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Postpartum Confinement Herbal Care 产后月子中药调理

Chinese herbs

Various physiological or pathological changes occur in the body of women during pregnancy and after labor. No matter it is a natural birth or a cesarean section, it will lead to the loss of Qi (means vital energy) and blood. Weak Qi and blood often means weakened immune function. At the same time, increased blood viscosity and coagulation make it is easy to aggregate into blood stasis. These lead to prolonged recovery or cause other postpartum issues. Hence it is important to prevent postpartum issues. Traditional Chinese medicine has been used to help new mothers to regulate and nourish Qi and blood, promote blood circulation. It can prevent or reduce various postpartum symptoms, quickly restore visceral functions, effectively balance yin and yang of your body.  It is helpful for your body to recover and good milk supply.

妇女产后机体出现各种生理或病理的变化。无论是自然生产或剖腹产都会导致气血流失,气血虚弱出现免疫功能低下,抗病能力弱。同时因为血液粘度增高,凝固性强,易聚集成瘀致恢复时间延长或引起其他相关产后诸病,因此产后病的防治相当重要。传统上中医药被用于帮助产妇调理,以益气养血、活血化淤。从而预防或减少产后各种症状,迅速恢复脏腑机能,有效地协调阴阳、平衡体质,防止皮肤老化,葆有肌肤弹性,恢复完美体形,使奶水充盈,确保新生儿更加健康。

It is a tradition in China for new mothers to take herbal medicine after giving birth. Some mothers with postpartum anaemia and sweating are easy to catch a cold, or have symptoms such as constipation, haemorrhoids,  prolonged bleeding (lochia), wound infection, joints pain,cold sores, lack of milk or poor milk flow, postpartum depression. Some mothers use them to promote the early recovery of the uterus and vagina, prevent uterine prolapse and quickly restore the body.

很多新妈妈产后经常会进行中药调理。有些妈妈产后贫血虚汗易感冒,或有恶露不尽、伤口感染、腰腹或关节疼痛、手足水肿、口舌生疮、乳汁缺少或排乳不畅、情绪低落抑郁、大便秘结或痔疮等症状。有些妈妈则想要促进子宫、阴道早日恢复,预防子宫脱垂和养颜美容,迅速恢复身材等。

There are some prescriptions and over-the-counter medicines on the market, but they must be used with caution. After giving birth there are some changes in the body. This stage will be different from normal and different from the time of pregnancy. As each mother’s physique and needs are different, the use of Chinese medicine should be different too. For example, it is necessary to remove blood stasis if there is congestion after childbirth. If there is no blood stasis, there is no need to do so. Some people will take ginseng to replenish deficiency. However, the mother may experience insomnia, irritability, restlessness and other adverse reactions. These could affect postpartum recovery.

市面上有一些药方和成药,但须谨慎使用。准妈妈分娩后,身体的机能会发生一些改变,这个阶段会不同于平常,与怀孕的时候也不同,每个妈妈体质和需求也不同,使用中药应有所讲究和禁忌。比如,产后有淤血的情况才要化瘀,没有淤血的情况不需要刻意地化瘀;有些会服用人参以补虚,结果产妇出现失眠、烦躁、心神不安等不良反应而影响产后恢复。

Therefore, confinement prescriptions cannot be the same. It is safe and reasonable to see a properly trained Chinese medicine doctor. He/she can make appropriate diagnosis according to your individual physical conditions, then make a personalised management plan.

所以坐月子所用药方不可一成不变,要让正规注册的中医师去根据不同产妇体质,不同时期,身体个人状况综合评估适当调整,然后制定个性化的调理方案才安全合理。

产前 Prenatal

A couple of weeks before labor you can visit our clinic. Have a consultation with our fully trained Chinese medicine doctors. We will gather your full health information based on Chinese medicine diagnosis approaches, such as observation, inquiring listening , inspection and pulse taking. According to your individual conditions, we give the most professional prescriptions and guidances.

产前1~2周左右孕妇可亲自到我们诊所由专家看诊,根据望、闻、问、切等方式,建立个人档案。根据孕妇自身的情况,给予最专业的生产指引和信心。

产后 Postpartum

Confinement after childbirth usually takes one month. According to your conditions, you may be given different herbs, including decoctions, granules or bath herbs.  After entering the fifth week, you can resume a light diet, or reduce the frequency of taking tonics. If take good care of yourselves during the whole confinement period, you may even notice some improvement of your past health issues, such as period pain, irregular period, cold hands and feet.

