Category: Pregnancy & Parenting

From biking and hiking to walking and jogging, today’s parents are keeping fit and bonding with their babies in the process. With an array of products unheard of a generation ago— like baby carriers, joggers and trailers— even the tiniest among us are enjoying the great outdoors. But while these items can make life easier and more enjoyable for both parent and child, they can be the cause of pain and injury if not used properly. The American Chiropractic Association (ACA) urges you to exercise caution and good judgment while exercising with your baby.

Biking

When biking with a child on board, use a trailer, a rolling ride-along that hitches to the back end of a bike. It is a much safer option than a carrier, a “passenger” seat that sits directly on the bike, according to Dr. Scott Bautch, of ACA’s Council on Occupational Health. Dr. Bautch prefers trailers because of their added stability. He cautions that carriers can decrease a bike’s stability, possibly causing it to topple and injure both the parent and child.

To further ensure the child’s safety while biking, keep the following tips in mind:

The trailer must be equipped with a harness that can be placed over the child’s body. The harness should be complicated enough that the child cannot unhook it or wiggle out of it.

• A screen that covers the front of the trailer will add an extra line of protection against stray pebbles and other flying objects.
• Be sure to select a trailer that has large, bicycle-style tires, which will add stability and ease to your ride.
• Protect your child’s head with a sturdy, adjustable helmet that can be sized to fit properly. If the helmet rests too high, it will expose part of the child’s head, leaving it susceptible to injury.
• >Bike only on smooth surfaces for optimal control.
• Only an experienced rider should attempt to bike with a child on board at all. And even then, the rider should practice with a ride-along trailer for two weeks before riding with a real child— in an effort to get a feel for the strength and coordination necessary to maneuver the bike.

Jogging

If you wish to go for a jog and bring your child along for the ride, the baby jogger is your best option. A baby jogger is a rolling pushcart that a parent can jog behind, using handlebars to maneuver. Here are some rules of thumb to consider:

• Make sure the handlebars of the jogger are both large and adjustable, so that they fit comfortably into your hands for complete control. The handlebars should be kept as upright as possible.
• Handbrakes and a locking mechanism are a necessity.
• Look for a jogger with a good shoulder harness to keep the child secure.
• Large, bicycle-style tires offer more control and stability.
• A screen over the front of the jogger adds to its safety by deflecting stray flying objects.
• Jog only on smooth surfaces.

Walking or Hiking

Backpack-Style and Front-Side Baby Carriers

For parents who prefer walking or hiking with their little ones, a backpack-style or front-side baby carrier could be for you. Dr. Bautch cautions, however, that there are risks involved with carrying an infant on your back in a backpack-style carrier. “The cervical spine of a child less than one year old is not fully developed. It is important at that age that the head does not bob around. The backpack-type carrier is not ideal because the parent cannot watch to make sure the child’s head is stable. A front-side carrier is better for a very young child,” explains Dr. Bautch.

Dr. Bautch also urges you to think about the following:

• A backpack-style or front-side carrier decreases a parent’s stability when walking or hiking. It is critical that a parent gets into shape before attempting to use one of these products.
• Since these carriers will change the feel of walking or hiking quite a bit, they should not be used by beginning walkers or hikers.
• If using a backpack-style or front-side baby carrier, make sure to select one with wide straps for your shoulders and waist. This will help distribute the carrier’s weight evenly. The shoulder straps should fit comfortably over the center of your collarbone.
• The carrier should include a harness to keep the child stable.
• Once you place the child in the carrier, check to make sure there is no bunching of material against the child’s body, particularly on the back, buttocks and spine. Isolated, uneven pressure like this can produce pain.

Baby Slings

The “baby sling” is becoming more and more popular for its versatility of positions and comfort. But if you wish to use a baby sling, keep in mind that it is intended only for very young infants and follows these tips:

• A baby can become very hot inside the sling, so be mindful of the temperature around you. Also, make certain the baby’s breathing is clear and unobstructed by the sling’s material.
• Never run or jog while carrying a baby in any backpack-style carrier, front-side carrier or baby sling. A baby’s body is not adjusted to the cyclic pattern that is a part of running and jogging. This motion can do damage to the baby’s neck, spine and/or brain.

Take Care of Yourself

Finally, don’t forget about your own health and comfort. When lifting a child to place him or her into a trailer or jogger, exercise caution. Don’t bend from the waist, but begin in a 3-point squat and implement a two-stage lift that consists of a) pulling the child up to your chest and then b) lifting straight up with your leg muscles. Stay as close to the car seat or trailer as possible and place the child into it without reaching, stretching or twisting. The further the child is from your body, the more strain you will place on your spine and musculoskeletal system.

