Dr Rupy: You're going to be running the show today because I'm not going to be able to keep you two under control.
Dr Anita Mitra: That is also true. Just admit defeat straight away. It's the easiest way.
Dr Rupy: Admit defeat. Look, it's fine. The purpose of this episode is to A, make sure that the podcast does not get cancelled, and B, to answer some of your questions that you're
Rachelle: My many questions.
Dr Rupy: You've got many questions, sweetheart, and I and I love it and I just thought, you know what, it'd be an amazing episode considering Anita who's one of our closest friends, you know, you're always like side messaging her or
Rachelle: For the scanner as well, you did our first
Dr Anita Mitra: I was the first person to see your baby. Yeah, I know.
Rachelle: Yes, you were.
Dr Anita Mitra: And I took the first family photo.
Rachelle: You did. But you had your, you both had your doctor faces on. So we were doing the scan and you both were like, you know that like glassy-eyed look where you're like, everything is fine. And I was like, Anita, tell me there are not twins. And you were like, oh no, no, there's just one. I was like, so there is a heartbeat. You were both like, it was so funny.
Dr Rupy: Yeah, yeah, it was great.
Dr Anita Mitra: It's definitely a whole other dimension when it's one of your best friends. I have to say. And I think it does actually highlight why you shouldn't really have friends as patients because it's a lot of pressure.
Dr Rupy: I can, yeah, because I get that as well, like just, you know, outside of a baby coming in and getting involved. Like, when I treat patients or whenever I give advice to friends, I always fear like, you know, any repercussions on the actual relationship.
Rachelle: That's kind of awkward because we asked Dr Mene, Anita's husband, to help deliver the baby. So he can, you can tap out at any point.
Dr Rupy: Yeah, yeah, yeah. No, he can't tap out.
Rachelle: He'll help deliver or
Dr Anita Mitra: That's a little bit of a different situation. He can be photographer.
Rachelle: I'm photographer. Don't give him my job, please. You're overseeing stitching work.
Dr Rupy: Yeah. The best handiwork.
Dr Anita Mitra: The best handiwork. Yeah, exactly.
Dr Rupy: Okay, so why don't we, why don't we kick off by
Dr Anita Mitra: Oh, it's already out of control.
Dr Rupy: It's already out of control. I'm trying to bring this back. Bring this back. Stay on task. Yeah, so I'm trying to get this on track. So why don't you tell us about your experience thus far, Rachelle, and Anita, you can, I don't even have to ask you to chime in. You're going to chime in with your own experiences and your thoughts on this as well. Yeah, so what, how many weeks are you now?
Rachelle: I'm 36 and a half weeks pregnant right today. So we're expecting a baby in three weeks.
Dr Rupy: Okay.
Rachelle: As well. So, um, I mean, I have to say, I think there is an element of luck to it because I have had, touch wood, quite a healthy, relatively seamless journey. And it is certainly not what I expected because I think you both know and I've had lots of conversations with you pre, um, after you had your twins, I was terrified. I am the worst patient at the best of times. I'm not a good, I'm not a good sick person. And actually vomiting, I have a phobia of it. I don't know what the name of that is, but I definitely have that. So the idea of being ill was terrifying to me, but pleasingly, I was relatively okay and I've had quite a manageable experience. So I'm very, very grateful, but I also recognise that's not everyone's experience and there doesn't seem to be like any rhyme or reason as to whether you get sick in your first trimester and to those that get sick throughout the whole period. Um, but it's been relatively fine. I've had some low blood pressure, a bit of dizziness and only one fainting episode, but it was on like in a in a health clinic. I was lying on the bed and I fainted and actually it was quite relaxing. So it couldn't have been, it couldn't have been like a better place for that to have happened. So I really can't complain to this point.
Dr Rupy: Yeah, no, that's great. Um, and like, you know, like you asked me to caveat right at the start of this, not everyone's experience is going to be like that. It's not going to be plain sailing. This is like, you know, your N of one experience. It's it's yours and we're not saying necessarily if you do exactly as you did.
Rachelle: No, of course.
Dr Rupy: That, you know, it's going to be seamless.
Rachelle: And it's not to say that if we were to have another child, it would probably from what I hear, everyone's like second pregnancy or third or however, they're all very different.
Dr Rupy: It could be completely different, right?
Rachelle: So I don't know if it comes down to just hormones or like how you manage stress or just luck of the draw at that point. But um, so far it's been okay. But Anita, you have had twins as well fairly recently.
Dr Anita Mitra: Yeah, nearly two years ago now. It seems like 15 years ago now. What was your experience like? Well, I think I have to say that being pregnant myself was very humbling after looking after probably thousands of women in their pregnancies over the last, you know, 10 or more years actually. Um, and it's interesting because like people often as you kind of alluded to, like expect that because you're really healthy or you know, you look after yourself, then your pregnancy is going to be absolutely fine. Um, and so often people are like, oh, well, you like, you're really healthy, you'll be fine. And actually sometimes you're not. Um, and it's if you're not, it doesn't mean that you've not done something or you're not kind of like doing what you're supposed to be doing. And I, I think that I was very at peace with kind of, you know, okay, I'm pregnant, my life's not going to be the same. But what I found really hard and I had to really kind of like wind in my social media use during the pregnancy was just kind of like comparing myself to other people. Um, because there are so many like really incredible, inspiring accounts out there, people who, you know, like working out all the way through the pregnancy, like, you know, doing all sorts of really fun things and like cooking loads of amazing food. And I was just kind of like, oh my goodness, I just need to get myself home and then I'll probably eat my food in the bath and then like just go to bed. And I hated it because I love exercising and I just really could not for the first, I don't know, I mean, I barely exercised in the whole pregnancy to be quite honest with you and I really didn't expect that of myself. Um, and it was hard because it's something that I actually enjoy. And like that's when like me and you would hang out for example, Rupy, or like, you know, that's my time for myself. And I was just so, so exhausted and I just couldn't.
Rachelle: Yeah, it's just like part of you's been taken away, isn't it? It's a big part of your identity and also what you do for like mental health as well. So with so many other sort of changes at that point, not being able to exercise is another, just another thing on the list of you're already feeling tired and probably also feeling tired because you're not able to, your body's used to getting a certain level of activity.
Dr Anita Mitra: Yeah, totally. And I just felt so sick all the time. Um, and I was really lucky because I never actually vomited. Um, I just had the most overwhelming nausea all the time. And I know we're going to sort of go on to that. But yeah. Um, I, I don't know, it's really interesting because obviously, you know, I spend every morning when I go to work, I do my ward round and the patient says, oh, you know, I feel really sick. And I'm like, yeah, yeah, okay, okay. You know, it's not because I don't care, but it's something that somebody says to me every day. All the time. And then there's just that kind of feeling of like, oh God, I actually feel really sick all the time. Um, so that was really hard. Um, and yeah, it just, I just had to really had to stop comparing myself to other people because I knew that, you know, I have a really, really busy job. Um, so I am generally exhausted most of the time anyway without being pregnant.
Rachelle: And you're on your feet all day as well and you're operating, etc. So that's like really hard to do. I find it really, like the prospect of being ill and like the first trimester is what you commonly sort of hear. Like I don't know how women do it and amazing that they do, like commuting into work, pretending everything's fine when they've also not told anyone or they feel most likely that they aren't, they don't want to share until things are sort of a bit more certain. I know nothing's a given, but like that's a lot of pressure for you and a lot of stuff that you have to deal with on your own and sort of like paint a smile on as well. That's so weird.
