Where Did My Abs Go? How to Flatten Mommy Tummy (Week 7)

Oooh, the dreaded "mommy tummy". I don't like it one bit. I am now 7 weeks post-partum, and although I am proud to say I've lost most of my pregnancy weight, my tummy is flabby and squishy. Yuk.

Okay, enough complaining. Ladies, we've all been told it takes time to get your body back after pregnancy. What we don't know is how long it takes to get it back. Some say that it can take you as long to lose the weight as it did to put it on. Nine months of trying to get rid of a tummy seems like a long time. But it's not just the tummy: my hips are wider than they used to be. If they don't move back into place, I'll never fit comfortably in my pre-pregnancy jeans again.

As I've learned throughout my pregnancy, patience is a virtue. So, I will be patient, and I will be persistent.

How I Lost Weight Through Breast Feeding
Breast feeding does help you lose weight. My beautiful son has helped me whittle my waist down to a point where I have probably about 7 lbs left to lose (I haven't weighted myself yet). My appetite dropped dramatically after I gave birth, and it plateaued probably at the 4-week mark. Now, something altogether horrifying is happening: I'm getting hungrier again. Okay, so it's not the end of the world, but it's not encouraging.

The Real Deal About Breast Feeding and Weight Loss
Yes, breastfeeding helps you lose weight--to a point. I am still 2 cup sizes larger than I used to be. More boobs = more weight. On top of that, milk in boobs = more weight. Then, la piece de resistance: my body wants to store more fat to help provide milk for my baby. Breast milk is laden with fat because that's what our babies needs to grow. Therefore, after shedding a lot of the pregnancy fat, my body kicks into fat storage mode and makes me hungrier. What fun!

If You're Breast Feeding, You Still Have to Watch What you Eat To Lose the Mommy Tummy
Bye-bye yummy, calorie-dense foods that I ate during pregnancy. Hello, nutrient-rich, low-calorie foods.  Not to say that healthy foods can't be yummy, but it's harder to avoid unhealthy foods when your cravings kick into high gear again. By 6 weeks post-partum, you're going to be pretty hungry, and if you're committed to shedding the mommy tummy fat, you're going to have to deny yourself those foods  your craving, which is tough work (I admit, I don't always succeed in fighting them, either!). My only advice is this: find some calorie-free distractions. Go for a walk with your baby (never a bad thing), see other mommy friends, or watch a good movie.

My Workouts
I started working out 3 weeks post-partum. Don't be too impressed--I wasn't doing a whole lot. I stuck by my rule of listening to my body and doing what felt right. Now, being a fitness professional I can do stuff like this because I know what exercises are safe to do and when I should stop doing something that doesn't feel right. Some very fit women who had no other complicating factors like Cesarean sections or epesiotomies can start training even earlier than 3 weeks. However, I don't recommend anyone start working out 3 weeks post-partum unless they are cleared by their doctor.

Core Exercises for 6 Weeks Post-Partum
If you have been cleared by your doctor, start slow. Remember that your abs separated to some degree while you were pregnant, and you don't want to over-stress them in a way that separates them further. The best rule of thumb is to do core exercises that engage your transverse abdominis (since I became pregnant, it has become my favourite ab muscle!). Here are some great post-partum core strengthening exercises:

• bird dogs
• plank and side plank or the easier modified plank
• side standing crunches
• supermans
• bridges
• scissors

Adjusting to a Post-Natal Body...and a Post-Natal Life (Week 3)

My beautiful, healthy son was born March 5, 2011. Okay, so he looked a bit like a monkey for a little while after he was born. Many people say he looks like his father, and Daddy wasn't too pleased with the monkey resemblance. The baby has since progressed to having more human features.

My Body Right Now
It has been nearly two and a half weeks since I've given birth, and I'm feeling more and more normal every day. At this point I have about 13 lbs of excess weight. Compared to my pre-pregnancy body, I feel flabby and weak, although if I compare how I feel to being pregnant, I'd say I feel like a champ. All that exercise I did before and during my pregnancy is paying off now.

I was lucky to have had a vaginal birth, which has made my recovery much easier. I was at the mall pushing my son in his stroller on my 3rd day post-partum. The only complicating factor was that I had an epesiotomy, which made it difficult to spend more than 45 minutes on my feet. It has since now healed to the point where I'm no longer in pain, and I don't even think about it any more. It should be fully healed in another 2 to 4 weeks.

Breastfeeding
My son took to breastfeeding immediately, which not only felt like my first achievement as a mom, but also helped to shrink my uterus quickly and helped me shed a lot of weight. All the tips I learned at the breastfeeding clinic came in handy, too. I definitely recommend learning how to breastfeed before your baby is born.