Thirty-five year-old Tracy had tried everything: monitoring her cycles through body temperature, over-the-counter fertility predictors and finally, fertility-enhancing drugs and in vitro fertilization. But after three years of trying, she still wasn’t pregnant. She began to think she was “too old” to have a family, though she was seemingly in great physical shape.

Tracy is not alone. Thousands of women go to fertility specialists each year. “After fertility treatments fail, many women are told ‘no’ [about having children] because of their age,” says D’arcy Brown, DC. But chiropractic may offer hope. At least one recent study showed that, after receiving chiropractic care, previously infertile women were much more likely to become pregnant (Journal of Vertebral Subluxation Research, 2003). And while reasons behind chiropractic’s success in treating infertility aren’t certain, there are a number of possibilities why it may work.

Dr. Brown, who practices in Aspen, Colorado, believes proper alignment works in several ways to increase the likelihood of becoming and staying pregnant. Chiefly, improper alignment of the cranial, spinal, and pelvic bones can hinder the nervous system, which controls a woman’s reproductive system, causing imbalances and hampering her ability to get and stay pregnant.

Distortions of the sphenoid bone in the skull- which can result from passage through the birth canal or from accidents later in life- are particularly problematic, says Brown, since misalignments there can affect the cranial nerve and pituitary gland. The pituitary gland is the regulator of a number of hormones important to fertility, including the follicle-stimulating hormone, estrogen, and progesterone. If any of these are out of balance, explains Brown, it can be very difficult to get pregnant.

Like Tracy, many of the patients Brown sees for infertility have tried everything. They come to chiropractic as a last resort. Brown first talks to them about their menstrual health history, noting signs of imbalance, which have often been problematic since the onset of menstruation, including heavy cramping, mood swings, and missing periods. “We balance the body [through chiropractic],” says Brown. Patients receive a combination of chiropractic and craniosacral adjustments, three times a week to start. After adjustments start to hold, patients visit once or twice a week.

How long should chiropractic take to work? Not long, says Brown. “We give it three months. Often women will become pregnant in the third or fourth month of treatment.” Brown has an impressive 75 percent success rate so far. Unless there have been serious compromises to reproductive health, he says, such as a history of extreme athletic activity or substance abuse, chiropractic may set the stage for a successful pregnancy for women like Tracy.

You’re pregnant! Congratulations! Your body’s changing-wondrously, marvelously. One unexpected and unwelcome change may be lower back pain. Recent studies suggest that two-thirds of pregnant women experience lower back pain.¹

These statistics seem reasonable. The weight of the growing baby, plus the weight of the placenta and amniotic fluid, create an unbalanced load in front of the lower back. The result is irritation of spinal ligaments, muscles, and tendons, causing pain, muscle spasm, and loss of mobility.

Of course, some cases of pregnancy-related back pain have specific medical causes. Uncommon conditions such as pregnancy-associated osteoporosis, septic arthritis, and inflammatory arthritis may need to be considered.²

That said, the vast majority of cases of back pain in pregnancy are mechanical in origin.

Your doctor of chiropractic will perform a complete examination and determine the correct course of treatment, if appropriate. Once you’re feeling better, you can begin

stretching and doing safe, gentle exercises that will help prevent recurrences of lower back pain. The goal is to strengthen your lower back and minimize the mechanical effects of pregnancy.

The best method of preventing back pain in the first place is being fit. This includes healthy nutrition, gaining a moderate amount of weight, and regular exercise. Your obstetrician will likely recommend vitamin and iron supplements and will monitor your weight. The average healthy woman gains between 25 and 35 pounds during the course of her pregnancy.³

Let’s fast forward a few years. Your newborn is now a toddler. Parents know that if you have kids, stuff happens. You bend over to place a bulky car seat in your car. Then you place your child in it. And then, you bend over to remove the car seat from your car. If you’ve gone to the mall, kids want Daddy or Mommy to carry them. Pick them up, cart them around, put them down again.

What’s a parent to do? It’s not like you can avoid any of these activities. Your kids are kids – it’s up to you to do stuff for them. The answer lies in regular exercise. “But how will I find time to exercise, when there already isn’t enough time to do the things I need to do?”

That’s a tough question, but if you recognize the benefits, you’ll make the effort to make the time. Forty-five minutes or an hour per workout, three or four times a week, will be plenty. And, once you’re in the habit of exercising, you’ll notice it’s easier to lift your kids, easier to bend over, easier to carry them. It’s easier because you’re

fitter and stronger. And healthier. And, surprisingly, you’re having more fun.

