Mamas on Bedrest: Will Beetroot Juice Lower Blood Pressure or Help Treat Pre-Eclampsia?

April 20th, 2015

Hello Mamas!

This came as a response to a post I did on the use of Nifedipine, an antihypertensive (blood pressure lowering) medication, used to treat preterm labor.

Latest details, revealed by the United States Of America Centers for Disease Control and Prevention and based, on over a decades research, suggests that fatalities, from causes associated with high blood pressure levels, are regretfully growing strongly. A particular possibly encouraging portion of wider research, suggests the important role beetroot juice may possibly play, in helping to better management regarding blood pressure levels. It may be a life saver for you to be alert to this research and I’m very happy to share these details to you.

I get a lot of these types of notices on my blog posts and quite frankly, I typically delete them. But with this one, I decided to see what “literature” they are referencing and to see if it is at all credible. But I will tell you right now, I am highly skeptical about this and using this “comment” as an example, I will share with you why I don’t recommend therapies on this blog.

So let’s pull this apart. The first statement is in fact true. There is an increase in the incidences of high blood pressure in the United States and many pregnant women are affected-be it with Pregnancy Induced Hypertension (PIH) or Pre-Eclampsia (the more complicated syndrome of high blood pressure, facial and extremity swelling and proteinuria). PIH is often managed expectantly, i.e., HCP’s monitor the blood pressure and make sure that it doesn’t go beyond a certain level. Health care providers also are vigilant to look for other associated complications and to see of the PIH is going to progress to Pre-Eclampsia. Now with isolated elevated blood pressure, it is likely pretty harmless if a woman wants to increase her beet intake. Beets are good sources of iron and vitamins, so incorporating them into the diet is a good thing. But without seeing any credible literature, I am not going to say that eating beets is going to have any particular impact on blood pressure or will prevent any progression of complications. So with that statement, I cannot recommend beet consumption as a means to prevent or treat pre-eclampsia. I’ve never seen any credible literature to this effect, so I am not going to make any sort of suggestion or recommendation. Pre-Eclampsia is a serious medical condition that can threaten the life of a pregnant mama and her baby. It requires intense medical supervision and any woman who has been diagnosed with pre-eclampsia or who is at risk for developing pre-eclampsia needs to have a close relationship with her health care team and receive guidance and treatment from them.

So let’s look at the next statement. A particular possibly encouraging portion of wider research, suggests the important role beetroot juice may possibly play, in helping to better management regarding blood pressure levels. I have no idea to what research this person is referring. I read a lot of articles and publications; the New England Journal of Medicine, The British Journal of Medicine, Obstetrics and Gynecology, The Lancet, The Perinatal Journal put out by the Association of Women’s Health Obstetric and Neonatal Nurses and many many others. Never have I seen any reference to beetroot juice being used for high blood pressure. I’ve not seen it in any cardiology journals, in anything put out by the American Heart Association or, as mentioned, by the US Centers for Disease Control and Prevention. Yes, curiosity got me to approve this comment because I want to see who is the reference for the recommendation of beetroot juice for the treatment of hypertension.

It may be a life saver for you to be alert to this research and I’m very happy to share these details to you. Really?? Again, who is/are the references? Who did the research? Where is it published? Most times when there is a release of medical information, the press release reads, “Researchers find XXXX leads to improved outcomes of YYY” and immediately following the headline, the publication and date are posted. Not the case here.

What really concerns me is that whoever wrote this comment, I don’t think really understands what the post they commented on was about. Nifedipine, an antihypertensive medication, is sometimes used as a tocolytic (a medication to stop preterm contractions) in women who are experiencing preterm labor. I cannot tell whether or not this person actually read the post, or happened across the Nifedipine in the heading and decided to comment. In either case, this comment tells me that they are not really well educated on preterm labor, hypertension, Nifedipine or the use of Nifedipine for the treatment of preterm labor. That being said, I’m even less inclined to regard any information that they submit regarding the use of beetroot juice as credible. As I have said, I’d like to see the references, but I am not in any way looking for Beetroot juice to be the next great cure for PIH or Pre-eclampsia.

