preterm labor
Mamas on Bedrest: Fish Oil for The Prevention of Post Partum Depression
November 11th, 2011
Click to take the postpartum depression survey conducted by Case Western Reserve University http://filer.case.edu/~axp335/postpartdep.htm Thank you very much for your consideration.
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November 14, 2011 kicks off the week long Living Self Care Challenge. Mamas on Bedrest & Beyond has joined forces with Dr. Diane Sanford-The Real Mom Expert, Post Partum Progress, My Post Partum Voice, Pregnancy.org and others to encourage mamas to put their own self care on the top of their “To Do” lists. For one week, the Living Self Care Blog will offer tips and suggestions to mamas on how to find ways to carve out a little “me time”. Participants will be eligible for prizes for their participation.
In honor of the Self Care Challenge and in an effort to raise awareness of post partum mood disorders, post partum depression in particular, I present to you now some very interesting information from one of my favorite researchers, Dr. Kathleen Kendall-Tackett. Dr. Kendall-Tackett, is a health psychologist and also an International Board Certified Lactation Consultant (IBCLC). As previously stated on this blog Dr. Kendall-Tackett has done extensive research on the effects of chronic stress and depression on preterm labor and post partum health. Much of her work is posted on her websites UppityScienceChick.com and BreastfeedingMadeSimple.com. Here, we highlight Dr. Kendall-Tackett’s findings on the effectiveness of fish oils as a prevention for post partum depression.
In a 2007 article published on the La Leche League’s Website Dr. Kendall-Tackett discusses the role that inflammation plays in post partum depression.
When we are faced with threat, our bodies have a number of mechanisms designed to protect our lives. Three interrelated systems respond: catecholamine, hypothalamic-pituitary-adrenal (HPA) axis, and the immune system. The catecholamine system (the fight-or-flight response) releases three neurotransmitters (chemical substances that transmit nerve impulses): norepinephrine, epinephrine, and dopamine. The HPA axis also releases several hormones including the stress hormone cortisol. In recent years, researchers have discovered that the immune system also responds to threat by releasing molecules that increase inflammation. These molecules are known as proinflammatory cytokines and they have a causal role in depression. The proinflammatory cytokines that have been identified most consistently in depression are IL-1, IL-6, and TNF-a.
Maes and his colleagues (2000) first identified increased inflammation as being related to depression and anxiety in postpartum women. When inflammation was initially identified as a risk factor for depression, it was generally seen as one of many: one that was comparable to risk factors such as low social support, maternal history of affective (emotional) disorders or trauma, infant illness or prematurity, or low socioeconomic status. More recent research, however, has revealed that stress of all types increases inflammation, and that inflammation is the likely mechanism by which the other risk factors lead to depression. This is true for depression in general and for postpartum depression in particular. These recent studies constitute an important shift in how we think about depression: inflammation is not simply a risk factor; it is the risk factor that underlies all the others.
Pregnant and postpartum women are particularly vulnerable to these effects because their inflammation levels normally rise during the last trimester of pregnancy — a time when they are also at high risk for depression (Kendall-Tackett 2005; 2007). Inflammation serves several important functions in pregnant women including preparing their bodies for labor and protecting them against infection once the baby is born. However, in depressed women, inflammation levels are too high.
Dr. Kendall-Tackett goes on to outline how stress can lead to depression which can lead to preterm birth. She also discusses the particular causes of increased stress in pregnant and post partum women: sleep disturbances, pain and psychological trauma. What new mama isn’t experiencing any one or all of these? The good news is that there are ways to mitigate the risks and reduce the incidences of post partum depression, and Dr. Kendall-Tackett says that fish oils play an important role.
In Can Fats Make You Happy? Dr. Kendall-Tackett discusses the role of fish oils in the prevention and treatment of post partum depression. She explains that in most industrialized nations, we consume far too many Omega 6 Fatty acids (found in vegetable oils and processed foods) and not enough Omega 3 Fatty Acids. Additionally, the Omega 3 fatty acids typically used to fortify foods are Alpha linoleic Acid, a plant based Omega 3 Fatty Acids. The long chain Omega 3 Fatty Acids docosaheaenoic acid (DHA) and eicosapentaenoic acid (EPA), found in fish, have been found to be more potent in reducing inflammation and in turn, depression. In countries where high fish consumption is the norm, the rates of depression are nearly half what they are in nations where fish is rarely consumed. The problem is further compounded by the fact that many pregnant women are counseled against eating lots of fish during pregnancy due to possible mercury contamination. So Dr. Kendall-Tackett and others recommend that women take Omega 3 (fish oil) supplements.