Eating and Diet
My appetite is much lower now than when I was pregnant, although I find myself incredibly thirsty. Being thirsty make sense given that I'm producing a lot of fluid for my hungry baby to consume. I'm drinking a lot of water, milk, and watered down juice when I want something with flavour. I'm also craving a lot of juicy fruits (like oranges, grapes, watermelon) which I also relate to breastfeeding.

Getting Enough Sleep
At night my son sleeps for 2.5 to 3 hours at a time, which makes for a lot of broken sleep for me. However, I've gotten accustomed to his schedule and have developed a routine that really helps me feel refreshed in the morning.

My partner, who is a bit of a night owl anyways, stays up with the baby while I hit the hay around 10 or 11PM. Because I'm also pumping breastmilk, my partner can feed the baby once or twice in the evening before they both go to bed. By the time the baby wakes up again, I have gotten between 3 to 6 hours of sleep already. Then, because I pumped enough breast milk to feed the baby throughout the night, I bottle feed him in the middle of the night, which makes for a much faster feeding time than if I were to have breastfed him. It also ensures he fills up his belly so he's not hungry again for at least another 2 hours. So all in all I spend more time sleeping and less time up with him.

I also try to keep the surroundings as dark as possible so the baby doesn't think that the middle of the night is a great time to be up and fully awake. If he doesn't appear sleepy even after he's fed and changed, I have him lay in the bed with us, which often works as a magic bullet to get him to sleep.

Walking as Exercise
Ever since I become pregnant, I've made a point to listen to my body. So after I gave birth, I started walking as soon as I felt like I could. I would never push myself, especially right after labour, but I would make the effort to get on my feet even just to go to the bathroom, take a shower, etc. Soon enough I was doing a bit of mall walking, and I now am at the point that I can do a brisk 20-30 minute walk every day. I'd like to mention that in my first 10 days post-partum, being up and about (e.g. going grocery shopping) would end up fatiguing me to the point where I needed to nap in the afternoon. It has only been in the past few days that walking hasn't exhausted me.

Core Strengthening
Yesterday I did my first post-partum core workout. It lasted all of 15 minutes, and I kept the intensity very light, but I did it nonetheless. So many people take an all-or-nothing approach to exercise: either they kill themselves by training at an extremely high intensity, or they don't exercise at all. I like to take my time and gradually increase intensity depending on how my body feels.

In my next blog I will discuss some good post-partum core strengthening exercises to help lose the dreaded "mommy tummy".

How to Eat Healthy After you Give Birth (Week 39)

Home Stretch!
I'm in the home stretch now, with less than one week to go until my due date (February 22nd). A lot of people ask me if I'm excited, and I found a great metaphor to help people understand how it feels to be pregnant: It's like waiting in line at bank for nine months to cash lottery ticket. Translation: it's exhausting, uncomfortable, and breeds impatience. It only gets worse the closer you get to your due date. At the same time, imagining my little one in my arms after the marathon of labour is enough to cheer me up!


You Won't Feel Like Cooking After the Baby Is Born
Being so tired lately, it has been hard to work up the motivation to get anything done (including blogging!). I've realized that on my good days, I need to make the most of my time and get things done that I've been putting off when I'm not feeling so great. One of those things is cooking. I've gotten a lot of advice from moms to stock up on food before the baby arrives, because I won't feel like cooking afterwards. Stock up on healthy foods that store well and prepare dishes for yourself that are easy to freeze and heat up.


Foods to Stock Up On

• milk 
• yogurt 
• cheese 
• juice (no sugar added)
• prewashed salad greens
• precut fresh fruits and veggies
• a roasted chicken or two (perfect for meals, snacks, and salads).
• low-sodium soups
• nuts 
• whole-grain bread (you can freeze it), crackers and cereal
• canned beans, fruits and vegetables
• pasta
• brown rice
• sauces

Things you Can Make Ahead

• lasagna
• mini-meatloaves
• pancakes
• bran muffins
• banana or zucchini bread
• omelettes
• casseroles
• stews
• chili
• stirfry
• soup

Store in single-meal containers in the freezer and mark them clearly so you won’t defrost a turkey burger when you’re in the market for banana bread.


Get Other People to Make You Food
More than likely you have people in your life that are as excited for your baby's arrival as you are--maybe more so because they're not the ones that are going to go through labour. Often these people would love to support you in any way, but they may not be clear as to how they can. If anyone does ask you, tell them to cook for you!

