January 2025

Kristin Revere talks with Lauren Scocozza, Vice President of Product for Willow Innovations, Inc., about why it is important for moms to have a feeding support system and how to set one up.

Hello, hello!  This is Kristin Revere with Ask the Doulas, and I am thrilled to chat with Lauren Scocozza today.  Our topic is all about the importance of having feeding support for moms, whether you’re a new mom or a seasoned mom, and how to set up a feeding support system and all about what’s on the horizon for Willow, which we’re a huge fan of all of Willow accessories at Gold Coast Doulas.

Welcome, Lauren!

Thank you, Kristin!  I’m so excited to talk with you today!  This is an absolute thrill for me.  One of my favorite topics is systems.  So I’m super excited for our conversation.

So you are the vice president of product for Willow Innovation, and for our listeners who may not be familiar, you created the first fully in-bra wearable pump and revolutionized how moms pump today.  And you are – as you said, leading the mission to elevate maternal experience by developing feeding products that fit into busy moms’ real lives.  And then you also have an adorable four-year-old daughter?

Yes, I am in the height of the toddler era at the moment.  And I joined Willow in my postpartum era, actually.  I have been here for a little over three years.  So I was very still fresh in the throes of postpartum in that first year with my daughter when I joined, and so I have a lot of really close emotional empathy for what moms go through, and new moms, especially around feeding.  That’s what I’m excited for us to talk about today.

Yes, and I feel like it’s overwhelming.  Our clients, whether they’re birth doula clients or students in our classes or baby registry clients – they’re always wondering and overwhelmed by all of the options with those pumping bras and which pump to register for or does insurance cover a particular pump.  We get a lot of those questions.

Yeah, and I think a lot about my own pregnancy period when it was time, and I know this is a topic that you guys talk about a lot, which is creating a registry.  And part of that is deciding what you need before you’ve ever – especially if you’re a first-time mom, before you’ve ever gone through an experience.  And that’s a really tough thing to do, right?  Part of what we’re trying to do at Willow, when we think about how we work with new moms or pregnant moms, is trying to conceptualize what it looks like for when you have a new baby.  And I think when you’re deciding what goes on your registry or what products you need, thinking about the way that your postpartum experience looks like can really help inform what works for you and what doesn’t.  I had a pump through insurance when I had my daughter, and I spent a lot of time tied up to a wall, and that was not really how I had pictured what postpartum was going to be like for me.

One of the reasons I actually came here to work at Willow, because I was so – I didn’t know about Willow at the time, you know, when I was registering for products, but when I had found out about it later, I was so incredibly moved by the fact that the founders of this product spent so much time with pregnant moms and early breastfeeding moms and pumping moms, and they kept hearing about how terrible the pumping experience was.  And instead of looking at that and saying, we have to get more milk for that baby or something like that, they said that’s really awful for her, and she is – a pumping mom is tied up to the wall 20 minutes at a time, 6 times a day, and she’s not spending time that she could be with her baby or being close in a way that she pictured or she hoped, and I love that they looked at that problem and thought, we can do better for her.  And especially for – like, thinking about my own experience and some of my friends, one of the hardest parts about matrescence is this idea that you’re going through a giant change and you don’t necessarily understand where the old you and the new you sort of come together.  And especially when you’re breastfeeding or pumping, providing breastmilk for your baby, there’s a physical aspect to that which is really difficult.  Even if it comes easy, it’s a lot of work.  But there’s also a big mental load to that, too.

So I love that our founders really thought about mom and her experience, and it’s something that our product team continues to put at the center of how we think about what to make and what to create in terms of our new products.  And we started in 2014 from a medical device incubator.  We still have a lot of that core healthcare DNA, and we utilize that in terms of how we decide what we’re going to make.

So yeah, that’s a little bit about how we started and why inventing the first ever wearable breast pump feels like it just happened.  We launched in 2017, but now the market is saturated.  There’s lots of wearable breast pumps, but we feel really proud that we stand to change the status quo, right, and really allow moms to feed differently.

Yes!  And it’s so important with commuting and traveling moms and the need to pump wherever you go.  I’m so thankful now that airports have the pumping pods and workplaces have designated rooms to pump.  But it wasn’t always the case.

Right.  And of course, you know very well, because of your line of work, the access to being able to pump is just as key.  The more milk that you remove, the more milk your body will make.  And wearable pumps, such as our Willow 360 and Willow Go, allow you to pump more often so that your body continues to make more milk for your baby.  And that’s really the beauty of these wearable pumps.  And that’s what we see with our data and from our moms and everyone who uses them.

It is brilliant and so needed, certainly.  So what are your tips for our listeners who are considering all of their options in planning for their feeding journey, whether they’re going to plan to breastfeed with the goal of pumping when they return to work and getting a stash set aside in advance, or if they plan to be exclusive pumpers?

Absolutely, and I think this is a great question.  I liked what you were saying about sometimes talking to pregnant moms or early first time moms, and what that feeding journey could look like and what they might need for it.  I think one of the most difficult parts for me personally when I was pregnant as a first time mom was sort of envisioning what was past the birth.  I almost couldn’t get over like, okay, what’s the birth going to be like?  This is going to be either the most pain I’ve been through – I didn’t know what it was going to be like when I got home.  I just kept thinking about the birth.

Very common!

Yeah, very common, right?  So it’s hard to conceptualize what it means.  And then you also have people saying things to you like you’ll have maternal instincts and you’ll just know what to do.  And I think in the age of constant information that we live in now, a lot of those messages are coming at you all of the time, and it can feel really hard and overwhelming when you do first get home from the hospital.  You’re like, did someone just allow me to take home my baby with no instruction manual?  What do I do now?  Which is why I’m so thankful for experts like you and postpartum doulas and people who are there to help mom and reassure parents that they’re on the right track.

In general, I think when moms are trying to think about their feeding journey, there are definitely questions you get, like, oh, are you planning to breastfeed?  Of course, yes, I would like to breastfeed.  Or no, I would not like to do that.  But you have no idea what’s going to happen, right?  There’s so many possibilities.  And I think it’s really hard to conceptualize what to do when you get home, as well.  Like, what does your space look like?  How does it feel when you have this new roommate coming home who actually doesn’t sleep on any kind of schedule for quite some time?

And so when we talk to pregnant moms and new moms about this, we are mostly, in the beginning, trying to help explain the idea of feeding support and feeding support systems and some tips to set yourself up for success.  I think the beauty of having postpartum doulas and lactation consultants is they can help you work through systems like that, as well.  And we’re always trying to create products that work within those kinds of systems.

So, for example, one of the things that I was thinking about: we have a great registry product  called the Find Your Flow Feeding Kit, and what it does is it actually includes several products for breast care, and really for early postpartum breast care.  A lot of these products are perfect for that.  And it comes in a 12-piece kit and it actually has virtual feeding and breast care content inside, and even a free virtual IBCLC appointment to help you get started in a way that you feel confident.

That is wonderful!  I feel like after baby arrives, the gifts are all for baby.  But the mother needs care, too.  So this kit is brilliant, not only for a baby shower gift, but also for that postnatal way to pamper a new or seasoned mom.

Yeah, and I think there are a lot of postpartum products for mom that are focused around the birth.  There are fewer that are about breast care.  And breast care is directly related to feeding, right?  If you’re choosing to breastfeed and pump, which obviously, at Willow, we talk to a lot of those moms – there are lots of things that can happen and change in those early weeks with your breasts.  There’s pain.  There’s discomfort.  Even wearing a bra can feel overwhelming at times.  And you might not expect all of that change to happen so fast.  Your breasts are also leaking when your milk comes in.  It can be very frustrating in those early days.  I think about it all of the time, of just constantly changing my clothes and feeling like I’m always wet, or feeling sticky and uncomfortable.  There’s so much healing that happens in your body after birth, but then your breasts are changing, as well.  So again, it’s one of those things where it’s not very much talked about, right, when you’re going to all your third trimester OB-GYN appointments.  A lot of it is focused on the birth and not necessarily on breast care and what feeding is going to feel like and be like after birth.