Should there is a need to withdraw milk, a special herbal formula is available too.

生产后坐月子通常以一个月为准,每周都有不同的中药根据不同的情况给产妇煎服或冲服,洗泡或煲汤料。进入第五周之后,产妇就可以恢复清淡、正常饮食,或者降低进补的频率。产妇在整个月子期间如能好好调养,通常原本有的一些妇女病和原发性经痛、生理期不顺,还有手脚冰冷的情况也会改善许多。
如有退奶需求者,则有专门汤方可供使用。

调理方案 Management Plan

At Almond Wellness Centre telephone or WeChat consultations is available. Afterwards we may prescribe the herbal formula. You may have family members come to our clinics to pick up the herbs.

If you have any questions during the confinement period, you can consult by telephone or WeChat.

杏林中医中心我们会通过辩证的方法,对产妇进行产后电话或微信问诊及看舌苔后开出药方,由家人到诊所领取煎服中草药包或冲泡浓缩药粉以及各种泡洗或煲汤的药包。

月子期间如有各种疑问,可通过电话或微信等咨询方式,足不出门就可以得到医师的专业回复,拥有你的私人中医师。

疗程:4 周

Course: 4 weeksAlmond Wellness Centre Wechat QR code

You can come to the clinic for a face-to-face consultation with a Chinese medicine practitioner before you give birth. After giving birth phone consultation is available.

Chinese medicine package

4 week’s dosage, including raw herbs, and/or concentrated granules, herbs for bath, etc.

产前可来诊所中医师当面作舌脉诊查,产后可电话或微信咨询。中药药包 – 4 周量,包括草药或浓缩粉,外洗泡澡方等。

Association Between Maternal Caffeine Consumption and Metabolism and Neonatal Anthropometry

CoffeeQuestion

Is maternal caffeine intake associated with neonatal anthropometry?

Findings

In this cohort study of 2055 women from 12 clinical sites, measures of caffeine consumption (plasma caffeine and paraxanthine and self-reported consumption) were associated with neonatal size at birth.

Increasing caffeine measures were significantly associated with lower birth weight, shorter length, and smaller head, arm, and thigh circumference.

A study has found that caffeine consumption during pregnancy, even in amounts less than the recommended 200 mg per day, is linked to smaller neonatal anthropometric measurements.

The longitudinal cohort study in JAMA Network Open concluded that compared to women who drank no, or very little caffeine, women who drank the most caffeine (a plasma caffeine level of ≤ 28 ng/mL) had neonates who weighed 84 g less, were 0.44 cm shorter in length, a 0.28 cm smaller head circumference, a 0.25 cm smaller arm circumference, and a 0.29 cm smaller thigh circumference.

“Most of the research on caffeine and neonatal size at birth focuses on birthweight and length, while relying on self-reported measures of caffeine consumption.,” said senior author Katherine Grantz, MD, an investigator in the Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health, in Bethesda, Maryland.

The current study analyzed data from the NICHD Fetal Growth Studies–Singletons, which enrolled 2,055 nonsmoking women at low risk for fetal growth abnormalities with complete information on caffeine consumption from 12 U.S. clinical sites between 2009 and 2013.

“In the NICHD Fetal Growth Studies, we have rich data on multiple measures of neonatal anthropometry to more specifically characterize neonatal size, as well as objective measures of plasma concentrations of caffeine and its primary metabolite, paraxanthine,” Grantz told Contemporary OB/GYN.

The two main sources of caffeine were coffee and soda, which accounted for 35% and 41% of caffeine intake, respectively.

Caffeine was evaluated by both plasma concentrations of caffeine and paraxanthine and self-reported caffeinated beverage consumption measured/reported at 10 to 13 weeks gestation.

Caffeine metabolism was defined as fast or slow, based on genotype information from the single nucleotide variant rs762551.

“Prior caffeine studies have observed lower birthweight after consumption of higher amounts of caffeine — usually 200 to 300 mg, or 2 to 3 cups of coffee, daily,” said Grantz, who served as a co-principal investigator of the NICHD Fetal Growth Studies.

Before starting their analyses, the current authors knew that the average consumption in the sample was much lower, about 35 mg/day, and only 16 women reported drinking more than 200 mg/day.

