Top Three Myths of Gestational Diabetes with Lily Nichols

Today I am so excited to have registered dietitian and real food advocate Lily Nichols! 

Lily, who blogs over at www.pilatesnutritionist.com, is an expert with heaps of experience counseling women on their diets throughout gestational diabetes.  She recently published a book earlier this year, Real Food For Gestational Diabetes, and is on a self-declared mad mission to evolve the medical communities archaic approach to caring for women with gestational diabetes and bring it more up to date with the current scienctific research and understanding.  Below is a transcribed interview I had with her a few weeks back.  It is a must read for anyone diagnosed with gestational diabetes!


SSB: So Lily let's start off by going over what you think are the top 3 most notorious myths concerning gestational diabetes?

Lily: I would say that a lot of women have been told that they need to eat a very specific level of carbohydrates and they cannot go lower than this level of carbohydrates without harming their baby.  That is a huge myth, and that is one of the things that I tackle pretty in depth in my book, Real Food For Gestational Diabetes, because it simply just doesn’t hold up to the science, doesn’t hold up to the research.

Another one is that baby will be big no matter what.  So a lot of women have been told that when you have gestational diabetes the chances of having a “big baby”, a macrosomic baby, are higher- and that’s true, it is higher- however statistics, you know it’s statistics, and yes statistically your chances of having a large baby go up but that doesn’t mean that you have to be a statistic, right? So the chances of you having a larger baby correlate very strongly to blood sugar control during pregnancy.  So if you know what to do to keep your blood sugar under control your risk of having a big baby goes way way way down and if your blood sugar stays at pretty much normal levels you have no higher risk of a big baby than somebody who doesn’t even have the diagnosis.  So that’s a big one.

It’s hard to choose just three but I’d say the final one is that a lot of women believe that they will require insulin and that there is nothing that they can do to reduce the chances of requiring insulin and that is also not true. 

The conventional diet therapy for gestational diabetes, which I kind of eluded to earlier, is pretty high in carbohydrates, a minimum of 175 grams per day and women who follow that advice- again from the research- shows that there is about a 40% chance that you’re not going to be able to control your blood sugar through that diet alone.  But they have also shown that if we change up the way we think about the diet for gestational diabetes and instead think of a low glycemic diet and one that is a little lower in carbohydrates we can reduce the likelihood that a woman will need insulin by fifty percent (italics mine), which is huge!  

"...We can reduce the likelihood that a woman will need insulin by 50%, which is huge!" 

So I’m into giving women all the information they need to make better choices and reducing those chance because I believe that- and I think most doctors agree- that the goal is to control this as naturally as possible.  As always there are going to be some women that no matter how hard they try, you can do everything right, and you will still need insulin.  But we can put your odds in your favor by giving you better dietary information.

SSB: So if a woman finds herself diagnosed with gestational diabetes, what are the most important first three steps she should take?

Lily: Number one is you want to start monitoring your blood sugar.  Knowledge is power! If you don’t know where your blood sugar is at you are pretty much helpless.  You will have no idea what to eat, a lot of women feel like they have to starve themselves, they just don’t know what’s going on.  If you don’t check your blood sugar you will never have the information to change up your diet or lifestyle to get your blood sugar under control.  It’s kind of like see no evil, hear no evil kind of thing.  You want to be able to see clearly what’s going on and observe patterns in your blood sugar so you know what changes to make.

So for example some women will notice that their blood sugar will go high after breakfast and at lunch and dinner it’s ok.  So that might give them a clue, ok maybe I need to take a closer look at what I’m eating for breakfast and experiment a little to find something that is going to work better.  So monitoring the numbers is huge, you can notice trends, and then you adjust and be proactive.