Dr Anita Mitra: Did I tell you I was pregnant in White City House gym? And I remember me and you had gone to like a TRX um, workshop.
Dr Rupy: Yeah, yeah, I remember that. Yeah, yeah.
Dr Anita Mitra: And I was so, I felt so sick. And I was so exhausted. And then there was Rupy all like, yeah, like, how are you doing? Saturday morning. And I was just like, please just put a gun to my head. And um, honestly, and then I was like, waves of nausea. And then like Rupy was just like bouncing off the walls. And I was like, gosh. And then I think, yeah, I'm fairly sure that's when I told you. And I was just like lying on some foam roller just like, please just somebody end it.
Rachelle: Roll this over me.
Dr Anita Mitra: Exactly.
Rachelle: What you said about like removing social media, like you, you go through periods of time where you just delete Instagram, which I think is super healthy.
Dr Anita Mitra: I do.
Rachelle: But it's really weird because that first week, you end up scrolling whatever other apps you have. So I find that I'll scroll LinkedIn because that's the only other social media. And it's like, so it is kind of like what you're, your brain is used to seeing like and your eyes are used to seeing those flickering images, but sometimes I go off it. However, I didn't really during this pregnancy. I have gone off now, but that comparison point, I mean, that's dangerous in every respect. Um, as well, it's not just pregnancy related. Like it's not good for your mental health and when you're pregnant, you're dealing with like all these life changes, etc. You don't need anything added to make you, you're already a bit vulnerable.
Dr Anita Mitra: Yeah, yeah, yeah, exactly. And I remember there was someone else who was pregnant with twins literally like 10 days different from me. And I she would like post pictures of her belly and I was just like kind of like, I don't know, like why the why the heck was I bothered about like what size my belly was compared to hers. But I was like, oh, is it the same? I don't know. What do I look like? And you know, just all these kind of things.
Rachelle: Have you noticed the comparing of like what the size, the size and like what, like you're not supposed to look like them in the beginning. So why would you look like them, why would you look like them during?
Dr Rupy: Yeah.
Rachelle: As well.
Dr Rupy: I'm glad you talked about that comparison point because both of you exercise very regularly, you know, eat super healthily. You both got quite demanding jobs, although Anita, I think probably.
Rachelle: No, I'm going to give it to Anita. It's not a competition, guys. What if I'm going to be in a competition, you win the competition.
Dr Rupy: But, but um, but yeah, like, you know, your your sort of baseline was similar in some regards, but Rachelle has exercised throughout her entire pregnancy. And like, she often shocks people in the gym when she turns around and she's like, and they're like, whoa.
Rachelle: I did pull something in my back last, about 10 days ago and I haven't been able to walk properly since. So that is my fault. Uh, not pregnancy related, but that's user error. Yeah. Um, but you know, to your point, I can, I can only imagine. I was really worried about not being able to exercise because for me, for my mental health, it's very important. But I'm moving, so I am so thankful that I have been able to. But, you know, you also have to just listen to your body at that point. And you also were having twins, so it's sort of double the the strain and the impact too. If you, if you don't feel up to it or you're not well rested, I know this is a big thing that you focus on Rupy. If you're not well rested, you can't, you're going to injure yourself. It's actually counterproductive. And so all you needed to do at that point was survive. And also your job is so intense that that is exercise as well.
Dr Anita Mitra: Yeah, yeah. It definitely was a survival thing. Yeah. Yeah. You always have to do it safely and like be signed off to exercise in the way you want to.
Rachelle: You've got tons of notes. I've seen your iPad there. It's it's full of uh, some some questions. So why don't you
Dr Anita Mitra: I'm surprised it's just notes and not an Excel spreadsheet.
Rachelle: Oh, I know. Yeah, considering Rachelle, she is. I think Anita did it. Yeah, yeah, yeah. So my question, so we talked a little bit about nausea and obviously you found that to be very difficult. And that is like what you hear from the majority of women. Is it luck that some people get sick and some people don't get sick? Um, is there anything behind it? What can you do to manage it? Because I have, I've read some stuff, but I don't know.
Dr Anita Mitra: I'm sure you have.
Rachelle: I'm not going to tell you where I read it. It doesn't sound like you at all. It's just Google, it's just, it's just Googling. And like, obviously at that point, especially like before I was pregnant, even at when we just found out, I was like, okay, I have to like strategize this. I need to work out what can I do? And like I was the psycho who bought like vomit bags and put them in all of my handbags.
Dr Rupy: Oh wow, I love it.
Rachelle: In case I was sick on the tube. Like what would I do? Like that would be the worst.
Dr Rupy: That was actually a morbid fear of Rachelle. She was like, what if I, what if I'm sick on the central line and like, you know, no one's helping me and like, I don't physically look pregnant. So people think I'm like on a bender from the night before.
Dr Anita Mitra: Well, people are quite awful on the tube, I have to say. One of the things I was most surprised about was other women on the tube. Oh my gosh. I remember once being, actually I'd been to your hen party. I was coming home. It was like a heat wave and I was very heavily pregnant and I wanted to sit down and then I saw this other woman and she was there with like three kids. So I was like, so I think you know what I feel like right now. And she looked at me and then she just looked away and I could tell she felt guilty, but I was just like, yes, you enjoy your seat there and I will just stand.
Rachelle: The women are the worst in my opinion. I find this going into work every day. I get this, but it's also, but you know what, like, and I didn't want to wear the badge. I understand the badge exists for a reason. So in the end, I bought the badge. I didn't have a badge. I bought the badge in case like I was wearing a jacket or something and it wasn't as and you know, obviously it's like very PC, you know, people don't want to be like, oh, assume you're pregnant. But I bought the badge. The badge does no, makes no difference. People do not give you their seat. And everyone averts their eyes. The women are just as bad as the men. And also like at one point, I remember being on the central line, which isn't not very, not very pleasant at the best of times. It was sort of during summer and we'd stopped in between stations and I was standing right in front of a guy who was looking on his phone and I was getting one of my dizzy spells and I was like, oh my god, I'm just going to have to sit on his lap. Oh my god, I would have loved that. No, no, I was thinking about this for about five minutes whilst we were like, would he think that's weird? Could I get away with this? Do I say, I'm sorry, I'm pregnant. Um, do you mind if I just sit on your lap for a bit? Like, I was like, what am I going to do? And in the end, I like deliberated for about seven minutes. I was like, I'm really sorry, I'm pregnant. Do you mind if I sit down? He was like, oh no, of course. Oh, like I didn't notice. But but people are really fixated on their phone, I have to say.
Dr Rupy: Yeah, yeah. You can imagine like you're just in your own world.
Rachelle: You see when they avert their eyes. You see when they avert their eyes.
Dr Rupy: She did tell me about that story. I was like, sweetheart, you shouldn't have deliberated for that long.
Rachelle: I know, but I just didn't want to be that, it's also a bit awkward, but I am the first person if I see someone who is clearly pregnant, I will ask whoever's around to give them their seat. But like, I don't know, I felt weird doing it for myself.
Dr Anita Mitra: Yeah, I know what you mean. Yeah.
Rachelle: You wouldn't ask them politely though. Would you ask them politely?
Dr Rupy: No.
Rachelle: I would say, do you mind please giving this lady your seat? Because she's clearly pregnant. Clearly is the word where you know that I'm, yeah.
