Dr. Carla Cashin, ND | Naturopath Victoria BC

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 monitored in hospital for 3 to 5 days before returning home. I 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 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. For clear fluids, I recommend homemade chicken stock, caffeine-free teas (peppermint, ginger), diluted juices (equal parts water and juice concentrate; apple, cranberry and pomegranate are nice options), and coconut water. Once tolerated, full liquids such as pureed soups or smoothies can be consumed. When all types of foods can be consumed, chicken soup and stews are particularly nourishing. As well, oatmeal and these lactation friendly bars are a great food to support your milk supply coming in, as oats promote lactation.

Beneficial nutrients for healing can be found in brightly coloured fruits and vegetables, good quality proteins such as fish, pasture-raised meats and eggs, nuts and seeds, and complex carbohydrates such as legumes and whole grains. Vitamins and minerals that 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 skin cells, 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 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 high levels of other beneficial phytonutrients called anthocyanins. An excellent source of zinc is pumpkin seeds, and for selenium, Brazil nuts. A handful of pumpkin seeds and just 2 Brazil nuts daily 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 maternity doctor, or midwife before applying topical ointments to your surgical incision. Calendula (Calendula officinalis) and St. John’s Wort (Hypericum perforatum) 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.

For my patients, I formulate a topical oil blend of Calendula and St. John’s Wort. Once a patient’s sutures have been removed and their maternity health care provider 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 health care provider immediately.
 

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 exposure. To support a healthy microbiome, ensure adequate consumption of fiber rich foods (vegetables, whole grains, legumes) and increase probiotic rich foods such as yogurt, kimchi, sauerkraut, beet kvass, kombucha. Some postpartum mothers may choose to supplement with a probiotic for a period of time after antibiotic exposure. Good quality probiotic supplements typically contain well researched Lactobacillus and/or Bifidobacteria strains.

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 to 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. 

A healthy gut flora can be established in infants born by Cesarean delivery by supporting skin-to-skin contact with parents as soon as possible after birth, and encouraging breastfeeding. Skin-to-skin contact helps babies born by Cesarean delivery come in to contact with skin flora as opposed to hospital flora, and may lead to a healthier microbiome. Amazingly, breastmilk actually contains beneficial microbes which seed an infant’s gut, and additionally breastmilk contains prebiotics which promote growth of beneficial microbes. Breastfed infants born by Cesarean delivery end up having a similar gut microbiome as vaginally born infants over time. If you are having difficulty breastfeeding, reach out for support from your nursing team in hospital, public health nurses, midwife, or a lactation consultant.

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