¹Pennick VE, Young G: Interventions for preventing and treating pelvic and back pain in pregnancy. Cochrane Database Syst Rev 18(2):CD001139, 2007.
²Sax TW, Rosenbaum RB: Neuromuscular disorders in pregnancy. Muscle Nerve 34(5):559-571, 2006.
³Jain NJ, et al: Maternal obesity: can pregnancy weight gain modify risk of selected adverse pregnancy outcomes? Am J Perinatol 24(5):291-298, 2007.

In a classic scene in the classic 1984 movie Starman, the extraterrestrial Jeff Bridges tells the human Karen Allen that, yes, he does know how to drive. Starman has just blasted through a traffic light changing to red, other vehicles crashing in his wake. Jenny Hayden, his protector, is screaming at him. “You said you know the rules,” she berates him. “I do know the rules,” he rejoins, calmly and purposefully. “I watched you very carefully. Red liight stop. Green light go. Yellow light go very fast.”

Everyone can recognize themselves in those 60 seconds of film footage. In fact, many people who originally saw Starman nearly 30 years ago can recite those lines verbatim. The scene resonates for us because it is deeply human, because we have said and done the things the lead characters are saying and doing. We are drivers ourselves. We have taught others how to drive. We have been back-seat drivers, although we try hard not to be. And occasionally, very occasionally, we press down hard on the accelerator when we see a light change from green to yellow.

Jenny Hayden finds herself unexpectedly caught in a “do as I say and not as I do” situation, again something with which most of us are all too familiar. Jenny very much wants to be a good teacher, in a very challenging set of circumstances, but as always actions speak much louder than words. At this point in the film Starman is only just beginning to develop an ear for the subtleties of human communication. The only things he can go on, the only things on which he can base his decisions, choices, and actions, are the objective actions of others. When confronted with a yellow light, he does what he’s seen others do. He “goes very fast”.

This story sounds so familiar because, in part, it reminds us of how we are with our children. Starman himself is very much like a child and even began his sojourn to Earth as a newborn infant. We want our kids to eat right, get regular exercise, and make good decisions. But often the examples we set for them show the exact opposite behaviors.

We skip breakfast, eat junk food, and rarely serve fresh fruits and vegetables. We may join a health club, but rarely use it after the initial flush of excitement in the first two weeks. Instead of spending time with our kids outdoors, walking, hiking, or biking, we spend three or four hours each night sitting on the sofa or recliner, mesmerized by the television screen, computer monitors, or phone text messages.

Like Starman, our kids learn by our example. They’re watching our every move, although they may pretend they’re doing other stuff. The health and well-being of our children depend on our backing up our instructions and verbal guidance with consistent action.^1,2,3 Regular exercise. Five servings of fresh fruits and vegetables every day. Eliminating excess calories. Getting plenty of rest. Encouraging a positive mental attitude.

If we want our kids to be healthy and well, it’s important that we do the things that will help them learn how to take healthy actions on their own behalf. They are following our lead.

¹Stabouli S, et al: The role of obesity, salt and exercise on blood pressure in children and adolescents. Expert Rev Cardiovasc Ther 9(6):753-761, 2011

²Sandercock GR, et al: Associations between habitual school-day breakfast consumption, body mass index, physical activity and cardiorespiratory fitness in English schoolchildren. Eur J Clin Nutr 64(10):1086-1092, 2010

³Fox MK, et al: Food consumption patterns of young preschoolers: are they starting off on the right path? J Am Diet Assoc 110(12 Suppl)S52-S59, 2010

The weight gain, the bloating, the nausea… Most new mothers will tell you that the aches and pains of pregnancy are a small price to pay for the beautiful bundle of joy they’re rewarded with nine months later.

But as many new mothers can attest, the muscle strains of pregnancy are very real and can be more than just a nuisance. The average weight gain of 25 to 35 pounds, combined with the increased stress placed on the body by the baby, can sometimes result in severe discomfort. In fact, studies have found that about half of all expectant mothers will develop low back pain at some point during their pregnancy. This is especially true during late pregnancy, when the baby’s head presses down on a woman’s back, legs and buttocks, putting pressure on her sciatic nerve. And for those who already suffer from low back pain, the problem can become even worse.

During pregnancy, a woman’s center of gravity almost immediately begins to shift forward to the front of her pelvis, according to Dr. Jerome McAndrews, spokesperson for the American Chiropractic Association (ACA). Although a woman’s sacrum— or posterior section of her pelvis— has more depth than a man’s to enable her to carry a baby, the displaced weight still increases the stress on her joints. “As the baby grows in size,” Dr. McAndrews explains, “the woman’s weight is projected even farther forward, and the curvature of her lower back is increased, placing extra stress on her spinal disks in that area. As a result, the spine in the upper back area must compensate— and the normal curvature of her upper spine increases as well.”

