Diagnosing Reflux

For the first two weeks of M’s life, I was completely amazed. K had been a very alert newborn- she rarely slept for longer than 1/2 hour at a time during the day, and never for more than 2 hours at night. She needed to be held constantly and with my postpartum depression and anxiety, it was overwhelming.  But M has been completely different. He’s relaxed, sleepy and content; he will nap in 2 hour stretches, wake up to eat and look around, then fall back asleep. For two full weeks I was in awe of this little baby who was just so EASY.

Around the two week mark, his casual spitting up became much more prevalent. His lazy manner of nursing turned into a struggle; he would gulp, cough, unlatch and scream. After each feeding, his little legs were pulled up to his stomach, and he would grunt and cry. He had incredible gas; I could hear his stomach gurgling, and any release of gas was explosive and sounded painful.

I assumed I was eating something that was bothering him, or that maybe my fast letdown was causing him to gulp too much air. But after carefully recording what I ate for a few days (and finding no patterns at all), and adjusting how I nursed and how frequently I burped him, the pain and discomfort seemed the same. M was no longer falling asleep nursing – he was in too much pain. We went through dozens of outfits and burp cloths daily- he was spitting up at least three or four times after each feeding. I was briefly reassured because he was still gaining weight (by three weeks old, he had jumped from 8lb 12oz to 10lb 12oz), but ultimately I knew there was something wrong.

At my most recent checkup with the midwives, I brought up my concerns. Instantly, the midwife mentioned GERD: gastroesophageal reflux disorder. Though she couldn’t diagnose anything, she suggested that we consult with a pediatrician. Again, since M was gaining weight well, she didn’t seem too concerned. But she wrote a referral, and two days later, we were in the pediatrician’s office.

Our family is very familiar with GERD; both Jand myself have had it at one point in our adult lives, plus my mother and grandmother also have it. But in an infant, it seems a lot scarier. Knowing that each time he spits up, stomach acid is burning up his esophagus makes me wince; I know that pain, but when it happened to me, I knew what was causing it and why. M has no clue why eating hurts him.

The pediatrician did a full assessment. She asked about any and all symptoms I’ve observed, checked M for signs of anything else that could be wrong, and told me a bit about reflux and GERD. All babies have reflux; the muscle that closes the stomach off to the esophagus isn’t fully developed yet. With an all-liquid diet, inevitably some of that liquid is going to come back up. Where typical reflux becomes GERD is when there is some damage being done, or obvious discomfort. Though M was gaining weight well, and didn’t have any blood in his spit up (two of the more severe signs of GERD), he was in obvious pain after feeding and after spitting up.

For a confirmed diagnosis of GERD, the pediatrician said they would have to do a swallow study. However, since this is a long and bothersome process, her practice deals with it a little differently. Because GERD is suspected, we were given a two week trial of Prevacid. If it helps, we’ll just keep on with that. If it does nothing, or if it makes it worse, we’ll start looking for other reasons for M’s pain (such as a protein intolerance/MSPI).

We’re only a few days into the trial, so we haven’t noticed any changes yet. But I’m hoping this is the answer for M; I’d like to ease his pain as quickly as possible. I’ll be sure to update after our next pediatrician’s visit!

For a confirmed diagnosis of GERD, the pediatrician said they would have to do a swallow study. However, since this is a long and bothersome process, her practice deals with it a little differently. Because GERD is suspected, we were given a two week trial of Prevacid. If it helps, we’ll just keep on with that. If it does nothing, or if it makes it worse, we’ll start looking for other reasons for Baby Oats’ pain (such as a protein intolerance/MSPI).

We’re only a few days into the trial, so we haven’t noticed any changes yet. But I’m hoping this is the answer for Baby Oats; I’d like to ease his pain as quickly as possible. I’ll be sure to update after our next pediatrician’s visit!

Welcome, Maxwell!

Here we are, a month after the birth of baby M, and I’m just managing to get this posted. But you’ve been there; life just gets in the way. So, without further ado, the story of baby M.

Though my pregnancy with K lasted until 41 weeks, I was hoping and praying that Baby M would come early. Between the aches, the low iron and the trouble sleeping, I was so ready to have this baby.

Sept 18 was a scary day for me; during my second IV iron treatment, my blood pressure spiked then fell to 56/30. I couldn’t see, hear or respond to the nurses, and it took close to an hour to get me regulated again. After heading up to L&D to have a non stress test to check on M, I was sent home – everything looked great, and it was just a freak reaction. Since J was going to be out all afternoon/night, we sent K to my MIL’s for a sleepover. I figured all I really needed was rest.

At 3:45am on Sept 19, I woke up thinking I had peed myself (so glamorous). I slowly got out of bed, and the trickle turned into a gush. Though I was told it hardly ever happens this way, my water broke all over the bed. J wanted to make sure it wasn’t just pee…but the sheer volume of it proved it was definitely my water.

