fulham osteopaths

As an osteopath, using cranial and traditional osteopathy, I have now been working with post natal mothers for 20 years. Some of these mothers come to see because they are suffering from aches and pains, and others see me in a preventative health capacity, for a post natal check up.
The post natal period is a time where a woman’s body can be more vulnerable to injury and strain, partly because of the effects of pregnancy and birth on her body. The loss of good abdominal tone to support the spine, long periods of time spent sitting feeding a baby, repetitively picking a baby up, and putting him or her down in a cot, bathing baby, not to mention fatigue. All have their toll on a woman’s body.
Osteopathic treatment helps resolve any strains in the back and pelvis from the birth process but also it helps a woman’s posture return to a good pre-pregnancy posture. I see part of my role as an osteopath to help support and educate my mothers on a whole number of issues, but most importantly the issue of self-care during their early months of growing into their new motherhood role.
Much of my advice is quite simple, rooted in common sense. I would like to share some of my tips with you, and hope that they will help you feel as good as you can.
Fatigue, Awareness, Flexibility and Fitness are the three key areas that I would like to address.

Fatigue & Exhaustion

Someone that has not had a baby, not struggled with disturbed sleep, and with little help and support probably has no idea about the type of fatigue & exhaustion mothers of young babies frequently experience. Fatigue is a big issue, because it affects one’s mood, one’s coping strategies, and reduced the feeling of joy in one’s life. From my perspective, when someone is fatigued, they have an increased vulnerability to injury and strain. When fatigued most of us do not think things through carefully, it is easy make mistakes, do something silly, have accidents and hurt oneself.

Post Natal Recovery

The best advice that I received from my independent midwives when I had my first child was to try and stay in bed for the first week after giving birth, and for the second week to try and stay in the living room. My midwives said that in their experience, mothers who followed this advice made a more swift post natal recovery. Without this advice, I would have felt under pressure to be out and about and “ back to normal” within a few days of giving birth. This advice, made me stop and reflect on the demands of giving birth, and it gave me permission to start my motherhood journey more conscious of taking care of my well-being as well are taking care of my babies every need.

Realistic expectations

The way each of us lived our lives before we had our first child, what we expected of ourselves, is probably unrealistic for most mothers to aspire to once their first child has been born. It is a new life with a young baby, the old life has gone in many ways, and now a new chapter of life had begun it is time to find new ways of living. Realistic, realisable expectations are vital, otherwise everyday life can leave you feeling disappointed or angry that you did not achieve what you had hoped. Unrealistic expectations can result in you feeling like you are constantly in overdrive, constantly frazzled and frustrated. Reasonable, realisable expectations for the day are vital.

It is good to reflect on what is vital

Food for the mother, sleep for sanity, nappies for baby, feeding baby, changing baby. Does it really matter if your home is not perfectly tidy? Does it really matter if you do not answer all your calls and emails, etc? Who are the friends that support you and who are the friends that leave you feeling drained? Which social events do you really enjoy going to, and which do you choose to go to, just to be polite? What is vital for your well-being? Only you can know. It is good to stop, think and re-evaluate, especially when you are feeling fatigued.

Nap

With a young baby, it can be very easy to seize the time when they are asleep to catch up on everything. I ask my mothers to listen to themselves. If they are feeling that awful numbing tiredness, then their priority has to be sleep.
A nap when baby is sleeping has to be a good thing, given the amount of sleep deprivation most mothers of young babies experience. I tend to encourage my mothers to think of naps as building up their “ sleep bank account” so that it is always on “it’s overdraft limit”. Getting a nap when you need it hopefully making the next night and the next day more sustainable.

Pace

It has taken me a long time to understand the importance of pacing my domestic life. I naturally want to get everything done quickly, so that I can eventually sit down. But that “eventually sit down” experience never appears. Doing a task or two, and then a pause for a sit down or a cup of tea, a glass of water, a read of a magazine, a few moments breathing, all help those of us that tend to be running all the time have a more gentle and reasonable pace. I’ve found that this approach leaves me feeling OK rather than frazzled at the end of the day.
One small step, one small task, this is all part of learning about pace, and being able to move things forwards steadily. We all know the story of the race between the hare and tortoise, and how the tortoise passed the finishing line first!

How could life be made more simple?

