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5 Ways to Prevent & Manage Gestational Diabetes Mellitus

11/12/2021

 
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Written by: Dr. Samantha Zahavi

​Yoga Mamas Naturopathic Doctor

​Gestational diabetes (GDM) is the development of diabetes (blood sugar dysregulation) during pregnancy. It is usually diagnosed by a blood glucose challenge test between 24-28 weeks of gestation. It is important to prevent GDM because it can cause complications for mama and baby like pre-eclampsia and predisposition to diabetes after birth. The good news is, there is a lot that can be done to prevent and manage GDM to reduce the severity and risks for mama and baby!

GDM is a complex disease with several contributing factors, including a disruption in glucose and lipid metabolism, inflammation and changes in the gut health. Yoga Mamas Naturopathic Doctor, Samantha Zahavi lists 5 tips to help prevent and manage gestational diabetes.

1) Walk for at least 10 mins, 30 mins after every meal

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​Moderate-intensity walking after meals can reduce post-meal blood sugar spikes and improve overall blood glucose control in women with GDM. Some studies show that walking 30 minutes after meals may be the optimal time frame in order to optimally modify the glycemic (blood sugar) response. Timing your walks in this way may have a greater positive influence on GDM than simply walking for 30 minutes per day at a non-specific time.

2) Eat complex carbohydrates high in fiber

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Prenatal mamas should aim for 25-30g of fibre/day in pregnancy. Unlike simpler carbohydrates (ie white bread), healthier complex carbohydrate options provide the body with essential fibre which is digested more slowly in the gastrointestinal tract and doesn’t get directly converted into sugar. These two factors explain why complex carbohydrates produce less significant post-meal blood sugar spikes and may lead to reductions in insulin resistance (an important factor in the development of GDM). Fibre also lowers the risk of obesity, heart disease and inflammatory illnesses.

The fibre content of food items can be found listed under the carbohydrate section in the nutritional breakdown. Higher fibre contents reduce the total amount of carbohydrate that gets converted directly into sugar. For example, a food item with 20g of total carbohydrates and 2g of fibre is a poorer option for blood sugar control than a food item with 20g of total carbohydrates with 15g being from fibre.

Downloading a Glycemic Index (GI) food guide may help you choose healthier carbohydrate options. You may download A Glycemic Index Food Guide, here: https://guidelines.diabetes.ca/docs/patient-resources/glycemic-index-food-guide.pdf

​3) Eat smaller and more frequent meals throughout the day, spreading daily total carbohydrate intake over 5-7 small meals

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The Endocrine Society recommends limiting total carbohydrate intake to 35-45% of total calories/day for women with GDM. (Caloric needs differ amongst individuals but in general, it is recommended that pregnant women consume about 1,800 calories/day in first trimester, 2,200 in second trimester and around 2,400 calories/day in third trimester. Proper nutrition, however, should be based on consuming well-balanced meals and eating whole foods as much as possible, rather than focussing on counting calories.)

The amount of carbohydrates eaten at one time can proportionately raise blood sugar higher. Therefore, the American College of Obstetrics and Gynecologists recommends spacing your meals and carbohydrates out throughout the day, consuming three smaller meals and 2-4 snacks per day. Eating regularly and consuming smaller meals may help to decrease blood sugar spikes and improve glucose control in women with and without GDM.

Eating smaller and more regular meals may also help to reduce nausea, dizziness, shakiness and other unpleasant pregnancy symptoms.

4) Pair carbohydrates with protein or healthy fats but limit saturated fats

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Protein requirements naturally increase in pregnancy. Eating adequate amounts of protein in pregnancy can also help to offset nausea and vomiting of pregnancy, too! Since protein and fats take much longer to digest than carbohydrates they can keep you full longer throughout the day and offset spikes in blood sugar. This is why I always recommend that snacks consisting of carbohydrates be paired with a protein or healthy fat. For example, an apple with a handful of nuts and seeds or a whole grain piece of toast with avocado. 

When consuming fats, saturated fats should be avoided, especially for women with GDM. A high intake of saturated fats can interfere with insulin signalling and can increase inflammation and endothelial dysfunction which are both contributing factors in GDM. On the flip side, healthy fats, such as those derived from fish, seafood, some nuts and seeds can have anti-inflammatory properties and are associated with a reduced risk of GDM.