Dr Rupy: Yeah, yeah, yeah. You're insinuating that they should have done it anyway. So anyway, back to nausea.
Rachelle: So nausea, do we know why some people have it, why some people get it worse than others and for longer periods? And is there anything that women can do to sort of manage, manage it?
Dr Anita Mitra: So no one really knows why some people get more nausea than others. I think everyone will get a little bit, um, but some people it will be manageable, some people it's manageable with medication, some people, you know, they suffer all the way through the pregnancy and never really manage to get on top of it. Um, there's something called hyperemesis gravidarum, which is excessive nausea and vomiting. Um, people can often lose a lot of weight in the pregnancy. In very rare circumstances, and I have seen this, people actually need to have what we call TPN, so total parenteral nutrition, which is where you're basically fed through a drip, um, in order to actually maintain any kind of nutrition. And so one of the factors that we do know is associated with nausea and vomiting is higher levels of HCG. So that's human chorionic gonadotropin. It's the hormone that you test for on a home pregnancy test. And so, yeah, people say if you have higher levels, you're more likely to get nausea and vomiting, but I mean, I've seen patients with very rarely in the hundreds of thousands, millions, um, with things like a molar pregnancy. That's a pregnancy where there's a, the genetics of the pregnancy are not right with the egg, um, and so you have very, very high levels of HCG and those people aren't always vomiting. And then on the other hand, people who are having, you know, a healthy pregnancy have, you know, they can't get out of bed in the morning because they're vomiting so much. So it's not just simply, you know, kind of like a dose related thing. There's obviously more to it and I've never really found a reason why some people get it and some people don't. Um, calling it morning sickness is interesting because I think everybody knows it's way more than just the morning.
Rachelle: No one says it lasts for the morning, that would be pleasant.
Dr Anita Mitra: Absolutely. Um, I definitely found that mine was worse in the morning and I'd wake up feeling sick. And so I would actually, I ended up just taking medication for it. I was taking, um, so an anti-acid medication and also a couple of anti-sickness medications because I just needed to to get through it. Um, and so I would set an alarm half an hour before I needed to get up, take my medication, then go back to sleep. Um, and Manny had made me uh, this little pill box. You know, you get those like days of the week pill boxes. And so I had one every morning, I just open it up, knock them back and then go back to sleep. And then it was the only way I could get up in the morning.
Rachelle: And you found that was effective though?
Dr Anita Mitra: Yeah. But I think definitely, I think it can be worse in the morning if you are hungry, you have low blood sugar. And that's one of the things that lots of people say snacking frequently really helps because you don't want those kind of like peaks and troughs of blood sugar. Um, so that can be really helpful. Um, I don't know what you've had found.
Rachelle: So I had, I had read something about the blood sugar levels and I had done a continuous glucose monitor a few months earlier just by chance. And so I knew what spiked my glucose. So I was really conscious to, because I went in there, I was like, I'll put, carry sick bags with me everywhere. In all of my handbags, I had, um, snack bags of protein. Rupy's laughing. She's not lying. But they're still, they're still in my bag. I still have the sick bag in my handbag. I've never used it, thank gosh. But I found, um, protein snacks really helped. And so I would have like seeded nuts, uh, seeded crackers, nuts, edamame, and all that. And I found that really helped sort of, I guess, satiate me in between meals. And obviously having to adjust meal sizes, like I got to a point, at first I was like, okay, I'll introduce more snacks. And then I was like, I am so full. And now I feel sick from eating more. This is not sustainable. So I started splitting my breakfast and my lunch into two meals. And actually, I think just having less in your stomach and like being able to digest that and then having a bit more was quite good.
Dr Anita Mitra: Yeah, exactly. Not like overloading your, um, your stomach and your, your gut. Um, and I think, I mean, having really high fat snacks can make it worse because if you eat a very fatty meal, it sort of delays the emptying of the stomach and that can make you feel more sick. I think also the, the thing about feeling sick is that obviously your appetite massively changes. Um, and so I always used to have this, it was a, it's a Greek recipe. Um, sorry, it's not from the Doctor's Kitchen app. Yet. It'll be on there soon. Subscribe. Um, but, uh, it's a lemon beef stew. It's a Greek recipe. And it was my absolute favourite and it absolutely turns my stomach now because when I was, uh, when I felt really nauseous in pregnancy, I remember trying to eat it once and I just like, I, it's a beautiful recipe, but I've never ever had it since then.
Rachelle: Oh, that's sad.
Dr Anita Mitra: Yeah, I know. And, and so I think just certain foods will really turn you off and then certain things you just really want to eat. So like people always talk about pregnancy cravings as well. Um, and
Rachelle: Did you have any, Anita?
Dr Anita Mitra: Well, I wouldn't say it was a particular craving. It was just again, this like survival game that I was playing with myself. I've got to play it. Um, but honestly, if people claim they didn't know I was pregnant in the first few weeks, I mean, I don't know what they thought I was doing, but I used to literally go to work and by 8 o'clock in the morning, I was like hoovering down salt and vinegar walkers baked crisps, um, in the like back corridor in theatre. It's like normal Anita. And then if I hadn't had a prawn mayo sandwich by 10:30, good God.
Rachelle: That is super specific.
Dr Anita Mitra: Yeah, I know.
Rachelle: Did you ever put the chips in the, sorry, crisps. Did you ever put the crisps in the sandwich? Because that would be good. I can see that would be good.
Dr Anita Mitra: Too much effort. You don't want to lose your prawns on the floor. And also I was like kind of like hoovering it down in the corridor and like just, you know, when I could. Um, but yeah, I just honestly, the amount of money I must have spent on prawn sandwiches. That is wild. But one of the things that I found really difficult was that obviously, like you know that you're pregnant and you're like, okay, I've got to do everything to try and look after myself and my baby. And and this is the thing, you know, like people hear about, oh, you should eat this, you should eat that. And everyone, when you're pregnant, you just, you, everybody does the best that they can in that situation. So if people are hearing like, oh, this person's eating that and I feel bad because, you know, I've not had like 30 super foods today, then, you know, it's just what you could stomach, right? You just, you're doing the best that you can for you and your baby.
Rachelle: And whatever you can keep down at that point, because I guess keeping anything down, even because like a lot of people say in the first trimester or however long, they can only stomach white carbs. If that's all you can keep down, keep it, like that's great. Eat that because not having anything in your stomach is going to be worse for you and baby.
Dr Anita Mitra: Absolutely. And there's like, there's lots of like old wives tales like, oh, you need to eat like ginger biscuits or like, you know, so many different, everyone's got their different foods, but I just always generally tell people little snacky things, carbs, salty carbs.
Rachelle: Like when you're hung over, salty carbs work.
Dr Anita Mitra: Yeah, so like crackers with a bit of salt on or something or like the, you know, like salted popcorn. Yeah, protein. But whatever you can handle and I mean, I also really went off coffee. You guys know that I'm the biggest coffee fan in the world. I literally cannot function if I haven't had one within like half an hour of opening one eye. And I just didn't want caffeine and it made me feel a lot worse.
