The postpartum period can be particularly challenging after C-section, as a mother is caring for a newborn but also recovering from major abdominal surgery. This article discusses how naturopathic doctors promote healing and speed recovery after cesarean delivery.
Healing Through Food:
A good starting point is nutrition, as food is medicine. Mothers who have undergone a cesarean delivery are often monitored in hospital for 2 to 4 days before returning home. I often encourage new parents to ask family members and friends to be supportive by preparing healthy foods. These nutrient dense foods can be brought into hospital instead of relying on processed hospital food. The food recommendations listed below will supply you with nutrients required for healing from surgery, but will also benefit your newborn as nutrients consumed will be passed on to your newborn in breastmilk.
Your nutritionist or nurse in hospital will inform you when you can start eating clear fluids, progress to full liquids, and finally introduce all food groups into your diet. Clear fluids include chicken or vegetable broth and fruit juices without pulp. I recommend homemade chicken stock, as it can be made with organic ingredients and herbs which improve its nutrient profile. You can find some recipes here. For fruit juices, I suggest pomegranate and cranberry from concentrate which contain less sugar, but more beneficial phytonutrients such as anthocyanins. Anthocyanins are anti-oxidant and improve the integrity of blood vessels. Cranberry juice can also help prevent urinary tract infection, a common complication following cesarean delivery. Once tolerated, full liquids such as smoothies can be consumed. I recommend non-dairy based smoothies.
The macronutrients that are beneficial for healing are found in brightly coloured fruits and vegetables, protein such as fish and organic pasture-raised meats, and vegetable, legume, or whole grain carbohydrates. Vitamins and minerals which are particularly important for healing after surgery include vitamin A, C and E as well as zinc and selenium. Postpartum it is safest to get these nutrients through food as opposed to supplementation.
Vitamin A promotes healing of epithelial cells, which line our mucous membranes and skin, and boosts the immune system. Beta-carotene is a precursor nutrient to vitamin A, and can be found in orange coloured foods. I recommend steamed carrots, yams, squash and salmon as great food sources of beta-carotene. Direct supplementation with vitamin A is not recommended without first consulting a health care practitioner, as it can be toxic to you and your baby’s liver in high doses. Vitamin C with bioflavonoids is also very important for healing after surgery as it boosts the immune system and improves the integrity of vasculature. Citrus foods often come to mind when people think of vitamin C rich foods, but I prefer berries because they also contain anthocyanins. The best food source of zinc is pumpkin seeds, and for selenium Brazil nuts are excellent. A handful of pumpkin seeds and Brazil nuts daily should provide adequate amounts of these important minerals.
Naturopathic Topical Applications for Healing Surgical Incision and Scar Prevention:
There are a few excellent herbal preparations that can be applied topically to improve wound healing. Please speak with your surgeon before applying topical ointments to your surgical incision. Calendula (Calendula officinalis), St. John’s Wort (Hypericum perforatum), and Sea Buckthorn (Hippophae species) are my favorite topical herbs for wound healing after surgery.
In traditional Western herbalism, Calendula is well-known for its anti-inflammatory and wound healing properties, while St. John’s Wort oil is revered for its pain relieving effect. Please note that St. John’s Wort oil is photosensitizing, and sun exposure should be avoided with its use. There is some in vitro research suggesting that Calendula and St. John’s Wort can recruit fibroblasts to the wound site. Fibroblasts are cells which synthesize extracellular matrix and collagen and are involved in wound healing. As well, both herbs have been studied in patients following cesarean delivery to assess their wound healing activity with promising results. In addition to Calendula and St. John’s Wort oil, Sea Buckthorn oil is also an excellent topical application for wound healing. It is rich in vitamin E and beta-carotene which promote wound healing.
For my patients, I formulate a topical oil blend of Calendula, St. John’s Wort, and Sea Buckthorn. Once a patient’s sutures or staples have been removed and their surgeon has approved the use of topical ointments, I have patients apply the oils to the incision with sterile gauze and massage the remaining abdomen with the healing oil as well. If you notice any signs of infection such as increased redness, swelling, discharge at the incision site or fever, please contact your surgeon or naturopathic doctor immediately.
Homeopathic Arnica for Rapid Recovery:
While scientific evidence is limited for homeopathic remedies, I still occasionally recommend low potency homeopathic remedies because of their safety profile and extensive traditional use. Homeopathic remedies are small amounts of herbal and mineral substances used for medicinal purposes. Arnica (Arnica montana) is a homeopathic remedy with indications in post-operative care such as in cesarean delivery. Arnica is reported to aid in soreness from delivery, promote more rapid healing from surgery, and control bruising. Patients of mine who are prescribed homeopathic Arnica usually require less pain medication and have limited bruising. Although homeopathic preparations of Arnica are safe for internal use, herbal preparation of Arnica should never be taken internally or applied topically to open wounds.
The Importance of Maintaining a Healthy Gastrointestinal Flora after Cesarean Delivery:
It is standard practice to administer antibiotics at cesarean delivery in order to prevent wound, womb, and urine infections in mothers. Unfortunately, antibiotics kill healthy bacteria in addition to disease causing bacteria, and may have long-term effects on maternal health. The community of trillions of symbiotic bacteria which make up our gut flora is now considered a “super organ,” playing a crucial role in digestion, metabolism, and immune function. Disruption of our gut flora is associated with a growing number of diseases. Therefore, I work with postpartum mothers in my practice to restore a healthy gastrointestinal flora following antibiotic use. I often recommend probiotic supplementation with species such as Lactobacillus acidophilus and Bifidobacteria bifidum.
Infant gastrointestinal flora is influenced by many early life exposures, one of which is mode of delivery. Infants born by cesarean delivery have a different gut flora compared than infants born vaginally. This difference in gut flora following cesarean delivery may have long-term consequences on infant and childhood health. I believe it is important to support infants in developing a healthy gastrointestinal flora.
The main recommendation I have for parents is to exclusively breastfeed until 6 months of age, with introduction of complementary foods and continued breastfeeding afterwards. Breastfeeding encourages growth of healthy gut bacteria. If you are having difficulty breastfeeding, contact a naturopathic doctor, midwife, or lactation consultant. Minimizing antibiotic exposure is also important to ensuring a healthy gut flora and your child’s overall health. I also often prescribe probiotics to babies delivered by cesarean section to encourage development of a healthy gut flora. Please note supplementation with probiotics in children less than 1 year of age is not advised without prior consultation with your naturopathic doctor.
Establishing a Support Network:
While I’ve discussed several naturopathic treatments for healing after a cesarean delivery, keep in mind the best results are often achieved with guidance from a qualified health care practitioner who fosters a healing doctor-patient relationship, takes a comprehensive medical history, and tailors treatments to your individual needs. Emotional support from family and friends, and connection with nature can also facilitate great healing.
I wish you all the best in your healing journey and as a new parent,
~Dr. Carla Cashin, ND | Naturopath Victoria BC
*Originally published by Birthways at www.birthways.org