I paged the midwife, and she told me that since the fluid wasn’t clear (it was green/brown), they wanted to check me out in 8 hours, provided I hadn’t gone into active labour first. I showered, took some Gravol and Tylenol, and lay back down. I had some mild cramping, but really nothing major.

By 10am, contractions were nowhere to be seen. We decided to go for a walk at the mall to get coffee and see if the activity might start something. When I was still contraction-less at 12pm, we headed to the hospital to get checked out and have another non stress test.

Here, we learned a few things. The midwives are very hands-off; they prefer for things to happen as naturally as possible. That being said, because my water contained meconium (baby poop), they were much more concerned about a risk of infection. If the fluid had been clear, they would have let me wait up to 72 hours before suggesting an induction. Since it wasn’t, the most they felt comfortable with was about 24 hours. So, after chatting it over with J, we decided that if labour hadn’t started on its own, we would come in for an induction at 7:30 the next morning.

2 P M 

We got home around 2pm, and I took some more Tylenol and laid down. K was having a blast at her Grammie’s house, so we figured we’d go over to see her at dinner time, one last time before the impending induction. At about 4pm, I was having irregular, slightly painful contractions, so we jumped in the car to go visit K. Though my MIL had made dinner, by 4:45 I knew I needed to go home. The contractions were ramping up fast.

6 P M

I jumped in the shower to try and relieve some of the pain on my back (apparently, my babies like to hang out in a posterior position, meaning lots of back labour for me!). By 6pm, I was begging J to page the midwife for me; this was the real thing. We hesitated briefly, because I didn’t want to get to the hospital and only be dilated to a 2 or 3, and be turned away. But, the contractions were intense enough that I was really nervous for the drive in to the hospital; so when the midwives told us to head to L&D, we did.

8 P M  –  5 C M  D I L A T E D

I was checked in and given a birthing room by 8pm. The contractions were coming fast and hard; J is hands down the best labour coach I could imagine, and even the nurses on the floor asked if he wanted a job as the resident doula. There was no doubt to my midwives, before even assessing me, that I was in active labour. When they checked, I was 5cm dilated and 90% effaced. Halfway there, I cheered silently, though I knew the hardest part was yet to come.

8 : 3 0  P M –  N I T R O U S  G A S

After a half hour of monitoring, I jumped in the shower again. Hot water was incredibly soothing between contractions which were 2 minutes apart, and J was right in my face, keeping me focused. After a few incredibly intense contractions in a row, I knew I needed a little more assistance. The hot water was nice, but wasn’t really helping all that much.

While the midwives hooked me back up to the monitor (I was allowed 30 min off/30 min on, because I opted out of continuous monitoring), they asked if I wanted to try some nitrous gas. Knowing how well it had worked (briefly) during K’s birth, I happily accepted. Though it didn’t stop the pain of the contractions (or even really dull them), it certainly made me care less about the pain, and made everything a little more bearable.

9 : 3 0 P M  –  9 C M  D I L A T E D

By 9:30pm, an hour and a half after I’d been admitted, contractions changed again. I told the midwives that I couldn’t do it, that it was too hard. Thankfully, the student midwife offered to check my progress; I think she knew I needed some hope. At this point I was 9cm dilated with only a bit of a lip left; that gave me some new energy. With K, it took 8 hours to go from 7cm to 10cm, so I felt great about my progress. With a bit more hope, I took a few contractions leaning over the back of the bed (almost on all fours). At this point, I started feeling the urge to push. Though I wasn’t fully dilated yet, the midwives encouraged me to follow my body, and push if I felt I needed to. I pushed a few times, and M had descended to a 0 station  when he had been at -2 before.

As I was pushing, supporting myself on my knees was getting too difficult. Also, my reliance on the nitrous gas meant that my pushes weren’t very effective. So at that point, I flipped over into a seated position, gave up the gas, and settled into pushing…for real.

P U S H I N G

At this point with K, I had my epidural, so I don’t remember how intense pushing actually was. Anyone who tells you that pushing feels good after contractions?? Well….we need to have a few words. After four or five contractions/sets of pushes, I was exhausted. I told the midwives that I couldn’t do it, and I needed a break. Since my contractions were right on top of each other, there was no break to be had. But, in another amazing intuitive move, the student midwife asked for my hand. Just before the next contraction, she guided my hand down, and I could feel M’s head RIGHT there. With a few more pushes, J could see a head of dark hair. Mustering all of the strength I possibly could (and bursting blood vessels in my face and shoulders), I pushed through four more contractions. When I felt his head, then his shoulders slip out, I’m pretty sure I cheered and fist-pumped…then my slippery, beautiful Maxwell was placed on my chest. It was 10:57pm.

B I R T H – 1 0 : 5 7  P M

I kept saying over and over that I couldn’t believe I did it; I really didn’t think I could have an epidural-free birth. But M arrived, safe and healthy, and I felt fantastic.