Number two is I would suggest they pay attention to the foods that raise their blood sugar the most, and that, in general, is the foods that are high in carbohydrates.  Start to get comfortable with which foods contain carbohydrates and which ones contain more or less of them, so you can kind of see “oh I can eat a much larger volume of vegetables versus rice” and still keep the carbohydrates under control.  Especially be cautious of the foods that are high in processed or refined carbohydrates because those tend to digest much quicker, spike the blood sugar much more, lead to unstable blood sugar and insulin levels- which then just further fuel those cravings for more of those foods- it’s kind of like this vicious cycle thing. So just get comfortable with where your carbohydrates are coming in, what sources, and again, tying it into number one, seeing how it affects your blood sugar because carbohydrate tolerance, how well your blood sugar responds to any given amount of carbohydrates, is different woman to woman.  Some people can handle a lot more and still have normal blood sugar and other people have to be super super strict- and you only know if you test your blood sugar and see!

Number three is to listen to your body.  And that is kind of a weird one to choose for gestational diabetes but gestational diabetes tends to medicalize pregnancy, right, you have to be monitored and you have to follow a certain meal plan, so they say, and you have to eat this many grams of carbohydrates and you have to check your blood sugar at this hour after eating, it kind of puts you in this very regimented schedule, and even though some of those things need to happen, it’s important, but there’s still room within any of these plans or regimens to customize it based on what is going on in your body.  So how are you feeling after you eat whatever recommended amount of food that was on your meal plan?  Are you completely stuffed? Are you starving?  Are you just right?  You know that’ll give you different information.  So instead of trying to meet a certain goal of your meal plan, you’re meeting your body’s needs instead.  How do you feel when you move or exercise a little more?  How do your blood sugars respond?  All these things, these mindful practices, really go a long way in helping you become a master of gestational diabetes and getting your blood sugar under control, and thus making sure your pregnancy is as healthy as possible.

SSB: And I will also add that they should go out and buy your book! (laughing) Because that one was darn good!  The thing that I loved the most about your book was the stories that you included in there of past clientele.  I mean it just knocks your socks off to see these women struggle, some for so long, through so many pregnancies, and then just have these, like, miracle stories basically, just by changing their diet!   It just was amazing.

Lily: And I could write a whole other book with only those stories now!  I have an online program as well, in edition to the book, which offers more support and guidance to make this as easy as possible, and the stories that I am hearing from the program are insane!  One of the women had had two previous gestational diabetes pregnancies and this was her third gestational diabetes pregnancy.  Both previous times she required insulin.  And the statistics are, you know, that if you’ve had gestational diabetes once, you’re going to get it again.  And then the odds are if you have to take insulin to control your blood sugar, you’ll likely have to take insulin again.  And then as you get older, which you know obviously as time passes and you have a later pregnancy, your older, usually your insulin resistance gets worse and again more likely to require insulin.  So this gal was able to avoid insulin in her third gestational diabetes pregnancy.  She was completely diet controlled.  No complications, baby was born perfectly healthy, I believe close to 8 pounds, no issues.  And I mean as a clinician I like people to be proactive about things but I’m also a realist.  So you know, I’m like, “given your history, it’s pretty likely that you will require insulin, keep that in mind, it’s not a bad thing, having your blood sugar under control is the number one most important thing and greatly reduces risks for your baby”, right? But lets do everything we can and just see what happens, and it just goes to show that when your given the right information and you’re not overwhelming your body with the wrong foods, and the wrong quantities, and all this garbage, literally miracles can happen.

SSB: Yeah, yeah, it’s the power of food.

Lily: Yeah, super empowering that your body is on your side.  You know a lot of women feel like their body has failed them with gestational diabetes.  And I’m like, no no, your body is just talking to you my friend. (Laughing)  Lets just respond as kindly as we can.

SSB:  So protein is of paramount importance in pregnancy but it becomes even more so in gestational diabetes.  What are some plant based protein options for vegetarian and vegan mamas or do you think these women should rethink the boundaries of their diet with gestational diabetes?

Lily: Vegetarian protein is a little bit tricky with gestational diabetes because many plant based protein options also contain a high amount of carbohydrates so it makes it a little bit tricky to find the right balance while still giving you enough energy, enough calories.  So it kind of becomes a battle between protein versus carbohydrates so sometimes vegetarian women will kind of need to get a little more into the numbers with food to make sure they are balancing things out ok. 

