralach, 2018). 



What should you do to recover from maternal depletion?

An important first step in recovery is replenishing the macro and micronutrients in your body through a conscious diet and supplementation. Having your doctor run blood tests to check your levels is a great way to determine which nutrients you are most deficient in, but the following are the most commonly deficient in postpartum women. Regaining these vital nutrients can help regain some of your energy.


  • Take a DHA supplement to help repair the nervous system and the brain, and to improve mood and cognitive function. Mother Nutrient has an Omega 3 DHA & EPA supplement that provides high levels of DHA and EPA, which can not only help a mother regain depleted stores but can also support her baby’s brain development. 

  • Take a high quality multivitamin. Mother Nutrient also offers a comprehensive Prenatal/Postnatal and Nursing Support supplement that contains 20 essential vitamins, minerals, trace elements, and other nutrients that are important for the mothers. Only active forms of vitamins are used, which means they are easily absorbed and gentle on the body. 

  • Up your intake of iron, zinc, vitamin B12, vitamin C, and vitamin D, all of which tend to decline during pregnancy. (Serrallach, 2018, King 2002) 


The following are recommended food sources for these nutrients:


  • Improve sleep - Changing the number of hours of sleep may be challenging, especially when your baby is little, but you can shift your actions leading up to bedtime to optimize the quality of sleep you’re getting. Stay off screens, use low light, and create a calming environment that is dark and quiet. 

  • Get support - whether it’s through asking family or friends, hiring a babysitter, a house cleaner, a therapist, or a nutritionist to improve your emotional and physical well-being. You can’t have too much of it!


Mother Nutrient is here to be your support too.

We offer unique, holistic recommendations for lifestyle, diet, and supplements to improve your preconception, prenatal, and postpartum healing and self-care.



Start by taking our free Wellness Quiz to find out how we can help! You will get a customized nutrition report, as well as recommendations for specific supplements based on your results. Take the quiz here







Did you know about or experience maternal depletion? Share in the comments below!  



References

1. Serrallach, O. (2018). The Postnatal Depletion Cure: A Complete Guide to Rebuilding Your Health and Reclaiming Your Energy for Mothers of Newborns, Toddlers, and Young Children. New York, NY: Grand Central Publishing.

2. King, J. C. (2003). The Risk of Maternal Nutritional Depletion and Poor Outcomes Increases in Early or Closely Spaced Pregnancies. The Journal of Nutrition, 133(5). 

3. UNFPA(1989) State of World Population 1989. Investing in Women: The Focus of the Nineties. United Nations Population Fund.

4. Hibbeln, J.R. (2002). Seafood consumption, the DHA content of mothers' milk and prevalence rates of postpartum depression: a cross-national, ecological analysis. J Affect Disord., 69(1-3):15-29


Are you feeling tired, lightheaded or dizzy? Have you been experiencing a racing heart or shortness of breath? While feeling tired is a perfectly normal part of recovering from pregnancy and birth, it’s important not to ignore symptoms that could point to a common but serious postnatal issue: postnatal anemia.


Postnatal anemia indicates low hemoglobin in the red blood cells, which is most commonly caused by iron deficiency (De Benoist, 2008). Iron plays an important role throughout women’s lives, especially during pregnancy and the postnatal period. It’s a vital component of hemoglobin, which helps to carry oxygen throughout the body. Women, however, are at high risk of being deficient due to the demands of pregnancy as well as blood loss from menstruation and delivery.


Iron deficiency after birth is especially common. Studies have found that the prevalence of anemia 1 week postpartum for women who had normal vaginal births is 24%-26% in those who did not take any supplements. This percentage rises to a staggering 50-80% for women in developing countries (Milman, 2011). If you delivered via C-section, you are also more likely to suffer from anemia because you tend to lose double the amount of blood during delivery.


What are the symptoms of postnatal anemia?

Any combination of the following symptoms could be a sign that you have anemia. The symptoms can last 6 to 12 months.

  • Fatigue

  • Frequent headaches

  • Shortness of breath

  • Dizziness

  • Emotional instability, in particular extreme irritability

Postnatal anemia can also lead to higher risks for postpartum depression and urinary tract infections and can lead to reduced production of breastmilk. Since fatigue and depression can greatly affect the daily routine of a mother and her ability to care for her children, iron deficiency is an important issue to address for both mother and baby.


What causes postpartum anemia?

The biggest causes of postpartum anemia are iron deficiency during pregnancy, and blood loss and hemorrhage during and after delivery, particularly for women who have had multiples or Cesarean sections.

  • If you’ve been diagnosed with anemia during pregnancy, you are at higher risk of developing anemia after birth as well. During pregnancy, the body’s demands for iron increases threefold to provide enough nutrition for the growth of the fetus and placenta. For many women, it is challenging to keep up with these demands, and their iron stores become depleted, resulting in about 25% of Western women who suffer from iron deficiency anemia. In fact, anemia from iron deficiency accounts for 75% of all anemia that women experience during pregnancy (Horowitz, 2013). For women who carry multiples, the risk of developing anemia is even higher, since the iron requirements increase with each baby. 

