Postpartum Health and Wellness - a Functional and Integrative Approach

Postpartum health is seemingly forgotten by many in the conventional medical model. Even as a medical provider myself, I found the postpartum period to be difficult to navigate, especially after my first baby. Between nutrient insufficiencies, thyroid disturbances, adrenal dysfunction, and hormone imbalances, many moms (myself included) don't feel like themselves during the postpartum period. Throw in sleep deprivation and it is a recipe for feeling quite dysfunctional.

And what's worse? We are often told this is "normal." Of course, it is normal to feel tired in the newborn days with around the clock feedings, but has anyone mentioned trying to optimize these other areas of health? That nourishing the body and focusing on real recovery is going to lift that fog and make you enjoy motherhood?

Enter Functional Medicine.

Functional Medicine in the postpartum period is the ideal framework to getting back to feeling like yourself, regaining energy and enjoying motherhood. It is getting to the root cause of symptoms instead of brushing them off as "normal" or giving a pill as a bandaid to cover up undesirable symptoms.

I have found a few things to be key in addressing postpartum symptoms. In Functional Medicine these pillars are known as “the bottom of the matrix” or the modifiable lifestyle factors :

• Nutrition and Hydration

• Sleep and Relaxation

• Exercise and Movement

• Stress Management

• Support and Connection

These components of the Functional Medicine health plan are arguably more important than any medication or supplement I might recommend because if we don’t get these lifestyle factors aligned, we are often missing a big piece to the puzzle.

Nutrition and Hydration:

Like I mentioned, supplements do have their place and I often recommend them, but I do like to focus on getting nutrients from foods so that patients do not have to remain on supplements indefinitely. There are many benefits to using a food-first approach and eating real, whole foods. Some general nutrition and hydration strategies I recommend in the postpartum period include:

• There is no BEST diet for everyone.

• Consider a Mediterranean style eating plan which focuses on whole foods, omega 3 fats (fish, avocados, nuts/seeds, olive oil), plenty of plants (fruits and vegetables), high quality protein (grass fed beef, wild caught fish, and organic chicken), moderate amounts of dairy, and low in sugar and processed foods.

• Focus on whole foods and limiting processed foods.

• Eat the rainbow! A diet high in plants and phytonutrients is anti-inflammatory and good for the gut microbiome.

• Work on maintaining good blood glucose balance. If you are having a meal or snack that contains carbohydrates make sure to pair it with protein, fat and fiber to limit blood glucose and insulin spikes which can make you feel tired, foggy, and irritable.

• Aim for regularly timed meals.

• Focus on getting adequate protein. Breastfeeding moms need an additional 20-25grams of protein per day and a total of a MINIMUM of 71 grams of protein (I like to see closer to 100 or more grams per day, but this is patient specific based on body size and activity level).

• Maintain good hydration, ideally a minimum of 100oz of fluids per day if you are breastfeeding and more if you are also active (adding electrolytes can help to boost hydration status).

Sleep and Relaxation:

This may seem like a cruel joke to talk about sleep and relaxation in the postpartum period because I know that sleep is hard to come by, especially in the newborn days with around-the-clock feeding. What I like to emphasize to moms is that we want to aim to optimize the sleep they are able to get since we cannot control the amount of sleep. We also want to prioritize relaxation in whatever form feels good – taking a bath, doing some yoga or stretching, reading a good book, getting outside in nature to reduce stress (more on this later).

Sleep hygiene tips in the postpartum period (and beyond!)

• Avoid caffeine 6-8 hours before bedtime.

• Get outside first thing upon waking to get morning light (no sunglasses) to set your circadian rhythm for the day.

• Avoid using alcohol and marijuana before bed as it disrupts restorative sleep.

• Limit screen use before bedtime. Bright lights can prevent the release of melatonin which regulates our sleep-wake cycle.

• Exercise regularly but avoid exercise 2 hours prior to bedtime.

• Avoid napping later in the day (after 3pm) or taking long naps during the day.

• Create an environment conducive to sleeping.

• Establish a pre-sleep ritual (bath, reading, stretching, or anything that is relaxing).

Exercise and Movement:

It is crucial for all moms to be active in some way. This doesn’t have to be going to the gym or going out for a run, but if you enjoy those things then by all means do it when you are ready! Starting in the early postpartum period with gentle exercises is best and I do believe that almost all women would benefit from seeing a Pelvic Floor Physical Therapist before starting any vigorous exercise routine. Finding a way to incorporate exercise into your life has numerous health benefits. Ideally finding a balance between cardiovascular exercise, strength training, balance, and flexibility exercises is ideal but not critical to begin all of these all at once. Motherhood is full of ups and downs that will change your schedule week-to-week and even day-to-day so be easy on yourself. If you have missed a workout because someone is sick or didn’t sleep well, give yourself grace. Progress is greater than perfection!

Stress management:

Motherhood is stressful, there is no way around it. Managing this stress is going to be critical for good health. When you are stressed all the time, your body is pumping out cortisol, our stress hormone, and you are constantly in a state of fight or flight. This affects many downstream processes in our body including nutrient status, hormone production, and digestion. Using a mindfulness practice like meditation, prayer, journaling, gratitude, yoga, or even just deep breathing can help flip the stress switch off and allow your body to relax. Incorporating even just 5-10 minutes a day can make dramatic differences.

Support and Connection:

Finding your tribe and asking for help when you need it is going to make motherhood feel a lot less overwhelming. In the US and many Western countries we have gotten away from the community supporting mom and baby after birth. Gone are the days of multigenerational households where there are many hands to help take care of baby and cook nourishing meals for the family, as many live across the country from their family so help is not guaranteed. This can feel lonely and overwhelming. Finding a community whether it is a local mom group, story time at the library with other parents, or connecting with neighbors who have kids is going to help make the journey into motherhood a lot less lonely.

Focusing on these foundational aspects of health can make a huge difference. Beyond the basics, personalized laboratory testing and working with a medical provider who understands the postpartum period can help take your health back.

About the author:

Alison Percowycz, MSN, FNP-C is a Family Nurse Practitioner specializing in Integrative and Functional Medicine with a focus on Women’s Health in the Postpartum Period. She is the Owner and Practitioner at Wild Rice Wellness and is licensed and seeing patients virtually throughout Colorado. She is a mom of two, Claire (4) and Jude (1) and because of these two she is very passionate about getting moms back to feeling well and enjoying motherhood!

wildricewellness.com | @wildricewellness