As an example beans, like lentils, are a classic staple protein option for vegetarian moms.  Half a cup has around 7 grams of protein, which is the amount you would find in an egg, but it has 15-20grams of carbohydrates, while an egg has zero. So if you were to have, say, your complimentary protein matching, making a complete protein, having beans and brown rice at a meal, maybe you’ve hit 15 grams of protein-which in my opinion is a little low for a meal- but for many women you have already exceeded your carbohydrates limit for the meal. 

You might be at 30 or 40 grams of carbohydrates, and again, some women can get away with that and for some other women that is far too high to be able to keep their blood sugar under control.  So that part is a challenge just from the fact that vegetarian and especially vegan sources of protein often contain carbohydrates. 

Nuts happen to be a lot lower in carbs and you have a lot more fat to go along with the protein, so that is a good option.  If women are not strictly vegan and are willing to do greek yogurt, cheese or eggs, those are all very high in protein and fairly low in carbohydrates.  There are some vegetarian protein powders like pea or rice protein, again a low carb option. 

But even beyond meeting a certain protein goal, it’s not just protein that matters, it’s the type of protein and also the other nutrients that go with it.  For example needs for certain amino acids go up in pregnancy and protein foods are all made up of amino acids.  Some are essential, you have to get them from foods.  Some are nonessential, you generally don’t have to get them from foods, your body can make enough from other proteins. 

So one example is there is an amino acid called glycine which under normal circumstances is nonessential, but during pregnancy needs go up so drastically because it’s needed to grow a lot of the growing fetal tissues, a lot of the connective tissues needed for the growing uterus- so because your needs go up so drastically your body cannot get enough from other protein sources alone, you have to consume it directly. 

The highest sources of glycine are found in the bone, skin, and connective tissues of other animals.  So we are talking bone broth, slow cooked tough cuts of meat, pulled pork, or beef roast, chicken with the skin, fish with the skin, those give you a ton of glycine, and that is a really key nutrient for your growing baby and to support your uterus and all the changes that are going on in your own system.  In addition to that we have nutrients that we simply can only get from animal foods: vitamin B12- of course you could always do a supplement, the most absorbable forms of iron come from animal foods, DHA- aside from algae, is an animal based omega-3 fat, preformed vitamin A- not the beta-carotene that you get from carrots we only convert a very very tiny percentage of that into true vitamin A….and vitamin A needs to go up during pregnancy…..all those you can only get from animal foods.  So if women are willing to rethink the boundaries of their vegetarian/vegan diet, then yes, absolutely, I suggest some animal protein during pregnancy and, I’m trying to remember, I think it’s chapter 5 in my book that I go into all the research behind some of these foods that are super health giving during pregnancy and that provide a lot of these nutrients naturally, and quite a few of them happen to be from animal foods.  So I think as along as you are sourcing your animal foods from good places, grass fed beef, pasture raised chickens, wild caught fish, grass fed dairy, you are going to be ensuring that A: the animals are raised with respect but also B: there are higher nutrient levels in them too so it’s kind of a win win.

SSB: Well thank you so much for taking the time to be with us!

Lily: Your welcome!


You can find more of Lily on her website here.  If you or someone you know has gestational diabetes make sure to pick up a copy of her book Real Food For Gestational Diabetes.  I have read it and cannot recommend it more!  Get one for your ob or midwife too! 

 

Seven Steps To Cleaning Up Your Diet In Pregnancy: Step Seven

Perfect Pregnancy Nutrition | Smart Sexy Birth Blog

Ok moving on to our last step!

Step Seven: Treat Yourself Right

Did you really think I was gonna sit here and tell a pregnant lady to never eat sweets again?! Hell no!

One of the great pleasures of life is to indulge.  But today we make indulgence an after every meal kind of thing and in a way that takes the specialness out of it, don't you think? 

It use to be that pie and ice cream was for Sunday afternoons gathered around with your family and friends. Or, around where I’m from, kids saved up their money so they could go down to the local soda shop on a Friday after school and have their soda pop and peanuts.  It was something very special, almost sacred. 

So I say: life is too damn short not to have dessert, but do it selectively.

And when you do it, go for the real deal.

And that’s what I mean when I say treat yourself right.

Don’t waste your time with the cheap stuff…because what do I always say?

You’re not cheap so don’t eat like ya are!

