Traditional Chinese Medicine and Food Cravings

In TCM (Traditional Chinese Medicine), each of the 5 organ meridians correspond to the 5 flavors of food. An imbalance in the system will cause a person to either crave a certain flavor or have a strong aversion to that flavor. Meeting this craving (or not avoiding the aversion) is about balance — satisfying the need without over-over-indulging. There’s also the option that your craving means nothing but it’s still a good idea to always pay attention to your body’s signals.

Salty: KD

• Crave extra salt on meals, chips, cheese

• Related emotion: fear surfaces or is confronted, salt cravings help pad the body with more water

• Balancing cravings:

  • Instead of consuming overly salty foods, nourish the kidneys with the natural sodium found in celery, seaweed, bone broth, seafood, or beans

  • Western take: this could be a sign of chronic stress, adrenal fatigue or certain medications.

• Other beneficial foods: black beans, walnuts, blackberries, blueberries
  

Sour: LV

• Crave sour candy, citrus, sourdough bread, vinegar or fermented foods (kombucha, pickles), olive oil, olives

• Related emotions: frustration, anger or stress —> the LV Qi is constrained and not able to freely flow due to anger or stress and we crave sour foods to help disperse the stagnant energy

• Balancing cravings:

  • Drink warm water with ACV, lemon juice and honey in the morning, snack on green apples, eat cruciferous vegetables

  • Avoid alcohol, fatty/greasy foods
    

Bitter: HT

• Craves coffee, chocolate, caffeine

  • Chocolate is a comfort food for many (hi Mom)

• Related emotions: lack of joy, mental restlessness

  • We are craving stimulation and bitter foods to wake up the nerves of being frazzled or fatigued

• Balancing cravings:

  • Consume red foods - beets, cherries, strawberries, red cabbage, red grapes, red beans, tomatoes or watermelon

  • Western take: make sure you are eating high quality chocolate (70% cocoa or higher) and getting enough magnesium-rich foods like leafy greens, nuts and seeds
    

Sweet: SP/ST

• Craves sugar and sweets, grains, dairy, candy, ice cream

• Related emotions: worry and not feeling nurtured or grounded

• Balancing cravings:

  • Nourish the spleen by consuming root vegetables (to help ground the person), cinnamon, ginger, beans, brown rice, oats, fruit

  • Western take: make sure your blood sugar is not fluctuating too much. If you are feeling fatigued or foggy, your body may be craving sugar as a way to quickly increase blood sugar
    

Pungent: LU

• Craves spicy food or hot sauce, wasabi, jalapeño or mints/gum

• Related emotions: sorrow, grief that has been suppressed

• Balancing cravings:

  • Release emotions, consume onions, ginger, garlic (not too much as they are hot foods), almonds, pears, sesame seeds

Cravings can often tell us a story of our needs whether it is our overall body, our nutrition or even just our emotional needs. The next time you go to grab a pickle (am I the only one pregnant?), think about other ways you can also nourish your body, mind and soul.

Traditional Chinese Medicine and Dampness

Dampness. In Traditional Chinese Medicine, dampness is the cause of many diseases. If you were ever more musically inclined than I was, you were probably told to avoid dairy prior to a choir concert because it could make your voice rattle. That is a prime example of dampness in TCM. For some it looks like impaired digestion (mucous stools, loose or sticky stools and maybe even undigested food in the stool), others are a little phlegmy, and some people are oh-so-fortunate to have heaviness, swelling or water retention or a distended abdomen. Now, before you figure there’s no hope and you are doomed with loose stools and phlegm the rest of your life, there are some things you can do to limit the formation of dampness and decrease dampness.

Proactive measures that limit the formation of phlegm and dampness

• Eat food and drinks at room temperature or warmer

• Incorporate bitter, pungent and aromatic foods and spices

• Drink bone broth as a snack

• Appreciate the flavor of foods

• Eat small to moderate size meals and avoid over eating or eating until you are overly full

• Drink ginger tea

• Exercise regularly

Foods to incorporate to decrease dampness:

• Lightly cooked vegetables

• Whole grains (brown rice, barley, rye, oats)

• Bitter, sweet, pungent and aromatic spices

  • Includes: cloves, ginger, black pepper, cardamom, cinnamon, mustard, mustard greens, nutmeg, thyme, turmeric, basil, parsley, garlic, onions, shallows, horseradish, turnips, radish, cayenne

• Legumes (kidney beans, pinto, red lentils)

• Meat, poultry and fish in small quantities 

• Small amount of whole fruits and lemons

• Sesame, pumpkin and sunflower seeds

• Tea (green, oolong, jasmine, raspberry leaf)

• Bone broth

Foods to limit or avoid when you are feeling phlegmy or damp:

• Cold, raw foods (uncooked vegetables)

• Refined sugars

• Fatty meat (bacon or duck)

• Eggs

• Fruit juices

• Coffee and alcohol

• Deep fried foods

• Nuts

  • Limit to 1-2 portions per day (8-10 nuts is one serving)

• Dairy (cold foods - cheese, milk, ice cream)

• Wheat (refined flour or pasta and bread)

• Cold or iced drinks

• Banana

  Avocado

Breastfeeding and Pelvic Organ Prolapse

Is weaning the best option when a mama has incontinence or prolapse?