Exactly, and that’s why I feel like a breastfeeding class – we offer both a breastfeeding class as Gold Coast, as well as a pumping class, and having that education during pregnancy and having partners or other support people attend so they can better support the feeding journey.

That is so crucial.  In my job now, I think all of the time about how I wished I was better set up for success myself postpartum with that kind of – I mean, I took the birthing classes and things like that, but breastfeeding and pumping felt like an overwhelming black hole that I could not understand, and I really do love that that’s part of the curriculum that you guys are doing.  Because that shift in mindset around feeding is going to happen postpartum, whether you’re prepared or not.  If you decide that you’d like to breastfeed and pump and provide breastmilk for your baby, in the beginning it’s a 24-hour job.

It sure is.

And I think that is the joke that people say to you.  Well, when the baby comes, you’ll never sleep again.  They don’t really tell you what the shape of that looks like, right?  If you’re a lactating mom and you’re deciding to breastfeed and pump, you’re feeding your baby every two to three hours around the clock, and so it’s not that you’ll never sleep, but you’re not getting enough in a chunk to feel rested, right?

One of the systems that we talk about is, if you have a partner or a doula or a support system, what can you do when you’re pregnant around your home to help set you up for success when you come home in those early postpartum weeks and you are doing that 24 hour feeding cycle.  I know that you guys probably help moms set up their spaces all the time.

We do.  A little station with all of the mom care needs, as well as the baby or babies, if they’re multiples.

I love that.  We have some great content from experts – postpartum doulas like yourself – who helped us create these kind of systems and ways of helping mom understand her space, but then helping us create the products that fit into that system.  And so if you think about the idea of a nursing cart – that’s more popular now.  This Find Your Flow Feeding Kit that has these early breast care items has a lot of what you need to get that nursing cart started.  So like cooling gel nipple pads and reusable breast pads for leaking.  Hot/cold breast therapy packs.  Warm helps the milk get started, and cold can help soothe and also slow it down.

When you’re pregnant, you’re not sure how breastfeeding will go.  You may be an oversupplier and or undersupplier.  Your milk regulates for quite some time in the beginning, so it’s kind of all over the place.  And some of these tools can help you feel more comfort or more healing as your nipples and your breasts are super sensitive and you’re working on either latch during breastfeeding or also getting used to pumping.

No matter how you plan, things may change.  I know I took a breastfeeding class with my first pregnancy, and then my daughter ended up with a short NICU stay, so I needed to pump in the hospital and then go back from my postpartum room to the NICU and had a short amount of time, once I was able to give her my pumped milk, to feed her, because everything was so structured.  And then eventually, I wanted to transition to breastfeeding and had to get additional help from lactation consultants.  So it’s helpful to have a pumping plan, even if your idea is to wait until you transition back to work, because a NICU stay may happen or something else can come up.  I was not prepared for a pumping journey so early on.

I feel that very closely, personally.  Myself, I had my daughter during the height of COVID, and I had postpartum complications.  And so I was readmitted to the hospital twice, but because of the rules at the time, she wasn’t allowed to come with me.  So in a similar way to the baby being in the NICU, we were separated, and we had not planned for that.  I think there’s so much that you think about with birth and how that’s going to go, and there’s a lot of possibilities that can happen postpartum, but I think instead of being worried or overanxious about all the possibilities, I think thinking through the plan, which is what they coach you on when you’re doing a birth plan, right?  Thinking through a postpartum feeding plan will help you make decisions when you get thrown a curve ball, like you did or I did.  Maybe that means you feel you would like to breastfeed, but you want to pump later, but something could happen.  What happened to me is my husband had to give my baby a bottle before my milk came in, so I’m so glad that a friend of mine had put in a registry gift a container of formula.  It wasn’t what my original plan was, but again, curve balls get thrown all the time.  We were separated, and the baby needed to eat.  When I came back home and we learned to latch and all of those things, I got to have some of what I initially wanted from the beginning, that closeness, the goals that I had for myself.  But also, that was one of the first big feeding lessons that I learned, which was it’s never going to be exactly what you want, but that doesn’t mean that it doesn’t work for you and your baby, right?

Yes.  I love that.  It’s all about being flexible and knowing that if you have the right support team, you can figure out anything that might come your way, whether it’s a change in birth plan or the postnatal plan, like you mentioned getting readmitted and knowing that you had support from friends and your partner certainly helped.

Absolutely.  I think the other sort of tip around early feeding and coming home postpartum can also be a little bit of what we were talking about, that 24-hour cycle of feeding.  A hard lesson that I learned early on was night parenting looks a little different than daytime parenting, and I didn’t really have a good setup at home that was ready for that nighttime parenting.  You know, I think a lot about how when I first came home after my hospital stay, my body was still healing from birth, and I realized that I never knew I had such a high bed that I could not get into!  My husband and I and my baby were sleeping in the living room because the couch was the easiest way for me to get up and down as my body was healing.  But we hadn’t really planned on that, you know?  We had a nursery setup, an area with the bassinet, we had our room.  But okay, now we’re all in the living room.  How long are we going to be in here for?  Do we need to set up some stations here?  We didn’t have any of that.  And so in fact the baby woke up in the middle of the night, one of the first two nights, and we couldn’t see anything because we didn’t even have a lamp.  Like, we just had the overhead lights.  It was like, okay, what does it look like at night?  We need some soft light.  We can’t use our phone camera for all of this.  It was kind of like learning by being thrown into the fire.  Oh, okay, I need to set up my space to work for us.  And that was such an amazing revelation.  And I know that postpartum doulas often meet with parents when they’re pregnant to help them prepare plans about their space and how to change it.

Yes, they do, definitely.  And whether it’s looking at stations – and some of our clients may be in their living room during the day and then in their bedroom with a bassinet, and others may prefer to have baby in the nursery.  We try to optimize feeding as well as sleep in all of the spaces that our clients and their babies are.

And then as far as the wearable pumps, any tips for our listeners in selecting one?  How do you make sure the fit is perfect when you’re potentially ordering it online, for example?

Yeah, the fit is crucial for success with wearable pumps, in general.  One of the nice things about that breast care kit that I was talking about earlier that we sell – it actually includes a nipple sizing guide in it.  So even if you get that as part of your registry before you choose a pump, you’re able to size yourself.  I think the most important thing that most IBCLCs or LCs will tell you is your nipple size will probably change over the course of your pumping, right?  Early postpartum, you’ll be one size, and then as your milk comes in and as your journey continues, your nipples and your breasts – everything changes constantly.  So having a great nipple sizing tool like we have in our Find Your Flow kit – and we also include in all of our pump kits – is crucial.  And resizing yourself is crucial.  So sizing yourself once and being sort of done, remembering that your body is going to continue to change is great and saying, if you are starting to pump and it’s not feeling right – pumping should never hurt, ever.  That’s a good sign that something is incorrect, so whether that means you’re the wrong size or something with the pump itself is not great – like, pumping should not hurt.

Now, in general, breasts can be sore, of course, in early postpartum, but in general pumping should not hurt.  So resizing yourself, looking at size – it’s crucial.  And one of the differences with wearable pumps, obviously, from a traditional desktop pump is that you can’t always see your nipple with them on because they’re wearable in your bra, and so that’s why sizing with a nipple ruler is so crucially important.

I also think that working with an IBCLC or an LC is really helpful and really great.  And there are definitely appointments that you can get covered by certain insurances, so I always recommend people looking into that.  And we have great IBCLC partners here at Willow as well who will even help with virtual consultations for free if someone can’t afford it or doesn’t have insurance to cover it.  So I think in order to be set up for success, knowing that breastfeeding and pumping are not just things you should know how to do, but they are skills that you can learn and get great expert advice from will help you sort of reach out and say, what’s my modern village look like?  Doulas to postpartum sleep experts to IBCLCs.  Who can I go to, to help me through this really new time in my life?  I think those things are really key in general.