Rachelle: Really? So I had a similar experience with coffee because I'm the same, like within half an hour of waking, I must have a coffee in my hand and Rupy won't let me use the coffee machine because he's so precious about it. I'm very precious about it. He has to make the coffee. Like if I press the coffee machine on, he hears it, he's like, Rachelle, step away from the coffee machine. But I found in the first trimester, it was making me feel nauseous. And I wasn't, I had a little bit of nausea, but it was, it was the manageable type. But it was making me nauseous on an empty stomach. So I would literally sit there with a handful of walnuts before Rupy would have give me the coffee and I'd eat them and then that sort of made it like go down a bit better. But I also the year before had swapped and this wasn't because I was planning to get pregnant or anything. Um, but I had swapped my second coffee for a matcha just so I could sleep better. Um, and I feel that I actually sort of do better with the matcha.
Dr Rupy: Yeah.
Rachelle: And I've been able to, because I guess like, how did you manage the coffee withdrawal too? Because that's something that you love.
Dr Anita Mitra: Well, I just had so much nausea, I didn't. I've been through that before because when I went on the my honeymoon to the Maldives, I decided to, you know, influenced by Rupy. By my coffee fast. I decided to stop drinking coffee. And then do you know what happened though? Manny told me, if you turn into a B, I'm going to kill Rupy. And then I was getting really bad headaches. And I was like secretly drinking Coke from the mini bar. I didn't want to tell him because I didn't want to get Rupy in trouble. And then I was like taking paracetamol because I had such a bad headache. And then I went snorkeling and then one day, um, it was really, um, it was really rough in the sea that day we went snorkeling and then I vomited when I was swimming because it was so rough. Oh my gosh. And then I had a terrible headache as well. And I got back and I thought, forget it, I'm having a coffee. Have a coffee. But no, I just didn't, I didn't get any coffee withdrawal when I was pregnant because I probably just felt so bad in other ways.
Dr Rupy: Yeah, yeah.
Rachelle: That would have been cruel. It wouldn't have been, you wouldn't have been able to distinguish what is what at that point. You're getting hit by everything.
Dr Rupy: I mean, so many people have issues with caffeine withdrawal. And I mean, clearly that was one of the most extreme. I never forget, I had a patient, this is when I was working in A&E in Australia. We had a patient, we admitted her overnight and um, I can't remember the exact reason, but she was in for a neurological complaint. And she, she was in the next day during morning round and she was just complaining of this really bad headache. And I remember, I asked the, we were on a ward round with a consultant and we couldn't figure out exactly why she had this headache. They were thinking about doing a lumbar puncture, etc, etc. And I remember just asking her like, do you drink much coffee? Turns out she drinks like six double espressos a day. Get that woman a patch. Yeah. She hadn't had any coffee because we kept her nil by mouth and stuff. So it always, I never forget that. And it's, it's powerful, you know, those headaches, those powerful, they can be really bad.
Rachelle: But going back to nausea.
Dr Rupy: So, so we've established that HCG may be associated or high levels may be associated with nausea, but as Anita rightly pointed out with the molar pregnancy, um, example, it's not a clear cut association. There are some other things in the literature that I looked at. Um, estrogen and progesterone fluctuations may contribute to nausea and vomiting in pregnancy. Also something called growth differentiation factor 15 that I can't admit that I've ever come across before. Uh, that might be associated. Also leptin. So there are some studies that have found that increased leptin levels. So leptin and ghrelin. So ghrelin is like the hunger hormone. The way you remember it is ghrelin makes your tummy grumble and leptin is the opposite. Um, so uh, high levels of this leptin, um, might be uh, related to nausea and vomiting in pregnancy. And there is a suggestion that um, genetic factors may also play a role as well.
Rachelle: My mum was really ill with me. She says I was a challenge from the start. Yeah, yeah. And she was really, really ill. I don't know if she had HG, but it wasn't diagnosed as much back then, but she was really sick throughout. So I was terrified that was going to happen to me. But the other thing I read is vitamin B6, um, may be helpful. And so I started taking a high dose vitamin B complex. Yeah. Yeah. Yeah. We're already on a vitamin B complex anyway. But we went, we went specifically for a higher one that one that had a higher amount of B6 in, yeah.
Dr Rupy: Throw everything at the wall, see what sticks at that point.
Rachelle: So one thing I will say about supplements and things is that, um, so lots of people take like a kind of generic, uh, pregnancy supplement and they're often, it's a multivitamin in most cases. So the most important thing to have in pregnancy is folic acid for the first 12 weeks. Some people will be advised to take it for the duration of the pregnancy. For example, if you are having a twin pregnancy or if you have a, um, a higher risk of, um, neural tube defects, various reasons you might be told to take it for longer, but that's the most important thing. And also vitamin D. Lots of pregnancy supplements have iron in, okay? And so iron can be incredibly constipating, okay? And so you mentioned about the hormone progesterone. Now progesterone slows down the, uh, the gut. So it's one of the reasons why you get super constipated in pregnancy. If you're constipated, then you will often feel more sick. So all of these things kind of play into it. So one thing that can be useful is to, if you're feeling really sick, maybe look at your pregnancy vitamin, just thinking of like small tangible things that are actually useful. And, and, and maybe taking the nutrients that you need and any extra ones that you want or or also need as individual supplements. Uh, okay. Um, and so, you know, using, I always tell people just go to like the pharmacy and get the really kind of like basic ones because they're all, you know, if you're going to be taking lots of them, you just want something cheap that's actually going to get those nutrients in. You don't have to have anything super fancy. Um, but often you maybe don't necessarily need extra iron and that is one of the things that does make people feel really sick.
Rachelle: That's a really good point. That's really interesting. I didn't know you were only supposed to take prenatal those tablets for three months. I'm still taking mine. And I'm pretty sure on the back of it, they tell you to take it also whilst you're nursing as well.
Dr Rupy: There are some nursing supplements.
Rachelle: Yeah, this is an all, this one said it was like a prenatal. I just followed the instructions on the pack. You're a great consumer. When I remember which medication to take, Anita.
Dr Anita Mitra: No, I mean, you can take it. With all of these kind of supplements in pregnancy, it's what you feel comfortable with. So, I mean, you need it in the first few months, but then if you want to continue taking it, that's absolutely fine. Um, it's, yeah.
Dr Rupy: They're pretty harmless those those prenatal supplements. Yeah. I mean, if you if you're not going to utilize it in your body, you'll just pee it out. Uh, and rarely any of those will accumulate. So I don't think you've got to worry about that. Although, yeah.
Rachelle: I was going to say on the nausea, because I want to ask about pregnancy probiotics as well. But on the nausea and keeping in mind, we've spoken about blood sugar levels as well. You know, people say that, you know, when you feel sick, you can have some ginger. So I was having like ginger tea. I didn't think it was that effective. Then people were recommending ginger, so it's like little sweets, but they've got really high sugar in them. So I found this like raw dehydrated ginger. Now, I'd have to, no, no, I'd have to assess, I literally would sit there and be like, how nauseous do I feel? Is it worth me eating this? Because it's like a hit in the face. It's really quite aggressive. But it was immediately effective. You really had to toss up. It was just some brand I found on Amazon. It was just raw dehydrated ginger, but it had no sugar in it. It would clear, it would literally work within minutes, but it was revolting to have.
Dr Anita Mitra: Sometimes a lot of ginger makes me feel really sick because I had a turmeric shot the other day that I was not expecting to be, it was basically a ginger shot with a bit of turmeric on the side. Yeah. And, um, someone gave it to me and I was just like, do you know what? Let's just like, you know, down the hatch. And I was like, whoa, that was a lot of ginger.
Rachelle: It's quite, it's quite an aggressive.
