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Sunday, April 17, 2011

Good labor snacks--and why moms need them

There's an old wives' tale that you shouldn't have anything to eat other than ice chips during labor (with the possible exception of clear liquids such as popsicles). The good news: research has shown for years that there are clear risks to withholding food and drink from laboring moms, and that they need calories and hydration to complete the hard work of labor and birth, with literally no benefits at all to withholding food or drink. This means you should be able to eat and drink anything you want! The bad news: most OBs believe the old wives' tale and aren't even aware of research contradicting it.

Chapter 4 of The Thinking Woman's Guide to a Better Birth, by Henci Goer, is called "IVs: 'Water, Water,  Everywhere, Nor Any Drop to Drink." She details the history behind current obstetrical traditions and superstitions regarding eating and drinking during labor, as well as the risks of withholding food and drink from a laboring woman, and risk/benefit comparisons. There are several pages of explanation of why routine IVs have serious risks of their own with no potential benefits; routine IVs do not replace eating and drinking in labor.

Synopsis of Ms. Goer's Bottom Line on Forbidding Food and Drink in Labor:

Pros: None

Cons: Hunger, thirst, discomfort, dehydration sometimes resulting in fever, exhaustion leading to fewer or less effective contractions (which is viewed "Failure to Progress" and is seen as a necessity to augment labor by means of Pitocin or other drugs and interventions), imbalance of electrolytes, drop-off in blood sugar levels producing ketones which can cross into fetal circulation causing fetal blood to become more acidic (acidosis) which is a symptom of fetal distress. Increased perception of pain when hungry and/or thirsty. Seizures can result if mom's electrolytes are out of whack and blood sugar is bottomed out.

What kinds of foods make good snacks during labor? Here's Ms. Goer's suggestion: "Fat delays digestion. Solids must be broken down into tiny bits to pass into the intestines. High concentrations of sugar and acid and either low or high concentrations of salt also slow digestion. Heavily sweetened drinks can also cause nausea and acid in the stomach, which, as we have seen, should be avoided. Icy liquids empty more slowly as well. Given these criteria, choose food and drink that you know you tolerate well, the kind you would consume if you were recovering from the stomach flu."

Eating and drinking small quantities more often is easier on the digestion than larger quantities less frequently.

That being said, it's your labor, and if you're craving something that's on the forbidden list (for example, greasy or rich foods) and don't care if it comes back up, have at it. While not all moms vomit during labor, vomiting can help with dilation.

Many mommas can manage to eat lightly in early labor but don't want to eat as labor progresses. Some moms aren't hungry in labor or are nauseated and food doesn't appeal to them. For a short labor, that's fine; listen to your body. For a long labor, momma will need sustenance from somewhere (if not from food and drink, then from IVs. See chapter 4 of The Thinking Woman's Guide to a Better Birth for full list of pros and cons to that option). Sometimes it's easier to drink little sips in between contractions even in active labor, transition, and pushing, than it is to eat.

I've compiled a list of popular labor snacks and drinks. Feel free to take what works for you and leave the rest behind, keeping in mind your particular dietary needs and preferences.

Labor drinks:

water (will meet your hydration needs but not needs for calories, blood sugar, electrolytes, and more). Bring plenty of bottled water for your birth partner and doula, as well as for yourself for dumping in electrolyte powdered drink mixes.

100% fruit juice (non-acidic). If packing for hospital or birth center, 100% fruit juice boxes are convenient.

electrolyte drinks. You can make your own safe electrolyte drinks if you don't want to ingest the artificial ingredients in Gatorade. Some moms have enjoyed Emergen-C powdered instant drinks for a labor pick-me-up, but as the previous linked article explains, there's a question whether Vitamin C overload (or possibly the imbalance of calcium and other minerals/vitamins in the presence of large volumes of Vit C) can contribute to hemorrhage. A sort-of-natural alternative to Gatorade is Crystal Lite's Pure Fitness powdered electrolyte drink, which contains no artificial colors, flavors, or preservatives, and is sweetened by Stevia.   While traditional artificial sweeteners such as aspartame, saccharin, acesulfame K, etc., are clearly not safe for pregnancy, Stevia may be a safe alternative. I'm not turning this blog into a discussion about Stevia; you can Google it if you're concerned. I've also heard good reviews about Vitalyte electrolyte drink, but I do not have personal experience with it.