In general, for wearable pumps, in the same vein of pumping should never hurt – one of the things that we worked on at Willow with our Willow Go pump is to basically make it the most comfortable pump on the planet.  That was really our goal.  Comfort is so related to output.  That has to be comfortable.  There is a lot that we designed intentionally into this pump to make it the most comfortable, and mainly I would say to new moms is thinking about the flange itself, and that is the space where your nipple enters into that’s connected to the rest of the pump.  Our flange is pretty long, and that is on purpose.  Your nipple will expand into the flange as the motor pulls for the tug and release to indicate to your breast that it’s time to express milk, and you want that to be long and comfortable so that your nipple has room to expand into it.  Our flange also has no hard edges that press against your skin, so there’s no feeling of pain or discomfort from that, and it’s one continuous long piece.  So as your nipple enters into the flange, there’s nothing rubbing against your nipple as it goes in and out, which is really crucial.  And it’s one of the reasons why Willow Go continues to be moms’ favorite pump.  It wins lots of awards for output, and you can see in reviews online, it’s definitely a hospital grade wearable pump that is most comfortable for moms, so they have the most output success with it.  So those would be things that I would look into, for sure.

If you’re looking at a pump – every pump kind of markets very similarly now, so it’s like everything is discreet.  Everything is hospital grade.  I would really look at some of the details of how the pumps are made.  A smaller pump isn’t always the most comfortable because the shorter the flange, the more your nipple is going to hit either the back of it or rub against it in some way.  So I would definitely look into the design and mechanics of certain pumps when you’re looking at them, especially for wearable pumps, because some of those things are really important to having success.

Right.  And then your pumps tend to be on the quiet side compared to a lot of other pumps.  That’s also something to factor in.

Absolutely.  And some of the best testimonials we get are actually from second or third time moms, which I always take as a badge of honor.  They’ve been through it before; they kind of know.  A lot of moms with toddlers; like, I got to run around, and I can’t actually sit and be tied to a wall.  I have to actually be moving, and I want to get a pump session in.  Those are some of our features – quiet, small, discreet.  Those things are all really important, and like I said, a lot of pumps will say that, but what we find is our pumps continue to get the best output in the time that moms are pumping, which is really at the core of what you want to be successful.

So what’s next for Willow, Lauren?

As we talked about, we’re definitely passionate about helping moms and sort of elevating that maternal experience.  And we want to build solutions that really work for moms’ real lives.  Our pumps are smart pumps, so they’re app connected, and you can control those pumps from your phone.  So for ultimate discretion, sticking them in your bra, being able to pump, and starting and stopping them and controlling the suction all from your phone is super helpful.  But also we want that to go beyond.  So in the same way that you’re helping prepare pregnant moms and even early postpartum moms for what’s to come and how to work through different curve balls that they get, we would like our app to do more work than just control the pumps.  And we’ve added a ton of content from experts, like doulas like yourself, IBCLCs, OB-GYNs.  We have one click to services for people to be able to have virtual appointments if they need them.  And we just launched a couple weeks ago a partnership with a healthcare AI tool called Emma.  It is absolutely fantastic.  It was built by women who wanted to help scale the experts and the vetted scientific information that’s out there, just for women’s health.  So you can actually ask Emma questions about feeding, about postpartum, all the way to menopause, if you wanted to.  She’s really focused on women’s healthcare, and she can help guide you to some great resources.

So we want to be there for moms as they’re figuring this thing out.  Feeding your baby and being postpartum is a huge mental load.  And anything that we can do to make it a little bit easier for her, that’s what we’re going to focus on doing.  So items like our kit that has everything you need in it for breast care are the types of products that we’re going to continue to launch.  You can actually buy our Willow Go and 360 products in Target and Amazon and places like that, but we’re going to be introducing some new products next year to support that feeding journey and help mom create some systems that alleviate that mental load and increase her accessibility to postpartum products.

Excellent.  Any final tips for our listeners?

Yeah, I was thinking about this.  I know this is a question that you ask.  I was trying to think about what I would have hoped somebody would have said to me when I was trying to breastfeed and pump, when I felt like it was overwhelming or a little hard.  I think what I would have said to me four years ago is that any amount of breastmilk that I can provide for my baby has benefits for me and my baby.  The longer that I can do it, the longer those benefits last, but it’s a marathon, not a sprint.  So it doesn’t matter if you breastfeed once a day or eight times a day.  It all counts.  It all matters.  And we even have data and some studies that show that even just 50 milliliters, which is a little bit less than 2 ounces, of breastmilk per day can provide babies with the same important nutritional and immune-boosting benefits as being exclusively breastfed.  So any amount of breastmilk is great.  I think sometimes it can feel black and white or a binary, like I’m either doing this or I’m not, and the truth is, most women are doing a combination of lots of things throughout their feeding journey.

Exactly.  Supplementation may be needed.  A mix of pumped milk and breastfed – I agree.

We did the study earlier this year – it was almost 2000 moms.  More than 60% who met their feeding goal combo fed.  There’s lots of tools, like pumps, like formula, that can help you be successful in breastfeeding.  And it looks different for everyone.  It even looks different between babies, which I’m sure you’ve seen.  It’s not a failure if it doesn’t look exactly how you pictured, and at the end of the day, there’s no mom better for that baby than you.  And that’s what I would say to anybody who’s starting out on this journey and what I wish that I could say to my former self.

So true!  Excellent tip!  So how can our listeners connect with you?

We are online on our website.  You can see all of the products that we have for feeding and postpartum there.  And on Instagram @willowpump.  We have a really great Willow mom community that is growing every day, and people share all kinds of tips and tricks and connect with each other.  It’s sort of that modern village that I love.  So that’s what I would say!

Excellent!  And then you mentioned your products are available at Target and Amazon, as well?

Yes, as well as on our website, and of course, through insurance.  You can definitely get our pumps through insurance and some of our other products, as well.

Well, thank you so much, Lauren!  I appreciate the time and all of your wisdom!  We’ll have to have you on again!

It was so fantastic to speak with you, Kristin!  Thank you for having me!

IMPORTANT LINKS

Willow Innovations

Birth and postpartum support from Gold Coast Doulas

Becoming A Mother course

Buy our book, Supported

Kristin Revere and Dr. Desiree Cassell discuss how to find the best pelvic floor physical therapist for your unique needs and when to hire them on the latest episode of Ask the Doulas podcast. 

Hello, hello!  This is Kristin Revere with Ask the Doulas, and I am thrilled to chat with Dr. Desiree Cassell.  Dr. Cassell is a doctor of physical therapy specializing in women’s pelvic health.  She is the host of The Balanced Momtality podcast and owner and PT at The Balanced Momtality Women’s Health and Wellness, where she coaches women in person in her home state of New Mexico, as well as virtually all over the world.

She is a foodie, lover of all things movement and nature, and a mom to three energetic and active kids, 13, 6, and 4.  After her first pregnancy, Dr. Cassell suffered with her own pelvic floor dysfunction, and like many, she just accepted it as part of motherhood.  Sadly, that meant no more jumping on trampolines and crossing her legs fiercely every time she sneezed or laughed so she wouldn’t pee herself.

After PT school, she got pregnant with her second and was determined to put her knowledge to the test and was able to completely resolve her issues, even while she was pregnant, leading to her passion in educating, empowering, and supporting other women throughout their lifespans so that they won’t have to accept these common issues as part of life.

Desiree uses a holistic, whole body approach to helping women heal their bodies and stay balanced through all stages of life, starting at the core.

Welcome, Desiree!

Thank you so much for having me!  I am so thrilled to be here!

And our topic is an important one!  We are talking about pelvic floor physical therapy as a way to optimize both your birth experience and postpartum recovery.