He snuggled into me as the midwives stitched me up (second degree tear again, ugh), and latched on to nurse right away. After the stitches were done, and I had gotten about an hour of skin to skin time, the student midwife helped me up to shower and pee while M had his newborn exam.

He weighed in at 8lbs 12oz – a full pound and a half bigger than his sister and 21 1/4 inches long. He scored a 7 and a 9 on his Apgar, and the meconium in my water had no effect on him at all. Since I had gone med-free, and M was in great shape, we were prepped for discharge; a mere 2.5 hours after he was born.

D I S C H A R G E D  –  1 : 3 0  A M

We were at home and settled in for the night before M was even 4 hours old. Thankfully, being so new, he was exhausted; we all fell asleep at 3:30am, and slept until almost 9am. I’m enjoying that now, while it lasts.

Recovery was a breeze this time. I’ll write another post soon about recovery, adjusting to 2 kids, and K meeting M for the first time (it was precious). For now, I’m going to go enjoy the brief amounts of sleep that I can grab, before M wakes up to nurse again!

We were at home and settled in for the night before Baby Oats was even 4 hours old. Thankfully, being so new, he was exhausted; we all fell asleep at 3:30am, and slept until almost 9am. I’m enjoying that now, while it lasts.

Recovery is going much better this time around, but we’re only 24 hours into this thing at present writing. I’ll write another post soon about recovery, adjusting to 2 kids, and Littke Oats meeting Baby Oats for the first time (it was precious). For now, I’m going to go enjoy the brief amounts of sleep that I can grab, before Baby Oats wakes up to nurse again!

We officially have a two year old in the house!

A few weeks ago, K celebrated her second birthday; her favorite thing right now is anything to do with birthdays, so she was extremely excited. We held her birthday party a few weeks ago, on a beautiful Saturday where we could all be outdoors. Though I’m always tempted to amp up my party-planning skills and create a Pinterest-perfect event, at 35 weeks pregnant in the middle of the summer, it just wasn’t happening. Thankfully, all that K requested was chocolate cake and balloons; really, the best part of any party.

Her actual birthday was acknowledged and celebrated a little, but it was a whirlwind day (my younger sister got married). So instead, we’ve had a birthday week (or two), celebrating all over the place.

So what does Little Oats, the two-year-old, look like?

Height: about 30 inches, though we haven’t measured her since her 18 month check

Weight: 25lbs

Sleep: She’s sleeping through the night in her Big Girl Bed, which is terrific, and still having about a 1.5-2 hour nap each afternoon

Favorite Foods: waffles, smoothies, yogurt-covered raisins, beets, granola bars, and anything with ketchup

Common Sayings: “It’s an emergency/It’s a big problem”, “What’s next on the list?”, “Of course!”

Favorite activities: playing with her water table, watching Paw Patrol or Team Umi Zoomi, dancing to Shake it Off or Uptown Funk (girlfriend needs some newer songs), colouring, climbing her play kitchen.

Challenges: the tantrums are real. Especially because her language is so good, she can express exactly what she wants, and throws a massive fit when she can’t have it. She is also a bit of a slave to schedule; if we throw off bedtime or naptime too much, sleep is a problem for the next few days. We also need to work on her listening skills; she gets a LOT of time outs because she doesn’t listen to what we ask her to do.

So far, two is an absolute blast. Yes, she is incredibly opinionated, and if we deviate from routine too much, it is nearly impossible to reason with her. But she is talking up a storm, she has a killer sense of humor, and she is aware of her surroundings enough to be able to make observations (ex. “Everybody has noses, Mommy.”) While she works on establishing her independence, I find myself needing a lot more patience, but I know that ultimately she is just developing her own style and personality. The more she grows, the more excited I get to see her interact with her baby brother (who is due in less than a month!)

So far, knock on wood, the twos aren’t that terrible!

Packing a Hospital Bag: Round Two

When I packed a hospital bag the first time around, I felt like I was headed away for a week. I packed everything that was on every ‘suggested’ list I could find online, and probably more. However, since I gave birth with midwives, my maximum hospital stay was twelve hours; had I not gotten an epidural, it would have been around 4 hours. Needless to say, the large suitcase I packed (plus a diaper bag for the baby) went largely untouched.

Knowing now what I didn’t know then about my hospital stay and what I would actually need, my hospital bag is going to look quite a bit different. However, if you’re using my list to pack, remember a few things. At my hospital (is it a Canadian thing? I don’t know), there are very few things provided. Every hospital-packing list I’ve read mentions to clear out your room; take pads, underwear, diapers, nipple cream, peri bottles, everything. Well, for some reason or another, none of those things were provided. So there may be a few things I’ve listed that you can forget about, because your hospital is well stocked and generous. Also, since I live 5 minutes (in traffic) from the hospital, and my stay will be so short (barring any complications), I’m really not packing for any extended length of time. This is more of a ‘labour’ bag than a ‘postpartum’ bag.

