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Fertility: it’s worth the weight….

Yes I know Miranda Kerr has had a baby and other supermodels have too, but something that I have noticed in my natural fertility practice is that it can be very difficult to help skinny women to conceive.

My definition of skinny is a Body Mass Index (BMI) below 19 or 20 aslow body fat can cause low levels of gonadotrophin releasing hormone which can prevent ovulation. This lack of ovulation can cause some underweight women to have no periods, or to miss periods or to have a luteal phase defect – all of which can affect their ability to conceive both naturally and during IVF.

Fortunately, less than 5% of Australians are underweight and some may not need to gain weight if they are in good health. However, if you are struggling to conceive then I recommend that you try to gain some weight to reach a BMI of 19 to 20.

Poor diet, malnutrition, excessive exercise, eating disorders, low appetite and food aversions can all contribute to low body weight and infertility. If you feel that being underweight could be affecting your ability to conceive, then here are some healthy weight-gain strategies that you might like to try:

Choose more energy-dense foods (yes, the types of foods that people usually avoid when they are on a weight-loss diet). Go for high calorie foods such as full fat milk, avocados, nuts. High fat foods have twice as the energy of protein and carbs and will give you more calories. Although high-fat, high-calorie food is not healthy for most people, they may be essential for someone needing to gain weight. Choose healthy fats such as mono-unsaturated and polyunsaturated rather than saturated fats.

Regular meals daily make meals a priority and take the time to have a meal. Aim for three healthy meals every day and try to eat more food within the first 20 minutes of a meal – such as eating the main meal first and leaving the salad and soup for later.

Large portions you can eat more at each meal by adding extra food to your plate or an extra piece of cheese on your sandwich, having milk from a bigger glass and eating cereal from a larger bowl. Expect to feel full after every meal.

Extra snacks eat more frequently to increase your calorie intake by including snacks in between your main meals – snacking on dried fruit, nuts and seeds is an easy way to add calories.

Juice and milk these drinks are an easy way to take in extra calories – drink more fruit juice and add more calories to your milk by adding in powdered products such as Sustagen.

Exercise to build muscles to gain weight, go for strength training activities and increase your calories to support that exercise. The combination of strength training and eating extra food will help you to gain both muscle and fat. An extra 500 to 1000 calories a day above your normal calorie needs will be enough to support you during exercise and to build extra muscle.

Bon appetite!

Boobs and Booze: Is it okay for breastfeeding mothers to drink alcohol?

Since 2004, I have been group leader of the local mothers group as part of my volunteer counsellor position with the Australian Breastfeeding Association (ABA). This requires me to facilitate a topic of interest related to feeding or parenting once a fortnight.
At tomorrow’s meeting, we will be talking about whether it is safe to drink alcohol when you are breastfeeding. The take-home message from this meeting will be that NOT DRINKING is the safest option but if we know the facts about how alcohol affects breastmilk, we can decide how to safely combine drinking and breastfeeding if we have a special occasion coming up or just want to enjoy a glass of wine with dinner.
Some of the facts that will be discussed are:
  • How alcohol gets into breastmilk via your bloodstream and the fact that alcohol will be present in your breastmilk about 30-60 minutes after you start drinking.
  • How much alcohol gets into your breastmilk depends on how much you weigh, how much you have eaten, how quickly you are drinking and the strength and amount of alcohol in your drink.
  • The reason why time is the only way to reduce the amount of alcohol in your breastmilk and the “pumping and dumping” myth.
  • What a standard drink looks like. As a general rule, it takes 2 hours for an average woman to get rid of the alcohol from 1 standard alcoholic drink (ie 4 hours for 2 drinks, 6 hours for 3 drinks and so on). This brochure issued by the ABA has a useful table which shows the approximate time taken for alcohol to be cleared from breastmilk. This table can help mothers to estimate how long it will take for their breastmilk to contain no alcohol.
  • The Australian guidelines recommendation for all women (except when pregnant) is no more than two standards drinks per day. It is generally recommended that breastfeeding mothers can have up to 2 standard drinks (but not every day) once their baby is a month old (which is around the time that breastfeeding is going well and there is some sort of pattern to a baby’s feeding).
  • When feeding an older baby, who tend to have a more regular feeding pattern, it can be easier to time a drink so that the next feed will contain little or no alcohol. However, sometimes babies don’t stick to their routine and may need extra feeds if they are unwell or “out of sorts”.
  • Drinking 3 or more standard drinks per day can be harmful to your health and your baby’s health. Motor development skills have been found to be significantly lower in infants regularly exposed to alcohol through breastmilk (Little, 1989).
  • Some ABA counsellors have reported instances of babies being drowsy and fussy after being breastfed by a mother who has had alcohol. Studies have shown that one standard drink changes the smell of breastmilk and has a mild sedative effective on the baby. A drowsy baby may not suck well which can lead to a reduction in milk supply. Any drug that causes drowsiness in the infant may be implicated in SIDS.
  • Mothers who have been drinking often report a delayed let-down reflex and a perceived reduction in milk supply. They also report having a lower tolerance to alcohol which could be attributed to low oestrogen levels during lactation which can be associated with higher alcohol levels.
  • Too much alcohol can impair the mother’s ability to properly care for her baby, cause the baby to be slower to reach developmental milestones and decrease the flow of milk which can reduce supply.
  • If you are planning a big night out and think you will have more than 2 standard drinks, you may wish to express and store some milk beforehand and arrange for someone who is not affected by alcohol to look after your baby. Do NOT sleep with your baby if you or your partner is affected by alcohol.
  • We will also discuss some strategies to reduce the amount of alcohol in breastmilk such as breastfeeding your baby BEFORE you drink (and you know it will be a couple of hours before you are likely to feed again), eating before and while having a drink, as well as alternating alcoholic and non-alcoholic drinks.
  • And, why it is better to give a breastfeed with a small amount of alcohol than to feed artificial baby milk (in short, the health risks of artificial baby milk outweigh the health risks of a breastfeed that contains a small amount of alcohol).
And what about the old wives’ tale that drinking a dark beer like stout will improve your milk supply? What actually happens is that the alcohol in the beer stops the milk from flowing freely, causing it to stay in the breasts, giving the false impression that you have more milk!