Because of this low consumption, we were uncertain we would see any significant results, so it was surprising that we still found that increasing caffeine consumption, even at low levels, was associated with some smaller anthropometric measures in the offspring,” Grantz said. “Also, the finding that the decreases in birthweight were manifested by decreases in bone and muscle measures, but not skin folds and fat mass, were unexpected. These findings may indicate decreases in lean tissue as caffeine consumption increases.”

The clinical implications of the study are unknown, considering there were only small reductions in some neonatal anthropometric measures, Grantz said. “Other evidence suggests that even small amounts of caffeine intake during pregnancy (50 mg/day) could be associated with a higher risk of excess growth in infancy and childhood that could put children at higher risk of later cardiometabolic disease,” she said.

“Therefore, our results could indicate some disruption in normal fetal growth patterns, but will require more research to confirm.”

Although the study authors are unable to make recommendations based on the results of their single study, “we encourage pregnant women to talk to their providers about caffeine consumption, and suggest that caution may be warranted,” Grantz said.

The next step for the investigators is to evaluate the serial ultrasounds and fetal volumes conducted throughout pregnancy by the NICHD Fetal Growth Studies to determine when changes begin in fetal growth in relation to caffeine measures, and how these changes may be manifested in fetal volumes.

Disclosure

Grantz reports no relevant financial disclosures.

Reference

Gleason JL, Tekola-Ayele F, Sundaram R, et al. Association between maternal caffeine consumption and metabolism and neonatal anthropometry: a secondary analysis of the NICHD Fetal Growth Studies–Singletons. JAMA Network Open. Published online March 25, 2021. doi:10.1001/jamanetworkopen.2021.3238

Acupuncture and acupressure for pain management in labour and birth: A critical narrative review of current systematic review evidence

Levett KM, et al., Complementary Therapies in Medicine, 06/17/2014

 

Results

The RCTs included in these systematic reviews differed in terms of study designs, research questions, treatment protocols and outcome measures, and yielded some conflicting results. It may be inappropriate to include these together in a systematic review, or pooled analysis, of acupuncture for labour with an expectation of an overall conclusion for efficacy. Trials of acupuncture and acupressure in labour show promise, but further studies are required.The aim of this study is to examine current evidence from systematic reviews on the topic of acupuncture and acupressure for pain management in labour and birth, and to evaluate the methodological and treatment frameworks applied to this evidence. The use of current systematic reviews of the evidence for acupuncture and acupressure for labour and birth may be misleading. Appropriate methods and outcome measures for investigation of acupuncture and acupressure treatment should more carefully reflect the research question being asked, the use of pragmatic trials designs with woman–centred outcomes may be appropriate for evaluating the effectiveness of these therapies.

 

Methods

A search limited to systematic reviews of the MEDLINE, CINAHL, PUBMED, EMBASE and Cochrane databases was performed in December 2013 using the keywords ‘CAM’, ‘alternative medicine’, ‘complementary medicine’, ‘complementary therapies’, ‘traditional medicine’, ‘Chinese Medicine’, ‘Traditional Chinese Medicine’, ‘acupuncture’, ‘acupressure’, cross–referenced with ‘childbirth’, ‘birth’, labo*r’, and ‘delivery’.The quality of the evidence is also evaluated in the context of study design.

Recurrent miscarriage–outcome after supportive care in early pregnancy

coverLiddell HS et al, Aust N Z J Obstet Gynaecol. 1991 Nov;31(4):320-2.

This study did not use acupuncture or herbs, but it is interested to include it here as a way of managing early pregnancy in women who have had previous miscarriages. There is currently no known prevention therapy for unexplained recurrent miscarriage, but this study showed that emotional support and close supervision helped improve outcomes in subsequent pregnancies.

 

Abstract

One hundred and thirty three couples were investigated at a recurrent miscarriage clinic. In their next pregnancy 42 women (Group 1) with unexplained recurrent miscarriage were managed with a programme of formal emotional support and close supervision at an early pregnancy clinic. Two women were seen in 2 pregnancies (44 supervised pregnancies); 86% (38 of 44) of these pregnancies were successful. Four of the 6 miscarriages had an identifiable causal factor. Nine women (Group 2), also with unexplained recurrent miscarriage, acted as a control group. After initial investigation they were reassured and returned to the care of their family practitioner and did not receive formal supportive care in their subsequent pregnancy; 33% (3 of 9) of these pregnancies were successful (p = 0.005; Fishers Exact Test). Whilst acknowledging that there is a significant spontaneous cure rate in this condition, emotional support seems to be important in the prevention of unexplained recurrent miscarriage, giving results as good as any currently accepted therapy.