Managing Your Energy Levels During Pregnancy (Week 36)

I'm in the home stretch now. Four more weeks (roughly) to go, and my excitement/anticipation is growing. That's not the only thing that's growing: as of three days ago, I measured 42 3/4" around my middle. This is the point in the pregnancy that I'm saying to myself, "Really? Can my belly get any bigger?" Of course the answer is "yes", but it's pretty disconcerting nonetheless.

Energy Fluctuations
One thing that I've noticed throughout my pregnancy is that my energy levels have fluctuated quite dramatically on a week-by-week and even day-by-day basis. I was told to expect that my energy levels would suffer in the first trimester, pick up in the 2nd trimester, and then drop off again in the 3rd. Although I did have a marked improvement in energy in the 2nd trimester, I've found that in this last stretch there has been a lot more variability. Sometimes I have good days, and sometimes I have bad days.

Sure, I've put on about 1/3 of my pre-pregnancy weight, which is a lot of work to haul that much extra weight around. But that doesn't explain why some days are easier than others. It all boils down to fluctuating hormone levels and the physical adaptations to pregnancy that my body has to endure. Although at this point I've become used to the feeling of not having as much control over my body as I once did, I've found ways to optimize my energy levels.

How to Boost Your Energy During Pregnancy

• Exercise. It's no surprise that I recommend exercising as a way to boost your energy, however this advice comes with a caveat: pick a day when you're feeling more energetic to get in some activity. Forcing yourself to exercise when your energy is low will more than likely make you feel more tired, not less (this is advice runs counter to what you would do if you weren't pregnant: exercise can often boost your energy when you're feeling low). Also, at this point, just getting off the couch can be enough to be considered exercise. Walk, stretch, do yoga, swim, or do a prenatal exercise class or video.
• Rest when you need to. There will be days when you just don't feel like moving at all. Get over it and just accept it. I had to. Resting when your body tells you to will make you feel better. So get as much sleep as you can. Take naps, or just put your feet up and relax in a comfortable position. As it is, many women don't sleep as well in their last trimester as it gets more uncomfortable to be in a much larger body. And if this wasn't convincing enough, just remember that soon enough your time will no longer be your own, and your opportunities to rest will be dictated by someone else. Enjoy it while you can.
• Eat well and drink plenty of water. Eat foods rich in iron and protein. Choose foods such as red meat, poultry, seafood, leafy green vegetables, whole-grain cereal and pasta, beans, nuts, and seeds. Bright-colored veggies and fruits are packed with nutrients--some of which can help increase energy. The jury's still out on whether or not caffeine is okay to have during pregnancy, so play it safe and stay away from it. Besides, having caffeine too close to bedtime just increases your chances that you won't get a good night's sleep, and caffeine in general makes you dehydrated. Dehydration can decrease your energy levels, so drink for two. If you're urine comes out a pale yellow, you're drinking enough water.
• Manage your stress levels. Being pregnant can be stressful in and of itself. There's a lot of learning and a lot of planning to be done before your little one arrives. So take some time and meditate, pamper yourself, laugh, and spend as much time as you can with loved ones--especially your partner. Again, all of these things will be harder to do once the baby arrives, anyways.

So many moms have told me to enjoy my time being pregnant, and although it's not always easy, life is always better when you count your blessings instead of your aches and pains.

On Breastfeeding and Birth Plans (Week 35)

Why I Chose to Breastfeed
It was quite early into my pregnancy that I decided that I would breastfeed my baby. I had two reasons for choosing this: a) vanity, and b) miserliness. First, breastfeeding will help me to lose weight more quickly than if I formula feed. Believe it or not, you need to take in more calories when you're breastfeeding (up to 500 calories per day) than when you're pregnant (200-300 calories per day). That's because when you're breastfeeding, a lot of calories you take in are diverted to creating breast milk for the baby. Also, breastfeeding encourages your uterus to contract to its original size more quickly than if you don't. That satisfies my vanity quite nicely.

As far as miserliness is concerned, that is more obvious: breastfeeding is a lot cheaper than buying formula, which can cost up to $250 a month.

My Visit to a Breastfeeding Clinic
Today I made a visit to a breastfeeding clinic to learn all I could about how to breastfeed. Hearing the stories of the pain and frustration experienced by other moms I know during their first few weeks of trying to breastfeed, I wanted to make sure I was aware of all my options.

I learned a lot, to say the least. At the clinic I got the chance to see some patients breastfeed their babies, and learned what to watch for in terms of signs of a good latch. I was also lectured on the ins and outs of  sore nipples, skin-to-skin contact, breast engorgement, and even how to tie a baby wrap around my body so that I can carry my baby hands-free (a great way to do chores, run errands, or simply go for a walk with the baby).