(collage credit goes to Hellobee – original post at http://www.hellobee.com)

1. Extra-large underwear: Mesh undies were non-existent at my hospital. So I ran out to Walmart, and bought the biggest, cheapest granny-panties I could; ones I would have no qualms about throwing out if they got ruined (or once the post-partum situation cleared up).

2. Tena pads: A tip from my midwives: instead of buying Always pads, or something similar that tend to stick to stitches, the Tena incontinence pads are bigger, more absorbent, and don’t have that ‘dry’ layer that is plasticky and painful.

3. Nursing bras: These Gilligan O’Malley bras from Target are wonderful. Plus, since my milk won’t have come in, I really just need something that gives easy access to baby.

4. iPod docking station: For music during labour.

5. Labour dress: This ‘swim coverup’ was $7 at Walmart, and it is super comfortable. All of the necessary points for access (in case of IVs, epidural, shots, and nursing) are totally available, and it covers up more than a hospital gown. Last time, I had to take it off when I got an epidural, but since that’s not in the plan this time, I should be able to keep it on.

6. EOS lip balm: Because hospitals are dry.

7. Yoga pants: Leaving the hospital less than 12 hours after giving birth, I still looked VERY pregnant. Yoga pants were comfortable, stretchy, and since I bought them for $20 at Costco, I didn’t care if they got ruined.

8. Exercise ball: I laboured for ages at home on my exercise ball, and I made Mr. O pack it in the car when we headed to the hospital. I didn’t use it for long, but having it was wonderful. I’ll definitely bring it again.

9. Water bottle: Tiny styrofoam cups that need to be refilled every three seconds? Not really great for keeping up fluid levels. So I packed my own 1L Contigo water bottle.

10. Clif bars: Rules differ about eating during labour, but with the midwives, we are encouraged to keep eating and drinking throughout the process. I stocked up on Clif bars, trail mix, and other easy snack foods to keep with me (also good for Mr O, should the cafeteria be closed).

Getting Labour Started

I’m currently 38 weeks pregnant, and it’s been a rough few weeks. With my iron levels so low, and the awful pelvic and back pain I’ve been having, I’m ready for M to make an appearance.

At my most recent appointment, my midwife handed me a bright orange piece of paper. “I think you need this,” she said, and when I read the title, I almost hugged her.

‘At-Home Induction Techniques’, it said- or ‘How to jump-start labour safely’.  I’m hesitant to share these here; not because I don’t want you try them out, but because I’m not a medical professional. So please note- these are things to try once you’re safely to term, and only after getting clearance from your health care provider (okay…you probably don’t need someone to sign off on walking or sex…but be careful). Also, important to note, that if your body isn’t ready to go into labour, these techniques probably aren’t going to help. They won’t dilate your cervix or necessarily cause contractions; but they’ll help things along naturally.

1. Evening primrose oil: In capsule form, this oil can either be swallowed or inserted internally. It helps to get your cervix ready for labour; it won’t cause you to dilate, but it certainly helps. My midwives recommended 500mg twice daily in capsule form from 38 weeks on.

2. Red raspberry leaf tea: There are many conflicting opinions on when to start drinking red raspberry leaf tea. Some sources indicate that it is safe any time after the first trimester, others warn to avoid drinking it until you’re full term. My midwives recommend 2 cups daily from 36 weeks, then doubling doses at 38 weeks and again at 40 weeks. Red raspberry leaf is a uterine tonic; it will help your body contract more efficiently and effectively.

3. Nipple stimulation: Whether manually or with a breast pump, nipple stimulation releases oxytocin (the natural form of pitocin used in inductions). I used my pump when I was overdue with Little Oats, and the contractions certainly ramped up while I was using it, but ultimately died down when I stopped. Other people swear that they’ve gone into labour from nipple stimulation alone.

4. Homeopathics: This is one to be cautious of. Talk to your health care provider and be sure that you are buying the correct dosages of the correct homeopathic from a reputable source. I talked to three midwives and my doula before using homeopathics with K, and will not start them this time until closer to my due date. The one recommended by my midwives is caulophyllum, or blue cohosh. I take 3 of the homeopathic ‘pellets’ once per day for 4 days, then take a 3 day break, and take them for 4 more days. I didn’t end up getting to a second round of these with K; she came on one of my homeopathic ‘days off’.

5. Sex: You’ve heard it before, I know. The best way to get baby out, is the same way you got baby in (in most cases). Between the oxytocin released, and the prostaglandins in sperm, my midwives have often said that this is the ONLY method that works reliably for the majority of people. And if you’re one of the lucky ones who actually find sex appealing at 9 months pregnant, that’s even better.

6. Belly massage: Mix 6 drops of clary sage oil into a few tablespoons of castor oil, and store in an airtight jar. Rub a small amount of this into your belly nightly. Some people swear that it causes contractions. At the very least, clary sage oil smells incredible, and the oils will moisturize that tight belly skin.