The recommended doses of Omega 3 Fatty Acids needed to prevent (or at least lower the risk of and reducing the symptoms of post partum depression) are the following:
- 200mg-400mg of DHA (minimum) daily. This dose may actually prove to be too low. In countries where fish consumption is high, women consume about 1000mg DHA/day.
- 1000mg EPA for the treatment of depression
- The US Food and Drug Administration finds Generally Recommended as Safe (GRAS) up to 3000mg/day EPA/DHA
If mamas on bed rest are concerned about their risk for post partum depression-or if they feel they may be depressed, they should first and foremost consult with their health care provider for a complete evaluation. If it is safe to do so and their provider notes no contraindications, mamas may choose to begin taking a fish oil supplement rich in Omega 3 Fatty Acids DHA and EPA. Mamas should be sure that their supplements are contaminant free and are manufactured using proper (Pharmaceutical) manufacturing practices to ensure that the proper amounts of fatty acids are contained in each supplement.
Fish oil Supplement Mamas on Bedrest has found that meets all of the aforementioned criteria.
What’s your take on fish oils? Share your questions and experiences in the comments section below. To keep the discussion going, chat with us on twitter (@mamasonbedrest) or on our Facebook Page. To receive our blog as soon as it is published, subscribe via RSS feed. Simply click the orange circle on the top of this page, the upper right hand corner.
Mamas on Bedrest: Are You Aware of Prematurity?
November 4th, 2011November is Prematurity Awareness Month.
Throughout the month various organizations will be presenting programs to raise awareness about prematurity.
What’s most interesting to me is that prematurity and preterm birth are not discussed during pregnancy-at least they weren’t discussed during my first pregnancy. When I was pregnant with my daughter, I had complication after complication. It was with her that we contemplated bed rest, but she and I would always rally, we’d both settle down and we managed to keep going. I went into labor at 36 weeks, 6 days. She was coming fast and furious and there was no stopping her! Still, I was unaware that she would be considered premature (she missed 37 weeks by a mere 4 hours!!) and that she would land in the NICU. I’m not going to rehash that story as I have already told it here. But I often wonder, given my complications and mishaps why no one ever mentioned,
“If this baby comes before 37 weeks, she will be considered premature. One out of every 8 babies is born premature in the United States. Worldwide, 13 million babies are born premature each year. These are the potential complications that could arise and if she is born early, she will likely be cared for in the NICU (neonatal intensive care unit). “
I realize that most OB’s prefer to be positive and to avoid “planting seeds of doubt” in minds that may already be “overactive”. But I was really taken aback the first time that I saw my daughter with a myriad of wires and leads attached to her and was scared out of my wits when I picked her up and an alarm went off. (It merely indicated that a lead had come off of her little foot, but the bells, whistles and lights that began wailing were frightening to say the least!). There should be at least some mention of preterm labor and preterm birth and what that means at some point in the prenatal period. Perhaps as each trimester begins, OB’s and midwives could review what is going on developmentally and what would happen if the baby were to be born at that point in time and how the baby would be cared for. That would have helped me greatly.
So Mamas on Bedrest, I am sharing a few resources here that I highly suggest you review. You don’t have to delve deep into prematurity, but be aware that if you are not at or beyond 37 weeks and your baby were to be born now, your baby is premature and will need special care-perhaps for years to come. Here are some resources to “keep handy”.
March of Dimes
The March of Dimes is quite frankly the most widely known organization dedicated to the health and well-being of babies. They have (in the United States) nationwide offices and resources on all things baby. They have supported extensive research and programs to promote full term pregnancies and to help prevent preterm birth. They run awareness campaigns for Prematurity Awareness Month and in January 2012 will host the Prematurity Prevention Symposium in Washington, DC.