You are worth way more than a snickers bar.  I mean its not even real chocolate for heavens sake!

Think pure, quality, ingredients. 

The other little trick is to think creams not cakes. Why? Well what do you have with cakes and cookies? You’ve got this duo of processed flour and processed sugar, both of which pull a double whamy and jack around with your insulin levels.  Whacked out insulin levels is what causes the excessive weight gain and metabolic disorders like gestational diabetes to set in.  But with creams, yes you do have the sugar, but on the other side you also got these rich, satiating, fats, full of essential nutrients for you and your baby.

So when it comes to desserts I like to say: get French.

Think puddings, sweet creams, flans, ice cream. 

If cows milk is not your thing, coconut cream will be your best friend.  It makes darn good vegan ice cream.

This doesn’t mean you skip cake at the baby shower, by god eat the cake if you want to, but just be selective about the floured desserts more often than not.

Other great options are fruit.  A bowl of cut up strawberries, sweated with some sugar, and drizzled in heavy cream hits the spot any old day. 

And then there is chocolate!  Thanks be to god that chocolate is a real food. Full of magnesium and calcium, antioxidants, the darker the better. 

You’ll see in your fun sheet some tips on picking out the good stuff.

Sign up here to get access to the free fun sheets that go with this class!

 

Bottom line have fun with it.  Make a ritual out of it.  Pick a day to have a fun outing with the hubs, family or girlfriends and go explore your local eateries and restaurants. Have people over to share in something you make at home or you know what, screw the people, make it for yourself! Sit down, just you and your baby, and enjoy every guiltless, sexy, silky bite on your own. 

Whatever you do, bring joy and pleasure back to the table, because that is just an important part of a healthy life as it is getting your veggies in.  Send guilt and shame back to where they came from.

Okay so that’s it! That is the seven steps to Perfect Pregnancy Nutrition!  Not rocket science is it? 

We love to get allllll dramatic about healthy eating here in the states and make it out to be some great monumental feat but in reality its just little things done here and there that make all the difference in the world.

Remember if you take care of your body it will take care of you. Be easy on yourself and, most importantly: have a hell of a lot of fun!

All my love to you and your new budding family.

xoxo
Allyson

Missed the the rest of the steps?! Find Part One, Part Two, Part Three, Part Four, Part Five, and Part Six.

 

Returning To Work As A Breastfeeding Mother with Emma Pickett

Smart Sexy Birth | Tips on going back to work and breastfeeding

We have a very special guest today! Emma Pickett is a lactation consultant who works and lives in England and has agreed to grace us with her words of the wise on going back to work while continuing to breastfeed.

I have to admit me and the breast pump never got along very well, but I also have to admit that my attempt was pretty half-assed.  I never had to pump which probably played a larger part in my lack of success.  

I know this topic is a hot one for many many mamas across the board so without further ado I will hand it over to Emma.  This is an article that she had written previously on her blog that she adapted for us north americaners.....I was truly astonished, as she points out below, that the U.S. actually has better breastfeeding stats compared to England, even when they recieve 6 + months of maternity leave compared to our puny 8-12 weeks here.  I was also flat out amazed that England does not have any laws in place for a woman to have pumping rights in the work place!  The U.S. still has a long way to go in supporting its mama but it turns out we do have some things in our favor.

Happy reading.....and happy breastfeeding!

 


 

I’m a lactation consultant in the United Kingdom and I commonly work with breastfeeding mums who are returning to work and keen to protect their breastfeeding relationship.

In the UK, mums regularly return to work after six months of full-time care of baby and twelve months isn’t at all unusual. I take my hat off to any mother who is returning to work after just a few weeks and is determined to make breastfeeding work. It’s hard but women manage it every single day. And despite the much longer maternity leave in the UK, American mothers exclusively breastfeed to six months in greater numbers than the British do. You also have greater numbers doing any breastfeeding at six months. We really don’t deserve to be smug.

Mothers are deployed in the military to foreign countries and STILL manage to pump milk and ship it home. Women work night shifts and have several children. They have babies with special needs or special needs themselves. With the right pump and a bit of organisation, you can keep your baby exclusively fed on breastmilk for as long as you want to.