7. Walking: For about a week and a half when I was pregnant with K, we headed to the mall after dinner and walked laps. This time around, walking the mall is tough when you have a easily-distracted toddler (and its back-to-school shopping season), so we haven’t really gone walking as much. But not only does walking provide you with some much needed exercise, gravity also helps baby settle into place and put needed pressure on your cervix.

8. Mental and Emotional preparation: This is often overlooked in preparing for labour. With K, I got so focused on the fact that her due date had come and gone, and I was uncomfortable, that I didn’t spend any time mentally preparing for labour. Spend some time sitting in the quiet, visualizing how you’d like your labour to go, and thinking through the task you have before you. Sometimes, just dealing with some of the fears and worries you have surrounding birth is enough to allow your body to relax enough for labour to start.

9. Stretch and Sweep: This is on the list, but isn’t something that you can (or should!) do at home. Once your health care provider has assessed you and is comfortable with your progress, they may gently separate your bag of waters from the cervix, which releases hormones and can jumpstart labour. It can be incredibly effective if your body is ready for labour; but it can also be painful and ineffective if your body isn’t quite ready.

10. Castor oil: This is the last thing on the list from the midwives, and the one that comes with the most warnings. Castor oil WILL clear you out. The whole reason it is supposed to help with labour is because it causes gastrointestinal discomfort (read: diarrhea), which is sometimes enough to irritate the uterus. I’ve heard a hundred horror stories about women who take it and spend the next several hours on the toilet…and usually don’t go into labour because of it! The warnings on my sheet are this: wait until the midwife thinks that you are effaced and dilated enough to give it a try, make sure you keep hydrated to avoid losing too much liquid, and don’t plan to leave the house in the 24 hours following your dose (other than to head to the hospital). Honestly…I know that there are several mamas who have successfully used castor oil, but I think I’ll give it a pass (until I get REALLY desperate).

There are dozens of other tips you can find for getting labour started if you look around, and everyone has an old wives’ tale or horror story about the way that these methods work. In my opinion, you should do what you’re comfortable with. If, like me, you’re the type who gets anxious and stressed out, maybe you want to set a limit on what you’re going to try. Ultimately, baby is going to come when he or she is ready, regardless of what you try. So if raspberry leaf tea grosses you out, or you can’t imagine having sex at 9 months pregnant, don’t stress about it. There are plenty of things to try, if you want to.

Have you tried anything on the list? Have they been successful, or were any of them colossal failures?

Iron Deficiency in Pregnancy: Part Two

Here I sit, 38.5 weeks pregnant, with iron levels that have dropped through the floor.

When I last wrote about my low iron levels, I was confident that a regular supplement and some high-iron foods would reverse my problem. I took Palafer, which is a supplement designed for pregnancy, and it worked well when I was pregnant with K. But at 32 weeks, I had a bloodwork follow up. And not only were my iron levels low, they were dismal. My ferritin levels (stores of iron) were also extremely low.

I headed to the midwife and the naturopath for help; I had 8 weeks to get my levels up. It certainly explained why I have felt so awful this pregnancy; with iron levels like mine, it was any wonder I could get out of bed in the morning. Both the midwife and the naturopath told me to get on a liquid iron supplement as soon as I could (doubling the standard dose), and continue with the iron rich foods.

I started on Floravit, a liquid supplement that provided around 30mg of iron daily, plus the Palafer I was already taking. I ate every food I could think of that was high in iron, but I stopped at liver; pregnant or not, I really didn’t think I could stomach it. I was given three weeks to see how I would respond to this new, intense treatment; if it didn’t work, we would consult an OB and see what was next.

The Floravit was like drinking pennies, the Palafer was ridiculously constipating, and I don’t think I want to look at spinach for a long, long time. I was feeling very confident when, at 36 weeks, I had the bloodwork redone.

Less than 24 hours later, my midwife was on the phone. “I’m not quite sure what’s happening,” she said, “But your hemoglobin and ferritin levels are lower than before.” My hemoglobin is hovering around a 9 (normal starts at 12), and my ferritin levels are too low to register (‘less than 5’ is the official note on the report). These levels aren’t low enough that I need to be hospitalized for iron infusions (I believe that starts at about a 6), so while we’re working on getting these levels raised, it doesn’t make my pregnancy (or delivery) a ‘risky’ one. It does, however, mean that we need to keep a careful eye on the amount of blood lost during delivery. It means that M could have low iron, or that he might be low-birth-weight. It also means that a few of my options post-delivery are limited.