One thing they also made me aware of was how having a birth plan can help me stay in control of what happens to me at the hospital while I'm in labour, as well as what happens to me and my baby after delivery.

The Quick and Dirty of Creating a Birth Plan
The first question I asked myself was, "how do I know what I want to happen during my labour and delivery if I've never done it before?" The lactation specialist recommended that I seek out a doula to educate me about the process about labour and delivery, as well as coach me during the actual process. Again, being cheap, I had decided a while ago not to use the services of a midwife or a doula, so this didn't interest me too much.

So, I did what I always do: I did my own research. What I found was that I have a lot of choices that I can make at the hospital so that I am not confined to their regular procedures. The birth plan is also helpful to your partner to understand what it is that you want to happen. This is particularly useful because he or she can be your advocate when you are in the throes of childbirth, and not feeling very communicative. I am also going to talk to my obstetrician about my birth plan so that he can make further recommendations.

In general, some things for you to consider include:

• Hospital vs. home birth
• Vaginal vs. cesarean delivery
• Types of interventions you would like (or not like) to happen; e.g. pitocin, amniotomy, episiotomy
• Who you want to have around you; e.g. your partner, family, etc.
• The kinds of pain relief methods you'd like to employ; e.g. breathing techniques, massage, epidural
• You may want the option to walk around, drink and eat during labour
• The position in which you'd like to give labour--as opposed to the traditional "on your back" hospital position
• How you would like your baby fed: breastfeeding vs. bottle feeding

After writing my birth plan I feel a lot more confident about going into my last stage of pregnancy than I did before. I highly recommend empowering yourself by learning as much as you can, either through clinics, hospital workshops,hiring a midwife or doula, or simply do as much reading as you can.

Getting a Cold During Pregnancy: What Medicine Can you Take? (Week 32)

I'm sick, and have been for the past few days. I have had the usual cold symptoms: runny nose, sore throat, and a mild headache from sinus pressure. Luckily I have no fever.

So what does one do when she is pregnant and has a cold or the flu? Is there anything that is safe to take to help alleviate symptoms? Although there is some debate as to what medicine is safe to take, and when it is safe to take it, there are some drugs that have not shown any harmful effects to the baby. Nevertheless, always consult with your doctor before taking any medications.

What You Can't Take

• Ibuprofen (e.g. Advil), or any kind of NSAID (non-steriodal anti-inflammatory drug) can be harmful to the baby during any stage of pregnancy. Generally, anything labelled as an anti-inflammatory should be avoided.
• ASA (e.g. Aspirin). While shown to be relatively safe during the first trimester, it can cause labour complications and should be avoided later in pregnancy.
• Avoid cold remedies that contain alcohol. 
• Avoid the decongestants pseudoephedrine and phenylephrine, which can affect blood flow to the placenta.

What you Can Take

• Acetominophin (e.g. Tylenonl) is perfectly safe to take while pregnant, and will not only offer some pain relief, but also help to bring down a fever.
• Guaifenesin, an expectorant (Hytuss, Mucinex, Naldecon Senior EX, Robitussin)
• Dextromethorphan, a cough suppressant (Benylin Adult, Robitussin Maximum Strength Cough, Scot-Tussin DM, Vicks 44 Cough Relief)
• Guaifenesin plus dextromethorphan (Benylin Expectorant, Robitussin DM, Vicks 44E)
• Cough drops
• Vicks VapoRub

All in all, you can rest assured that it is safe to take over-the-counter cold medications on a short-term basis. These drugs, however, should not be used indiscriminately or for extended periods of time. In addition, use should be confined to only those products that are appropriate for the symptoms.


Non-Medicinal Aids

• Rest, and plenty of it
• Water, and plenty of it
• Lots of clear, decaffeinated liquids, such as teas and broths
• Orange juice or other juices with vitamin C
• Taking your prenatal vitamin, which contains vitamin C to boost your immune system and zinc to help fight off germs. And don't forget to get your vitamins and minerals the natural way — by eating food rich in nutrients. You can find vitamin C aplenty in citrus, strawberries, melon, kiwi, mango, papaya, broccoli, red cabbage, tomatoes, bell peppers, spinach, and a host of other delicious foods. Get your zinc from turkey, beef, pork, cooked oysters, yogurt, wheat germ, oatmeal, and eggs.
• Eating fresh garlic — known to have virus-fighting compounds (if you can actually get it down), or using anti-viral spices such as cardamom, cinnamon, and cloves in your cooking
• Humidifiers to keep the air around you moist (consider a warm mist humidifier)
• Saltwater gargles to relieve sore throat pain (try one teaspoon of salt in eight ounces of warm water to get the fastest relief)
• Steam inhalation or nasal lavage to relieve nasal congestion or sinus headaches (for lavage, dissolve a quarter teaspoon of salt and a tiny pinch of baking soda into eight ounces of lukewarm water, and use a nasal aspirator to irrigate — or clean — out your nasal passages)
• Saline sprays to moisten your nasal passages (but make sure not to use the medicated sprays)