It works for American mums because you have state and federal law that protects your right to continue to give your baby the milk that makes sense. It’s not just about employers being lovely and kind. These laws exist because they make sense for everyone. It means less absence (as breastfed babies are less likely to be ill with conditions like diarrhoea and respiratory infections and ear infections). It means better employee recruitment and retention and better employee morale and productivity.

The first few days and weeks are often a blur for new mums. The learning curve is steep and you survive day to day – remembering to shower and put food in the fridge for yourself if you are lucky. For those mums still in the middle of that blur, the thought of the eventual return to work can be one that provokes anxiety.

You can’t imagine how it will feel to leave this new special person in your life.

How do you people cope with drop-offs to childcare and getting back to work after potentially several night-wakings?

What do you do if you don’t want to give up breastfeeding?

Here are my SEVEN top tips for returning to work as a breastfeeding mum.

 

 1. Don’t think about it.

 

OK, now I don’t mean that too literally. My message is just that if you are going to take 6 weeks, 3 months or a year off work and you spend most of that stressing about the return to work, you will be seriously missing out.

 

STOP yourself thinking about it too much. If you stare at your gorgeous three week old and think fleetingly, “How can I ever leave you?” (which is how nature very much wants you to feel), that is fair enough. But if you spend chunks of your maternity leave feeling anxious and worrying about practicalities, you will be wasting the special times you do have together.

 

This time is precious. Your baby now is not going to be the same person when you return back to work. They will sleep differently, feed differently, and interact differently. You will not be leaving THIS baby but an older one.  So get your childcare sorted (which you will have thought about in pregnancy anyway) and other than that, there’s not too much more to do! If you intend to express milk at work, it’s a good idea to speak to your employer before you go back to work to talk about arrangements. It makes sense to find out in pregnancy how things work at your workplace and what systems are already in place. And then just carry on as normal. Don’t jeopardise breastfeeding by focusing too much on the return to work. We don’t need a baby that is only a few days old to be taking a bottle. We want them to learn how to latch correctly on the breast so you are comfortable, they can transfer milk effectively and we give your supply the best chance we can. When you are really happy with the latching, then you might try and express some milk and experiment giving it to baby. If they don’t immediately take to a bottle, don’t panic! It’s very easy to set yourself into a panic when the truth is that things usually work out with the right information and the right support. The person who gives the bottle when you are away from baby is going to have their own strategies and probably their own experience and baby will know it’s not you. Babies can also be fed milk in other ways if the bottle really really isn’t accepted. There’s cup feeding and syringe feeding and even finger feeding using a feeding tube. The world doesn’t end if a baby doesn’t take a bottle so don’t spend the start of baby’s life stressing about it.

 

 2.  As mentioned, speak to your employer.

 

Talk to them when you are pregnant. Find out what your rights are. What have other colleagues done? Is there a workplace buddy who can offer you practical and emotional support?

 

 3.  Talk through your schedule with a breastfeeding counsellor or lactation consultant.

 

Chat through your expectations. How often do you need to pump? How much breastmilk does a baby take in a bottle when they are away from mum? (The milk calculator on www.kellymom.com is useful for this). Is there a way to get in some extra breastfeeds in the day? Could you visit baby in your lunch hour? Maybe do a feed when you collect baby rather than wait until you get home? Maybe it makes sense to pump again at home just before you go to sleep?

 

4. Talk to your partner and family.

 

Your partner needs to know why this matters. They need to know that you are going to need time to pump at home too and they are going to need to help take some responsibility for home life running smoothly (please tell me this would happen anyway). What sometimes happens is that the mum takes more leave and takes on responsibility for baby organisation and when she goes back to work, that responsibility continues. But your husband or partner is just as capable of buying diapers and thinking about dinner. Perhaps more so while you are adjusting to getting back to work. Your childcare (professionals or other family members) also need to know how to store and prepare breast milk and they need to know about paced bottle feeding techniques and the ideal way to give a bottle (have a look at ‘paced bottle feeding’ on YouTube).