Mamas, I do my best to bring you the latest credible information and the newest advances in treatments for high risk pregnancy. Your lives and the lives of your babies are of utmost importance to me and I try to weed out extraneous “information”. I am sure that sometimes you may think that I am being too stringent or too protective of the website. My goal is always to bring you the best, and when something doesn’t meet standards of care or deviates so radically from the medical literature, I typically don’t include it. Now you know why.

Let’s see what this comment yields. I’ll keep you posted.

Addendum: I looked up Beetroot Juice and it seems that there was a study done at Wake Forest University that showed Beetroot Juice increases blood flow to the brain and that these findings show that there may be some usefulness to drinking beetroot juice to prevent the progression of dementia. There is nothing about treatment for high blood pressure in this research. I didn’t find any specific research indicating the drinking beetroot juice or eating beets decreased blood pressure during pregnancy. However, as previously stated, beets are high in iron and vitamins (as are many fruits and vegetables) so incorporating them into your diet, as a way to round out your nutrition, is a good thing. To try to treat PIH or Pre-eclampsia, I did not find evidence.

If any of you have credible research resources that indicate beetroot juice is useful in lowering PIH or Pre-eclampsia, please share these references in the comments section below. Thanks.

Mamas on Bedrest: Your Twin Babies Will Always Remain Close

April 6th, 2015

Good Morning Mamas!

Twin FetusesLast week I had the great privilege to speak at the Austin Mothers of Multiples Meeting. Mothers of Multiples Meetings can be found nationwide throughout the United States and these non-profit organizations-comprised of mothers of multiples-provide support to families who have twins, triplets or higher order multiple births. At this particular meeting, in addition to me sharing about bedrest and how mothers of multiples are supported while on bed rest, there was a twin panel; a panel of adult twins who shared their twin experiences and shared what parents of twins could expect as their children grew up. The panelist shared everything from how they liked or disliked being dressed alike to how they have an inexplicable bond with one another.

I found the panel fascinating.  There was one set of male/female twins, one set of female twins, one set of male twins and a male identical twin who had a rare form of cancer that caused him to lose several of his limbs. His identical twin brother was not affected by the same disease. These twins generously shared what it’s like to be a twin and some things that parents of twins can look forward to (and not worry about) as their twins grow up.

Twins always share an unspoken (and inexplicable) bond. All the twin sets shared that they are connected to their twin in a way that they are connected to no one else on the planet. Each grouping said that they often know what the other is thinking, can sense when the other is upset or not feeling well (even if they are far apart as the sole identical twin said. His twin is back “home” in Australia!) and that they always feel best understood by their twin.

Built in Playmate/Confidant. The twins said that one of the best things about being a twin was that when they were little, they always had someone to play with. As adults, they always have someone with whom they can share their secrets or concerns that truly understands them.

Twins don’t always like the same things, but often do. Interestingly, the male/female twins were both dental students at the University of Texas and were currently sharing an apartment. They said that when they were younger, they had different interests in school and were not at all competitive about grades or friends. The male twins were both undergraduate students at the University of Texas and while not living together or studying the same major, they were in a couple of classes together and did live close enough that they were in a study group together. The female twins said they were very competitive all the way through high school and purposely chose to go to different undergraduate schools. The interesting thing about them is that once they got out of undergraduate school, one twin got married and had children here in Austin. When her twin later moved to Austin and then got married, they had 3 children born within days of each other. The twin who married first actually has 5 children and her first and last children she had solo while her 3 middle children are each born within days of a cousin-one of the other twin’s children!