Birth, it is a magical time where we finally meet the newest love of our life. Unfortunately, the birthing process sometimes leads to less than magical side effects like incontinence (leaking of urine when we laugh, cough, sneeze, jump or lift or a strong urge to go all.the.time) and maybe even pelvic pain or pelvic organ prolapse. For many moms that are breastfeeding they are given two options: 1) deal with it until you decide to stop breastfeeding or 2) wean your child. Since I’m feeling feisty today I’m going to put it bluntly, both of those options are steamy pile of BS. And since I like to back up my feistiness with research, here’s why you deserve better:

Relaxin and estrogen are not the enemy

Doesn’t increased relaxin and decreased estrogen weaken the tissues of the pelvic floor? Well, kind of. Prolactin, can block the production of estrogen. And it’s true, a decrease in estrogen can weaken the pelvic floor musculature but this is most commonly seen with the hormonal shifts of menopause, not postpartum. Relaxin has also been shown to decrease by three days postpartum so it is unlikely that relaxin is causing the pain or discomfort.

Many mamas who supplement also experience similar issues so emphasizing the hormonal effects of breastfeeding at the expense of looking at the bigger picture can lead to insufficient care for new moms. For a long time breastfeeding and hormones have been blamed but there is new information coming out about the importance of nutrition, methylation (liver support), the gut microbiome and even sleep quality as it relates to pelvic pain. All of this to say, it isn’t just breastfeeding but everything going on around you that can affect what’s going on down there.

Prolapse, incontinence and pelvic girdle pain are all signs of mechanical dysfunction

Often times mama who have prolapse or incontience also have hip and/or low back pain, diastasis recti and even pelvic pain. These are all signs of a mechanical problem. Mechanical problems are often best treated, well, mechanically. This is where a professional trained in pelvic floor rehabilitation and functional movement excels. A proper evaluation of the pelvic floor looks at you, the mama, as whole. If you aren’t sure what to expect, here’s a great article on what to expect at Your First Visit to See a Pelvic PT. The evaluation often includes your history, a movement exam (including how you are breathing, your posture, etc), specific tests to look for both stability and mobility, myofascial palpation (do you have tenderness in the abdomen, pelvis, buttocks or even the thighs), and the pelvic floor exam once you feel comfortable. This whole-body approach will help your provider determine the mechanical cause(s) of prolapse, pain, discomfort or incontinence in order to treat the entire system.

Breastfeeding and Pelvic Girdle Pain - Are they related?

There was longitudinal study out of Norway that followed over 10,000 women that showed breastfeeding has a small beneficial effect on pelvic pain and should be encouraged rather than discouraged.

The Catch: Lactational Atrophic Vaginitis

Atrophic vaginitis is dryness and inflammation of the vaginal tissues generally seen in post-menopausal women but can sometimes cause symptoms in lactating moms due to excessively low estrogen. Signs of lactational atrophic vaginitis include pain during sex, decreased sex drive, vaginal itching or dryness, frequent UTIs, irritation with clothes and an increased urge to urinate.

Although lactation atrophic vaginitis is caused by decreased estrogen, there are solutions that can help manage this discomfort! The management of atrophic vaginitis is different than the management of prolapse, pelvic pain or incontinence as it may include hormone replacement in the form of topical estrogen (see OB/midwife for appropriate recommendations), botanical therapies and self-help measures. Botanical therapies may include moderate amounts of phytoestrogens like soy, oats, sesame seeds, barley, apples, carrots, lentils and pomegranates. Self-help measures include using water-based lubricants to help moisturize the tissue or Vitamin E oil or hyaluronic acid suppositories.

There are many factors that influence postpartum recovery. It is important to figure out what influences you individually. For some moms, they need more emotional support or self care time, others benefit from attention to nutrition, improved sleep (yes, difficulty sleeping is closely related to pelvic pain) some are in pain from physical complications related to their birth and labor experience. If any provider undermines your confidence in feeding your child by stating breastfeeding is the only cause of your pain or discomfort, you are allowed to fire them. Each mama is different and it is important to enlist the appropriate support team to look at the whole picture. Along with you, that team may include a chiropractor or physical therapist trained in pelvic floor rehab, your OB or midwife, nutritionist or a functional medicine doctor. It’s important for the team to work together WITH YOU to determine the root cause of your incontinence, prolapse and/or pelvic pain.

I know you would probably love to be in control of your pelvic health and have a plan so I’m excited to offer a complimentary 15 Minute Healthy Mama Strategy Session or you can schedule an appointment today. I look forward to hearing from you and if you have questions, don’t be afraid to reach out and ask!

