Pregnant: Any advice to help avoid post partum relapse?

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Pregnant: Any advice to help avoid post partum relapse?

Postby hlm286 » Wed Dec 23, 2009 11:32 am

I'm currently just starting my second trimester of pregnancy, and although I'll hopefully have a while before the birth, I've been thinking about the higher recorded incidences of post partum relapses in the first 6 months and I'm wondering if any of you who have had experience in this area, or knowledge on the topic, have any advice for me to help avoid a relapse after the birth. I am currently taking a prenatal vitamin, 50mg of zinc and 2000 IU of vit D, I feel very well, and I plan on breastfeeding for atleast the first 6 months (I've read a study on here as well that breastfeeding has shown to reduce relapse risks) so I will not be starting any medications until I'm done breastfeeding (I have not started any DMT's since my diagnosis last June). I know there's no gaurantees, I'm just looking for any helpful advice. Thank you!
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Postby jimmylegs » Wed Dec 23, 2009 3:58 pm

congrats h! from my perspective, i think you're well on your way to being protected from a relapse. you have hit the main two, D3 and zinc, that spring to my mind for pregnancy, and the multi certainly can't hurt. i don't know off the top of my head of specific other nutrients that are particularly drained by pregnancy. you'll have another multi after the baby arrives, right? and keep up the d and zinc?
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Postby hlm286 » Thu Dec 24, 2009 8:25 am

Yes, I probably will end up increasing my vit d a bit as well (maybe 4000 IU). I just didn't want to overdo the vitamins during pregnancy but some days during winter I don't get outside much at all and if I do, mostly at work with the kids, I'm all covered because it's so cold out! Thank you for your insight though, I appreciate it!
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Postby jimmylegs » Thu Dec 24, 2009 10:30 am

sounds like a good plan, h. as you increase your d3 intake it gets increasngly important to ensure you are matching your intakes of calcium and magnesium. what's in the prenatal pill for those two, if i may ask?
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Postby VailKin » Fri Jan 08, 2010 12:49 am

If you can handle it I'd suggest breastfeeding longer than 6 months. I'm pretty sure I remember my neuro telling me that my risk of relapse postpartum was highest at the 6 month mark. I breastfed for 19 months - minor flares began again shortly after that but MRIs showed no changes for 5 years.

My only other piece of advice is sleep when the baby does.

Best of luck,
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Postby Johnson » Fri Jan 08, 2010 1:29 am

Hi, and congratulations on your pregnancy. Babies and pregnant women are so beautiful.

I am a man, so maybe not the most credible advisory on pregnancy and nursing, but I was very involved throughout my wife's pregnancy, birth, nursing, etc. The longer you can breast-feed, the better, for both you and your child. My wife nursed our son for 13 months (she deserves a medal!), and he is smart, healthy, and in the top percentiles for height and weight. It is an immeasurable gift, in my most humble opinion.

I was thinking that 5,000 IU of Vit. D3 was better than 2,000, when I saw jimmylegs suggest 4,000. Either, or. Cold water fish oils are good too (cod, herring, anchovy, salmon...).

Keep your folic acid up - through leafy greens - collards, kale, chard, etc., which will also give your baby a good birth level of Vit. K. Ideally, you have been doing all that since before conception.

For goodness sake, don't let them give your baby any injections of anything before at least 2 years old. There is incredible pressure to give Vit. K shots, Hep C vaccine (for weeping sake!), and goodness alone knows what else - in the delivery room!. Do not let them put anything into your baby - unless, of course, it is an emergency. Try to let the umbilical cord pump all of its blood into the baby before cutting it too, unless of course, you are keeping cord blood for future treatments (we did, but I'm not sold on it), or there is a contraindication to your, or the baby's health.