 

 5.  Practise pumping.

 

Is the breast pump you are using a home something you are familiar with? Do you have a backup if you need to pump at work? It’s a good idea to use a DOUBLE electric breastpump if you can. You want one that’s robust and used to frequent use. You may be able to hire one. Watch out for used pumps as some aren’t ‘closed systems’ and milk and mould can get inside the pump and make them potentially unsafe.

 

There are tricks such as preparing the breast using massage and warm compresses. And we know that women who finish a pumping session using hand expression techniques can increase their output considerably.

 

 http://lllrochester.weebly.com/uploads/7/9/5/4/795404/marmet_technique_tearoff.pdf

 

It’s also not a bad idea to build up a bit of a freezer stash before you go back. If you start pumping for one extra session each day and storing that in a freezer bag (store them flat and build up layers of thin flat bags which defrost more easily and take up less space), you will have some wiggle room if you need it. It’s not entirely predictable how pumping will go at work and some women find that their pumping output decreases towards the end of the week and then a weekend of normal breastfeeding boosts it back up again. If you have that freezer stash, it will take away some of their anxiety.

 

 5.  Get your kit.

 

So you need a pump and some bottles and some breastmilk storage bags. What else? Surprisingly not much. You don’t need to store freshly expressed breastmilk in the fridge at work if you don’t want to. You can have a freezer block and an insulated bag and put any expressed milk in there. It is fine in that for 24 hours. So if you store it like that at work, put it in the fridge when you get home, then that milk can be given to your baby’s carer for the next day.

 

http://www.llli.org/faq/milkstorage.html

 

It’s also really important to note, you don’t need to wash and sterilise the pump between pumping sessions. Breastmilk is fine at room temperature for up to 6 hours. So you certainly don’t need to wash a pump between your 11am pumping session and your 2pm one. Lots of working mums use a technique called ‘wet-bagging’, putting a pump in a plastic bag between sessions and then putting it back in the fridge. Then simply take it out next time and wipe any wet parts with paper kitchen towel if you don’t fancy cold drips against you! This also saves precious time.

 

 6.  Breastfeed when you can.

 

Your supply is more likely to be maintained if you breastfeed when you get the chance. Is your childcare near work or home? Could you work from home for one day a week for the first few weeks? You could breastfeed early in the morning, then once more at drop-off, once more at pick-up and again at home later in the evening. Breastfeeding at the weekends and during holidays will help to boost your supply.

 

 Here are the stories of three mothers:

Phoebe is returning to work at 2 months. Her baby feeds around 6 times in 24 hours and a few of those are at night. She has a job where she’s often out of the office and pumping during a working day isn’t easy. She breastfeeds her baby at 5.30am when they wake up. When she gets to day care, she does a little mini-feed just to get as much milk in him as she can and then she goes to work. She pumps around 10.30am and it takes 10 minutes with a double pump. She stores the milk in a cool bag with an ice block and leaves it in her desk. She keeps the wet pump in there too in a Ziploc bag. Some days she is on a client visit and she drops by her baby’s daycare around lunchtime for a breastfeed. If not, she’ll pump again at around 1pm. She leaves work at 4pm and feeds her son at his daycare. She breastfeeds again at home at 7pm after his bath and again at around 11pm. He wakes in the night to breastfeed and Phoebe co-sleeps with him (following the recommended safety guidelines) so night feeding fits with her sleep cycles and it isn’t too disruptive. Her son’s daycare give him a bottle of expressed milk roughly every 4 hours. On days she visits at lunchtime, he gets one larger bottle in the morning and a smaller one in the afternoon. They are careful not to feed him too close to when she is due to pick him up. Because Phoebe’s baby is ‘reverse cycling’ (feeding more at night than he does in the day, he takes expressed milk less frequently in the day than another baby of the same age might).

 

Carla is going back to work full-time at 6 months. Her son is an enthusiastic exclusive breastfeeder and she’d like to avoid using formula if she can. When her son is 4 months old, she writes to her boss (she is a PA in a law firm) and explains she would like to express her milk at work. Her boss explains the company procedure of having a small office set aside for pumping and there is also a fridge available. Carla explains she intends to express around 3 times in the working day and one of those times will be during her lunch break. Her boss is fine with that. She has a double electric pump which she starts using from 4 months and she gives her son a bottle every other day to get him used to it. She finds he prefers to sit a bit more upright and usually takes 3-4oz from the bottle.