Yeah, I am so thrilled to talk about this because this is, again, just something that I didn’t know.  I had already had a baby and I didn’t know that pelvic floor PT was a thing.  So I am just so passionate about spreading the word and just making sure that people are aware that there is support out there and that you don’t need to pee your pants.  We don’t have to accept this common thing.  And I think that’s the thing is it’s common, not normal.  So many things we just accept as normal, and they’re just not.  So I’m thrilled to talk about all the ways that pelvic floor PT can help.

Yes, it’s such an important topic.  I feel like there is more knowledge, in that postnatal phase, especially, of the leaking and the fact that you don’t need to suffer and there is support.  Oftentimes now I’m seeing OBs and midwives talk about pelvic floor physical therapy as an option in that six-week visit.  Before, when I was in my early days as a birth and postpartum doula, my clients weren’t learning about that until I brought it up as an option, and now I feel like there’s more awareness and education within the healthcare system.  Would you agree?

Yes, I do think that it’s kind of a trendy thing right now, which is good.  I think that it’s good to have it just be more in the know that pelvic floor PT exists, at least.  Now it’s about knowing that it’s more than Kegels.  It’s more than peeing your pants.  There are so many other things that pelvic floor PT can prevent and treat.  Again, I think even OBs and midwives and other women’s health providers might know it exists, but there’s still such a misunderstanding of all the ways it can truly help.  Ideally, I’m seeing women pre-pregnancy, during pregnancy, early postpartum, but I see women five, ten years postpartum, twenty years postpartum with that common story of, this started after my first baby, or maybe it started after their third baby.  Or I mentioned this to my provider and they told me to do Kegels.  Or I was told this is normal.  It’s just so disheartening, because it’s not true and we can do better, but it starts with knowing better.  We have to know better before we can do better.  So again, thanks for having me here so we can help our listeners know better so they can do better!

Yes, that’s what it’s all about – knowing your options.  If you don’t know them, then you don’t have any, and then you just end up suffering in silence.  I also feel like, as you said, pelvic floor PT is a trendy topic, so friends are finally talking about it amongst themselves, whereas before it was more of a hidden thing.  I tend to work with a lot of athletes, and in those circles, with runners and swimmers, they talk about pelvic floor physical therapy and physical therapy in general and the ways to return to their passion and their sport without leaking or other physical discomforts, but now it is becoming more mainstream and not just discussed within my circle of clients who happen to be athletes.

Yeah, I’m so thankful for that.  It’s something I think everybody should know.  Everybody does have a pelvic floor, males included, but women are so underserved, and so I do have that passion of just helping women understand their bodies.  This is like a taboo space.  Our culture has made the pelvis and the vagina and anything in that area such a taboo topic where we are afraid to even talk about with maybe even your mom or your sister or your friend.  If you feel brave enough to bring it up with your provider, only for them to blow you off and write you off.  It’s just so unfortunate, and it’s a cycle that needs to be stopped.

Yeah, and I love that your own personal experience in healing yourself led you to focus on this particular specialty because within physical therapy, there’s so many different ways that you can specialize and work with different populations.  I love that your own experience as a mom led to your passion in not only creating your local practice, but supporting more families with your podcast and your virtual services.

Yeah, it’s so funny because it really was so mind blowing.  I did not expect to be a vagina doctor.  That was not where I thought I would go!  I was really into sports, ortho.  You know, I’ve always been athletic.  I did sports through high school and lifted and played basketball recreationally in college.  I stayed active and had my own injuries.   I’ve also had a burn injury and things where I was like, you know, I just like the outpatient ortho world.  And I was so surprised that the women’s health pelvic floor thing kind of just fell in my lap at a clinic that I was really wanting to get into.

Step back just a little bit – my third year of PT school, I was pregnant with my second, and I was still peeing myself from my six-year-old six years ago.  And at that point, I had had that gender health pelvic floor course in my program, and it was just a general pelvic floor health class.  It didn’t go deep, but it was enough to learn that, no, it is not normal to pee yourself and not normal to have a lot of these different aches and pains that we accept during pregnancy.  I learned about pelvic organ prolapse, a term I had never heard before, and I was like, wait, you mean our organs can just fall out of our body?  That is not okay!  At the time, I was like, man, who would ever want to do this specialty?  I give them so much praise, but not for me!  No thanks!

Then I got pregnant with my second, and I thought, you know what, I’m going to actually put what I learned to the test because I’m personally sick of peeing myself.  Like, that’s not okay, and I’m sure it will get worse through this pregnancy, and I was already starting to have some heaviness, which I later learned was pelvic organ prolapse, and some of these other aches and pains that we accept.  And I got it all to go away.  My leaking stopped.  A lot of my pain stopped.  My prolapse heaviness symptoms went away, and it was while I was pregnant.  And that was just that light bulb moment for me of like, oh my gosh, this actually really is a game changer, and how did I not know about this sooner?  It’s just touching back on it being so accepted.  Even my mom is like, yeah, that’s why I don’t get on trampolines anymore.  That’s just what happens when we have kids.  We just are told to accept it and that it’s normal.  Once I learned otherwise, I was on a mission.  But even then, I wasn’t sold that I was going to do that.  Being in that ortho clinic that wanted a women’s health therapist, they said you can do part women’s health, part ortho, and we’ll pay for your training to go take those courses.  I was like, okay, sure, I love women.  I love moms.  Let’s just give it a shot.  After seeing those women and again hearing those stories of being written off, hearing the stories of not having intercourse for five-plus years because of pain or not being able to go out on road trips because they have to pee all the time – getting these women on a different level of quality of life.  That was just so rewarding.  And sometimes – many times – being the first person to really hear them and hear their story and validate them.  It is just such a passion of mine now, and totally unexpected, but now I can talk about it all day long, obviously.

I can tell – it’s beautiful!  So Dr. Cassell, when should women start making that first appointment for pelvic floor physical therapy?  When is a good time to see an expert like yourself?

I am a huge advocate of being proactive and preventative with our health and wellness, so I do think every person should see a pelvic floor PT if you have never seen one.  But again, a lot of these other symptoms that I mentioned that are very local and obvious things, like leaking – and again, it is never normal, so even if you’re leaking on that third sneeze, it’s still not normal.  If you’re leaking because you’re pregnant, still not normal.  You had a baby?  Still not normal.  So any amount, any time – if you did not try to release it and it’s coming out, whether it’s urine, feces, gas – that is not normal.  If you cannot hold that and you are losing control – but also if you’re having inability initiating your urine, or you’re constipated – constipation is another big pelvic floor symptom that so many Americans struggle with.  It goes hand in hand with the gut.  I look at that whole body, whole system approach, so we’re looking at gut health.  The pelvic floor is so intimately connected with everything in that space because of the proximity with bladder and the uterus and the rectum and therefore the GI tract.  So we can see a lot of constipation, bloating.  Pain is another big, obvious thing.  If you’ve got pelvic pain – and this can look like pubic bone pain, tailbone pain, pain with sitting, pain during intercourse, pain after intercourse, heaviness.  Again, heaviness is not normal.  Obviously, there’s some level of normal heaviness when you’re pregnant and it’s your second, third, fourth pregnancy.  Sometimes that heaviness comes on a little sooner.  But even then, we need to make sure it’s not true pelvic organ prolapse because once those pelvic organs, whether it’s bladder, the uterus, the rectum – if they’re starting to lose their structural support with the ligaments, not the muscles – so the ligaments and tendons are there, holding those organs up, and once that starts to stretch and those organs are starting to drop, we need to get on that as soon as possible because age and gravity are not on our side, right?  Things will only get worse, so we need to make sure we’re preventing any extra heaviness and pressure.  That could be from constipation.  That could be from baby.  That could be from pelvic organ prolapse.  That could even be a sensation you’re feeling of heaviness from your pelvic muscles cramping up and spasming because they’re trying so hard to support your body.  So again, heaviness, you really want to look into that.