I hope that my male voice is not unwelcome, and all the best to you.
My name is not really Johnson. MSed up since 1993
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Postby jimmylegs » Fri Jan 08, 2010 4:22 am

lol j i did not suggest the 4000 here although i have many times elsewhere.. 2000iu is better than most i think! but it's true, 4000 is considered maintenance when NOT pregnant.. ie when consuming for one :)
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Postby hlm286 » Fri Jan 08, 2010 12:06 pm

Thank you all for your responses (and I appreciate a males advice just the same as females :wink: )

Jimmylegs, you asked before, sorry so late responding, the zinc in the prenatal I'm taking is 20mg. I also take a 50mg supplement. The calcium in the prenatal is 200mg, mag 100mg. My neuro suggested not taking more than 2000iu of vit D and I think I'll stick to that for fear of overdoing the vitamins during pregnancy.

I do plan on breastfeeding as long as possible, but probably not more than a year for personal preference. I breastfed my daughter until she was 10 months old and oddly enough my symptoms first were tracked back to the same month I quit breastfeeding. (It started with Lehrmitte's until 5 months later when I was diagnosed with a major attack. I have since fully recovered minus some numbess in my hand, tingling in feet and legs and bladder spasticity.)

I met with my neuro yesterday and he said that they have found that breastfeeding helps prevent relapses so he was glad that I chose that over medications so we were on the same page. He just wants to see me back 3 months after the birth but said there's no need to perscribe medications since I'm pregnant and then will be breastfeeding, but we'll see what my plans are for the future after that. I'm still on the fence about the meds. I've heard so many mixed reviews but at the same time, I don't know anything about them. However, I also think that if there were no meds for MS 10 years ago, then shouldn't I want to join in on the breakthrough to see if the negative statistics improve? But then with all the new CCSVI news, I believe that could be the cause so I'm very interested in that as well. However, they're not testing anyone for it or doing anything for it in my area. :( Hopefully things will move along quickly and I'm praying this will turn out to be a helpful treatment.

But for now, I'm focusing on good nutrition, supplements, and trying to relax a bit and take it one day at a time.

Thank you everyone for your help and support. :)
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Postby hlm286 » Fri Jan 08, 2010 12:09 pm

Jimmylegs,

oops you asked about the d3 in the prenatal, not zinc, the d3 is 200iu
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Postby jimmylegs » Fri Jan 08, 2010 5:01 pm

LOL i think i was asking about the calcium and the magnesium.

i'd generally say, to those not pregnant, take 4000 d3, 1000mg ca, and 500mg mag. so if you're cutting the d3 in half to 2000, i'd tend to recommend cutting the calcium to 500 and the mag to 250. the prenatal looks to be getting you almost halfway there.

because of the interactions between d3, mag and calcium, i'd suggest including a plain cal-mag supplement that does not contain any vit d, and taking it at a time of day where no other vitamin d3 is going in.

HTH!
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Postby Cece » Mon Jan 11, 2010 10:28 am

If CCSVI has merit, then the postpartum relapse may be a delayed autoimmune clean-up response triggered by hypoxia to the brain during childbirth. So I would also focus on "the big day" and make sure to breathe and stay as relaxed as possible through it all. Also, being fit going into childbirth has got to help with handling the enormous aerobic workout, so maybe focus on building up to it with workouts in the last few months. (I did not do this, for my three pregnancies, I was a complete slug by the end!)
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Postby hlm286 » Mon Jan 11, 2010 5:32 pm

Thank you for your input. May I ask, did you have MS before you had your children? If so, did you have postpartum relapses? How were your symptoms during your pregnancies?

I believe your advice about exercising, I am trying to start an exercise program to continue throughout my pregnancy and hopefully adopt for a lifelong habit. (Still building up the ambition :wink: ...)
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Postby Cece » Mon Jan 11, 2010 9:02 pm

Yeah, I was diagnosed with MS about six months after baby #2. It was a classic postpartum relapse; I developed eye issues and minor foot drop and recovered. So far *knock on wood* my relapses have been minor and my recovery good.

I did not relapse after baby #3. And I managed to breastfeed for a full year and stay off of the Copaxone until I was done and not relapse then either. That felt like a gamble....

I felt horrible during all three pregnancies but I didn't have relapses during them.

Best of luck with the exercising and of course the baby!
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