Fussy eaters

A common concern expressed by parents at my clinic is how can they get their fussy child to eat a healthy and varied diet.

From 6 to 12 months this can be easy as babies are willing to try new foods, flavours and textures especially if you allow your child to play with their food. Forget the special pureed food, forget feeding them with a spoon (only to have them turn their head), let your baby explore, feel and play with their food and they will taste it and grow to love that food.

A few years ago, one of my clients told me she was worried that her 10 month old daughter wasn’t interested in solids. She would refuse the food that her mother tried to feed her. After implementing some of the suggestions I made, this mum sent me a beautiful thank you card with this message:

“Dear Inez, Thank you so much for all your support. It seems my daughter likes the food that my husband and I eat more than something I prepare especially for her. She also loves fresh fruit more than stewed fruit. So I have decided to take it easy and am more relaxed about introducing solids than before. Thank you again for your kindness. My daughter and I have been helped so much by your advice.”

So what were my suggestions that helped this 10 month old to eat real food? All I suggested was that she let her daughter play with her food and to spend meal times together as a family sharing food. I gave her Gill Rapley’s BabyLed Weaning website which explains the concept including safety tips to prevent choking hazards. I also emphasised that eating together as a family encourages babies and children to try new foods. Babies tend to become fussy eaters if they have their meal on their own and away from the family table. They don’t get to see the variety of food that their parents are eating which would normally make them interested in trying those foods.

The concept of letting babies touch and explore food as a way to introduce solids is not new and is something that families have been doing for a long time (especially when there is more than one child in the family and a lack of time to prepare special baby meals). Babies who have their first taste of food this way tend to eat a healthy and varied diet. It’s not until the toddler years that they may start to reject new foods without tasting it. Don’t you love those assertive toddlers that want to do everything themselves and do things their way?

Remember that toddlers learn by copying you, their siblings and playmates. They may start to reject new foods but this should pass if they see other people around them eating a variety of foods. Research has shown that you may need to offer a new food up to 12 times before a toddler will accept it. Avoid making food a battle but if food rejection is becoming an issue offer them a choice between two or three food options to appeal to their growing independence. If your toddler likes to help around the house, ask them to help prepare their own food as a way to encourage healthy eating.

Toddlers may be reluctant to eat well if they are tired, unwell or anxious, distracted by toys or a new environment, had enough to eat beforehand or filled up on too much juice or milk, and if there is no mealtime routine or the mealtime experience is negative.

Holding on: is your child afraid to do a poo?

Some toddlers can go through a stage where they refuse to pass a bowel motion. Initially, it can be due to a fear of making a mess but it can get worse as constipation sets in and the bowel motion becomes painful to pass which causes the child to hold in their poo even more. The good news is that this toileting problem can be treated with homeopathy.