But then we also want to look outside of the pelvis where things like hip pain, hip dysfunction, hip instability.  A pelvic floor muscle that we have is a hip stabilizer, as well, so we can see a lot of hip issues.  And knowing, too, that the pelvic floor does connect that whole pelvic outlet, so it does connect up to the tailbone, and therefore, that sacrum bone.  We see a lot of spinal issues, so low back pain, SI joint pain, even mid and upper back pain and neck pain.  TMJ is a huge connection both physically and just nervous system wise from the tone and clenching, but there’s a direct fascial link there.  So if you’ve got TMJ, I can pretty much guarantee you’ve got pelvic floor tightness, as well.  And so I think so many people just think of pelvic floor issues and think it’s weak; we need to strengthen it.  When really, so many times, I find that yes, even if weakness is an issue, things are usually too tight because it doesn’t know how to support the body, so therefore it just cramps up and creates a spasm in that muscle.  And you can’t really go into strengthening right away or you’re going to make that situation worse.  Again, it’s really helpful to get that internal assessment to know, where is your pelvic floor?  Are you going to cause more issues by starting to do things like Kegels and strengthening?  Instead, maybe we need to focus on some other things to help that whole system work together.

But before I go off on any of those tangents, I just want to again touch on when you should see a pelvic floor PT, because aside from just those symptoms that I mentioned, another common symptom is diastasis recti, which is that separation of your abdominals that happens with every single pregnant person.  However, we can see excessive forces there which then can cause extra thinning and therefore dysfunction and maybe even a possibility for hernias and things like that.  Hernias are also another sign that you have pressure issues in the core and would benefit from seeing a pelvic floor PT.

But obviously, pregnancy.  Pregnancy is a huge thing, and I think the sooner the better.  If you’re pregnant, again, get in to see a pelvic floor PT before you have any issues because then you can avoid things that we accept like leaking, round ligament pain, SI joint and low back pain, urinary urgency and frequency and just feeling like you have to pee all the time or you can barely make it to the bathroom.  We can avoid a lot of that.  The sooner the better.  And also to prepare for birth, because birth is a marathon, and that marathon of pregnancy, you also need to train for.  We need to make sure you have that flexibility in your pelvic floor muscles to open up and get out of the way so baby can come through, especially if you’re looking at having a vaginal delivery, and especially if you’re having a VBAC.  If we have some scar lines from that Cesarean, we need to make sure things are mobile and moving and that that scar and restriction isn’t going to impede baby from coming through that birth canal safely.  It’s also about optimizing your pushing strategy so we’re not getting too much pressure and causing prolapse.  And we’re looking at how we can optimize recovery and heal optimally postpartum so that you’re avoiding all of those issues.

Also, not just waiting for that six-week check, because unfortunately, that six-week check does such a disservice to what should be happening as moms getting cared for and looked over.  I think six weeks is way too long, but it’s also way too soon to tell someone they’re “cleared” to just return to activity as normal.  Again, postpartum, anyone that’s had a baby, I think, should see a pelvic floor PT.  But if you are having obvious symptoms like I mentioned before, then it’s more of a sign that your body is trying to yell at you to get some help.  So it’s better to be a little bit more proactive, as I say.

Exactly, rather than reactive.  Have a plan, and even if you need to get a referral, which not all pelvic floor physical therapy requires, depending on your insurance plan, you could get that referral done during pregnancy and not wait for that six-week visit.

Yeah, because honestly, especially with the insurance world – and I’m not an insurance based practice, for many reasons, but there’s such a benefit to having those as options, obviously, but one of the big downsides is a wait list.  So if you already know that your due date is coming up – some waits are two to three months, so if you wait for that referral at your six-week check, you’ve already missed that window that is so crucial for healing.  From a pelvic floor PT standpoint and a recovery standpoint, those first ten to twelve weeks are crucial.  That is where we can either put too much pressure on the system and caused a lot of issues, because the tissues are so vulnerable and are trying to heal, and if you are putting too much pressure through the body because you are slouched over, feeding and caring and holding 90% of your day, and you’re not breathing correctly as you’re moving throughout the day, that can cause the leaking and cause the prolapse and cause the pain.  When really, we can optimize reducing that pressure, improving your movement strategies, and helping your body slowly get back into strength training and impact training so that your tissues are actually healing and remodeling at the length and the direction that they should and therefore providing the support you need and preventing issues.  It’s just such a bummer when I see the women who have waited until they got the clearance.  They went straight back into running or something, and they come back four to six months postpartum and now they’ve got all these issues.  I’m like, oh, man, I wish I would have seen you sooner, because we would have made a much bigger impact!

And you mentioned that in pregnancy preparation, it can help with pushing.  I mean, you can see a pelvic floor physical therapist in pregnancy, and there are a lot of things externally that can be done to reduce discomfort and have a better outcome.  You mentioned VBAC as an example.  I do refer a lot of my VBAC clients to pelvic floor physical therapy for the reasons you mentioned.

And that’s so good because it’s something that, to me, seems so obvious.  A C-section is intense.  Birth is intense, even if you had your most “optimal birthing experience.”  You and your body are probably still kind of traumatized and thinking, what the heck did we just go through?  But especially if you ended up with an emergency C-section situation or even opted for that C-section delivery, which again, no shame either way – but your body is going to be going through a lot.  A C-section is not a gentle procedure by any means, and many times, they are just given the pain meds, given the stool softeners, given a handout, and sent on their way.  It’s just so sad because with C-sections especially, you have physical scar lines that are going to be changing how your muscles work, how your body is going to show up for you.  And if you don’t rehab that and get that scar moving and return that core strength and stability, you cause so many issues down the line, and it might not be six weeks, six months.  It might be six years, ten years down the line that we see the issues from that.  But a C-section – it’s just such a bummer.  I do think it should be standard of care to see a pelvic floor PT from any delivery.  But it’s an obvious one for me because it’s a procedure, and abdominal procedures – a physical therapy referral after any abdominal procedure, I think should be standard of care.  It makes so much more sense for them.  On a joint, you get an ACL repair, or even a laparoscopic ankle surgery, and they’re sending you to PT two to three times a week for six to eight weeks.  But they cut into your abdomen, or you birth a child, and there’s nothing.  It’s just so mind boggling to me and so sad, honestly.  I’m just a huge advocate to change that.

I agree.  And as you mentioned, with Cesarean recovery, I feel like there’s a misconception that the only people who need pelvic floor physical therapy are those that had a vaginal birth and maybe some trauma in labor or leakage, but it is both the surgical birth as well as vaginal, as a good candidate for pelvic floor physical therapy.

Totally, because obviously, yes, you might not have vaginally delivered your baby, but say that was an emergency C-section and you did push for a couple hours.  Maybe you’ve been laboring for a couple of days.  Your pelvic floor still took quite the beating during that delivery.  But even if you had a planned C-section and you had zero labor, your pelvic floor still carried that baby for you for nine months.

Exactly, that’s the thing!

It still took a beating, and it’s all connected.  It’s a system.  It’s not just your pelvic floor, and it’s not just your abs.  It’s putting that whole core system back together and making sure it is functioning optimally as it should.  Or are you engaging your core incorrectly and increasing pressure every time you engage your core?  Is your pelvic floor even turning on, because it is part of your core, and if it’s not turning on when it should, then you are going to have issues.  It is something I get asked a lot.  Would that be beneficial for me?  I had a C-section.  And I’m like, yes, you, especially because you had a C-section!  I’m sure we’re looking at back pain a lot of the time.  Scar pain, scar sensitivity, pain with intercourse.  There’s a lot that pelvic floor PT can do.  And even looking up beyond the pelvis at things like mommy wrist or having that nerve pain coming down in your arm.  Upper back pain, neck pain from all of the slouching and carrying and feeding and holding that you’re now doing, that your body hasn’t been used to.  It’s just optimizing our movements and making sure that every time you are bending over and picking up that baby, you’re not increasing pressure on the pelvic floor, and instead, you’re making that actually more of a pelvic floor and core workout, as I like to teach my patients.  I really don’t go for traditional Kegels very often at all.  It’s more looking at how is that whole system working together?  Are you engaging your brace every time you’re bending over, pushing, pulling, carrying anything?  Is your breath working with that core brace as it should?  And then when we do that correctly, everything is a core workout, and therefore everything is a pelvic floor workout.  And then you’re also reducing risk of injury.  Again, I could talk about it all day.  It’s such a benefit and such an underutilized service.