For example, I’ve been given the choice between ‘active management’ of delivering the placenta, or natural delivery. With natural delivery, the placenta is delivered through a series of further contractions, with your body taking the lead in expelling it. This can last from 10-60 minutes, and has a higher risk of postpartum hemorrhage (slight). With active management, however, you receive a shot of oxytocin (either in the thigh, or through IV), which causes contractions and expels the placenta faster, usually with midwife assistance (pushing on the uterus, gentle pressure on the cord). This process usually lasts 5-10 minutes.

Due to my iron deficiency, and the danger that is postpartum hemorrhage, it has been strongly recommended that I pursue active management. While yes, I could still refuse, its in my best interest to go with their recommendation. This terrifies me a little; I couldn’t tell you why, because after delivering a baby, what’s a needle in the thigh?

I had my iron checked again yesterday, following a week of triple doses of iron supplements. And, like I expected, the results have remained exactly the same. No change whatsoever, despite all of my best efforts. I’m worried as to what this might mean. I’m going back to the naturopath next week, and my midwives and I are going to consult with an OB who specializes in issues like this.

I hate having unresolved issues, especially when the clock is ticking and delivery is right around the corner. I’m sure there will be a follow-up post to this one in the next little while; what the OB recommended, how we managed delivery, what my iron levels were like post-birth. But for now, I’m just waiting to see what happens.

Does anyone have experience with this? Any reassuring stories…or even tips to help me out?

Iron Deficiency in Pregnancy: Part One

Note: this post was written for Hellobee when I was about 18 weeks pregnant. I’ll post a follow up in a couple of days, from 38 weeks.

Iron deficiency is something that over half of women will deal with at some point in their lives. For me, the anemia hit as a teenager; I was put on an iron supplement as well as a birth control pill in order to control my cycles, and prevent me from losing so much blood each month. For many, this is when iron deficiency first rears its ugly head; your periods start, they’re a little out of control, and your body can’t keep up with the deficit. For many, this is also resolved by a few months on an iron supplement.

In my case I assumed my iron deficiency was under control and my doctor stopped following up. I stopped the iron once in university, and turned to coffee to control the tiredness. I never really thought about my low iron again, until I was pregnant with K.

When I hit third trimester with K, I was absolutely exhausted all the time. I had awful headaches, I couldn’t focus, and I felt really foggy. I assumed this was just typical third trimester (in the blazing hot summer). However, routine third tri blood work revealed that not only was I anemic, but my ferritin levels were at a 3. Normal levels for women range from 12-150 ng/mL, so this was really concerning to my midwives (especially for someone about to deliver a baby and lose a lot of blood).
In a drastic attempt to increase my ferritin levels (the protein that helps with iron storage), I started a high-dose iron supplement formulated for pregnant women. I also began adding dark leafy greens, red meats, beans, and fortified protein powder to just about everything I ate. Combining my iron-rich meals with vitamin C also helped increase iron absorption; take your iron supplement with a glass of orange juice to help this, too.

Thanks to my constant monitoring, my iron and ferritin levels came up a fair bit (to about 15-20 pre-delivery). I stayed on my iron supplement until about eight weeks postpartum, when I ran out and really didn’t see a doctor to follow up.

With this pregnancy, the exhaustion hit almost immediately. Again, I assumed it was typical pregnancy exhaustion, until the familiar headaches, fogginess and inability to concentrate began to show up.

I had bloodwork done at 12 weeks, and lo and behold, my ferritin levels were back down to 5. I grabbed the Palafer supplements from the pharmacy, and began pumping iron into my diet, along with vitamin C to help it all absorb. The fogginess faded, the headaches disappeared, and my energy came back by about 16 weeks. I’ll be continually monitored throughout this pregnancy to make sure my levels stay up, but I’m grateful that we caught it early this time.

So, what exactly IS iron deficiency (or iron-deficiency anemia)? Iron-deficiency anemia is a decrease in red blood cells, caused by having too little iron in your body. When you lack iron, your body can’t produce hemoglobin (which helps blood cells carry oxygen). This lack of iron causes you to feel weak, lethargic, foggy and irritable. What I learned, to my surprise, is that over 50% of pregnant women have low iron; compared to about 20% of non-pregnant women. Men tend to have much more iron in their bodies; only about 3% of men have iron-deficiency anemia.

Iron is essential for producing new blood. During pregnancy, a woman’s blood volume increases by almost 50%…if you’re low on iron, this process is much more difficult. Also, babies tend to load up on iron before they are born, taking all of yours; breastmilk is low in iron, so they’re preparing themselves for the first several months.

So how will you know if you should have your iron levels tested? Here are some of the most common symptoms of iron-deficiency anemia:

• Headaches, worse during exercise
• Breathlessness
• Exhaustion
• Dizziness
• Difficulty concentrating

One of the easiest ways to boost the iron in your body is to eat iron-rich foods. There are two forms of iron that can be eaten: one is called heme iron (coming from an animal source), and nonheme iron (which comes from plant sources). Your body absorbs the most iron from heme sources. When pregnant, you should be aiming for about 30 mg of iron per day through a combination of food, prenatal vitamins, and an iron supplement if prescribed/given by your doctor.

