Although not strictly back pain related.....Importance of Fish Oil in Pregnancy

Although fish oil or omega-3 fatty acids aren't strictly a back pain issue in pregnancy, I've decided to write a little bit about them because of the myriad questions I get about them and of their importance for the expectant mother.

Now for a little biology lesson:
We all know that an infant gets all of its nutrition from the mother during pregnancy. What a mother eats greatly is passed directly to the baby through the umbilical cord. We all know that it is important to get folic acid for spinal cord development, iron for blood supply, and calcium to help build those little bones. However, you may not know that omega-3 fatty acids are essential for brain development! Pretty important, huh?

If you want all the gory details, read on:
There are 2 important types of omega-3 fatty acids for brain development and enhancement: DHA (docosahexaenoic acid) and EPA (eicosapentaenoic acid).  These fats are long chain fatty acids that we must get from food. (Our bodies aren't able to make them.) When omega-3s are present, the brain is able to function better because it helps build the fatty sheath that surrounds a nerve (called myelin). Myelin speeds up nerve transmission and enables our brain to send more accurate and faster messages to the rest of the body.

*Omega-3 fatty acids make up 70% of a baby's brain and the only way for a baby to obtain these necessary nutrients is from its mother.  How the baby's nervous system develops will depend greatly on how much Omega-3s the mother has during her pregnancy.
Now for all the questions I routinely get about fish oil....

Why can't I just eat more fish?
Well, you certainly can. We would all do well to replace meat products in our diet with fish. However, when you are pregnant you want to limit the amount of fish you eat. High levels of mercury in fish such as swordfish, mackerel, and some tunas could cause problems to your unborn baby (called heavy metal toxicity). Those fish should be avoided.  According to the FDA only low-mercury fish should be eaten while pregnant and then not more than 2 times per week. However, even eating fish twice a week will not give you a sufficient amount of Omega-3s (it's not even enough for someone who is not pregnant!). So even if you eat fish, you should still supplement with a good omega-3 supplement.

How does my baby benefit from omega-3 fatty acids?
This is one of my favorites because it really amazes people. (It still amazes me!)

• Stronger immune system
• Better hand-eye coordination
• Higher IQ
• Fewer behavioral problems
• Reduced risks of asthma

Additionally there are great benefits for the mother as well....

• Less risk of postpartum depression  
• Reduced risk of breast cancer 
• Decreased chance of pre-term labor
• Improved cardiovascular health

On the other hand, a deficiency in the omega-3 fats can adversely affect learning, behavior, visual acuity, and retinal function in infants

I thought omega-3s were only important during breastfeeding?

They are very important during breastfeeding, but they come into play long before the baby is born.
Throughout pregnancy, maternal fatty acid blood levels drop. This results from the growing infant’s need for the fatty acids to build developing brain tissue. This leaves the mother with depleted stores of essential fatty acids for her own nervous system health (her body will actually strip her own nerves of the fatty acid to provide it to her infant during pregnancy and while breastfeeding). When her system is depleted of these fatty acids, they are not easy to replenish.

As a result of this, with each pregnancy, omega-3 supplies in mother and, therefore, baby, are decreased. Mothers with low fatty acid levels have been shown to have higher levels of postpartum depression because of the difficulty the nerves have to pass accurate messages. Because of this, it becomes even more important for mom to supplement her omega-3 intake during pregnancy, particularly in the 3rd trimester when fetal brain development is most rapid.

There are so many types of fish oil out there, how do I know which one is best?

When looking for an omega-3 supplement, one needs to find pharmaceutical-grade. This denotes the highest level of purity attainable in these supplements avoiding damaging mercury and PCBs as much as possible. I personally recommend Nordic Naturals to my pregnant patients. I like them because they exceed industry standards, they are of the highest purity, they are used most often by researchers, and lastly, they taste good! (They are strawberry- or lemon-flavored, so you don't get the "fishy burps" you often get with other products.) 

More info about Nordic Naturals



For more information about fish oil research and references check out:
Latest fish oil research

Breech babies and the Webster Technique

*Although my focus for this blog has been devoted to back pain and discomfort of pregnancy, I have received a number of questions about the Webster Technique and breech babies. To answer all of your questions most effectively I am going to dedicate this post to that topic.

Why is a breech baby a problem?

Did you know that MOST breech babies are delivered by c-section? Did you also know that the national c-section rate is over 30%? That means one in every three women who are pregnant will have a c-section. Is that OK with you? It shouldn't be.
Here's why I say that. . .