Dr Rupy: This is where some of the old wives tales, there is a grain of truth there. So there are some studies that demonstrate the anti-emetic effect of ginger, uh, at doses of like 500 to 1500 milligrams per day. That's actually quite a high dose. So you tend to get that from extracts, but certain people might be a little bit more susceptible to smaller doses. So you can sort of understand why ginger, but like I've had so many instances where people are like, everyone just keeps on telling me to eat ginger and the ginger's not working. And to be honest, it won't work for everyone. But clearly you had some.
Rachelle: It would, it would work for me. I had it in my like little, in my handbags with my, with my nuts and seeded crackers, my sick bags and my ginger. But I think the point is to look for one that isn't just sugar. Yeah. Because of what you said, there is a little bit of evidence around maintaining your your blood sugar levels.
Dr Rupy: Yeah, and that sugar would like spike your sugar and stuff. And just on that note about glucose spikes, there isn't direct evidence linking glucose spikes to pregnancy induced nausea. Um, but there there might be some benefit in terms of uh, consuming a little bit more protein to sort of keep your sugar levels stable so you don't get those uh, potential troughs that could be troublesome for for folks. So maybe that's why that morning sickness has got a bit of a reputation because that's tends to be when your glucose levels are slightly lower. Um, but yeah, like there isn't a great amount of evidence.
Rachelle: The other thing to say is that obviously, you know, if you need to take medication, you know, if you're dehydrated, you're losing weight, or if you just want to try and get rid of the sickness feeling, it's okay to use medication as well. Absolutely. Um, because, you know, there's lots of medications that have been used for many, many years, um, during pregnancy for nausea. Um, and we do have lots of good data to show that they are safe. So there's a really good guideline from the Royal College of Obstetricians and Gynecologists, which talks about all the different medications that have been used for many years in pregnancy for nausea and vomiting. And, um, yes, uh, they don't have a license to be used in pregnancy. So when we talk about the licensing of of medication, it's all about the the testing that the medication's been through, um, and the manufacturer has to basically prove things to say, yes, this medication is used for this, that and the other. So, uh, the anti-sickness medication, majority that we have are not licensed, um, for use in pregnancy specifically, but have been shown over many, many years to to be safe and to don't have significant impacts on the baby's health.
Dr Rupy: And luckily, it didn't affect you, but like, you got to toss up the the risk uh, benefit profile. So if you can't consume water because you're or you're just vomiting so much, you're losing your your fluid volume, then yeah, taking those anti-emetics and making sure they're rehydrating with electrolytes, etc. It's super important.
Rachelle: I'd make no mistake. If I was ill and needed to take medication to stop being ill, I would be taking it. Yeah, yeah. Absolutely. No judgment here from my end. But what about the pregnancy probiotics? So I was already taking probiotics and then I was trying to work out which ones I could continue to take. And I know that some are targeted specifically for pregnancy and they say they have special strains. Is, is there any science behind this or is it just more like marketing?
Dr Rupy: So, uh, there isn't too much evidence. Um, so what we were able to dig out is, um, a meta analysis of randomized control trials. That's basically a funky word of saying, uh, a load of studies, you put them into, um, an analysis and then you see like if they overall trend in one direction or not. Um, and they found that they were able to detect beneficial bacteria in breast milk. So this is postpartum obviously. Um, they also looked in the same paper, they looked at, um, whether probiotic supplementation during pregnancy reduced the risk of total food allergy in in babies. And they showed that there was a a very small, um, risk reduction. But again, like there's there's not many of these studies and they tend to use the same probiotic strains because they're easy to, uh, to create, um, and ultimately, whatever you put into these studies is, you know, um, you're very limited in in looking at these particular strains. Um, and overall, that many studies don't really show benefit or harm. So I would say it really depends on you. If you feel like it makes you feel better, then there's no harm in taking it. Um, but I wouldn't be sold on the benefits unless I've missed.
Rachelle: Yeah, so I think that a lot of the probiotics on the market find specific bacteria that have been, you know, found in people who have a certain condition or a certain disease. And so for example, you know, this one bacteria, people who have complications in pregnancy, say a premature baby, they have lower levels of that bacteria. So then what people do is they make a supplement and say, well, our probiotic supplements this bacteria, so then theoretically you shouldn't have a pre-term baby. And I have actually got colleagues who are doing some really, really interesting research looking at, um, using probiotics in pregnancies, but at the moment they, you know, don't have really robust data to say, yes, this is what the probiotic is that you should be taking. So what I'm trying to say is that a lot of the data is very heavily extrapolated. And just because people had less of a bacteria with a pregnancy complication, doesn't mean that you taking it is going to make your pregnancy safer or better. So I obviously, you know, PhD relating to the vaginal microbiome, I love all this kind of thing. I'm really interested in probiotics and, you know, my dream would be to actually create really, really effective probiotics for a lot of gynecological health issues. So it's not that I don't believe in them at all. But I personally think at the moment, we don't have very much data to support the fact that everyone should be taking them. If you feel comfortable taking them, great. But actually, I think we should be concentrating a bit more on trying to get them in our diet. Yes. Um, because actually, when you look at the things that have the really good pre and probiotics in, then you're going to be having a really great diet. Yeah. And you'll get much more of the benefits. So like really good fibre, all these products tend to have lots of phytonutrients, so, you know, good chemicals that are going to support our health from another perspective. If you're having like fermented like dairy products, for example, then you've got lots of calcium and vitamin D. So you're getting other things. So maybe actually having them as a whole food. And again, please see the Doctor's Kitchen app. Then, you know, is there like a drop down menu in the app for like pre and probiotic foods?
Dr Rupy: Uh, not but if you type in probiotic, you'll get some of the foods that, um, you we have recipes for. And it's like, you know, things with kimchi and kraut and kefir and all that kind of stuff.
Rachelle: I ate a lot of them. You do actually, you know. Because deliberately though, but I also took, I wanted to know more so around the probiotics, whether I needed a specifically a specific one because I was already taking, taking one. But this goes back to like something we were talking about earlier, immune compromised, like your immune system being slightly compromised. And that's why I guess making sure you've got like the right foundation in your diet can only sort of help.
Dr Rupy: Well, generally your diet is super healthy because you A, because I married you. You're Doctor's Kitchen wife. Uh, but B, uh, you're very cognizant of your diet anyway. You always have like your BBGs, your beans, berries, greens, seeds and nuts every single day. I mean, that's just it's like second nature for you. But then you also supplement that diet with kimchi, like I know you love that brand, uh, Eaten Alive. Oh, that is amazing. That stuff is so good. I love them. The purple.
Dr Anita Mitra: With scrambled eggs on that amazing bread that you always have.
Dr Rupy: Yes. I know. I now make that bread. Ask Rupy, I make that bread.
Rachelle: I'm also someone like I could make my own pesto, but I can easily buy it. Um, so I'm too lazy to do that, but I make that bread every week. Also, I'm gluten-free and that bread is so delicious. And we were talking a little bit before about pregnancy constipation and stuff and like making sure you get the right things in your diet and you're really conscious of that. I've made an effort to make it's so easy.
Dr Rupy: Yeah, totally.
Rachelle: You should, you should link the recipe. It's the best bread.
Dr Anita Mitra: The recipe is on your Instagram, isn't it?
Dr Rupy: It's on Instagram, but it's also on the app as well for free. Um, so we have a whole bunch of recipes that are for free. This isn't the whole podcast about the app.