The first time I came across this problem was when my son was 3 years old and he would scream and become distraught whenever he felt he needed to pass a bowel motion. His bowels motions then became so hard and large which made the problem worse because going to the toilet was excruciating for him. Like most parents with this problem I tried increasing the fibre in his diet, laxatives and reward charts to no avail. The only thing that worked for him was homeopathic treatment. The first remedy prescribed for him acted like a laxative which would expel the poo even though he resisted it. It wasn’t until we tried him on a higher strength of the same remedy that the fear of passing a bowel motion resolved. He is now 12 years old and has never had a toileting problem since.

The reason why homeopathic treatment works for this issue is because it can calm the emotions and allow the toddler to pass a bowel motion without fear.

I recently treated a 4 year old girl who had developed a fear of passing a bowel motion for the past year. Her mother said the problem had progressively got worse and she is now holding on and refuses to pass a bowel motion to due intense fear. Over the past year they have tried suppositories, reward charts and increasing dietary fibre without success. She was even hospitalised after being constipated for a week and refusing to go to the toilet. As you can imagine, this problem was a great source of worry for her parents who had been trying everything to help their little girl for over a year.

Fortunately, within a month of homeopathic treatment she was able to go to the toilet with no problem and had become less fearful about things in general. Her father said he wished they had tried homeopathy in the first place.

So if your child has this problem, find a registered homeopath and give it a try. And don’t give up if the first remedy doesn’t help as it could take a couple of consultations to find a homeopathic remedy that will be effective for your child.

Recognise your fertile time

I highly recommend that all women read The Billings Method: using the body’s natural signal of fertility to avoid or achieve a pregnancy by Dr Evelyn Billings. By learning to recognise our fertile time, the Billings Method can be used to conceive a baby or avoid a pregnancy (with an effectiveness rate which is the same as the Pill but without harmful side effects).

The Billings Method has proved invaluable in the treatment of infertility when intercourse is timed to coincide with the appearance of fertile mucus. It is not uncommon for women to conceive using the Billings Method after IVF has failed. The Billing Method has an 80% or higher success rate for natural conception compared to the average IVF success rate of 47%.

It teaches women to recognise when they are fertile by being alert to when their body produces fertile mucus. All evidence supports the theory that no fertile mucus equals no pregnancy. Put simply, sperm cannot survive without it due to the acid environment of the vagina. The fertile mucus protects and nourishes the sperm, helping to retain their fertilising capacity for 3-5 days. It helps guide the sperm to the fallopian tubes and acts as a filter, removing damaged sperm cells.

On the other hand, if you want to avoid a pregnancy, recent trials of the Billings Method indicate a method effectiveness of better than 99% for contraception. This is because couples are advised to avoid intercourse when fertile mucus is present (or when there is bleeding as menstrual blood can obscure mucus should it be produced during a period which is possible during short cycles). This effectiveness rate compares well with other contraceptive methods: The Pill (99%); Mini Pill (96%); IUD (94-99%), Rhythm (53-86%). This just proves what scientific studies have shown us – that fertile mucus is essential for conception.

The Billings Method can be used during all phases of life – with regular cycles, irregular cycles, during breastfeeding or approaching menopause. To find out more read my article

The Pill and infertility

Can the Pill affect your fertility? Do a google search and most of the information and research will tell you no. For the majority of women regular menstruation will resume within a few weeks of stopping the Pill. However, the articles and research papers on the internet do not seem to consider the percentage of women who may be sensitive to the effects of the Pill.

There is clinical evidence to show that some women can experience amenorrhea (no periods) and that ovulation can be suppressed for up to two years or more after stopping the Pill. In some cases, the Pill can also change the cervix which affects the production of fertile mucus. Professor Erik Odeblad from the University of Umea in Sweden discovered that a post-Pill infertility was caused by a shrinkage of the crypts in the upper cervical canal that would normally produce fertile mucus. Without fertile mucus, the normal acid environment of the vagina is hostile to sperm and it cannot survive. In fact, there is a natural form of contraception called The Billings Method that is between 97-99% effective when intercourse occurs on the days when there is no fertile mucus. It is simple, no fertile mucus = no pregnancy.
One of the reasons that the homeopathic fertility program has a high success rate is because it can remove the effects of the Pill, stimulate ovulation and allow the body to start producing good quality fertile mucus again. The effects of the Pill and the quality of fertile mucus is a factor that is not addressed by fertility specialists so if IVF has not worked for you then you might like to consider the homeopathic fertility program.

Low Breastmilk Supply

A common reason for giving up breastfeeding is when mothers suspect that their milk supply is low. Sometimes mothers can mistakenly think that their supply is low as they lack confidence in their ability to provide breastmilk and can become worried when their babies seem unsettled. At other times we can confuse normal infant behaviour as a milk supply problem.

