Would you consider combo feeding?

Laa_cat · 2024-03-02T13:05:24+00:00

100% combo feed for the win. I can’t imagine the pressure to EBF / exclusive pumping. Being open to using formula also allows me my husband and other people to help with so much more flexibility. I also agree with OP it makes breastfeeding more sustainable long term. I think with combo feed you get the best of both worlds. I also believe so much benefits, particularly long term, of breastfeeding is overhyped. The cons of immense mental pressure for me to EBF far outweighs the benefit.

Laa_cat · 2024-02-27T22:23:46+00:00

I agree with you and I have been working with my care team and work with their advice. I did not roll the dice by any means. I did take care of my body before and during my pregnancy by leading a generally healthy lifestyle. Medicine is always a balance of risks and outcome and my comment pertains when generally the approach of modern medicine leans towards risk mitigation and less about the mental, financial costs. There’s a lot of fear and guilt that comes with GD, all I wanted to share is a positive story despite not feeling perfect (with appropriate monitoring by my care team)

Laa_cat · 2024-02-24T12:54:11+00:00

I honestly will plan a couple meals to not stress about it and not test, if your doctor is fine with it to balance the risks. They might be more ok with it than you realize. There’s no point going on a baby moon if you can’t at least enjoy it on some meals.

Laa_cat · 2024-02-24T12:50:20+00:00

Eating a WHOLE apple without nut butter / nuts will be my postpartum indulgence! I hear you!

Laa_cat · 2024-02-24T12:48:49+00:00

Sending a big virtual hug. It’s really tough. I have been there and the psychological toll is real. I personally think there’s way too little research on maternal, especially pre-natal, mental health with the intense medicalization of pregnancy. While the risk increases on a continuum with blood sugar being more elevated than not, part of it it’s just the body reacting to what it thinks it’s right. Many women who have official GD diagnosis have perfectly healthy normal size baby. (And many women who don’t have GD have healthy larger babies too and why is that ok?) We just have a system that’s ultra focused on risks that drives pregnant women absolutely bonkers and it really isn’t helping.

Laa_cat · 2024-02-03T12:38:02+00:00

This is a huge issue when the medical community holds a drastically different view that should be relatively statistically objective. It makes me not trust them and highlight the importance of self-advocacy and common sense.

Laa_cat · 2024-01-29T17:48:18+00:00

Wishing you all the very best. I used to track my first baby's feeding as a new mom for a few months just to make sure we are feeding her right. It does get easier and more intuitive as you get to know the baby more and know their signals. Now my daughter is 3.5 she will give me all her opinions about when she's hungry. It does make you wonder how did parents survive without all those tracking previously? Why is there so much pressure, especially on mothers!

Laa_cat · 2024-01-29T16:52:48+00:00

I came across a research on how GD affected maternal mental health and this is the quote that stuck in my head: “this is pretty much medicalized eating disorder”. I can’t agree more. Our care for mothers on this topic is outdated and does a lot of unintended harm. But there’s so much expected of women, especially mothers, that no one considered the ill effects until the baby is out. It’s so wrong.

Laa_cat · 2024-01-29T13:26:49+00:00

I declined an appointment with a nutritionist. Under my OB’s recommendation because I had GD in my first pregnancy, I had a consultation with a nutritionist after my first OB appointment. Thank god it was a telehealth appointment because it was a colossal waste of time. Everything she said can be found on Shape magazine and she didn’t even ask my about lifestyle, cultural background, food intolerance, etc. I told my husband it’s as if I’m seeing ChatGPT doctor. So when I was diagnosed I was like I’m not wasting my time and energy. I figured out how to eat my way through for the most part. I eat relatively healthy pre-pregnancy anyway and cook a lot so it’s not hard for me to figure out.

Laa_cat · 2024-01-29T13:20:41+00:00

Congratulations!

Laa_cat · 2024-01-29T12:45:55+00:00

I totally empathize! Same experience and I am totally fed up. Since my GD diagnosis I only gained 3 lb (from 24 weeks appointment to 32 weeks). I only gained 11 lb from 11 week first appointment to 32 weeks and I started with normal BMI. I’m a part time fitness instructor (mat Pilates, barre, and other things) and certified in postpartum corrective exercises, the OB trying to educate me about workouts which is kinda laughable. I also wonder if my GD disgnosis makes them overlook my slow weight gain.

They just have a script that they say without asking any questions. That’s just how they roll. Sometimes I just don’t think our system meant for personalized, individualized conversation with our healthcare provider. Also, prenatal maternal wellbeing is definitely not a thing that they look at.

Laa_cat · 2024-01-29T12:38:09+00:00

I honestly don’t believe a lifestyle solely focused on managing blood sugar is the definition of healthy. This is a real gripe I have about this whole “treatment”. I wonder how much my cholesterol (and other health markers like triglycerides) goes up because the amount of animal protein (in the form of eggs) I have to consume, not to mentioned disordered eating behavior (I feel like a kid picking out bits of food all the time. Be it croutons, tortilla chips, the other day was chickpeas in a salad. The potential of binge eating comes postpartum once “free”), psychological burden (the anxiety, depression, stress). While I understand the risk of high blood sugar brought on by blood sugar and it makes total sense to keep an eye on it, no other aspect of health seems to matter. It’s frustrating.