Rachelle: It's not, it's not, but like what you should eat, but because your immune, so you're talking about like fermented foods, etc. Yeah. Talking about probiotics because I found I kept going down. Like normally if I get a cold, like I'm partial to the common cold, shake it off in a day, maybe a day and a half. I was going down for a week at a time. I probably had three or four colds that floored me for a week in my first trimester or maybe even into the second trimester. So why is your immune system compromised when you're pregnant? I'd love to know that because it feels a little bit just on the face of it, counterintuitive. I would have thought you'd be have super, superhero powers.
Dr Anita Mitra: Well, superhero powers are used in other domains, should we say. Um, no, it's very simply, it's so that your baby doesn't get rejected by your body because it's a foreign object. So you need to slightly, um, and it's not very nice to think of your baby.
Rachelle: Not a foreign object, but you know. That is not the way I expected you to say it.
Dr Anita Mitra: It's a way of protecting your baby. Um, and that's why, for example, um, when some people have autoimmune conditions, um, actually find that it slightly gets better sometimes in, really? In pregnancy. So, yeah.
Rachelle: That's amazing.
Dr Rupy: I didn't know that.
Rachelle: I did start taking a high dose vitamin C as a result because I was like, I can't go down every time I catch a cold.
Dr Rupy: Well, it's really interesting because there's this emerging evidence around the gut placental axis. I mean, there's a gut something, something axis for everything. He's got everything. Yeah, literally does. What's your opportunities? I know. It's where the metabolites produced by uh, your gut microbes may actually reach the placenta and shape the baby's immune development. So whether or not probiotics will have an effect on that, I it's hard to say, but because you're getting so many prebiotics into your diet, you're actually helping with your microbes and that's helping baby's immune system, but that would also help with your own immune system as well. But I guess what Anita said about like the fact that from an evolutionary standpoint, you are growing a quote unquote foreigner inside you.
Rachelle: That is so wild.
Dr Rupy: So you don't want to like reject that foreigner.
Rachelle: That would be the unintended consequence.
Dr Rupy: Yeah, yeah, yeah. It's fascinating. It's really fascinating. Yeah, yeah.
Rachelle: Great.
Dr Rupy: All right. Well, sweetheart, I think that was great. I think you're a very good podcast.
Rachelle: I am so surprised I got an invitation in the first place. I almost fell off my chair.
Dr Rupy: I just, I got an email invite.
Rachelle: An email. How formal.
Dr Rupy: Rupy and I don't email each other all the time. It was a diary management thing.
Rachelle: It's a, Rupy invites you to the Doctor's Kitchen podcast. I never thought I would see the day.
Dr Anita Mitra: I was thinking about this last night when I was having a shower because I was kind of like planning in my head like, you know, what am I doing tomorrow? And I just remember thinking of those times in lockdown when Rupy would be doing like cook alongs with DJ Badalia and you would be like texting, um, on on this like WhatsApp group we had with some friends like, should I go in the kitchen? And because you were like this like hidden facet of his life at that time.
Rachelle: I was banished.
Dr Anita Mitra: And uh, now here you are.
Rachelle: There you go. Will I get invited back?
Dr Rupy: We will see. We'll see what the audience thinks. Will I get an invite back?
Dr Anita Mitra: Yeah.
Dr Rupy: I don't know, sweetheart. We'll leave it up to the uh, the audience.
Rachelle: No, I'm sure.
Dr Anita Mitra: Well, I'll volunteer to babysit for the next uh, postpartum episode.
Rachelle: Oh, thank you. Thank you.
Dr Rupy: I'd like, I'd like to, I think we should do, I think you should do a postpartum one on food. Like that's just so interesting.
Rachelle: Yeah, if you're up for it, that is, you know.
Dr Rupy: We'll see, we'll see what the experience is like.
Rachelle: I just have questions. I don't know.
Dr Rupy: Yeah, yeah. No, that's great. I actually think this is really.
Rachelle: What do different cultures do, right? Yeah. Because like I remember we had lunch with Rupy's parents or dinner with Rupy's parents. And Rupy's dad was like, ghee, mothers, they have a lot of, women have a lot of ghee. And we sort of just like brushed it off. We were like, they're always trying to push ghee. And then I was Googling something and I was like, your dad's right. He was saying that the women in the village ate a lot of ghee because it has something to do something for like breast, um, for breastfeeding. It sort of like stimulates or like your supply or something. And so they're obviously doing it based on years and years of tradition.
Dr Rupy: Well, I mean, the the Occam's razor, the simplistic sort of, um, answer to that is because women need more calories in general. And, and, you know, when you're living in the village, you, you know, you've got limited supply of of food and protein. But you're
Rachelle: Yeah, but, but, but no, no, no, but I read it on an, I don't know if it was a reputable source. No. It wasn't Lad Bible. It wasn't Lad Bible, but they were talking about different things like flax seeds and stuff and they did mention ghee.
Dr Rupy: Yeah, yeah.
Dr Anita Mitra: No, I think it's very interesting like what different cultures do.
Dr Rupy: I think it's really interesting just finding out what Rachelle reads on the internet and then she poses the questions to me. I'm like, you know what, sweetie, if you're reading that kind of stuff, everyone else is reading that.
Dr Anita Mitra: Well, that's the reason I read the Daily Mail. I need to know what my patients are reading about. No other reason at all.
Rachelle: You keep you, yeah, that's what people want to know.
Dr Rupy: Okay. Well, I hope this is very educational for you.
Rachelle: Oh, we're still recording.
Dr Rupy: And I appreciate you coming down.
Rachelle: Yeah, no, we are. I thought we stopped.
Dr Rupy: We can stop now if you like. Yeah.
Rachelle: Another thing that I find, um, well I had from my personal experience and some from some other women I know who are pregnant, pregnant currently, is low blood pressure and like these dizzy spells. Like is there anything you can do to manage it? Because as I would tell Rupy, I'm like, I will have eaten recently. I will be sitting down and then all of a sudden I get dizzy and it lasts for about five minutes or so and you sort of feel like you're out of body at that point. So I'm like, I'm not hungry, it's not like blood sugar or anything. It's sort of unexplained. So is there anything that you can do in that moment or to prevent that?
Dr Anita Mitra: I mean, it sounds like you're doing all the things, you know, like sitting down, elevating your legs, drinking plenty of fluids. Um, I, I mean, I wear compression stockings most days when I'm operating, but definitely in pregnancy, um, I found them quite useful because, you know, keep the blood moving.
Dr Rupy: Do a lot of surgeons do that? Wear compression stockings when they're operating?
Dr Anita Mitra: I've not really asked people about their sock fashion. Maybe I should do a survey. You should do a survey. I don't know. I wear them because I just get really painful calves.
Rachelle: Like cramps?
Dr Anita Mitra: Yeah, I get like pain in the evening. I'll sometimes be trying to sleep and I get really bad cramps. Actually, that's one thing that happened in pregnancy. This is, I'm just talking generally now in life. Um, but when I was pregnant, I started taking magnesium supplement because I was getting really bad, um, leg cramps, um, at night. And it helped. Yeah, definitely. Um, but yeah, I think that, um, it's a really difficult one because it happens for a good reason because there's lots of, um, changes that happen with your heart and with your blood vessels in order to make sure that the baby gets plenty of blood. So your blood pressure will naturally drop in pregnancy. And there's lots of changes that happen even just in the first few weeks, um, that really change about your heart and how your blood flows around the body. Um, because you need to drop the blood pressure so that the blood can go to, um, you know, make sure it goes to the baby and make sure it's flowing around nicely. Um, and it's, you know, it's something that has to happen to keep the baby safe and
Rachelle: Just want to be, hope, hope you're not walking when you get dizzy.