She starts solids around 10 days before she goes back to work and he takes small amounts initially and Carla knows his breastfeeding schedule will remain unaffected for a while. The week before she starts work, they visit the nursery together and he has a few hours there. He then has two trial days where Carla practises her expressing schedule and the daycare workers give him a bottle and some solids.

On her working day, she breastfeeds him as normal at 6am. She drops him off at daycare at 7.45am and offers again and he takes a small feed. At work she expresses at 11am, 1.30pm and 3.30pm. She collects her son at 6pm. He is keen to breastfeed when she arrives and they breastfeed at nursery. She breastfeeds him again at home at around 10pm as a dreamfeed.  He wakes once at around 2am and she breastfeeds him again.

While he is at daycare, the carers give him bottles and offer solids and he usually takes around 12oz in total while they are separated. As he has 3 good breastfeeds in addition to that in 24 hours, Carla isn’t worried. Carla expresses more milk at work than her son takes in a bottle at the moment. Over the next few weeks, she moves to expressing only twice. Carla ends up offering exclusive breastmilk until 12 months and then she gradually introduces full fat cow’s milk.

 

Karen is returning to work when her son is 6 weeks old. She practised expressing and giving some bottles in the 2 weeks before she was due back to work but she didn’t introduce a bottle before then. She breastfeeds at 6am. She expresses at 11am, 2pm and 5pm. She uses a double electric breast pump and stores her milk in a mini fridge. She gets around 90-120mls (3-4 oz) each time she pumps. She collects her son at 6.30pm and breastfeeds. She breastfeeds again at 9pm and 11pm (and he often wants to cluster feed in the evening. She finds that wearing him in a sling makes life easier). He feeds again at night at around 2am.

 

Does any of that fit with what you might do? The truth is that every story is different and every family find their own way. The months that you choose to combine working and giving breastmilk will be hard work but what part of new motherhood isn’t? And the effects of your decision will last a lifetime.

 



So ladies what to do you think? Got questions? Let us know in the comments section below!  To learn more about Emma, and get your hands on all her amazing articles, videos, and resources, head on over to her blog www.emmapickettbreastfeedingsupport.com.

xoxo

Posted on September 17, 2015 and filed under BREASTFEEDING, POSTPARTUM.

Seven Steps To Cleaning Up Your Diet In Pregnancy: Step Six

Smart Sexy Birth | Perfect Pregnancy Nutrition

We are in the home stretch! You've cleaned out your fridge, made some switches in your shopping cart, switched out the sammie at lunch, "nutrified" your plate, armed yourself with some awesome snacks and now onto step number six:

Sack The Sugar

This one is a biggie. 

Added sugars have made there way into just about every corner of our diets, many of which we least expect.

Back in the 1700s we averaged in about 4 pounds of sugar a year. Nowadays we are hittin' back nearly 180 pounds!!! That is 45 bags of sugar! Just imagine that for a second, 45 regular sized bags of sugar piled up in your shopping cart.... going in your belly....

A high sugar diet can wreak havoc on your body, influencing everything from fetal development to maternal weight gain to labor and delivery (I will get into the nitty gritty details of that later on in the coming weeks).

So getting savvy on your sugar intake can be nothing but good for you and baby. 

The best way to go about it is to identify your biggest sugar culprits and then eliminate them by finding a similar yet less sweet replacement. 

For most american women that’s gonna be soda and juice….and yes I said juice.

But fruit has all those vitamins and antioxidants in it, you say!? Yes it does. But it also has a TON of sugar.

And even though we may consider it "natural" sugar, it has the exact same physiological effects as the white stuff.

How could that be? Because when you juice a fruit you strip out the fiber. And fiber is the stuff that helps the sugar slowwwly trickle out into your bloodstream. Without that fiber the sugar is a free rolling man and hits your bloodstream like a mac truck. The metabolic effects that begin to play out are no different than if you had slugged back a can of coke. 

