[hannahmom]

Hi ladies,
I seldom wander from my fluffy little diaper world

: -- but I have a pg-related question

A mama with pre-e there got me thinking...

I had PIH with dd. I responded well to side-lying bedrest for 3 weeks (until my 40 wk due date) at which point my mw decided to induce. I never developed any other symptoms of pre-e - never spilled urine, had any abnormal swelling, headaches etc... Obviously in hindsight, and not 9 mos pg with my first babe, had I had it to do over, I would have insisted on continuing with bed rest until my body decided to go into labor. Especially after dealing with a difficult induction

I've heard that PIH is often a first-time mom thing and future pgs are most often PIH-free. What has been your experience?? I really want a homebirth next time around after having such a managed induction and difficult labor. Is PIH a complication that would not make me a homebirth candidate?

Thanks!

 

[kofduke]

Hey hannahmom - I was told absolutely NOT A PROBLEM by my OB. She said that primagravits (sp? - means first-time pregnancy) was a risk factor for PIH/Pre-E. She also said that if I was still with them, they'd help me find a nutritionist if I wanted to do so (there may be dietary implications). So, I wouldnt' think that you'd be barred from H/B!

 

[mama2annabelle]

Have you heard of the Brewer pregnancy diet? Dr. Brewer has had much success with his patients avoiding or reversing PIH and Pre-e through nutrition. You can learn more about it at www.blueribbonbaby.org .

 

[kimberlylibby]

You can get EXCELLENT information from http://www.preeclampsia.org

It is my favorite site for PIH info.

The Brewer diet is HIGHLY controversial, as women have gone into kidney failure following it.... due to overtaxing their already damaged (from previous PIH) kidneys with protein. It is something you really need to think about and read about before pursuing.

I ended up doing a modified Brewer diet maintaining the emphasis on fresh vegetables, but eliminating much of the animal fat/protein. I eat a vegetarian diet, but do aim for lots of good proteins and NO refined foods if possible.

Still, despite making my own breads (even milling my own flour from wheat berries) and keeping focused on a healthy diet, I did have recurring PE.

It is by no means a guarantee you will get it again, but you are *higher* risk of getting it again.

The further along you are in your first pg when you get pih, and the lower your risk of getting it again.... like if you had it severely at 26 weeks with your first, you're much more likely to get it again than someone who had it mildly at 41 1/2 weeks, KWIM?

Good luck! I actually planned to **not** have more children because of 5 losses and the eclampsia/hellp from my first pg, but 2 weeks after my husband's vasectomy, we found out we were pg with this wee one!

Kimberly

 

[kimberlylibby]

Just re-read your post... if you *ONLY* had the high bp and no swelling, headaches, or protein issues... I am guessing you are at no higher risk than any other mom.

Some doctors won't even classify pre e as pre e without more than one symptom...

for me, I had 170/110 bp, gained 25 lb in ONE WEEK (couldn't wear ANY shoes in ANY form, even men's size 10 wide sandals!!), spilled +4 protein, had lights flashing in my eyes, headaches so bad I would shake... etc....

Kikmberly

 

[kimberlylibby]

Oh, and sorry if I come across as a know-it-all-annoying-nagger.... PIH is a cause close to my heart.

 

[kofduke]

Kimberly, we are all praying that the wee one stays in and is healthy for a bit longer!

Anyway, I didn't know about the time of pregnancy thing...I was already 40 weeks when my b/p shot up and I started spilling proteins. Maybe that's why my doc was so unconcerned (not at the time. about future p/g).

 

[hannahmom]

Thanks girls... I got PIH at 37 weeks although I suspect that it started a week earlier (I had left work a couple times just feeling kind of dizzy and weird). My BP was around 149/100 so it wasn't too alarming.

I've heard that diet can play a role in PIH/PE - but I've never heard specifically of the Brewer diet. I know those last few weeks I was not as concious of my salt/fat/processed foods as I could have been. I wish I knew about the diet factor then - my induction really lead to a pretty traumatizing birth when I had been hoping (like we all do, I'm sure) for a positive, natural birth. If that is the case about taxing the liver - I will certainly modify as well.

Kimberly - not a nagging know it all - at all!!! I have so many ??'s! (And keeping my fingers crossed for you and your little one, mama)

Did this lead to any BF complications for you guys? I had a LOT of trouble getting started and I was told the elevated BP constricts all your vessles and delays your milk. I kind of think that is baloney though because my milk came in on day 4 or 5 and other mamas (who didn't have any complications) said that's when theirs came in too.

 

[kimberlylibby]

Yes!!! on the bf complications.

I didn't get dd to latch until she was 10 weeks old!!!!

My milk came in on day 2 1/2.... it was the middle of the night on day 2 and I pumped and got something ridiculous like 1 1/2 ounces (compared to a teaspoon at the pump before) and then throughout the next few days got up to 6 oz per pump (10x/day).

Kimberly

 

[hannahmom]

What do you plan to do this time to try and avoid bf complications?

I wondered if I was getting bogus info - dd did NOT latch for a long time either... I thought that due to a comedy (actually tragedy) of errors at the hospital that I just didn't get enough help and support. Now I'm wondering if it wasn't a combination of everything.

:

Next time around I want a lactation consultant by my side as soon as that babe pops out, I want a pump in my room and I want a nursing counselor to spend the night with me as soon as we get home (if I don't have a homebirth). I am so determined to get a good start -- I really grieved after I stopped bfing - even though I exclusively pumped for months.

 

[Defenestrator]

There may be a lot of other reasons why moms with pre-e have trouble breastfeeding that I am not aware of, but I have a good remedy for the troubles related to edema that I would like to share.

Your body has a natural letdown reflex in response to baby's cry and sucking, but when your tissues are swollen the swelling can physically block the letdown of the milk. When moms have pre-e, the huge amounts of water they are carrying can cause edema in the breast tissue as well. There is often additional edema from fluids given during hospital labors and c-sections.

There is a technique called reverse pressure softening, which helps to push water out of the nipple and areola area so that the breastmilk can letdown more easily. I read about it a while back but have not been able to locate the article. I will try and describe the technique. Basically, before you prepare to breastfeed, you take two or three fingers, place them on your areola directly above and below your nipple, and apply firm and constant pressure for one minute. If you want, you can rotate your fingers into a different position to provide pressure on more surface and then press for another minute. Immediately afterwards, attempt to latch on the baby. It sounds simple but it really makes a difference. The quicker letdown provides a more immediate result for the baby and encourages a longer, stronger latch.

I am sure I have not been entirely clear. If there are any questions, I would be happy to answer them.

It is interesting to me that a pp was able to get a good amount of milk with pumping but not get baby to latch. I wonder if the horns on the pump had a similar effect to this technique of applying pressure to the surrounding tissue so that milk could flow better.

Good luck!