Dr Rupy: Yeah, yeah. What, what were you taking in terms of the magnesium? Was that, do you remember what type of magnesium? Is it citrate or glycinate?
Dr Anita Mitra: The one that doesn't make you have diarrhea. Which one's that?
Rachelle: I think it's citrate because I take, I've always taken magnesium. I'm not a very good sleeper. I always take magnesium before bed, but the calf cramps, the pregnancy calf cramps, oh, it's so painful, so painful.
Dr Anita Mitra: Yeah, yeah. Yeah, I found it definitely made a difference.
Rachelle: Yeah. I was already taking them, so. Also, if you've got a magnesium bath, never does anyone any harm.
Dr Rupy: Magnesium bath.
Rachelle: Are you supposed to have baths when you're pregnant?
Dr Anita Mitra: Yeah, you can do. But again, that if you have a really hot bath, that can make you feel really dizzy and feel really unwell. So but you can definitely have a bath when you're.
Rachelle: Oh, I didn't know. I thought baths were a no-no and saunas I get because they raise your internal body temperature.
Dr Anita Mitra: Yeah, saunas are a no-no.
Rachelle: I miss a sauna.
Dr Rupy: Yeah, I know you do. Yeah.
Rachelle: Um, the other thing I had a question around, what to eat postpartum? So obviously like people will tell you and we learned a lot about this in the, um, the NCT classes about how your hormones are like fluctuating and they're completely different after you have a baby and they have to like settle and it could take up to two years or whatever. What can you eat then? And I'm sure every, like different cultures will have specific things that they do. Um, what can you eat to sort of like manage as best as you can? Not like hack the system. I don't think you can hack that. But make it as, um, smooth a transition or like what can you do to help?
Dr Rupy: So, I mean, apart from like the maternal diet being generally healthy and this is what is frustratingly vague about all the advice. It's like, you know, making sure you get fruits and vegetables, nuts and seeds, omega-3 sources are super important. Um, protein, I think is probably one of the biggest things that people need to concern themselves with, particularly if they're on plant-based or vegetarian diets. So your protein requirements do increase during pregnancy and especially if you're breastfeeding postpartum as well. Um, and so your requirements are anywhere between 1.6 and 1.8 grams per kilogram. So if you weigh 50 kilograms, then you're looking to get at least 75 grams of protein plus. And if you think about like a typical sort of 100 gram piece of chicken breast, that's got roughly 25 grams in. So that's three chicken breasts every single day. That's quite a lot. I mean, you don't need to get it purely from chicken breast, obviously. I'd recommend you get it from a variety of different sources, like tofu, tempeh, edamame, hemp seeds, these are all great sources, peanut butter. But protein's super important because protein is basically the building block of everything, your hormones, your enzymes, um, it's got obviously the structural component, your muscles. So that's super important to make sure you're getting, uh, first. And then everything around it, like the probiotic rich foods, your dark green leafy vegetables, your BBGs, these things.
Rachelle: It's not really different to pre-pregnancy really.
Dr Rupy: Not really, I wouldn't say so.
Rachelle: I was just curious because the hormones obviously, like if there was anything else that you you needed to do.
Dr Rupy: Uh, the the increase in calories is definitely where you want to be more focused postpartum when you're, if you're breastfeeding as well.
Dr Anita Mitra: The other thing I would say is just kind of like from a more like practical point of view as well, is that you, my best advice if you're having a baby is have some food prepped in the freezer.
Rachelle: Oh, yes, that's our task for this weekend.
Dr Anita Mitra: Yeah, because you just like, you're not really going to feel like cooking and there's so many other things that you're doing. But also remember that you're going to be tired because, you know, your baby's going to be waking up in the night and so you'll be sleep deprived. And then when you're sleep deprived, your hunger cues are all over the place and then you kind of want to eat maybe like less healthy things. And that's obviously okay, but, you know, you want to make sure that you've got something that's going to be healthy on hand. Um, some of my friends had their third baby a few months ago and I wanted to get them a gift. Um, but I knew that, you know, when you're having your third baby, you basically got every baby gadget out there. Um, and so I basically said to them like for the next six weeks, I'm going to cook you something every week.
Rachelle: Oh, that's so lovely.
Dr Anita Mitra: And so I made like a massive.
Rachelle: You are already the world's busiest person, so, and you have your little twinies, so.
Dr Anita Mitra: Well, I really like cooking and, you know, look, I'll be honest with you, you guys know, I'm not ashamed of it, but I do have someone who cooks for me every week. So I don't really cook very often because it's the only way I can find to not bankrupt myself on delivery. Other meal delivery apps are available. But so I just like cooked them something every week.
Rachelle: That's so nice.
Dr Anita Mitra: Um, and it was really fun because I was like, oh, what can I put in here that like is going to be really healthy but like really nice and something that's going to heat up really well. Um, and then also like finger foods. So one of my friends, as you know, has a really cool cheese company called the cheese society. And so when my friends have babies, I always send them a box of cheese.
Rachelle: Especially the unpasteurized type that they can't eat during.
Dr Anita Mitra: Well, yeah, and also because it's just such a good like one-handed meal. You, you know, you have it with some nice crackers. Um, and then, you know, just also thinking about other things that you might need after you've had a baby, you know, people, everybody, Rachelle, close your ears here, but everyone's going to bleed a little bit when they give birth. However you have your baby, there's going to be a little bit of bleeding. So, you know, you want to kind of think about like getting some good iron into your diet. That's a good idea. Um, so that's another thing to think about. Protein for healing, again, whichever way you've had your baby, there's going to be some healing to do with the body. Um, so, and also lots of people talk about having oats when you're breastfeeding because apparently it helps to stimulate milk production. People talk about Guinness as well, but you know.
Rachelle: And they always say that.
Dr Anita Mitra: You can make a Guinness oat cake. I'm not sure I would. But I mean, I think just kind of like having, yeah, having a good stock of things in the freezer. Um, and then lots of kind of like snacky things, really good, just because when you're, yeah, when you're sleep deprived, you just.
Rachelle: You just have no headspace.
Dr Anita Mitra: My go-to is a Kit Kat and you don't want to be having Kit Kats all day.
Rachelle: If you have no Kit Kats in the house, you're already winning. So you have like your snacks to hand. Um, are there any like spices or anything? So Anita's mentioned oats. What about like spices, other sort of like things? Because people talk about like lactation cookies and all those for those that are breastfeeding.
Dr Rupy: They do. So we'll do another episode where we go a bit deeper into lactation cookies and what the evidence around that is. I think that might be in some way related to oats because oats have these, um, particular type of plant chemicals that might be, uh, beneficial for that. Um, and then there's flax and then there's a couple of other sort of like isoflavones and and stuff. Um, but and lignans, that's one of the other things. That's why you have a lot of these cookies with with flax seed in. Um, but we'll have to look into the evidence around that. I think some of the important things like, uh, Anita was talking about were iron sources. So yes, you can get that from from animal based proteins, but you can also get it from dark green leafy vegetables if you eat enough, particularly, uh, with vitamin C sources that increases iron absorption. And then, um, uh, things like beans and and uh, legumes, these are good sources of iron, particularly if you're plant-based.