Twins don’t always like being dressed alike. The panel was pretty unanimous in that they didn’t like being dressed alike-even if it was with the same outfit in a different color. The male twins shared how they would use being dressed alike to pull pranks on people-even their mama! The girl twins shared how as they moved through middle and high school they changed their hair and sought out other ways to distinguish themselves. They all, while realizing their similarities, sought to be individuals and preferred to be treated that way.

Most twins felt their parents loved them and treated them equally. With the exception of the male/female twin set, the twins felt that their parents treated them equally and as individuals, not favoring one or the other of them. With the male/female set, they admitted that he felt closer to his father and she to her mother, but they both felt that each parent loved them both and they both have great relationships with both parents.

Dating wasn’t an issue. The twins all said that dating wasn’t an issue and there was not an incident of both of them liking the same person. As the female twin set noted, and the other twins agreed, they tended to date (and in the case of the female twins marry) people who had the complimentary attributes of their twin.

Twin parents shouldn’t worry about…”emotional damage” they may cause from getting their twins confused. The parents seemed overly concerned that their twins may feel slighted but the twins on the panel assured them that they never felt slighted or that they weren’t individuals. They said it comes with the territory that they will be confused with their twin (even by their parents), even if they are not identical.

 

Are you expecting twins or higher order multiples? Has this panel review been helpful? Please share your comments or concerns below.

Do you have twins, triplets or higher order multiples? What has your experience been like? What is it like raising twins? Please share your experience with other mamas in the comments section below.

Are you a twin? Do you agree or disagree with what the twin panel had to say? Please add your voice to the discussion below.

Mamas on Bedrest: Want a Smarter Baby? Breastfeed!

March 30th, 2015

nursing infantGood Monday Morning, Mamas!!

According to a recent study done by Brazilian Researchers published in The Lancet Global Health, “Breast-fed babies may be smarter, better educated and richer as adults”. This article so intrigued me that I had to read through and see just what the researchers saw as the determining factors.

According to the Medline report and the actual publication, Brazilian researchers followed enrolled and started following 5914 neonates who were breastfeeding to gather information about IQ and breastfeeding duration. The data was analyzed between June of 2012 and February 2013.  3493 participants remained from the original study group. The researchers found that the durations of total breastfeeding (in months) and predominantly breastfeeding (breastfeeding as the main form of nutrition with some other foods) were positively associated with higher IQ, higher educational attainment, and higher income. Babies who were breastfed for 12 months or more were found to have higher IQ scores, more years of education, and higher monthly incomes than did those who were breastfed for less than 1 month. So based on these findings, the researchers concluded that “Breastfeeding is associated with improved performance in intelligence tests 30 years later, and might have an important effect in real life, by increasing educational attainment and income in adulthood.”

While the results of this study are in line with many other studies, the article has aroused some criticism. Dr. David Mendez, a neonatologist at Miami Children’s Hospital, said “Parents should not take the message from this study that ‘if you do not breast-feed, your child will not be a successful adult.'” The researchers found that it was duration of breastfeeding that was key. It did not depend on the infants’ families being wealthy or on the parents being highly educated, outcomes in the infants still showed breastfed babies were more successful and those who were breastfed longer were more successful.

What those critical to the study did point out is that it does take time and effort to breastfeed. Parents who are dedicated to breastfeeding and mamas who have a strong support while they breastfeed are going to be more successful. Moreover, they are more likely to be invested in the overall development of their child, making choices and exhibiting habits that nurture their child and guide them in more positive behaviors. They caution people against thinking that breastfeeding alone will give a child an advantage. However, the more its studied, the more we can see that breastfeeding does in fact lead to numerous benefits-for infants as well as for their mamas. Here are some of the benefits:

  • Breastfed infants are getting high quantities of saturated fatty acids (of which breastmilk is composed) and which the infant brain preferentially uses for growth and development
  • Breastmilk contains important immunologic factors that are passed from mama to baby so that babies are protected from many dangerous diseases while they are growing and being immunized.
  • Breastmilk is always ready; perfect amount, at perfect temperature. No need for bottles, or additional time to mix or prepare
  • Breastfeeding is economical. No additional costs to the family
  • Breastfeeding provides additional “skin to skin” time for mama and baby and numerous studies have shown that skin to skin, cuddling and closeness improves growth and development in infants
  • Breastfeeding has been shown to help some mothers lose the pregnancy weight
  • Breastfeeding is linked to reduced rates of breast cancer in mothers.

