Feet swelling that doesn't go away?

[MrsAngelic]

I think I used to know this but does it mean anything sinister if my leg, feet, and ankle swelling doesn't go away overnight? I had cankles last night, went to bed, and still woke up with them this morning. There may be slight improvement, but usually I'm normal size when I wake up. No face or hand swelling as far as I can tell. I'm drinking at least 9 glasses of water a day.

Do you think humidity could have anything to do with it? We're in North Carolina now, and with my first I had a lot of swelling in Miami, Florida. The others were born in New Mexico where it was dry and high altitude.

[chase_mommy]

I’m not sure if the humidity has anything to do with it but I just wanted to say that with my last pregnancy I stayed swollen the whole last month of pregnancy. It didn’t matter how much rest, elevation or water I drank it stayed pretty much the same. I did however, had to watch my salt intake because I would swell up a lot more than what my "normal swelling" was. I hope that made some since. Excessive walking or car riding would also make it worse but I defiantly was sporting cankles for awhile. Just keep drinking water and watch your other extremities for swelling. I would think as long as it stays in legs and PB is ok there isn’t much to worry about, at least that was my experience.

[HappyTomato]

It can be a sign of PIH/Pre-e but not always. Have you checked your BP lately? Do you dip your urine for protein? Have you had an unusual jump in weight? I've had pre-e twice now so these are the things my OB would be checking if I reported swelling that didn't go down. HTH

[Astraia]

Swimming and massage can also keep things circulating to prevent fluid build up in your legs.

If I'm standing/walking for too long my feet start to swell. You can't really see the difference but I can feel it, so it's very mild. I try to swim once a week and have started taking baths instead of showers to help minimize the swelling as well.

[Sojourner]

I believe that swollen feet are considered normal but swollen hands and face are not. I read that in Aviva Jill Romm's "The Natural Pregnancy Book". With my first I was swollen everywhere. With my second I was eating a little bit better and I was taking 100 to 150 mg of vitamin B6 everyday and had no swelling anywhere. The multivitamin I was taking was Optivite. Professional Prenatal by Lifetime has a good amount of B6 in it as well.

[UCmamaToMany]

This s a great site to go through http://www.drbrewerpregnancydiet.com/id35.html

If you can take a bath or preferably get to a swimming pool where you can get sumberged up to your neck, you'll have the best luck in getting rid of the water retention.

Decreasing your salt intake can do more damage than if you increased your salt intake and increased your water intake. You need the salt to help get rid of the water.

Dr. Brewer's site will really help you though.

[djsnjones]

Yes. One practice which helps moms to hold in their circulation all of that water that they are drinking (rather than just pee-ing it all out), is making sure that they salt their food. Doing that will increase the osmotic pressure in the circulation, which holds fluid in the blood vessels. When you see the fluid leaking out into the ankles, fingers and face, that is a sign that there is not enough osmotic pressure in the bloodstream to hold the fluid in the circulation.

Eating protein also increases the osmotic pressure in the circulatory system. And eating calories (wholesome, unrefined, complex carbs) helps to preserve the precious proteins that you eat. If you don't get enough calories, you will end up burning some of your precious proteins for energy for all of the various kinds of work that your body is doing.

The website linked to in the last post will tell you more about how that works.

Best wishes,
Joy

[MsBlack]

The brewer diet is not for everyone--the ideas are sound, but the amt of protein suggested is too high for some mamas. If you can do a urine test for protein (making sure you are well-hydrated before peeing, and that you clean off your yoni first, to get a 'clean catch'), that may help you decide. A trace of protein in the urine is normal for most pregnant women. +1 or more protein in the urine can mean that you are not eating enough protein and may benefit by increasing your protein intake.

Protein in the urine can indicate protein deficiency that is leading to poor performance by your kidneys (and poor state of the liver as well, but that is tested via blood tests not urine). This is unlike glucose in urine, which indicates *too much* sugar in your system that your kidneys are helping you to get rid of. Your kidneys are not supposed to 'help you get rid of' protein. The appearance of protein in the urine indicates that the kidneys are not properly doing their nutrient-recycling job--which is one of many tasks the kidneys are responsible for, along with production of the hormones renin and angiotensin that help you modulate blood pressure appropriately.