Shop on the Internet wherever you can. Companies like Ocado deliver all the way to your kitchen, which is wonderful if you live in an upstairs flat. What can you delegate? What is no longer useful? I found that the benefit of having my children has been that life has had to become more simple. Personally I prefer a more simple life. The important things are there and they are nurtured and not neglected.
Awareness of how you use your body helps reduce vulnerability to injury and strain
There are many parts of mothers’ daily activities can put strain her body, but most importantly when done with care and awareness vulnerability to strain in injury is significantly reduced.
A mother naturally spends long periods of time sitting whilst she feeds her young baby. Sitting poorly put great strain through the low back and pelvis often contributing to back pain or injury. Good posture whilst sitting is vital. It is easy to spend long periods of time slouching not because one is careless about sitting, but because the back muscles quickly get fatigued when the back is not well supported. Without a good chair with good support it is almost impossible to sit well whilst feeding a baby.

How does one sit well to feed a Baby?

Finding a good comfortable chair to feed one’s baby in is the starting point. I have one of these feeding rocking chairs, which is lovely, but the seat is too deep for almost all mothers unless they are very tall and have long legs. If your chair is too deep, you will end up slouching. If this is the case use a cushion to shorten the front to back depth of the chair. You needs to be able to get your bottom right back into the very back of your chair, so the back of the chair can support your low back.
Don’t sit with your legs crossed, as this twists your low back, and puts strain through your pelvic joints and low back. Try and have both of your feet firmly on the ground as then indirectly your feet are helping maintain good posture in your lumbar spine as you sit.
In essence, when you have a chair and seating arrangement that is right for you, it is possible to sit upright, feel comfortable and avoid slouching without having to constantly remind yourself to “ sit upright”.
Holding your baby for long periods whilst feeding can put strain on your arms and shoulders. Would you be more comfortable if you put a cushion or pillow under your baby, so that the cushion is taking some of the weight of your baby than your arms doing all the work? This is very helpful for mothers that bottlefeed.
The cushion known as “ My Brestfriend” is an amazing breastfeeding cushion. I think that this is the best breastfeeding cushion on the market, as it supports a mothers low back, and it raises the height of her baby so that they are both in the perfect position for breastfeeding. This cushion is quite firm, it straps onto the mother around her waist, taking her baby’s weight, allowing her arms and upper back to relax. I recommend this cushion to my patients because I feel it really reduces strain and tension in the upper back shoulders and arms. The company My Brestfriend are just launching a special pillow to allow mothers with twins to breastfeed both twins at the same time. Interestingly this way of feeding helps increase a mother’s milk supply compared to feeding one twin and then the next one.
http://www.mybrestfriend.com/

Lifting and putting baby down in their cot

Bending is always a precarious activity, because it puts your low back under mechanical strain. The loss of good abdominal tone that comes along with recently having had a baby increases this strain. Regaining good abdominal tone is key to preventing low back stain and injuries.
However, the strain on your low back is greatly reduced if you remember to engage your tummy when you pick up and put your baby down. Your tummy muscles act as a corset supporting and stabilising your low back. Bending your knees slightly to lower yourself towards down towards your baby’s cot means that you have to bend less to pick your baby up, and therefore the strain of bending is reduced.
When your baby is crying, it is only natural to want to pick them up and comfort them immediately, but it only takes a split second to remember to engage your tummy muscles and bend your knees.

Bathing Baby

Bathing baby in an adult bath always puts a strain on low and mid-back, If you have problems with your back this way of bathing your baby is best avoided. If my patients have a pre-existing back complaint, I always recommend that they use a “ Tummy Tub,” a specially designed baby bathtub that fits nicely in a kitchen sink, making it possible to bath baby with a nice straight back.
http://www.tummytub.co.uk

Carrying Baby

Carrying babies around for extended periods of time is part what comes along with motherhood. Gradually your back and arm muscles get stronger, and it is less tiring. Trying to alternate which arm you carry your baby in is helpful as this helps reduce fatigue and strain of your back.
When babies are older, most of us tend to carry them around on our hip. This is not ideal for your posture, because when carrying your child in this way you need to “ stick that hip out to the side” which once again puts strain on your back. What is the solution? This is difficult because until your child is accomplished at walking there is not much you can do to avoid carrying in this way. You could try swapping which hip you carry your child on but usually one side seems more natural to carry your child on than the other.
There is a wonderful strap on “ hip seat” called “ Hippychick Hipseat “, which greatly reduces the effect of carrying a child on one’s hip. I would strongly recommend this to anyone with existing back problems or so someone how back is starting to get achy and fatigued.
http://www.hippychick.com/

Walking with your buggy

Be aware of your posture when you take your baby for a walk. It is very easy to have a slouchy posture if the handlebars of your buggy are too low, or if you are using a buggyboard. When the handlebars of your buggy are correctly adjusted you will naturally walk more upright. It’s well worth spending a few moments to check whether your buggy has adjustable handles, if they are too low one slouches, when they are the right height, it feels natural to stands tall and upright. Consider buying a buggy you can adjust to fit you.
Buggyboads are very practical, but it is very difficult to walk with good posture when using one. I suggest only using them when necessary. If your child can scoot a little and then use the buggyboard for a short time, and then scoot again, this is much better for your body.