I agree!  Well, thank you for sharing all of your wisdom and passion with our listeners!  What are your top tips for finding the perfect pelvic floor physical therapist?

Good question!  I think that finding someone that is going to look at the whole system, because I’ve had some great physical therapists that are pelvic floor physical therapists in the area, and I’ve been disappointed to hear that they’re not looking beyond the pelvis.  So yes, we need to make sure that that pelvic floor is engaging and functioning well, and obviously, you should be getting an internal vaginal assessment.  I offer virtual coaching, and it so great.  I’ve seen it change lives.  There’s such a benefit from it.  But I do think there’s amazing benefit in also getting that internal, in-person vaginal assessment, and you can get that done during pregnancy.  Some therapists don’t like to do that during pregnancy.  We don’t do it during the first trimester, but I am a therapist who is a big advocate for getting that internal assessment during pregnancy so you can see and know what your pelvic floor is functioning like and positioning like going into delivery.  But again, someone that looks beyond that pelvic floor, looking at that whole system, looking at your feet.  How are your feet transferring forces up to your pelvis?  How is your posture above impacting your pelvic floor function?  Looking at that whole body piece.  And I would say someone that is spending a whole hour at least one on one with you.  If you are getting pushed off to a tech, if you aren’t getting that one on one – pelvic floor is very complex, and a 30-minute session does not cut it.  So we need to have some time with our patients and with our providers to really understand that big picture, and again, looking at it holistically, would probably be my two big tips.

Great advice, Dr. Cassell!  Any final words of wisdom for our listeners?

I think just learn your body!  Connect with your body, and if you are having any of those symptoms I mentioned, get some support.  It’s an awkward topic, I know, but the more we can learn our body and understand our body and how it’s supposed to function, we can understand better when it looks like it’s not doing its job and when we might need some support.  There are so many great resources out there to start with, and it can almost overwhelming.  If you are confused as to what information to take in, that’s where I would get some one on one support from a pelvic floor PT.  But there are some great free resources.  My podcast is one of them, and your podcast that I’m on now is one of them.  So just educate yourself.  Empower yourself.  Know your body, and then you can advocate better for yourself and help spread the word.  This is something that, while it is trendy, there is still a big population subset that does not know that pelvic floor PT is a thing, and I think we all need to know.

We do!  Excellent advice.  So how can our listeners connect with you?

 I do have my own podcast, The Balanced Momtality, Pelvic Floor, Core, and More is my podcast over there.  Another great free resource to just tap in and start listening and learning bits and pieces there.  But if you do want to know more, you can contact me on Instagram and Facebook @thebalancedmomtality.  I did have a hacking issue this morning, unfortunately, so I may need to be redoing my Instagram recount.  I will be so sad if I have to start all over.  But for now, it is The Balanced Momtality, and that is my Instagram page and Facebook.  And then I have my website by the same name, where I do have more information about my services.  Again, I offer virtual coaching and in person if you’re in the New Mexico area.

Love it!  Well, it was a pleasure to chat with you, and I hope to have you on again in the future!

I would be so honored!  Thank you so much!

IMPORTANT LINKS

The Balanced Momtality

Birth and postpartum support from Gold Coast Doulas

Becoming A Mother course

Buy our book, Supported

Kristin Revere and Maranda Bower talk about the importance of postpartum nutrition in the latest episode of Ask the Doulas.  They also discuss postpartum planning during pregnancy. 

Hello, hello!  This is Kristin with Ask the Doulas, and I am thrilled to chat with my friend Maranda Bower.  Maranda is the CEO and founder of Postpartum University, which is dedicated to empowering both mothers and professionals in redefining maternal well-being.  With her extensive experience in biology, nutrition, and perinatal mental health, Maranda stands as a pioneering figure in the field.  She possesses a profound understanding of the intricate psychological processes that underpin postpartum well-being.  As a prolific researcher and accomplished author, including the best-selling book Reclaiming Postpartum Wellness, her impactful work extends globally.  Maranda is also the founder of the postpartum nutrition certification program, which is the only functional nutrition certification dedicated to the unique period that is postpartum.

Maranda lives in her beautiful homestead in Alaska with her husband, four children, and many unruly chickens.

Welcome, Maranda!

Thank you so much for that introduction!

Yes, I am so excited to chat with you!  You’re one of my sheroes in the field.  I am all about postpartum planning, as you know from prior conversations, so our focus today is not only in prepping for the postnatal phase, but utilizing your wealth of experience in postpartum nutrition.  So let’s get into it!

Yes, my favorite topics ever!  First off, I really love being here, so thank you so much for the opportunity.  And you know, we spend so much time preparing for the birth of our baby, which is incredibly important, but not very many of us plan for what happens after in the postpartum period, beyond let’s get the best car seat and what about the breast pump and make sure that I have all the clothes for my baby.  But what about the mom, right?  Where’s the planning for her health and her well-being?  And what does that look like?

Exactly.  I think starting with your book as an entry point, even pre-conception, not only in the early pregnancy stage, and it certainly would make a wonderful baby shower gift, as a way to really understand the importance of that planning and especially the nutrition aspect of things.

Yeah, thank you for mentioning that.  And I’m a mom.  I’ve got four kids.  And I will tell you, reading a book in postpartum is probably the hardest thing in the world to do.

Yes!  Absolutely!

I know I have a postpartum book, but I don’t recommend it in postpartum, right?  If you’re in the throes of postpartum, yeah, it’s a great read.  It’s going to tell you where to focus your time and your attention and how to get through it.  But if you don’t have that handholding, meaning somebody there to help you and support you through all the things that you’re going through and helping you navigate the intricacies that is early motherhood and the sleepless nights and having to cook the meals and be in the kitchen.  Most of you probably have toddlers at the same time.  Again, I’m a mom of four; I get it.  It’s hard!  It’s really hard.  So reading, preparing for your postpartum, is absolutely amazing.  I highly recommend it if you’re in the position to do so.  And we can also talk about, what if you are in the throes of postpartum?  What can you do to kind of get out of feelings of stress and exhaustion, and what do you do when your body feels like it’s falling apart or you’re dealing with depression and anxiety?  And we can absolutely talk about those things as well if you’d like.

Yes, certainly!  Before we get into those aspects of not only nutrition but depression and anxiety, another thing that I would love to have you fill our listeners in on is your podcast, and that would certainly be a way for the postpartum moms who can’t focus on a book like yours to get some dedicated information on how to care for themselves.

Oh, yes, absolutely.  And the thing about my podcast that I love, and I hear a lot of people love, is the short episodes.  Nothing is over 30 minutes because we’re busy!  And it’s actually geared towards providers and professionals who are in the field, which kind of gives moms the insider scoop of what’s really going on or what they should be looking for in support people in their lives.

Exactly, yeah!

And there’s so much good information about how your body is actually physically functioning, psychologically functioning.  Like, what really changes?  We all know that our body changes, but nobody tells us how it’s changing, and nobody focuses there, which is why I focus so much on postpartum nutrition and things like that, because our gut changes significantly, which changes our brain.  You’ve got the gut-brain access there.  It changes so much of our bodies, and when we understand those intricacies, then we can see, wait a second, the way we’re taught about what is healthy and how to eat during this time – like salads and smoothies, for example – are actually not beneficial to the postpartum body.  Because we understand what is actually shifting and changing.

Yes!  So where to begin?

I don’t know.  I just dropped a big bomb there!

Let’s try to simplify and give our listeners who are in the early postnatal stages or could be in pregnancy and want to understand some easy ways to focus on getting the correct nutrients, minerals, and eating the right foods in the postnatal phase.

Okay, so if I may, maybe we can start with this question and wrap it around or put it into the question of how do we plan for postpartum, if we’re pregnant.