Rib and Chest Pain During Pregnancy (Week 30)

A week ago I started getting pain in my chest whenever I laid down to sleep either on my side or my back. I ended up having to sleep in my recliner upright for a few days for the pain to go away. Thank goodness I had an airplane neck pillow and a extremely comfy chair to get me through that time. The pain in my chest started just a few minutes after laying down, and radiated from my sternum (chest bone) and through my rib muscles on each side of it. The pain would make breathing more difficult, and the only thing that I could do to alleviate the pain the next day would be to have my partner stretch my chest muscles a few times throughout the day.

Although I have had this pain before I was pregnant, it would be rare. I would wake up in the morning with a stiffness in my chest, but shortly after getting out of bed and moving around the pain would subside.

Topical Pain Relief Creams a "No-Go"
A visit to the pharmacy for some topical muscle relief cream proved fruitless. I'm not allowed to take any anti-inflammatories, whether orally or topically, while pregnant. Not good. Fearing the worst--that the pain would last for the remaining two months of my pregnancy--I did some research online to see what was going on: why was the pain so severe, and why was it so consistent? The results I found were unsatisfying.

Is it Heartburn?
If you Google "chest pain during pregnancy" or "sternum pain during pregnancy", the results overwhelmingly tell you that what you have is heartburn. That's' baloney, I say. Here's what the symptoms are for heartburn:

• A burning sensation in the chest
• A burning feeling in the throat
• Feeling of food "sticking" in the middle of the chest or throat
• Sour or bitter taste in the mouth
• Difficulty swallowing

I know what heartburn feels like. It has visited me sporadically throughout my pregnancy. It's not fun, but it's not the kind of pain I was feeling. So what is it, then?

No One Really Knows What Causes It

The sobering truth is, there's no clearcut explanation for why this happens to pregnant women. There is a condition, known as Costochondritis, which is an inflammation of the cartilage that connects a rib to the breastbone (sternum). It causes sharp pain where your ribs and breastbone join....Hmmm, okay, this sounds a lot more like what I've been going through. My sternum and the muscles on either side of it are sore to the touch. Having said this, I'm not into self-diagnosis, so I'm also not about to jump to the conclusion that this is what I have.

Pain in the ribs and sternum is not uncommon to pregnant women. As the baby grows, the uterus expands and can put pressure on your ribs. The Intercostal muscles, which are located between ribs, can become strained. Rib pain can make movements and even breathing painful. During pregnancy, it may be difficult to find a position which isn't painful, which seems to complicate the situation. 

Okay, so the question remains: what can I do about the pain?

How to Ease Rib and Chest Pain During Pregnancy

Pain Medication. Before taking any medication, confirm that it is okay to do so with your doctor. Tylenol is generally considered safe during pregnancy, and more severe rib pain may take a stronger pain medicine. Many different types of pain medication can be prescribed during pregnancy for rib pain, but your doctor will need to decide which medicine is best for your pregnancy. 

Open up the chest. Sit upright in a comfortable chair and place a small pillow in the small of your back creating an arch. This will take some of the pressure off your rib pain and make it easier to breathe again. You will know when you find the angle that works best for you, some pregnant women need more of an arch than others.

Stretch the chest. Follow this link to find instructions on how to do an assisted chest stretch. Being pregnant, it is easier if you are seated in a chair. Your partner will have to raise his or her knee to place it between your shoulder blades. This stretch was my lifesaver--it immediately reduced the pain to almost nothing, and by the end of the day I'd have no pain at all.

Use ice to reduce inflammation. Place a bag of ice or a chilled gel pack on your ribs where the most pain is. If you have rib pain on both sides, place ice over each. It is generally considered best to have a thin layer of cloth between ice and skin, so you may be most comfortable by placing your ice pack right over your clothing. 

Raise your arms above your head. While seated, either with the ice packs or without, raise your arms above your head. I have a high back recliner, and I can grab the back of the seat with my hands to prevent my arms from getting tired. It's a great way to take the pressure of my uterus off my lower ribs. Hold this position as long as is comfortable, and repeat as needed.