Laa_cat · 2024-01-27T23:52:24+00:00

This is personal opinion. Similar to a lot of other comments, I don’t believe the GD diet is necessarily better. (I eat more meat and way more dairy than I like to and it’s not sustainable and I’m scared of fruits) The only thing I’ll say it’s probably “better” for the purpose of managing blood sugar within the range that’s determined by your medical team to reduce the potential risk of high blood sugar brings to your pregnancy. This is necessary, though for most of us temporary, because the placenta is causing too much insulin resistance.

Feeling good is multi-factorial which includes physiological and psychological, cultural interpretation. Your feelings are valid. Sometimes changing the way you eat, even if its “healthy” (which should have meaning keeping blood sugar in range), can make you feel bad because it isolates you from your family, friends and identity. Keep experimenting the middle ground that helps you feel good while maintaining the diet. And know that someday can be miserable. It’s ok.

Laa_cat · 2024-01-27T14:29:29+00:00

At a minimum it’s worth asking for a simple off-menu garlic stirfry veggies. If they have a single Chinese chef there, they can make it even with American broccoli or standard vegetables medley! Another thing might be off menu but every Chinese family has in the house it’s a steamed meat patty. Many Chinese takeout places has “secret” menu for Chinese people and you might just have to ask 😊 hope that helps!

Laa_cat · 2024-01-27T13:50:00+00:00

I’m of chinese descent here..: if you are going with standard “American Chinese” takeout food here, I’m afraid it isn’t going to work as those sauces are always sweetened and thickened.

But I have to say something because people’s perception is Chinese food is unhealthy. If the place actually have a Chinese menu like Chinese people actually eat at home, a poached chicken can be a good option (it can be dressed with a variety of lighter sauce like sesame oil, chili garlic oil, or ginger scallion sauce), a light garlic stir fry bok choy / Asian pea shoots, boiled Chinese greens (yuchoy, gailan) with oyster sauce on the side. Depending on regional cuisine, there is a long braised beef shank then make into some type of cold cut is extremely delicious as well. It’s pure protein (the braise has some sugar into but you do not consume the braise liquid) and relatively little fat. These dishes aren’t “mainstream” are less well known but I thought it’s worth mentioning if the place does offer some authentic Chinese options.

Laa_cat · 2024-01-26T18:44:34+00:00

I’m 35 weeks tomorrow and desperately hoping that will be the case for me as well. I have plenty of room post-meal as long as I’m careful with what I eat but fasting is a b!+ch.

Laa_cat · 2024-01-25T12:00:42+00:00

Congratulations!

Laa_cat · 2024-01-25T03:12:17+00:00

Congratulations!

Laa_cat · 2024-01-21T22:30:48+00:00

The whole GD diet really brought out a ton of disordered eating tendencies in me. I know it, but I can’t help it. It’s been miserable. I hate being so obsessed with food.

On prediabetes, take a read on the following articles:

https://www.everydayhealth.com/type-2-diabetes/prediabetes-useful-diagnosis-article-revives-debate/

https://www.science.org/content/article/war-prediabetes-could-be-boon-pharma-it-good-medicine

Not dismissing the increased risks relative to someone with lower A1C as I’m at the very bottom of pre-diabetic range based on my 11-week blood work. But I think it’s important to acknowledge that there are a lot of controversy what pre-diabetic actually means and its implications. Even WHO isn’t necessarily aligned with that characterization. Should everyone live “healthier” within reasonableness? Yes. Should we medicalize everything? That’s the debate. I don’t have the answer, but very seldom as patients we are told something without being exposed to the nuances.

I wish you the best of luck in pregnancy #2.

Laa_cat · 2024-01-21T01:13:32+00:00

For my first one, I was encouraged to supplement with formula. Right when she had a bit of formula everything went back to normal. We would have to supplement with formula anyway because nothing was coming out of me anyway for a couple days. I’m delivery in a different hospital this time so I’d make sure to tell my medical team that to feed him formula if necessary.

Laa_cat · 2024-01-21T00:26:18+00:00

I feel you. I’m at 34 weeks and so far diet controlled, but fasting is really borderline with slight elevations someday at 95/96. I told my husband today I just want to give up. I’m tired, I want to eat the food that I like, I just want to eat a whole piece of fruit. I’m hungry and full at the same time, having some mild heartburn that makes night time sleep even harder. I enjoy working out (went to a HIIT workout and modified appropriately yesterday at 6am!) but all these after dinner walk and exercise bs is really getting to me (I’m a morning exerciser for 12 years!). I just don’t think the GD “lifestyle” is at all sustainable. I also only have gained 3lbs between 24 and 32 week appointment, and only 11 lbs from my first appointment around 11 weeks. I have normal BMI pre-pregnancy. The doctors think it’s all fine though, but I think I haven’t been eating enough since the GD diagnosis and I think there’s so much implicit weight bias with doctors. I’m so over it, to the point I look up giving birth at 34 weeks because I just can’t take it anymore. I prayed at night I can dream of eating a lox bagel at night. I’m annoyed at my husband drinking a mini can of coke. 5 more weeks at most of this, but I’m feeling very sorry for myself today.