Some swelling of lower extremities is normal for many pregnant women. Even the hands, depending on various circumstances of your life. Swelling should reduce noticeably, if not completely disappear, after sleep, and the fact that it doesn't do so is a cautionary sign for me. Yes, heat and humidity can make a difference in the amount of reduction of swelling overnight--but you should still see *some* difference. Drinking more fluids, and salting to taste are important in maintaining proper osmosis and other circulatory/blood factors that help your fluids stay in your bloodstream rather than leaking out.

Exercise is also important--at least some gentle exercise, 3-5times a week for at least 20-30 minutes--to maintain healthy circulation/oxygenation and keep all of your systems running well. Swimming is especially good for swelling as the hydrostatic pressure is added to the muscular activity in helping force fluids up from the feet/ankles and back into circulation. Again, doesn't have to be too vigorous for your fitness level right now--but continuous for a time.

If you really are working up to pre-eclampsia, then it is important to learn more, and watch all of your signs more carefully for a time while you figure it out. Your blood pressure may rise or may not, not all women w/pre-e experience a significant b/p elevation, or at least not until very late in the game, and suddenly (a rise of diastolic--the lower number--of 15 or more points from your usual). Yes, some women experience pre-eclampsia as a result of inadequate protein intake. If you do test and find protein in your urine, then increasing your protein should show a noticeable change in your urine test within a week or so. However, research on pre-e suggests that there are many possible root causes for it--most of them dietary: deficiencies of calcium, omega3 fatty acids, the 'anti-oxidant' vitamins. It is also true for some women that excessive life stress can lead to sufficient physiological strain to bring on pre-e--once your b/p rises as a result of stress, for instance, you may no longer be adequately circulating oxygen/nutrients to yourself or baby, leading to other system breakdown and the group of symptoms we call 'pre-eclamspsia'. It is just as problematic either way, though! While you're considering diet and exercise, don't forget to include a review of life-stressors and whether or not you are managing stress well enough.

So, seems like a good time to learn more, do a diet review, take on more exercise if you don't already--take a pro-active approach to wholeness/welness for yourself and baby.

[djsnjones]

Some amount of exercise is safe in pregnancy, and some level of exercise is not safe. See this news report about a study which came out of Denmark in the fall of 2008, regarding what levels of exercise are safe in pregnancy.

http://www.nhs.uk/news/2008/12Decemb...dexercise.aspx

I suspect that this study simply underlines what the Brewer Principles are saying--that any time a pregnant woman adds a certain level of activity to her life (either recreationally or "activities of daily living"), she needs to add calories and/or salt to her diet to compensate for the extra calories burned and/or extra salt lost through sweat.

I also recommend this article by Anne Frye, one of our leading experts on the Brewer Principles. According to her, one of the earliest symptoms of the pre-eclampsia syndrome is a rising hgb/hct. As the blood volume falls, the blood becomes more "concentrated", and the hgb/hct appears to rise. So one of my recommendations for women who have had PE before, or who fear that they may be developing PE, is that they should request that their birth attendant (midwife or doctor) check their hgb/hct at every prenatal visit. By doing this, they can hopefully catch a falling blood volume early and engage some nutritional therapies which can correct that issue before it triggers the cascade of effects which culminate in PIH, PE, HELLP, IUGR, placental abruption, and/or premature labor.

http://www.naturalchildbirth.org/mam...id=44&Itemid=3

Joy

[MsBlack]

To clarify a couple of djsnjones' points:

The amount of water in the blood normally *increases* during pregnancy, slowly increasing until stabilizing at around 28wks. This is 'blood fluid expansion' and is necessary in pregnancy for a variety of reasons. During the time of fluid expansion within the circulation, hemaglobin and hematocrit usually fall at least a bit--which is normal, because your blood becomes more diluted with water. Hgb and Hct are not really lower than they were (if you're not anemic), they are the same, and still healthy for you/baby--the lower numbers only reflect a greater proportion of water in your blood compared to the amount of red blood cells and their oxygen-carrying factors.