The Preemie Primer
The Preemie Primer by Dr. Jennifer Gunter should be “required reading” for parents of preemies. Dr. Gunter is a mama to very premature triplets, 2 here and one in heaven, and shares how she combined her extensive knowledge as an OB/GYN and Rehabilitation physician to help with the care and development of her boys (now approximately age 8).
Fragile Beginnings Preemie Parent Alliance
A Massachusetts Based Coalition of Organizations, Fragile Beginnings is committed to improving the lives of parents of premature infants through direct support services, providing educational materials, as well as connecting them to community resources and to each other. They are hosting Prematurity Awareness, an event on November 16, 2011, to raise awareness about Prematurity in Massachusetts.
We are constantly adding to our resource page for Preemie Parents as we learn of organizations and resources.
Do you have a preemie parent resource or other information on prematurity? Please share such information at info@mamasonbedrest.com so that we can make it widely available.
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Mamas on Bedrest: My Little Lovely is 9 Today!
October 7th, 2011
My daughter is 9 years old today.
She awoke with an exuberance that has been bubbling up since we changed the calendar to October. This past Monday, she said to me, “Mama, it smells like October.”
“What does October smell like?” I asked.
“You know, like Fall and Halloween and….MY BIRTHDAY!!!!!!!!!!!“
She has literally been bouncing around all week in anticipation of her birthday festivities. And she has declared the entire month of October her birthday.
It absolutely blows my mind to see this person, who is a mere 6 inches shorter than me (but I’m only 5 ft tall so…), who has ever increasing curiosity about my make up and my jewelry, who is into all things girlie, pink and frilly and will who be a junior cheerleader tonight with a local high school squad emerge from the tiny 5lb 3 oz preemie who struggled to breathe at birth.
My daughter came into this world emergently and insistently on October 7th, 2002 at 8:03pm, 3 weeks and just under 4 hours shy of her due date. Hers was my most difficult pregnancy and one that on more than one occasion I feared wouldn’t survive. I spotted at about 18 weeks and we thought that I was miscarrying. I had “uterine irritability/preterm labor” around 20 weeks-then again at about 22 weeks and again at about 26 weeks. We batted around the idea of bed rest, but each time we got to that point, my daughter would settle down. It was so like her to want to do things in her own way; flopping around a bit as if searching for the exit, but then staying put. Not much has changed.
I am amazed at the bright-eyed girl who looks back at me with the same fixed gaze that she gave me the first time that I held her in the NICU. She looked at me then as if to say, “Oh, it’s you. Good to see you.” I am also amazed at the determination I see reflected back at me when we’re “locking horns”. She holds her ground and doesn’t back down to me or her father. Oh, she obeys what we say, but as she once told me, “Ya know Ma, when I’m older and all grown up, I’m not going to do this!” Of that I have no doubt. She knows what she wants and I am certain that she will get it!
It continues to be my joy and my honor to watch her grow and mature. (Some days more than others!) Watching her devour a burger and fries when she used to stop breathing when she first started nursing heartens me. To watch her tear out after her brother after all the nights I sat up giving her round the clock breathing treatments to ease her breathing and open her airways fills me with joy. To see her wearing one of my t-shirts and it only hanging just a little bit makes me smile because I remember how hard we worked (and how much I fretted) to get her to gain weight and grow for the first 2 years of her life.
I know now that my daughter never had (and doesn’t have) any doubt that she would (will) make it. It’s always been me who has doubted and believed all the negative news the doctors told me. When the neonatologist suggested that we insert a feeding tube down her nose to give her “an adequate amount of food”, my daughter gave him the same steely gaze she often gives me when she adamantly refuses to do something. Then she drank 40 cc of breast milk her very next feeding. “Take that up your nose!” she seemed to say to the neonatologist. And she was discharged 3 days later.
My daughter never ceases to amaze me and she most certainly inspires me. Happy Birthday My Little Lovely!
Bedrest Veterans, please share your stories of triumph. Mamas on Bedrest need to hear these stories and see our children to know that “good outcomes” really do happen. Share your stories below and give your support. Your story may be just what another mama needs to hold on for another day. Thank you!!