5) Eat a snack before bed

​Eating a snack before bed can help stabilize your blood sugar overnight, which can actually also reduce night time wakings. One reason for night wakings in pregnant and non-pregnant people is due to dips in blood sugar. 

Some examples of healthy night time snacks include greek yogurt, a handful of pumpkin seeds, a fruit paired with a healthy fat or protein such as cheese or almond butter or high fibre seed-based crackers with hummus.

In addition, blood sugar levels tend to naturally be higher in the mornings. So, it may be a good idea to eat lower carbohydrate meals in the morning and more carbohydrate-rich meals or snacks in the afternoon or evening (as long as you don’t forget your post-meal walk!) When having a small breakfast upon waking, you may want to consume your second small meal of the day about two hours later.
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Need more healthy lifestyle advice? Book a consultation with Yoga Mamas Naturopathic Doctor, Samantha Zahavi. Dr. Samantha Zahavi is a board-certified Naturopathic Doctor practicing in Toronto. She is passionate about combining medical knowledge with evidence based and well-researched Naturopathic treatments. As a Mom of two, she has combined her journey through pre-conception, pregnancy, postpartum and newborn care with her Naturopathic expertise to create unique and effective treatment protocols for women and children. ​

Although Samantha maintains a broad scope of practice, she has developed several areas of expertise:
  • Women’s Health (PCOS, Endometriosis, PMS, PMDD, Short-Luteal Phase, Hormonal Imbalances, acne) 
  • Fertility, pre-conception support, labour, postpartum and newborn care 
  • Autoimmune disease prevention and management
  • Gut Health (Crohn’s, Colitis, IBS, SIBO, H. Pylori, Indigestion and more)


REFERENCES:
https://pubmed.ncbi.nlm.nih.gov/29272606/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6267507/
https://link.springer.com/article/10.1007/s00125-016-4085-2
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7071246/
https://yalehealth.yale.edu/gestational-diabetes-treatment-plan
https://www.karger.com/Article/Fulltext/486810#:~:text=Multiple%20studies%20have%20reported%20that,levels%20%5B14%2C%2015%5D
https://nutritionandmetabolism.biomedcentral.com/articles/10.1186/s12986-020-00509-0
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6823013/
https://pubmed.ncbi.nlm.nih.gov/28927313/#:~:text=Conclusions%3A%20Compared%20with%20control%20intervention,gestational%20age%20and%20gestational%20weight
https://www.nature.com/articles/s41598-020-74773-8
https://www.cdc.gov/diabetes/basics/gestational.html#:~:text=However%2C%20about%2050%25%20of%20women,your%20levels%20are%20on%20target

5 Tips for Painless Breastfeeding

11/4/2021

 
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Paola Vallarino, IBCLC

Yoga Mamas Lactation Consultant

Have you ever heard that breastfeeding hurts and that pain during nursing is normal? Well, painful breastfeeding is common mamas but it doesn't have to be. It is common because we often don’t have lactation support, we think it will come instinctively and natural but it doesn’t, and then we think it wasn’t meant for us. But breastfeeding is actually painless, we only need to learn how to do it.

​Here are some tips that I’ve used in my practice as a Yoga Mamas Lactation Consultant, for you to have a happy and painless breastfeeding journey!

​​1. Try the baby-led latch

Sometimes we want everything to be perfect and we try too hard. Baby-led latching is many times the solution for a painful latch. Letting our babies take the lead and follow their instincts to latch-on is often the easiest way to achieve a good latch, especially the first hour after birth. 

Lean back and place the baby skin to skin on top of you, tummy to tummy. Allow your baby to find your breast and latch. When your baby’s chin feels your breast, the mouth will open wide and latch. If you feel any discomfort, try again. 

2. Try the sandwich hold

Gently hold your breast in a C shape as if it were a “sandwich”. Keep your hand 1-2 inches apart from the nipple so that you give your baby room to latch. This will help your baby achieve a deeper latch.
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​​3. Fix a poor latch

If you’re experiencing pain when breastfeeding, the most common cause is a poor latch. Try fixing it by holding your baby tummy to tummy and skin to skin on top of you. Your baby’s nose should be aligned with your nipple and you should wait for a wide open mouth to bring your baby to your breast (not your breast to your baby). Try different positions and if nothing works, seek help. A poor latch is not always the cause for pain when breastfeeding. You may need to get your baby’s mouth assessed by a Lactation Consultant, Chiropractor or Paediatric Dentist to see if there’s a tongue-tie or anything else causing breastfeeding difficulties.