Flexibility and Fitness

Being fit and strong before having one’s baby has to be the ideal, because one is then better placed to deal with all of the physical demands of caring for a young baby, but once that baby has arrived finding ways to maintain ones fitness and flexibility become increasingly important as your baby steadily become bigger and heavier.
Lifting you baby, carrying your baby, cuddling, feeding and winding, all put physical demands on your body. Your body is wonderful because it adapts and becomes stronger! However, it is easy for the body to become strong and stiff. Avoiding build up of stiffness in ones body has to be a priority if you wish feel great and avoid injury.
As an osteopath I see many mothers that have come to see me with shoulders, upper backs and necks that feel like they need almost constant massage, and a long soak in the bath. In almost every case, each of these mothers has developed very strong, but short, chest muscles, that slightly pull her shoulders forwards, resulting in a kind of tug of war between the muscles at the front of her chest and those of her upper back and neck. The resulting pain and tension is usually why she is lying on my treatment table.
To these mothers, I advise that they start doing just a few minutes of stretching whilst their baby is lying on their changing mat, or when they are lying under their baby gym. I have found that if stretching is going to become more than a good intention, it has to become a daily habit, which is why I tend to encourage attaching a stretching routine to daily activity, like after changing your babies first nappy of the day, or whist they are under their baby gym. Another good time to do some stretching or active relaxation is after you have brushed your teeth, before going to bed. Do you have a few moments to stretch and look after yourself? The answer has to be yes!
For me, when my babies were little, stretching after that first nappy change in the morning was the best time for me to do some stretches. If I left stretching until later in the day I would usually forget or feel too tired.
Developing a daily habit of doing a little stretching is a must if you want to feel good and maintain good mobility in your body. It is impossible to give an exercise program in this article, as each person has slightly different issues and requirement. But you know your own body; you know what feels good, trying to incorporate this into a small do-able daily routine will add to your feeling of well-being. You will be looking after yourself, you will be actively relaxing, and you will be limbering up your body. This has to be a good thing!

Some ideas for stretching

Whilst standing circle your arms backwards as if doing backstroke. This is good for loosening the front your shoulders.
Whilst standing put both of your hands on your head, allow your elbows out to go out to the side, and gently bend over to each side. This stretches your upper back and under your shoulder blades.
Try and remember some of the shoulder exercises that you learnt in your antenatal classes and start doing them again. Even better would be to go to an antenatal yoga class for fresh inspiration.
In the evening when your baby is in bed get out your yoga mat, lie down and breathe for 5 or 10 minutes, allowing your body to relax and sink into the floor. Try and remember some of the postures that you enjoyed doing at your antenatal yoga classes, and start to do one or two each evening.
Getting back to doing some regular exercise like swimming, and Pilates, helps a mother can regain her strength and fitness and flexibility. I believe this is key having the stamina to cope with young children.
I encourage all my mothers to try and go for at least one swim every week. Backstroke is fantastic, as it really releases tension at the front of the shoulders and help prevent reoccurrences of the problems that a mother has consulted me about. Even just 10 lengths are great. I remind my mothers that something is much better than nothing, so if you can only go for a short swim then that is wonderful because you will feel better, you posture will be better, you will feel that you have had some time to yourself.
Regular brisk walks are great free exercise. You might consider joining one of the exercise with your buggy in the park classes known as “Buggie Boogie“. You meet other mums, have fun and get back to shape.
Fat Free Mama offers Buggy Boogie on Wimbledon Common and also excellent, safe post natal pilates classes where you can take you baby along! http://www.fatfreemama.com
Post natal Pilates with a really good teacher is a must, as recovering good abdominal strength is keep to keeping your back healthy and strong in the long term, and from my osteopathic perspective this helps avoid unnecessary injuries.


Mindi Cotton is a consultant osteopath at Fulham Osteopaths, 769 Fulham Rd, SW6 5HA 020 7384 1851.