Here’s a list of some amazing iron-rich foods, from both the heme and nonheme categories:

Animal sources:

• 3 oz clams – 24 mg
• 3 oz organ meats – 5-9 mg
• 3 oz beef – 3-5 mg
• 3 oz duck, lamb or chicken – 3 mg

Vegan/Vegetarian sources (average 5-8 mg per serving):

• 1 cup spinach – 5mg
• Fortified instant oatmeal – up to 20mg
• Dried apricots – 3 mg per 6 apricots
• 1 cup swiss chard or other leafy green
• 1/2 cup kidney beans – 3mg

Note: cooking iron-rich veggies can leach some of the iron, so don’t boil them. Steaming is preferable, or sautéing in a cast iron skillet, which will actually boost the iron content.

Beat the Heat: Surviving a Summer Pregnancy

As a Canadian, the heat is one of the things I dream about from October to May, each and every year. When the cold sets in and the days get shorter and shorter, I long for the never-ending days of summer. How wonderful is it to leave the house without bundling up in four layers of clothing, or to pull out of the driveway without scraping, shoveling and brushing a path to freedom?

It’s finally summer here, with temperatures above 25 degrees Celsius and bright clear skies. Looking out the window makes me happy, and my mood lifts when I can throw on a pair of sandals and go. Yet, for two out of the last three summers, the heat has been my nemesis. Due in August with K, and September with M has meant that the longest, hottest days are also my most uncomfortable on the pregnancy front. I balloon up – my feet and ankles swell to the point where even flip flops are uncomfortable. Humidity makes it tough to breathe, and sweat accumulates in places that have no business getting sweaty in the first place.

So – how can a pregnant mama keep cool, happy, and actually enjoy the (brief) months of summer? Here are my top five tips for keeping yourself comfortable when the temperature soars.

1) Popsicles: I’m a die-hard fan of Chapman’s banana popsicles; are they just a Canadian thing? They’re magical, and I’ll probably go through a few boxes between now and the end of August. This recipe for hydrating pops looks delicious, and has the bonus of not being filled with added sugars and colouring. Another favourite of mine are herbal tea popsicles; I use tea like strawberry rhubarb David’s Tea, brew it fairly strong, then pour into popsicle molds. Again, no added sugar, no caffeine, and incredibly kid-friendly as well. Hellobee has featured plenty of other ‘pop’ recipes over the years; check out these mango pops, these tropical yogurt pops, or these great breakfast pops!

2) Swimming: The water is your friend, swollen pregnant lady. When you’re fully submerged, you’re nearly weightless, and that’s a feeling I’m sure you’ve forgotten at this point! I’m fortunate enough to have a pool in our yard, but even if you’re pool-less, there are still ways to enjoy the water. Sign up for an Aquafit class, use the local public pools, call up a friend with a pool and offer to bring snacks if you can float for a bit. If you’ve already got kids running around, make use of local splash pads, water parks, or a good old sprinkler in the yard. I’m guilty of floating my puffy feet in K’s water table while she splashes and plays…even a bucket of cold water on your back porch might help!

3) Air conditioning: find it, get it, embrace it. Again, if you’re lucky enough to have A/C in your house, then you’re set. Yes, it’s summer; but you can go outside in the cooler part of the day, and stay inside from 11-2, when the sun (and heat) is strongest. No A/C? No problem. Find a coffee shop with cool air, or take the kids to an indoor play place. They’ll have fun, and you can relax in the frigid air. For me, just going to work some days is wonderful relief; eight whole hours of freezing aid blasting on me.

4) Clothing: maternity clothing is getting so much better in recent years. You don’t have to confine yourself to heavy synthetic materials and items that don’t breathe. Embrace cotton, linen, and anything in light colours. I’ve been loving jersey skirts and cotton dresses; you look put together, but aren’t restricted by hot, heavy clothing. Old Navy has these great skirts, and these maxi dresses from H&M are comfortable and really affordable!

5) Swelling happens: The hotter it is, the puffier I get – and I’m sure most of you are the same. Surefire tips for alleviating the worst of my cankles involve amping up the water intake (yes, you’re retaining water, but I promise, staying hydrated helps), minimizing the salt that you eat, keeping your feet elevated when you can, and avoid sitting for long periods of time. Please note, while swelling is completely normal, any excessive or sudden swelling can be dangerous – give your doctor a call if you’re concerned (especially if your face starts to swell).

.  .  .  .  .

These are just a few tips in my toolbox; really, there’s no way to completely avoid the heat when you’re pregnant in the summer. But hopefully you’ll find a way to stay comfortable; those little babies are worth the unsightly cankles and boob sweat!

Banana Toffee Cake

I’m a lover of all things chocolate. When it comes time to try a new recipe, or experiment with some ingredients, I’m usually drawn to dark cocoa powders, luxurious bars of chocolate, and other rich things that are best served with a scoop of ice cream.