While these changes sound dramatic, Mother Nature does step in to help accommodate them. During pregnancy, hormones are released that help loosen the ligaments attached to the pelvic bones. But even these natural changes designed to accommodate the growing baby can result in postural imbalances, causing pregnant women to be more prone to awkward trips and falls.

What Can You Do?

The following tips are recommend for pregnant women looking for relief from the discomforts of pregnancy:

• Safe exercise during pregnancy can help strengthen your muscles and prevent discomfort. Try exercising at least three times a week— preceded and followed up by a gentle stretching routine. If you weren’t active before your pregnancy, however, now is not the time to start a new fitness routine. Check with your doctor before starting or continuing any exercise regimen during pregnancy.
  Walking, swimming and stationary cycling are relatively safe cardiovascular exercises for pregnant women, because they do not require jerking or bouncing movements. Even jogging, however, can be safe for women who were avid runners before becoming pregnant— if done carefully and under the supervision of a doctor.
  Whatever exercise routine you choose, be sure to do it in an area with secure footing to minimize the likelihood of falls. Also, be certain that your heart rate does not exceed 140 beats per minute during exercise, and that strenuous activity lasts no more than 15 minutes at a time.
  Stop your exercise routine immediately if you notice any unusual symptoms, such as vaginal bleeding, dizziness, nausea, weakness, blurred vision, increased swelling or heart palpitations.
• Wear flat, sensible shoes. Not only can high or chunky heels be uncomfortable, they can also exacerbate postural imbalances and cause you to be less steady on your feet than you already are. This is especially true as you get farther along in your pregnancy.
• When picking up older children— or any other object for that matter— bend from the knees, not the waist. And never turn your head when you lift. Just to be on the safe side, avoid picking up heavy objects altogether, if possible.
• When sleeping, lie on your side with a pillow between your knees to take pressure off your lower back. Many women find that full-length “body pillows” or “pregnancy wedges” are especially helpful during pregnancy. Lying on your left side is ideal. This position allows unobstructed blood flow, and helps your kidneys flush waste from your body.
• If you have a job that requires you to sit at a computer for long hours, be sure your workstation is ergonomically correct. Position the computer monitor so the top of the screen is at or below your eye level, and place your feet on a small footrest to take pressure off your legs and feet. Also, take periodic breaks every 30 minutes by taking a quick walk around the office.
• Eat small meals or snacks every four to five hours— rather than the usual three large meals— to help keep nausea or extreme hunger at bay. Good snacks include crackers or yogurt— bland foods that are high in carbohydrates and protein. Keep saltines in your desk drawer or purse to help stave off waves of “morning sickness” that can, unfortunately, occur at any time throughout the day.
• Folic acid supplements— at least 400 micrograms (mcg) a day— before and during pregnancy have been shown to decrease the risk of neural tube birth defects, such as spina bifida. Some doctors recommend even more for women who are already pregnant, or who previously gave birth to a child with a neural tube defect. However, check with your doctor before taking this or any other vitamin or herbal supplement. Some herbs and supplements that are considered perfectly safe for non-pregnant women can be dangerous or harmful to the baby or expectant mother.
• Get plenty of rest. Don’t let the demands of work and family life put you and your baby at risk. Pamper yourself, and ask for help if you need it. Take a nap if you’re tired, or lie down and elevate your feet for a few moments when you need a break.

Visit the Chiropractor

Visit your doctor of chiropractic. Before you become pregnant, your doctor of chiropractic can detect any pre-existing imbalances in the pelvis or elsewhere in your body that could make pregnancy discomfort even worse— or leave you with additional neuromusculoskeletal problems after childbirth.

Many pregnant women have found that chiropractic adjustments provide relief from the increased low back pain brought on by pregnancy. Also, scientific studies have found that spinal manipulation carries no increased risk to the pregnant woman or her baby. Chiropractic’s non-drug, non-surgical approach to back pain can be especially attractive to pregnant women who are trying to avoid over-the-counter and prescription drugs. Doctors of chiropractic can also offer nutrition, ergonomic and exercise advice that will help you avoid the discomforts of pregnancy.

Chiropractic care can also be helpful after childbirth. In the eight weeks following labor and delivery, the ligaments that loosened during pregnancy begin to tighten up again. Ideally, joint problems brought on during pregnancy from improper lifting or reaching should be treated before the ligaments return to their pre-pregnancy state. In addition, as the upper and lower spine return to normal, muscle tension, headaches, rib discomfort and shoulder problems can result. Your doctor of chiropractic can help.