But that water should stay inside your veins, inside your blood! When you are not healthy enough in pregnancy, those needed fluids leach out of your veins and into the tissues, into the spaces between cells of your body. THis is what we see as swelling, 'edema'. Thus, your blood fluid level reduces, your blood is not holding enough water and so, it will seem that your hgb and hct are rising IF you are swelling due to pre-e. I agree that this is another sign to watch for--though what I suggested is probably easier to begin with, since you can buy urine test sticks easily and test at home, but most people would have to see a Dr or Mw to get the blood test necessary for looking at hgb/hct.

All that said, most often swelling of extremities occurs because as pregnancy progresses, the weight of baby/uterus tends to slightly constrict veins that work to return blood from the feet, slowing down your circulation just enough to allow some fluids to leak out of your vessels, into tissues. This is why lying down/sleeping should help--with gravity out of the equation, your body should be able to recapture those fluids and fairly easily return them to bloodstream. Excercise helps by creating a stronger muscular pump to aid in more more efficient circulation to reduce occurrence of swelling as well as decrease swelling already present.

And yes it is true that overexercising can be counterproductive....but in my experience, only women athletes are prone to doing this in pregnancy The rest of us need rather more encouragement to exercise at all. Use of one's common sense is probably the best guide here.

And as for salt: salting *to taste* is very important. There is no one right amount of salt, you don't need to oversalt your food--you can trust that your taste for salt will lead you aright in this.

[djsnjones]

Thanks for the clarification for those who may be less familiar with what we are referring to! Unfortunately, the Blue Ribbon Baby website is currently offline, but if people want more details they can find other Brewer websites by googling for "The Dr. Brewer Pregnancy Diet". So thank you. The more clarification, the better.

I agree that some level of exercise is beneficial in pregnancy. I was surprised, however, about how little exercise was seen to cause problems in this study.

"The adjusted figures suggest there was a 65% increase in risk for women who engaged in any intensity of physical activity for 270 to 419 minutes a week, and a 78% increase for those doing more than 420 minutes, compared to those who did no exercise."

The 270-minutes-a-week level works out to only 30-40 minutes of exercise a day.

These other two reports may help to clarify more about what this study was suggesting.

http://www.dailymail.co.uk/health/ar...hers-warn.html

http://www.telegraph.co.uk/health/he...condition.html

This is just the abstract of the study itself...

http://www3.interscience.wiley.com/j...42092/abstract

Having said all of that, it still seems to me that women can offset the potential risks of their exercise if they just make sure that they are careful to compensate for the calorie loss and salt loss by adding extra calories and salt in their diet.

On the salt issue, I basically agree--salting "to taste" is the safest, most accurate way to replace salt according to the body's needs. At the same time, however, in this culture we have been so salt-conscious for so long that it seems to me that many people are so accustomed to suppressing their instincts regarding what their taste-buds are trying to tell them, that sometimes pregnant moms need to salt beyond what they think that their taste buds are telling them, to just get the minimum of what they need. According to the Brewers, if a mother has healthy kidneys getting some extra salt is less problematic than the potential of not getting enough, because healthy kidneys will simply excrete whatever amount of salt is not needed. There was also a study done in which mothers were not only given salt shakers with each meal and encouraged to salt their food, they were also given salt tablets after each meal. None of the mothers had any bad effects from this experiment. This was obviously an unethical study to conduct, because it could not be known ahead of time that such an experiment would have the results that it did, but at least we can benefit from the fact that it was done and showed that a healthy pregnant mom will not suffer any ill effects from getting more salt than she needs.

Joy

[Batia]

I experienced the same thing my last pg. I checked my bp often and it remained within good range. As long as my bp was good I wasn't overly worried about it.
Calcium and magnesium also control bp during pg. I am taking a calcium/magnesium supplement plus potassium and prenatals.

[UCmamaToMany]

Thank you all!