But sometimes, a bunch of bananas sits on your counter until they go mushy and brown. And the carton of whipping cream in the fridge is begging to be used. And sadly, the pantry is devoid of anything remotely chocolate.

That’s where this cake comes in. Banana Toffee Cake, straight from the oven, doused in caramel and served still warm. Better yet, the whole thing comes together in about half an hour (lets face it, isn’t that the hallmark of a good dessert?)

Sure, its a little heavy for a long, hot summer day…but its been raining here for two days straight. Bake this up, and either embrace or imagine a little bit of chilly weather. 

Banana Toffee Cake

Banana Cake:
1 3/4 cup flour
1 tsp baking powder
1 tsp baking soda
1/2 cup butter, melted and slightly cooled
3/4 cup white sugar
2 eggs
3 medium bananas, mashed (the riper, the better)
splash of vanilla extract

Whisk together the flour, baking powder, and baking soda. In a separate bowl, mix together butter, sugar, eggs, vanilla and banana until well blended. Stir in the dry ingredients just until blended. Pour batter into a greased 9×9 pan and bake at 350 degrees for 35 minutes, or until a toothpick comes out clean.

Toffee Sauce:
1/4 cup salted butter
1/2 cup dark corn syrup
1/2 cup brown sugar
1 cup of whipping cream (35%)

In a saucepan, mix together the ingredients and bring to a boil. Stirring frequently, boil for about 10 minutes, or until the sauce thickens slightly.

Poke holes all over the surface of the cake, and pour about 1/2 cup of toffee sauce over the top. Let it sit for a few minutes while it soaks in, then add more sauce. Reserve the remaining sauce to pour over individual slices as you serve them.

If your carton of whipping cream has any left, you can innovate like Mr O did, and whip the cream up with 1/2 oz of Fireball Whiskey. Spiked cinnamon whipped cream is a pretty excellent addition to this cake.

Prepping K for a Baby

There’s a lot you can say to an toddler that they’ll understand. Stop, don’t, please, cookie, Paw Patrol… K knows exactly what I mean when I use those phrases. But try to tell her that ‘Mommy has a baby in her belly’, and you’re met with a blank stare, a jab in the belly, and a lot of confusion.
Over the last few months, we’ve been trying to introduce the idea of a baby (and more recently, a baby brother) to K. And while several times, she’s tried to jam her baby doll into my belly, or look into my belly button to see the baby, I think she might understand that somewhere there’s a baby named Max, and he’s coming to meet us sometime soon.

So how have we gone about preparing Little Oats for the impending arrival of a baby? Here are 5 things we’ve been working on (and will continue to work on) until Baby Oats arrives.

1. Books: There are a ton of great books on the subject of getting a little sibling; some specific to brothers and sisters, some a little more general. We’ve looked at a few from the library that are big-sister-specific, but there are a ton of other titles that might be worth checking out.

• I’m a Big Sister (Joanna Cole)
• Olivia: Guide to Being a Big Sister (Natalie Shaw)
• There’s a House Inside my Mummy (Giles Andreae)

2. Baby dolls: When my little sister was born, my parents bought me my own newborn doll to take care of so I didn’t feel left out. I was a little older than K will be (I was four), but I still have that doll. We went looking for a baby brother doll for K, and I was a little shocked by the price tag on some of them. But then, on a chance trip to Ikea, we found this doll  – and K is already in love.

3. Baby clothes: Since we’re having a boy, we can’t really use many of K’s frilly pink clothes as hand-me-downs. So, in order to prep K for the baby, we’ve been letting her help choose new clothes for him. So far, she has chosen this fox hoodie from Carter’s, and these Robeez crib shoes. Kiddo has good taste – M will be a well-dressed little man.

4. Feeling baby kicks: K knows that Baby is in my belly, and she knows that he’s growing bigger. Now that he is finally kicking on a regular basis, I am so excited for her to start feeling baby kicks. It’s just getting to the point now where J can feel them from the outside, so in no time at all, K should be able to, too.

5. A big girl room: The final step to getting ready for baby is transitioning K into her ‘big girl’  room. While I would love to keep her in her current room, her nursery is much closer to our bedroom, and is already ideally set up for a newborn. By bringing her along and letting her choose cozy blankets, fluffy pillows and pictures for the walls, we hope she will feel that her new room is all about her (and NOT about the baby). We will be transitioning her into a single bed as well, and our hope is that this is done before M arrives in September. We want her new room to be a sign of ‘big girl’ status, and not evoke any feelings that she’s being replaced by the baby.

Even with all five of these things working together, she will still only be 25 months when M gets here. I know she won’t fully wrap her mind around it…but it sure is fun getting her ready for what’s to come. Poor kid’s world is going to be completely rocked. But at least she’ll have her new baby doll, Winston (her choice), for company.