As Dr. Lustig points out in his book Fat Chance: Beating The Odds Against Sugar, Processed Food, Obesity, And Disease, there are kids who get obese on drinking gallons of juice alone, it is powerful stuff. 

Another perspective to take is, how many oranges do you think it takes to make that glass of orange juice?

FIVE! Who sits down and eats five oranges in one sitting?! 

Below are some common sugar culprits and replacement ideas:

  • Instead of soda or juice, try sparkling water infused with real fruit.  Another thing to try is half sparkling water, half juice in your glass and as the weeks go by use less and less juice to slowly wean yourself off. Or simply just eat the whole fruit instead! Instead of orange juice, eat an orange.
  • Instead of flavored yogurt opt for plain. Some of those individual containers have up to 22 grams of added sugar, it’s like eating a candy bar! Add cut up fruit or a drizzle of honey for a touch of sweetness. 
  • Cut back on granola bars, cereal bars, and protein bars. HUGE sources of added sugar! They are glamorized candy bars.  Instead opt for high protein real food sources like cubed chicken/salmon, cheese, and a handful of nuts. 
  • Instead of flavored coffee enhancers, choose regular cream or half and half.
  • Instead of the Starbucks caramel macchiato, which has more sugar than a can of coke, choose a latte or cappuccino (or any other version that is just coffee and cream).
  • Other little culprits for added sugar are your nut butters- especially peanut butter, prepackaged salad dressings, cereals- especially granola, and flavored instant oatmeal.  Pick unsweetened ones or make your own.  Even if you don't want to lose the brown sugar in your oatmeal, still choose plain and add the sugar yourself because I guarantee you will put less in than they do in the factory.

Now here is the thing to keep in mind while you are doing all this:

Weaning yourself from sugar ain't pretty. 

Sugar is literally a drug, and just like any drug it is highly addictive. 

While you are cutting back you very well might experience irritability, fogginess, head aches, exhaustion, muscle aches.  The whole shebang.  It's called the DT's.

Be aware that it is coming.  You will feel worse before you feel better. It should dissipate within a week or two depending on how much your body was addicted.

One thing that will really help in the weaning phase is making sure you have meals with protein and fat. This is what you want to do anyways regardless, but doing so will help keep your blood sugars from getting all crazy and help tame those cravings.  Keeping your awesome snacks handy is key. It’s usually in-between meals, especially that four o’clock hour, that really challenges us to not dip into the sugar bowl.

The other thing to take note of is that your taste buds are probably gonna throw a fit on the new unsweetened versions in the beginning. 

I remember when I did this my biggest culprit was vanilla yogurt.  I’ve never been a big soda or juice girl, but I loooooved my vanilla yogurt. 

I always thought "oh yogurt, its so healthy, yadda yadda". But once I started to get savvy on the whole sugar dilemma I realized my little "health food" had nearly 19 grams per serving in there- and I was eating like three containers a day in my first pregnancy!

So off I go to switch over to plain.  Felt so European….la-ti-da...and then I tasted it. 

Um, no.

Sour, gross, and obviously NOT like vanilla yogurt.  

But I stuck it out.  I’d drizzle some honey in there, add some fruit, and before I knew it I was actually enjoying it.  It was like I could start to taste the subtle differences between different brands of yogurt, and the complex flavors of each one (yes, I became one of those yogurt snobs). 

So several months down the road I decided to try vanilla yogurt again just for kicks. I kid you not, it was SO GAGGINGLY SWEET, I almost had to spit it out! 

Isn’t it amazing how our taste buds can get so accustomed to something?  So trust me when I say just try to bite the bullet and try to stick it out there in the beginning.  You might be pleasantly surprised.

Check out your fun sheet in this section called Sugar By Every Other Name.  It gives you the lowdown on all the creative ways food manufactures like to name sugar so you don’t get fooled when reading labels.

Don't have your fun sheet yet? Enter in your email below and get access to the Perfect Pregnancy Class, 18+ free pdfs and fun sheets to help you get organized and shop smart, as well as the Have You Had? checklist that helps you make sure you are getting the 5 Essential Pregnancy Nutrients day to day.

See ya next time! xoxo

Read Step Seven here.