With all of these benefits and more, one would think that Breastfeeding would be a “no brainer” (pun intended!!). However, Breastfeeding is still somewhat controversial here in the United States, despite all the scientific evidence for its benefit, the “Breast is Best” campaigns and the recommendations from the American Academy of Family Physicians and the American Academy of Pediatricians. According to the US Centers for Disease Control and Prevention, only 79% of American mamas initiate breastfeeding at birth, and at 6 months that number drops to somewhere around 27%. At 12 months, a mere 12% of mamas are still breastfeeding their babies. Barriers to breastfeeding include:

  • Difficulty latching on
  • Lack of support from parnter/familly
  • Painful/sore nipples
  • Insufficient milk supply
  • Mother returns to work/limited ability to pump.

Many of these barriers are being addressed. “Baby Friendly Hospitals”(1) are allowing more time for mamas and babies to bond right after birth and during the hospital stay. Mothers are encouraged to breastfeed and lactation consultants are available to assist with any logistical difficulties. Lactation consultants are also available to answer questions partners or family members may have, and to educate the family on the benefits of breastfeeding and their important role in supporting mama.

Public breastfeeding is not widely accepted in the United States and many states, cities and local areas have laws/restrictions about how and where mothers may feed their infants. Breastfeeding advocates are working to have many of these laws and rules overturned, but face an uphill battle in some areas. Legislation has been passed in many states requiring employers to provide “pumping breaks” for breastfeeding mamas, as well as quiet, private and comfortable areas in which mamas can pump. These are all works in progress.

We cannot ignore the fact that up until the turn of the 20th century, everyone was breastfed. While the wealthy or nobility may have had “wet nurses” (other, often poor or servant lactating women breastfed their babies), all babies were breastfed until they were old enough to eat mashed table foods or cereals. It’s how we as a species survived. It has worked for centuries. Why is it suddenly “passe”?

I am sure that this article will continue to spark controversy. However, I hope that we don’t lose fact of the basic principle: babies were meant to be breastfed by their mothers. The physiology of a woman’s breast, and the milk that she makes is specifically designed to feed her infants regardless of the size of her breast tissue. Most infants can breastfeed unless they have a physical anomaly prohibiting them from doing so, and this is rare. Even in such cases, if mothers can pump, the infant can still reap the benefits in breastmilk. In mothers who have difficulties, with support, education and guidance, most all mamas who want to breast feed, can. The data is in and yes, Breast is best-for infants and quite possibly for the adults they will become!

 

 

References

1. Prof Cesar G Victora, PhD, Dr Bernardo Lessa Horta, PhDcorrespondenceemail, Christian Loret de Mola, PhD, Luciana Quevedo, PhD, Ricardo Tavares Pinheiro, PhD, Denise P Gigante, PhD, Helen Gonçalves, PhD, Fernando C Barros, PhD. “Association between breastfeeding and intelligence, educational attainment, and income at 30 years of age: a prospective birth cohort study from Brazil” The Lancet Global Health. Volume 3, No. 4, e199–e205, April 2015 (Released online March 17, 2015).

2. The Baby-Friendly Hospital Initiative (BFHI) is a global program that was launched by the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) in 1991 to encourage and recognize hospitals and birthing centers that offer an optimal level of care for infant feeding and mother/baby bonding. It recognizes and awards birthing facilities who successfully implement the Ten Steps to Successful Breastfeeding (i) and the International Code of Marketing of Breast-milk Substitutes (ii).