​4. Do some hand expression if you’re engorged

Engorgement is common in the first few days. Sometimes a latch can be shallow if your breasts are too engorged for your tiny newborn's mouth to latch on. You may use a breast pump prior to feedings to get the milk flowing and shape the nipple, then feed the baby. You can also do some hand expression as well, without the need of a breast pump. You only need to express enough milk for your breasts to be softer, avoid emptying your breasts since this could lead to oversupply in these first weeks. 
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5. Speak to a Lactation Consultant

​Still need help? Call an LC!
If you feel something’s not going well, if your baby refuses to latch-on or is not gaining weight, if you have sore nipples or are engorged, look for a Lactation Consultant (LC). They can watch a feeding and do a physical assessment of your breasts and baby’s mouth to identify the problem and help you fix it, you don’t have to go through this alone! 
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​Paola Vallarino, IBCLC
Paola is a Lactation Consultant with over 10 years of medical background and over 1,000 hours of clinical experience helping families to have a happy breastfeeding journey. 

​She is an International Medical Graduate, a Certified Breastfeeding Specialist and an  International Board Certified Lactation Consultant (IBCLC), the gold standard certification for health professionals working with breastfeeding families. She found a love for Lactation Medicine when becoming a mother. 

Paola also specializes in Child Nutrition and provides families with advice on how to feed their babies when starting solids or supplementing. For Paola, every family is special, and giving them the care they deserve by working on their unique feeding goals without any judgment is her number one priority. ​

​Paola is available in-clinic and virtually.

Meet Danielle Dutra, Yoga Mamas Registered Acupuncturist

11/1/2021

 
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Danielle Dutra is a Registered Traditional Chinese Medicine Practitioner (R.TCMP) and Registered Acupuncturist (R.Ac) with the College of Traditional Chinese Medicine Practitioners and Acupuncturists of Ontario (CTCMPAO). She believes that the best way to maintain good health is by taking care of the mind, body and spirit. When creating a treatment plan for her clients she takes a holistic approach.

Danielle offers three services to mamas, Monday through Thursday and Saturday:
  • Acupuncture
  • Cesarean Scar Release Therapy
  • Chinese Herbal Medicine

All of the services offered by Danielle may be eligible for coverage under your health benefits plan.

Acupuncture

Acupuncture treatments help mamas with:
  • Creating the optimal environment for conception
  • Alleviating prenatal symptoms like morning sickness, fatigue, aches and pains, and emotional imbalance
  • Preparing the pelvic floor for labour and softening the cervix (for prenatal mamas 36 weeks +)
  • Treating mastitis, insufficient lactation and postpartum pain
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Cesarean Scar Release Therapy

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Cesarean Scar Release Therapy is an incredibly healing treatment that:
  1. Speeds up the healing process of the scar
  2. Decreases pain in the connective tissue
  3. Helps to relax and fade scar tissue
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Chinese Herbal Medicine

Many traditional medicines are off limits for prenatal mamas experiencing morning sickness, lack of energy and digestive issues. Chinese Herbal Medicine is a safe way to get some relief of common pregnancy ailments.

It is also helpful for regulating your menstrual cycle which is important for anyone trying to conceive and replenishing your body postpartum. 
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A Note About yoga Mamas' Cancellation Policies

Please note that we do not offer refunds. Each event/course/training/wellness appt has it's own specific cancellation policy which is listed on each registration page. Please take the time to read these in full prior to registering.  Each event/appointment that we run is in partnership with a practitioner who is focusing their independent career in pre and postnatal health. This is their beautiful livelihood. This is why we have these policies in place. Thank you very much for your understanding. Jamie Kalynuik, Founder of Yoga Mamas
hello@yogamamas.co |  416-406-0116  |  1402 Queen St E Suite D. Toronto M4L 1C9 
  • Wellness Services
    • Wellness Concierge
    • Acupuncture
    • Cosmetic Acupuncture
    • Cesarean Scar Release Therapy
    • Chinese Herbal Medicine
    • Chiropractic Care
    • Counselling
    • Online EFT Tapping
    • Fascial Stretch Therapy
    • Online Holistic Nutrition
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    • Introduction to Solids
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