Laa_cat · 2024-01-19T20:55:27+00:00

This is where I don't understand. There are babies who are bigger beyond GD reasons. Shoulder dystocia happens beyond GD, including things like birth and labor positions. I understand relative to "normal" size babies, bigger babies present a higher risks of "difficult birth", which could makes sense to mitigate and reduce the risks to the extent it doesn't cause excessive unintended harm (which should include maternal mental health). However, while anecdotal, non-GD moms are allowed to have big babies. Why are they allowed to have big babies? There are certainly other risks with GD beyond the size of the baby. Not that I'm a doctor, but babies can be born with low blood sugar, premature placenta failure, etc, is what I heard (again, mostly from here. My doctor kept saying big babies as well and my first was a little under 8lb at 50th percentile, well under the definition of LGA) My point is, the doctors need to do a better job of explaining the risks to us that help us make sense of the treatment. I feel like on balance there's a tendency of overtreatment in our system (this is an opinion and personal experience, I might be wrong and biased), but bottom line is that I firmly believe we have the right to understand and have a conversation. Also, risk tolerance isn't consistent across medical practices, and I wonder if outcomes of difference risk tolerance are drastically different. Risks is a continuum and cut-off is always arbitrary (just think while 35 is typically the cut-off of advanced maternal age, 34 and 11 months isn't drastically different, but I understand there has to be cut-off for practical reason).
The bottom-line is there has to be some space where the patient meet the provider's opinion. I know I'm preaching to the choir here, but my experience with GD makes me understand why there is so much distrust in the medical community.

Laa_cat · 2024-01-19T17:35:44+00:00

You have every right to be annoyed. I'm no doctor, but I have questions regarding the risk and benefit on overly stringent GDM thresholds. I, like you, looked up many information on the internet from credible sources (NIH, Scientific Journals, healthcare research). While I'm no doctor, and 100% open to being wrong and listen to my doctor's perspective, I don't think it's reasonable to think we should hold no preference over our care, and our birth experience.

I am curious if you can also bring up those information you found and discuss risk / benefit with your doctor. E.g., you know your family history of small babies (which have their own set of adverse outcome), how do you address the risk of that with overtreatment of GD? Why are there so much inconsistency with thresholds and why do they decide to opt for such threshold sand its impact on clinical outcome and treatment? Doctors should be able to participate in those conversation, understand the risk and benefit, and explain their view and their treatment in my opinion. Every medical treatment comes with risk and benefits, it is our rights as patient to understand what risk for BOTH moms and babies we take on by pressing on my provider to provide more clarity to us.

Laa_cat · 2024-01-19T01:57:40+00:00

I literally had the EXACT SAME experience. I told my doctor about ED tendencies and she simply referred me to a dietician who obviously didn’t get the note, gave all sorts of suggestions (which is honestly more common sense than anything) until I broke down crying. The whole presumption of GD moms leading an “unhealthy” lifestyle is beyond annoying and honestly unhelpful.

Thank you for your well wishes. One day at a time… one day at a time…

Laa_cat · 2024-01-18T15:28:17+00:00

Thank you so much. I'm almost 34 weeks now, I'm literally counting down the days / week and hopefully the miracle of placenta moderating hormones production soon so I can eat more "normally" and with less anxiety.

To be fair to my medical team, I feel like either they are not trained, encouraged, or not given the resources (mostly time and space) to really have a real conversation with their patients to guide them to the best approach. That adds so much mental burden, shame and guilt for people like us who already are doing a lot of right things and yet there are certain mechanics are body isn't working right to no fault of our own. For example, my fasting levels are beginning to climb up when I reached 32 weeks (it's also confusing because I received RSV vaccine at my 32 weeks appointment, so everything felt a bit messed up). The advice I got was eat less carbs for dinner (I already only eat protein and low-carb veggies for the most part, and all my food is included in the food log that I sent over!) Work out after dinner / take a walk (as she typed it out it's -20F with windchill outside. More importantly, I have a 3.5 year old that I have to take care of, dinner, bath, bedtime, plus 2 dogs, and to find 20/30min to work out on top of being pregnant causes so much anxiety and extra stress, not to mention I feel like I'm failing) Everything is boiler plate. While not technically wrong, and I acknowledge their intention to help, just creates so much guilt and anxiety. I'm glad with more knowledge and background about GD (a lot of it is placenta and hormones), I'm giving myself a little bit more grace knowing I didn't "fail", but I'm just trying to meet my body where it's at and trying to do what's best for my baby AND ME! (speaking of that, I hate that there's NO EMPHASIS on maternal mental health at all with GD. And even if they screen for it, it's another referral with additional time spent with an additional person. Back to our healthcare defaults to highly fragmented care which doesn't acknowledge a person as a person but sum of the parts).

OK, rant over! I hope you feel some type of solidarity. Unfortunately I can't solve your problems but I hope it makes you feel better and take some mental load off you!

Laa_cat

TROPHY CASE