Yes, let’s do it!

And there’s a couple of things that I highly recommend.  If you’re able to, if you’re in a position to where maybe you’re pregnant or you’re planning to be pregnant, to start really looking into how do I take care of myself during this postpartum time.  And the first thing that I absolutely recommend is to just really take assessment of your life, where you are, how you’re living in your life.  What does your lifestyle look like?  Are you able to sit down and relax?  Is that a possibility for you in your life?  Are you constantly saying yes to the things that you really want to say no to?  Is your life so busy that it’s really hard to step away?  Deep, right?  But sometimes, oftentimes, we don’t get real with this.  Or we say, well, yeah, of course, because I have lots of family and I have kids to chase after and I’ve got this and this – and then we get overworked and we get exhausted just thinking about it, rather than actually dealing with the situation at hand, which is – that’s not sustainable.

No, and that leads to depletion, and as you had mentioned earlier, anxiety, depression, lack of sleep. 

Absolutely, all contributing factors.  But if we don’t get real with how we’re living our lives, our lives are going to push us down very quickly.  We are going to fall flat on our faces, and it’s going to hurt, and you’re going to burn out.  You’re going to get sick, and your life is going to force you to pay attention to it, especially in postpartum.  And that’s why often you see that depletion, the exhaustion, the hair falling out in giant clumps.  We see hormone imbalance.  We see depression.  We see anxiety.  All of those things, they’re going to come raging through.  So make sure you’re addressing that and you’re getting real with that.  And that’s probably one of the hardest things to do is just really get real and say, okay, what is it that I need, and how do I step back?  How do I say no in a way that feels good for me and maybe doesn’t hurt other people’s feelings, or whatever the case may be.  And I’ll tell you, when you are pregnant and postpartum, it’s like the ultimate excuse, so use it to your advantage.  “I’ve got kids, I’m sorry!”

That’s step one.  Step two is really, really looking at, okay, how am I going to nourish myself after growing a human being in my body?  That is no small feat.  As a matter of fact, I think it’s one of the biggest feats that we will ever accomplish in our lifetimes, to be able to grow life, give birth to life and sustain a baby with our bodies for many women.  And that’s just – it is miraculous that we are able to do such a thing.  And we have to know that it took all of us to make another baby, to make a child.  And in that, we have to step back and say, okay, well, if it took all of me – like, really, what did it take of me?

And I will tell you, nutrition is one of those foundational pieces that are really coming to life.  A lot of women are starting to understand what nutrition does, and we’re seeing it with the market of supplements and food products and things like that in postpartum because it does make a difference.  It makes a big difference in the way that we feel.  Nutrient depletion is a real issue.  Over 80% of women will experience it in their postpartum.  And when you’re depleted of nutrients, your body cannot function.  Your hormones cannot regulate.  You cannot heal your body.  You cannot produce the breastmilk that you need to and the formulation that it needs.  The composition of your breastmilk changes.  A lot of people don’t like to talk about that.  Breastmilk is still the absolute best for your baby, but it does change things for us when we are depleted.  And if we’re not getting the nutrients that we need, we’re going to feel exhausted.  Our gears are going to feel like they’re grinding.

Thyroid issues – one in seven women will experience thyroid disorders in their lifetime.  That statistic jumps up to 22% in postpartum.  They’ll experience postpartum thyroiditis.  That’s significant, right?  We’re almost at one in four there.  One in four women will experience a thyroid disorder.  And it’s not because – and this is what I always tell people.  We think often that, well, of course my thyroid isn’t functioning right.  I just had a baby.  This is what I hear from providers all the time.  And I hear from moms, because they’re listening to their providers.

And I will tell you, that is so far from the truth.  Yes, we have babies, and our bodies create babies.  That is actually what it’s biologically designed to do, and our bodies do everything they can to find homeostasis, which is a fancy word for saying it tries everything it can to find balance, to find normal.  And those symptoms are symptoms of something wrong, and we know that when we are experiencing depletion, when we’re not getting enough protein, when we’re not getting enough fat, when we’re not getting enough vitamins and minerals, we can develop postpartum thyroiditis.  It’s actually symptomatic of that.  Depression and anxiety in postpartum mimics symptoms of depletion of very key nutrients.

So we have scientifically proven that when we are depleted of key nutrients, we will feel the symptoms of thyroid disorder, hair falling out in clumps, aching joints, exhaustion, fatigue, depression, anxiety, mood swings, hormone imbalance.  These are not normal things in postpartum.  Our world has called them normal because they happen so frequently.

And certainly with breastfeeding and pumping moms, that depletion is intensified because of all of the work the body does.

It’s exacerbated, right?  Yeah, and it just spirals out of control, and you end up severely depleted, right?  And I will tell you, a lot of women are like, well, I thought I was able – and I’ll break this myth real quick because I know your audience will probably love it – they say, if I breastfeed and I don’t eat – I see this often – or I feel like I’m eating, and I’m breastfeeding a lot, but I can’t lose any of the weight – it’s because your body is in a state of starvation.  It feels, because it’s so depleted, that it’s starving, that it’s holding on to every bit that you’re giving it in an effort not to crumble and crash on itself.  And so if you really want to lose the “baby weight,” which I never recommend as a focus whatever.  It’s not a basis of health.  We need fat on our bodies to grow babies and sustain babies and all of the things, and to be healthy.  Actually, our hormones regulate with fat.  So there’s a whole myth out there to bust on that one.  But oftentimes when women come to me and they say, well, I can’t lose any of the weight, I tell them it’s likely because you’re starving of nutrients.

Yeah.  I mean, it makes perfect sense, and as postpartum doulas, we are making sure that our clients stay hydrated, that they’re snacking, that they’re eating healthy food and not just focusing on the casseroles and lasagnas that are brought to them.  The nourishing food that is going to heal them, and if they are breastfeeding or pumping, help give their babies the nutrients they need, as well.

Which is not an easy task.  And this is why I love talking with doulas and educating those people who are in the field, who are doing the hardest work.  If you’re in the home, if you’re holding mama’s hands and walking her through that process, not only is that hard work – it’s such a sacred journey.  I got started doing this work as a doula myself, and it’s by far one of my most favorite.  I just love – I have a special place in my heart for doulas, and I know that they work that they do is so important.  That’s why I love helping them understand what is really transpiring in the body.  And things that we’re often told, like salads and smoothies, are actually not helpful.  It’s not just about how many nutrients a food holds, right?  It’s actually more so about how is that food able to digest in the body.  What’s its bioavailability of nutrients, which is a fancy way of saying, can my body actually digest those nutrients and use them?  And for a postpartum mom, often the answer is no.  So then it becomes, okay, well, what is the most nutrient dense food that is easily absorbable for a mom?  Salads and smoothies are not it.  It’s going to be broths and stews and congee, high fats, high protein, lots of cooked vegetables, so very rich in nutrients which are cooked, which increases the bioavailability of food, which means you’re just drinking liquid nutrients, which means it’s easier on the body to digest and the body is not exerting extra energy to digest the foods.  That in itself is a whole episode, but that is such a key component to healing in the years after having a baby.

Exactly, Maranda, and that is why traditional cultures have always focused on warming foods in the postnatal phase.

It’s so interesting when we look at what we know in the science, which is very little.  Women’s healthcare in general is so understudied; it’s not even funny.  It’s actually very concerning.  And when we look at what is actually available and out there for science right now in this very moment compared to what we see in traditional cultures around the world who have been practicing these things for eons, since the dawn of time, we can see the correlation.  They connect.  They match.  It’s kind of funny; maybe we should stop listening to all of the science and start going back to the traditions of our world and our cultures because they really have it down.

Yes, agreed.  Absolutely.  There is a lot of focus on supplements and fast fixes.  What’s your take on the best way to absorb the nutrients, outside of food?