Dr Anita Mitra: And also, sorry, but you don't want to get constipated after your baby's born.
Rachelle: Oh, definitely not.
Dr Anita Mitra: After you don't want to get constipated after you've had.
Rachelle: During or afterwards. You don't want, I mean, never really.
Dr Anita Mitra: Who wants to be constipated? Let's be honest. But no, so everyone always talks about the first poo after having a baby.
Rachelle: They do. I've heard this already. People have told me.
Dr Anita Mitra: If you've had a vaginal birth, if you've had a cesarean birth, whatever you've had, you know, you don't want to be constipated. Um, and so if you get sent home with laxatives, please just take them. Okay? The ones that we commonly give people to go home with are ones that you dissolve in water and some people say they taste really disgusting. So I personally dissolve them in a little bit of squash. Um, and it just helps them go down a little bit easier. Um, but also there is, uh, lots of data looking at having caffeinated drinks. So having a tea or a coffee, um, helps to help your bowels to move. Um, which obviously you're probably going to want when you've got a new baby. But also chewing gum. So chewing gum is my.
Rachelle: I saw this on Instagram.
Dr Anita Mitra: Is my.
Rachelle: Did you see it on my Instagram? No.
Dr Anita Mitra: No. Maybe not.
Rachelle: I saw it on some, she's like, that's the incorrect answer, Rachelle.
Dr Anita Mitra: No, but after having surgery, actually chewing gum helps your bowel to to move. And so I really recommend it is your secret weapon in your hospital bag. Always take some chewing gum.
Rachelle: Really? I, so we just packed our hospital bag and I had a very comprehensive list. I did not have chewing gum on it, but I did see someone post like a reel on this and it was like, my husband's an obstetrician and this is the one thing that he says you should have. Like it was one of those like clickbaity videos that I, I clicked on because I was like, oh, what do I need? I was going to ask you. Good to know that it, good to know that it works.
Dr Rupy: It works.
Rachelle: Um, the other thing I was going to ask around water retention, why do you retain more water? I know there is something about needing to hydrate more when you're pregnant.
Dr Anita Mitra: Well, your, the amount of fluid in your body increases and so your blood volume actually increases by up to about 50%. And so I remember when I was pregnant, everyone, you know, everyone's like, oh, you're glowing. And you're like, well, I feel like, just no makeup. But, um, I do look back at photos of myself and I'm like, wow, I look like I've had a really amazing lip filler. Um, and I think it is just the amount of, uh, the amount of fluid in your body just really increases and you look really glowy and like your skin's really plump. And it's because, like one of the things that your body does is holds on to water, um, because you need to increase your blood volume, um, when you're pregnant to, you know, supply the baby and also in case you bleed a little bit. Don't want to freak you out, Rachelle, but that's one of the reasons why.
Rachelle: I don't think it's really hit me yet.
Dr Anita Mitra: The stork's coming anyway. I don't know what you're talking about. Yeah. We've got, we've got a few weeks. Yeah, yeah, yeah. But a few weeks. Yeah. No, they're all my questions. I think you answered them really well. And this is obviously.
Dr Rupy: Did you want to ask about baby brain? Not that I think you've got baby brain at all. In fact, I think baby, Rachelle's got the opposite. Like she's been probably more focused and more like diligent than anywhere. She wakes up in the middle of the night thinking about tasks.
Rachelle: I do. It's really annoying. No, no, no, Rupy. I felt it. When was like the second trimester, there was like three weeks where I was like, oh my god, I have developed baby brain. And I thought this was a joke. Like I couldn't get my sentences out. I think I recovered from it a little bit. I only forget some things now. Like sometimes I forget to pay for parking. And Rupy will get a fine. He's not happy about that. But I, I felt it for like three weeks. It came on hard. What is the science behind it? Because I know there was, I'm not going to tell you my source, but I saw that there is a recent study on how your brain composition changes during pregnancy and how long it takes to get back to its pre-pregnancy state. What, what can you tell me about that?
Dr Anita Mitra: Well, I feel like I'm in an interview now. As the podcast host becomes podcast guest. Yeah, I mean, there's been lots of really interesting studies looking at the changes in the brain during pregnancy and lots of them are using MRI, so it's a way of, um, having a really in-depth look at the brain. Um, and so the, the recent study that you're talking about is pretty interesting. It's, um, it was published in Nature Neuroscience, um, and it's one patient and they did, I think it was like 20 something MRI scans from before pregnancy up until about two years after the baby was born, looking at all the changes that go on. And there's like huge dramatic changes in the brain. Um, and actually what they showed was that there wasn't really any area of the brain that remained untouched because your whole brain is changing. And it's really interesting what you were saying about you woke up in the night and you're like planning things and stuff. And actually so many people say that they, particularly towards the end of the pregnancy, there's like insomnia happens because you're just always awake, always thinking about things, you're in planning mode. And I think it's kind of like, you know, we always talk about like nesting mode and everyone makes it sound like this really cozy thing of like, you're just like, you know, washing blankets and like holding like baby grows and stuff. Like, exactly. I think the nesting phase is this like frantic thing where you're like, have I done this? Have I done that? I need to do this, I need to do that because your brain is changing because it knows that you're, what you're going to have to do over the next, I don't even want to say a few months, it's like, you know, well, my mum's still sorting me out 39 years down the line. You know, it's, um, your brain just has to function in a completely different way. And, you know, there's been really interesting studies that look at the way that your brain reacts when your baby cries and someone else's baby cries. Um, and I know some people like can't handle the idea of a baby crying, but I think, well, particularly because, you know, I hear babies crying all the time at work, it doesn't really affect me in quite the same way, but when my child cries, you have this like visceral reaction and, you know, like, for example, like last night, one of the twins, he just, he was like kind of crying in his sleep. I think he wasn't really very well. And I literally couldn't do anything else. Like I was, I had all this work to do on my laptop and I was just kind of sat there like, because he was just like crying on and off and like, you know, not enough to like need to go in and like give him a cuddle or anything like that. But, you know, I just couldn't do anything else. Whereas if that was someone else's baby, you just kind of like hear crying in the background and it is because your brain has been programmed to react and and, you know, it's it's fascinating, but yeah, I mean, the kind of like concept of baby brain, I think it's always kind of like this sort of like disparaging thing about women. It's like, oh, you've got baby brain, but it is because you're, you're, your body is reprogramming to take on a completely different role. You know, it's, that's essentially why there's so many really fascinating studies, but essentially, I think that the kind of overarching summary is that your brain is just reprogramming itself for a completely new job.
Dr Rupy: And it's, it's really interesting because it shows how, how sort of malleable the the human brain is that it can react to all these completely different changes that are going on in your body. Yeah, yeah. It's incredible. I I remember coming across that paper as well and like they suggested it is this fine tuning that, you know, you're you're preparing your brain to be more sensitive to a baby's needs, a baby's cries and all that kind of stuff. And just, you know, just actually like we've known each other for so many years now and Rachelle's known you pre and post baby. And seeing your maternal side come out, not that you weren't compassionate before or anything like that, but seeing your maternal side come out is like a completely different facet to your personality that's like wonderful to to watch bloom. And it's, I can see it. It's the the evolutionary explanation behind these fluctuations in hormones that could have literal changes to your brain is fascinating. Yeah, yeah.
