"Should we keep this between poo and I?"

During pregnancy, our body goes through a whirlwind of changes. One of the most commonly experienced side effects I see in clinic, is constipation.

I have seen a lot of beautiful mothers with this concern and looking for ways to treat constipation naturally through their nutrition.

Pregnancy does predispose women to constipation. You are not alone!

A general rule of thumb to  confirm whether constipation is present is whether you are experiencing low frequency of defecation (less than 3 per week), passage of hard stools and/or experiencing difficulties when emptying the bowels.

 Constipation can occur at any time during pregnancy but is more commonly experienced in the first two trimester. It is due to a combination of both mechanical and hormonal factors affecting the normal functioning of the Gastrointestinal tract. During pregnancy our digestion starts to slow down and the movement of our food and bowels tend to feel sluggish and stagnate. When we than add a rise of our hormone progesterone (produced by both the ovaries and placenta) and a reduction in our motilin hormone (a peptide hormone which is responsible for smooth muscle motility) this can inhibit and decrease bowel transit times. Additionally, we have higher amounts of circulating estrogen and progesterone in the body, which stimulates the production of aldosterone. Aldosterone than stimulates sodium and water reabsorption in the small intestines, which is what causes stools to dry out and harden.

There are also some further reasons why constipation may be present. This can simply be due to the fact that the mother is not drinking enough water or consuming enough dietary fibres, or she is taking particular medications or supplements such as iron, which can affect bowel motility.

Constipation concerns aren’t only experienced during pregnancy. You can also experience constipation during the fourth trimester ( 1 – 3 months postpartum). Especially if there is haemorrhoids or anal fissures present; you may be at a higher risk of postpartum constipation.

 

TREATMENT AIMS:

(When looking at the following treatment aims; even if you do not experience constipation, these objectives are great preventative methods to consider.)

 Increase daily dietary fibre. Both soluble and insoluble fibre play their part in improving motility.  The daily fibre requirement for pregnancy is around 25-35g daily. This can be easily met by the following sample diet day.

BF - wholegrain oats with flaxseed and mixed seeds.

S – ripe banana and almonds (ensure ripe)

L – Mixed Salad sandwich with poached chicken

S – Greek yoghurt with mixed berries

D Grilled Fish with a lentil salad

S – Vanilla Chia seed pudding 

Further fibre rich foods include: wheat bran, oatmeal, grains, dried plums (prunes), kidney beans, raw fruits, Brussel, dark leafy greens, broccoli, seeds. 

Include bulk forming agents into the diet. Physilium husk is one of my favourites and assists in bringing moisture to the stool and stimulates peristalsis movements of the GI tract. Making passing the stool more comfortable and fluid. Note: ensure you are drinking adequate water alongside bulk forming agents and always speak with your health professional prior to consumption.

Increase fluids – Daily water requirements for pregnancy is 2.3 litres daily. From my personal experience in clinic, this is very rarely met and essential to prioritise.

Daily exercise. Moving the body during pregnancy has many proven benefits. Physiologically when we move our body we increase fluid (blood & lymph) circulation, increase oxygen transportation and therefore contribute to increased organ function.

Supplement with Probiotics. Due to varies fluctuating hormones and both metabolic and immunological changes we experience during pregnancy, our bacteria in our gut can be easily altered. Leading to an imbalanced or disturbed microbiome. Addressing this with a probiotic supplement can help restore normal bowel function and increase stool frequency. Not all probiotic supplements are treated equally, so it is important to ensure you get the right product that is strain specific. Strains specific to constipation include: Bifidobacterium Lactis, Bifidobacteriun Animalis, Lactobacillus Acidophilus & Lactobacillus Rhamnosus.

 

Lastly, it is important to note that pharmacological laxative use in pregnancy can increase fluid and electrolyte loss. This treatment method should be recommend last resort if dietary aims were unsuccessful. ALWAYS consult with your obstetrician prior to use. Always consult with your obstetrician and health practitioners prior to making any of the above changes whilst pregnant. That way they can cater to your personal needs and requirements.

 

chia oats