References:

1. https://obgyn.onlinelibrary.wiley.com/doi/full/10.1111/1471-0528.13118?fbclid=IwAR0g9BcZRjxZjUA-rpXpWykvR_gWeDzF7-nNd78k7OA9_e4gp6ZF5UJNCa4

2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4307380/

3. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(86)92068-4/fulltext

4. https://www.ncbi.nlm.nih.gov/pubmed/12867914

*Disclaimer:

The information by Dr. Lauren Keller of Elemental Chiropractic, Inc. is provided for general information only and should in no way be considered as a substitute for medical advice or information about any particular condition. While every effort has been made to ensure that the information is accurate, Dr. Lauren Keller nor Elemental Chiropractic, Inc. make no warranties or representations as to its accuracy and accept no responsibility and cannot guarantee the consequences if individuals choose to rely upon these contents as their sole source of information about a condition and its rehabilitation. If you have any specific questions about any medical matter or think you may be suffering from any medical conditions, you should consult your doctor or other professional healthcare provider. You should never delay seeking medical advice, disregard medical advice, or discontinue medical treatment because of information on this website.

Perineal Massage during Pregnancy & Delivery

Perineal massage is massaging of the pregnant mama’s pernineum (area around the opening of the vagina). Perineal massage is most effective at stretching the perineum to help mentally and physically prepare for labor in first time mamas. Often times perineal massage is recommended starting the last month of pregnancy and ideally starting earlier at week 34. Perineal massage is recommended 1-2 times per week for 5 minutes each time. As much as we all want to think that more is always better, research actually shows that 1-2x a week is the happy medium and there are no added benefits of doing it more frequently.

How To Perform Perineal Massage

First, talk to your provider to determine if it is safe for you to perform perineal massages. Some contraindications include rupture or leaking of membranes, spotting/recurrent vaginal bleeding and indications that the womb may not be structurally normal. Once you get the green light, decide if you want to perform the perineal massage or if you want your partner to help. Next, wash your hands and trim your fingernails!

Once you’re physically ready, find a comfortable position that allows you to reach your perineum. For some this is squatting on a chair with your knees spread or using a stool to support one leg while other fortunate people are able to reach simply by sitting propped up. The position doesn’t matter as long as you are comfortable. Next up, pick your lubricant of choice making sure you have enough but not too much (a rough guess is ~1 tsp but to each their own). Start by massaging the lubricant into your perineum and using your thumb and index or middle finger, insert your fingers into the vagina up to the first knuckle.

Once inserted, gently massage and stretch the vaginal walls apart (sides and towards the anus). You can press your fingers away from each other and hold the position while breathing and relaxing the muscles. Now, the goal of perineal massage is to GENTLY stretch the perineum so while there may be pressure, please do not go to the point of pain! To prepare for labor if there is pressure or discomfort, you can also practice breathing and progressive relaxation to help.

Benefits of Perineal Massage

Perineal massage prior to labor may reduce the likelihood of episiotomies and perineal trauma that requires stitching during childbirth. There were no differences in likelihood to have first, second, third or fourth degree perineal tears.

Perineal massage during the second stage of labor by a healthcare provider resulted in fewer mamas having third and fourth degree tears and more women with intact perineums.

For mamas who have birthed before, there was a significant reduction in pain at three months postpartum.

This one isn’t backed by research, but using perineal massage as a feedback tool can be a great way to help you connect and communicate when done with your partner. Often times the partners are overlooked during pregnancy and massage can be a great tool to help them feel connected and helpful to their partner.

Lubricants, Because They Ain’t All the Same

Lubricants serve a dual purpose as they make perineal massage more comfortable (hello, not stretching dry skin) and also hydrate the tissue. But not all lubricants are the same. Here are a couple of my go-to lubricants for all things perineal health:

1. Coconut oil - I prefer Skinny & Co. as their coconut oil is cold-processed and doesn’t lead to altering the vaginal flora like other highly processed coconut oils

2. Good Clean Love - organic, water-based lubricant that is free of petrochemicals, parabens, or glycerin

3. Desert Harvest - 100% all-natural aloe-based lubricant

Got questions? Don’t hesitate to reach out and ask! I hope you find this info helpful, and I can’t wait to hear from you!

References:

1. https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD005123.pub3/full?highlightAbstract=withdrawn%7Cperineal%7Cperin%7Cmassage%7Cmassag&fbclid=IwAR1TbGsOxDXoqG8eaRMOsCM56v9mmDyD2YrI1wiHnaHvF_tbUAbcWoVz6m0

2. https://www.aafp.org/afp/2014/0301/p335.html

3. https://www.cochrane.org/CD006672/PREG_perineal-techniques-during-second-stage-labour-reducing-perineal-trauma

4. https://www.ncbi.nlm.nih.gov/pubmed?term=16437520

5. https://www.ncbi.nlm.nih.gov/pubmed/11368136