However, for some women, low milk supply can be a real problem. It is important to know that the more milk that is taken from your breasts the more milk you will make. Introducing other fluids including artificial baby milk (infant formula) will decrease your milk supply. With the right information and support a low supply can usually be increased. If you are worried about your milk supply, contact the Australian Breastfeeding Association’s 24 hour helpline on 1800 686 268 or make an appointment with a lactation consultant – you can find a list on the Lactation Consultants of Australia & New Zealand’s (LCANZ) website

Male Infertility

I have just discovered a really good website on all aspects of male fertility and men’s health at www.andrologyaustralia.org

It is estimated that about 1 in 8 couples in Australia will have troubles conceiving and are considered to be infertile. About one in five infertile couples the problem lies with the male partner and male infertility is the underlying reason for 40% of couples using assisted reproduction technologies such as IVF.

So what is male infertility? Quite simply it is when a man’s ejaculated semen does not contain sufficient numbers of normal, functional sperm to travel and fertilise the female egg.

When a man is diagnosed as being infertile, it can be devastating news but fortunately the majority will still have children. It is important for men to realise that the diagnosis is not related to their masculinity. There are so many things that affect sperm health such as smoking, alcohol, recreational drugs, sexually transmitted infections, tight-fitting underwear, spas and saunas, work environments, lubricants, excessive exercise, medications, injuries, illness, age, blockages, sperm antibodies, diet and nutritional deficiencies. Sometimes sexual problems such as erection or ejaculation issues can prevent couples from falling pregnant. Again this can affect a man’s self esteem but usually there is a physical or stress-related cause. Check out the Andrology Australia website for more information.

My approach to treating male infertility is with nutritional supplements and a homeopathic remedy. There are so many studies showing that nutritional supplements increase sperm count and health. A research trial of 45 infertile men showed that homeopathy significantly improved both the number and the quality of sperm. Homeopathy can also assist with any erection or ejaculation problems. Homeopathic remedies need to be individually prescribed by a registered homeopath. If you live outside the Brisbane area, you can find a registered homeopath on the Australian Homoeopathic Association’s website at www.homeopathyoz.org

Fertility & Medications

After years of trying to conceive, one of my fertility patients has just discovered that her husband’s medication is known to reduce male fertility. He had been taking Salazopyrin, a commonly used medication for inflammatory bowel disease, which has been shown to reduce male infertility as well as an increased risk of miscarriage and birth defects if the drug is taken in the three months before conception. The good news is that the effect on male fertility is usually reversed within 2-3 months of stopping the medication but still very frustrating for this couple who were unaware of the effects of this drug on his fertility.

This story really highlights the need to check the side effects of all medications if you are trying to conceive.

There are several prescription medications that can affect both male and female fertility, most of them temporarily but sometimes permanently. Arthritis medication, anti-depressants, high blood pressure medication, antibiotics and cancer medications can cause fertility problems. The reflux medication Tagamet is known to cause abnormal sperm production. Antihistamines can dry up fertile mucus and have a damaging effect on sperm while pain relief medications such as ibuprofen and asprin can affect the ability of the embryo to implant into the uterine lining.

It is important to consult your doctor before stopping or changing any of your medications. In many cases, homeopathic treatment can be effective with no side effects.

More information about the side effects of medications can be found by telephoning the Medicines Line in Australia on 1300 888 763.

Fever- friend or foe?

I am often contacted by parents with young children who are anxious about their child’s fever. We’ve all heard the horror stories of fevers causing convulsions and this often creates fear when our children develop a fever. Most parents will try to reduce the fever with a dose of panadol or nurofen. However, a fever is the body’s way of fighting infection and using medication routinely to reduce it can make it harder for the body to do its job. In fact, studies have shown that suppressing a fever through regular use of panadol/nurofen can prolong some viral illnesses. This makes sense because the fever is needed to fight the virus or bacteria.

I recently attended the emergency department at the Mater Children’s Hospital in Brisbane and the walls were covered in posters reassuring parents that fevers are not dangerous. One such poster states:

Fevers are not dangerous

A fever is simply the body’s way of fighting infection – whether it is caused by a virus or bacteria. They do not harm the body or brain in any way. The body has a temperature control centre which prevents the temperature from reaching a dangerous level. If your child seems happy and comfortable enough there is no need to treat the fever – in fact, studies have shown that suppressing a fever through regular use of panadol/nurofen can prolong some viral illnesses.

Poster @ Mater Children’s Hospital Emergency Department Oct 2009


This information is not intended to substitute advice or instructions from your doctor or health care professional. It is based on the clinical guideline Feverish illness in children which is available at www.nice.org.uk