  • Postpartum hemorrhage. A typical delivery results in about 500 ml of blood loss and a Cesarean can yield in 1000 ml of blood loss. An estimated 2.9% of women in the U.S. experience postpartum hemorrhage, where she experiences excessive bleeding during or after delivery (Bateman, 2010). Typically after birth, the uterus contracts to expel the placenta and compress the blood vessels in the area where it was attached. Of the various ways postpartum hemorrhage can occur, the main cause is uterine atony, a condition in which these contractions fail to restrict the vessels after delivery. The result is that the uterus continues to bleed, leading to hemorrhage. It’s not surprising then, that the more blood you lose during this process, the more iron you lose as well. A small study on women who experienced postpartum hemorrhage found that 80% of the women who needed emergency hysterectomies as a result of severe uterine atony were anemic during pregnancy. So it’s a bit of a catch-22: if you’re anemic during pregnancy, you’re at higher risk of experiencing postpartum hemorrhage. If you experience postpartum hemorrhage, you’re likely to develop postnatal anemia. 


It’s clear that maintaining the necessary levels of iron is important for both you and baby.


So how can you help your body increase iron?


Nutrition plays a big role in the prevention and treatment of postpartum anemia. The best way to nourish your body is through iron-rich foods. You can get dietary iron through two forms: heme and non-heme. Heme iron is highly bioavailable, with 15-35% available to be absorbed by the body with little effect from other dietary factors, while the non-heme form has a much lower bioavailability at 2-20% (Hurrell, 2010). I recommend eating foods that are rich in heme-iron and boosting absorption with vitamin C. You can also cook using a cast-iron skillet to fortify your food with iron.



Foods that are high in heme-iron:

  • Red meats

  • Organ meats

  • Turkey

  • Chicken

  • Clams

  • Shrimp

  • Fish


What about supplements?

Increasing your iron stores through diet alone can be challenging, so supplementation may be necessary depending on your level of depletion. A great option that Mother Nutrient offers is to take grass-fed beef liver capsules that are easy to take, high in heme-iron, and are easily absorbed. The liver is nutritionally potent, packed with iron and vitamin B12, and has been traditionally used to aid postpartum women to restore their energy and nutrient stores after pregnancy and birth.


In more serious cases of iron deficiency anemia, you may be prescribed a supplement from your medical provider. While ferrous sulfate and ferrous fumarate are commonly prescribed iron supplements, I recommend taking ferric triglycinate or ferrous bisglycinate, which studies indicate results in fewer gastrointestinal issues (which is already common in the postnatal period) while being equally effective (Milman, 2014). Mother Nutrient offers an easy-to-take chewable iron chelate supplement that is highly bioavailable, great-tasting, and non-constipating.


It’s always recommended to consult with a medical professional to determine where your iron levels are. For recommendations about ways to boost your iron intake and address other related postnatal issues you may be experiencing, Mother Nutrient can provide practical, valuable, natural and holistic solutions.


Mother Nutrient Can Help!


In addition to the range of supplements, superfoods and probiotics we offer, Mother Nutrient also has a free Wellness Quiz that creates a customized nutrition report based on your answers to questions about your diet, lifestyle, and pregnancies. You will get recommendations on specific products, diet, and lifestyle changes that may help you. 



You can also join our list to receive a free copy of “Top 10 Postnatal Nutrition Tips” and to receive product deals, new product notifications, and other exclusive information. Sign up on our homepage today!





Did you have iron deficiency after your birth? What helped you? Tell me in the comments!



References

Bateman B, Berman M, Riley L, Leffert L. The Epidemiology of Postpartum Hemorrhage in a Large, Nationwide Sample of Deliveries. Anesthesia & Analgesia. 2010;110:1368-1373.


De Benoist B, McLean E, Egli I, Cogswell M, editors. Geneva: WHO Press, World Health Organization; 2008. WHO/CDC. Library Cataloguing-in-Publication Data. Worldwide prevalence of anaemia 1993-2005: WHO global database on anaemia; p. 40.


Horowitz KM, Ingardia CJ, Borgida AF. 2013, Anemia in pregnancy. Clin Lab Med. 2013;33:281–91.


Hurrell R, Egli I. Iron bioavailability and dietary reference values. The American Journal of Clinical Nutrition. 2010;91:1461S-1467S.


Milman N. Postpartum anemia I: definition, prevalence, causes, and consequences. Annals of Hematology. 2011;90:1247-1253.


Milman N, Jønsson L, Dyre P, Pedersen P, Larsen L. Ferrous bisglycinate 25 mg iron is as effective as ferrous sulfate 50 mg iron in the prophylaxis of iron deficiency and anemia during pregnancy in a randomized trial. Journal of Perinatal Medicine. 2014;42.

Content found on this website is not considered medical advice. Please consult with a physician before making any medical or lifestyle changes.

© 2019 Mother Nutrient

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