• A woman is five to seven times more likely to die from a cesarean delivery than from a vaginal delivery.
• A woman having a repeat C-section is twice as likely to die during delivery.
• Twice as many women require rehospitalization after a C-section than after a vaginal birth.
• Having a C-section means higher rates of infertility, ectopic pregnancy, and potentially severe placental problems in future pregnancies.
• Babies born after an elective cesarean delivery (i.e., when labor has not yet begun) are four times more likely to develop persistent pulmonary hypertension, a potentially life-threatening condition.
• Between one and two babies of every hundred delivered by C-section will be accidentally cut during the surgery.
• The US is tied for second-to-last place with Hungary, Malta, Poland, and Slovakia for neonatal mortality in the industrialized world.
• Babies born via C-section are at high risk for not receiving the benefits of breastfeeding.
• The risk of death to a newborn delivered by C-section to a low-risk woman is 1.77 deaths to 1,000 live births.
• The risk of death to a newborn delivered vaginally to a low-risk woman is only 0.62 per 1,000 live births.

"Cesarean Birth in a Culture of Fear" By Wendy Ponte
Mothering Magazine Issue 144, September/October 2007

What can be done about breech presentation?

Unfortunately, there is not a foolproof method to prevent or correct a breech position, but armed with a little information you can greatly reduce your risk of Cesarean section.

• The Journal of Manipulative and Physiological Therapeutics reported in the July/August 2002 issue that mother's with a breech baby should begin chiropractic care at least by the 8th month (as the baby is unlikely to turn on its own after this time.)
• The Webster Technique was effective in 82% of women in the same study.
• Currently, the International Chiropractic Pediatric Association recommends that women receive chiropractic care throughout pregnancy to establish pelvic balance and optimize the room a baby has for development throughout pregnancy. With a balanced pelvis, babies have a greater chance of moving into the correct position for birth, and the crisis and worry associated with breech and posterior presentations may be avoided altogether. Optimal baby positioning at the time of birth also eliminates the potential for dystocia (difficult labor) and therefore results in easier and safer deliveries for both the mother and baby.

I hope this little bit of information is helpful in understanding breech presentation and why chiropractic care is important. To learn more about the Webster Technique see my previous post "Can You Turn Breech Babies?" For more information about my practice and my successes with the Webster Technique visit my website at Keystone Chiropractic.

Sciatica: A Real Pain In The Backside!

Sciatica is another constant companion of many a pregnant woman. Like indigestion, edema, and constant urination, sciatica tends to show up in the 2nd trimester. And like its companions it tends to stick around until the baby is born. The good news is that sciatica can be sent on its way rather quickly and leave you alone to deal with the indigestion, edema, and constant urination.

What is sciatica?

Sciatica is an often misused term. Many people say they have sciatica if they have any lower back pain. However, sciatica occurs when the sciatic nerve (the largest nerve in the body and the one that innervates the majority of the lower body) becomes pinched or irritated.

Sciatic pain follows a particular path from the lower back or hips and runs down the leg generally ending near the knee. Sciatic pain is often described as a burning pain or a pins and needles sensation. Numbness and tingling can occur as well. Sciatic pain makes it incredibly painful for a person to sit, stand, bend, or really do anything other than lay on their back.


Why is sciatica so often associated with pregnancy?

Sciatica in pregnancy is common for 2 reasons.

Hormones: Our good friend relaxin is just doing his job and is allowing the pelvis to become hyper-mobile. (Read previous post on relaxin.) Unfortunately the sciatic nerve is attached in the pelvis and becomes irritated with all the unaccustomed movement.

Structure: As the baby grows, the uterus grows and puts pressure on the sciatic nerves and its surroundings. This weight is pulled forward, which increases the arch of the back and can lead to pressure on the sciatic nerve.

What can be done to ease the pain?

Sciatica can cause even the toughest to break into tears. It can be debilitating and miserable, but it doesn't have to last. Although it is tempting to stay in bed, not moving a muscle and praying to feel better, recent studies have shown that this is ineffective and can actually prolong the agony.
Getting up and moving while painful, will ultimately help the sciatic nerve.

Home remedies:

• An ice pack applied for 10 minutes to the low back can help and is safe for pregnancy.
• Sleep or lie down on your side with a pillow between your legs and one in the small of your back.
• Try to stand as straight as possible and sit up straight.
• Avoid standing or sitting for extended periods of time.
• No heavy lifting.
  

Outside help:

• Chiropractic is one of the best and safest treatments for sciatica. Using a gentle, low-force adjustment a chiropractor can free the sciatic nerve and allow normal impulses to return. A majority of women feel relief after the first treatment, and all but the rarest case are feeling fine by the 2nd or 3rd visit.

• Some women find that acupuncture can really relieve the pain. It is believed to be safe for the baby and effective. Although it is great for pain relief, it does not correct the underlying structural problems causing sciatica, and it will return.

So, all you sciatica sufferers, get moving. Help your amazing body do its job without hurting you!