When we start looking at what’s really happening in the gut, we recognize that if it’s hard for a body to digest raw food, for example, like a salad, it’s going to be hard for a body to absorb a manmade pill.  And we see a lot of studies coming out on supplementation and that it actually might be more harmful than it is good, because what we’re doing is we’re taking components of a food.  We’re taking out vitamins.  We’re taking out minerals.  And what we’re leaving is the rest of the nutrients that are so synergistic to the food itself.  When you are digesting a potato, you’re not just digesting the vitamins of a potato.  It’s not just like here’s your vitamin A.  Here are the vitamins in the potato.  It’s all of those components of the potato that actually make it supportive of digesting each other.  When you start looking at nutrition studies and dietetics, you’ll recognize that many nutrients work together to help each other digest and become bioavailable in the body.  The opposite is also true in that some nutrients don’t work together at all.  And so when we’re consuming this giant multivitamin full of things, it’s kind of funny because a lot of those things are not conducive.  They don’t work together.  They fight with each other, and they’re not going to be digested.  They’re going to be literally flushed down the toilet, a complete waste.  And I love specific supplementation, and the way in which I love supplementation, I will tell you, that I think is so powerful and so necessary for the body, especially in postpartum, because again, the postpartum body needs a lot of support.  Lots and lots of support.  The first thing we think of, well, supplements will be the easiest route.  But I want to tell you: herbs are the easiest route.  Herbs, because they’re so nutrient dense and very easy to digest.  We can either take them not necessarily in supplementation form, but in tea form.  That, my friend, is how you get the boost that you so desperately need, and it’s something that you can feel right away.

And for those who are really deficient – maybe you’re experiencing anemia, which is so common postpartum.  Taking liquid supplements, liquid food-based supplements, that is going to be your friend.  Don’t take pills.  If you can find a liquid supplement for whatever it is that you specifically need – because again, it’s not a one size fits all.  I’m just telling you some general things, but for every person, it’s very different.  There are liquid supplements that are available to you that, if you can’t get with food or enough with food, then you can absolutely take liquid supplements.  But I will tell you, herbs are by far so sustaining.  They’re something that we can grow in our own backyards if we really wanted to, which is why they’re not on the market as something that can really help us.  There was a study that was done on Prozac versus St. John wort, the herb, and which one was more effective.  And it was actually kind of a joke that this researcher was joking with another researcher saying, hey, I bet we can just study this and throw it under the water and everybody would stop going to St. John’s wort for depression support.  And what they actually found is that it works significantly better with far less symptoms.  It was a massive study and it was absolutely amazing.  But they can’t market it.  You can’t go and market that because people can grow it in their own backyards.  It’s not grown in a lab.  It’s not something that – you know, when you look at science, how is it a pill formed?  Well, it’s usually by somebody who comes in to a market and says, I’m going to invest my money in this, and there’s going to be a return on that money, and we have to pay the scientist and all of that.  None of that gets to be done.  Nobody’s going to invest in that because you’re not going to make anything because you can grow it in your own backyard, which means that you’re in control of that.

And there’s so many other components, too, that we can get into.  We need a series.

We do!  It could be a six-part series just for expecting families and then a three-part for birth and baby professionals!

To answer your question a little bit more thoroughly: oftentimes what we’re looking for in those quick fixes is how do we fit everything into this lifestyle that doesn’t support us, and that goes back to the first question, really getting clear about what in your life is not working for you.  Because if you’re just going to insert a baby into this crazy, busy life that most of us lead and expect that it’s not going to take a toll and then just try to throw in a bunch of quick fixes, it’s going to fail.

Right.  So for the birth and baby professionals who are listening, would you fill us in a bit about how they can expand their knowledge on postpartum planning and nutrition?

Oh, my goodness.  I do offer a lot of resources.  You can go to my website.  I have some free handouts that you can use for your clients.  And you will learn a ton just going through those handouts yourself.  And I also offer a certification program for that.  It’s actually the only functional nutrition certification program for postpartum.  There are other programs out there that lump pregnancy and postpartum together, and I am just – I do not agree with that because once we understand those physiological and psychological changes that are occurring in postpartum – yes, birth and pregnancy kind of go together, but we can’t lump them together when we’re talking about nutrition, when we’re talking about a lot of things related to the changes that are occurring in postpartum.  I think for one, making sure that you are really educating yourself, for those providers who are listening in and those doulas and advocates, making sure that you’ve got the right information.  And then passing that along to your clients.  You don’t have to be the doula or the provider who cooks meals.  If you want to, perfect.  That’s amazing.  You can absolutely do that.  There’s a lot of people who are doing that and have to be that person to do that and make a difference.  But I will tell you that not talking about nutrition is leaving a lot on the table for your clients to try to figure out themselves, and if you’re not talking about nutrition, your clients are going to experience all of the things that we say are typical and  normal.

I always say, I want to leave my clients feeling better that I am out of their home and I’ve done my time supporting them than having to rely on me to get what they need.  If they feel like, wow, that was such a transformative experience, having Maranda here, being my doula, supporting me in my journey, and I feel like I have all the tools I need to support myself without her here – that’s a game changer.  That’s a life changer.  That mom is going to go share with all of her friends what she learned.  She’s going to share all of your information, everything.  I don’t want a mom saying, please don’t leave me.  I don’t know what to do without you.

Right.  The goal is to work ourselves out of the job and have our clients feel confident and able to handle this transition, whether it’s baby one or five, without support.  So yes, I totally agree.

Yeah, and nutrition, again, the foundation to all of that.  If you’re not talking about nutrition, your clients are missing out.

Right.  Nutrition and rest, I feel, are the two most important things.  And as you mentioned, in that planning phase, finding out really what motivates you, how to ask for help, what your lifestyle is and how it’s going to change after baby – those are all important questions. 

So any final tips for our listeners, Maranda?

Oh, my goodness.  I feel like we talked a lot about planning for postpartum and maybe even helping your clients plan for postpartum, but what about those clients who are already in the throes?  And I think the same is also true – like, all of these things, and I do want to say, it’s never too late to heal.  I have lots of moms who have come to me two, three, four years postpartum and it’s still possible to heal.  If you’re a doula listening in, or a provider, that means that you still can help moms heal during this time, especially with nutrition.  And I think finding somebody who can help you and walk you through that process of learning what it means and helping you either – if you’re a mom in the home, helping you and literally holding your hand.  I know as a mom of four, this is exactly what we needed.  We kind of made a shift, I think, in the doula world where we were offering a lot of – or just in the mom world, too, of like, well, I’m going to go find a coach or I’m going to go find an online doula to help walk me through and provide the education.  I think that’s great.  It serves a purpose.  But there’s something incredibly valuable and purposeful and necessary about having that extra support on hand.  And so if you’re able to get that, I will tell you, not a single mom says that wasn’t worth it.  But every single mom says, I wish I would have done it.  There’s always regret for not having it.  There’s never any regret for having it.  So if you’re in a position to have the support on hand, to help you navigate what it means to shift your lifestyle so that you don’t have to say yes when you want to say no or to streamline how you clean your house, for goodness sake, because that can make a huge difference, or whatever it is that you’re going through that trips you up, that gets your frustrated, that you just need support with – especially with nutrition – then having that support system in place is so necessary.

It is, definitely.  How can our listeners connect with you?  You have Postpartum University.  You’re on social?

Yeah, I would say the best place – if you’re listening to this podcast and you love podcasts, come listen to me at the Postpartum University podcast.  You can find us on all major channels.  Come listen in.  Come learn.  Come connect with us there.  That’s probably the best place.

Excellent.  And then as far as your book, Reclaiming Postpartum Wellness, where can our listeners pick that up?

Straight on Amazon.  That’s the best place to get it.

Excellent.  Well, thank you so much, and I will have to have you on again, Maranda!

Thank you so much for your time and attention!  I’m just so grateful for being here.

I’m grateful for you!  Take care!

IMPORTANT LINKS

Postpartum University

Birth and postpartum support from Gold Coast Doulas

Becoming A Mother course

Buy our book, Supported