coconut water, which contains many nutrients and also contains electrolytes and outperforms electrolyte sports drinks and plain water in research on rehydration.

decaffeinated tea, unsweetened or sweetened with honey

Red Raspberry Leaf tea, which also confers labor benefits (as well as 3rd trimester benefits). You can also blend RRL tea into Pregnancy Punch with apple juice, honey, and frozen red raspberries for a delicious and nutritious labor snack, or freeze it as popsicles.

skim milk

fruit smoothies made with non-acidic fruits (and any other ingredients from this list that sound good, such as honey, yogurt, skim milk, etc.) Here's Birth Faith's Birthing Brew for labor nutrition and possible prevention of hemorrhage (this statement has not been tested by the FDA for effectiveness of use, etc.).

protein shakes/drinks

Light carbs:

honey. Honey sticks, honey packets, honey bears, whatever is most convenient. Honey sticks are easiest for mom to suck on without changing her position.

soft, non-acidic fruits

100% applesauce. If packing for hospital or birth center, individual packs are handy. Here's an innovative form of applesauce packaging: you slurp it through a built-in straw. Handy so that mom doesn't have to change positions.



rice cakes (with jam, honey, applesauce, etc.)

plain bagels (with jam, honey, applesauce, etc.)

toast (with jam, honey, applesauce, etc.)

oatmeal

Cream of Wheat

graham crackers. saltine crackers, any other crackers

cooked pasta, plain or with a bit of salt or cheese

cooked rice. If packing for hospital or birth center, the ready-packs of rice that only need microwaved 90 seconds are a convenient option.

granola bars or trail mix

cereal with skim milk

pancakes or waffles. You can make your own healthy ones ahead of time and freeze them to reheat, or buy pre-made ones. They have healthy alternative ones in the organic frozen section now.

puddings, custards (nonfat or low fat)

Jell-o. Make your own or buy pre-made packs.

sorbet. Individual cups are always a good idea. Do you really want to be looking for an ice cream scoop during labor?

popsicles

lollipops, especially sour ones. They tend to be less nauseating than sweet ones.

Light proteins:

fat-free yogurt or Go-gurt (These taste great frozen, and they have new natural Go-gurts with no HFCS and no artificial colors, flavors or preservatives.)

cheese cubes or string cheese

peanut butter crackers

eggs

chicken noodle soup or broth

protein bars

Don't forget to have more substantial food to sustain your birth partner (husband or significant other), doula, and possibly your midwives (if homebirth). Crackers likely won't tide them over. Also, Mom will likely be ravenous after delivering and will want a hearty meal to reward her for her hard work.

If your hospital has a policy of "nothing but ice chips or clear liquids," it's best to discuss this well in advance with your care provider to see whether this is strictly enforced or whether most moms do in fact eat and drink freely while in labor at that facility. Find out early enough so that if this is going to be a problem, you have time to shop for another care provider or another birth location.  If you cannot or choose not to change birth location, you can pack a small lunchbox/cooler of foods and drinks for your birth partner who will certainly be very hungry and thirsty. If any staff asks about the food stash, you can truthfully tell them that your birth partner gets hungry and needs to eat to maintain blood sugar and supportive mood. Do you catch my drift? Good, because I would never tell you to lie to staff or care provider.

Now, go eat, drink, and be merry!

What did you eat and drink during labor? What did you wish you could have but didn't/couldn't? What was satisfying?

9 comments:

  1. AWESOME! I will save this and send to my doula clients.
    Also, Ultima Sports Mix is a natural electrolyte powder mix that is sweetened with Stevia. Its sold in most health food stores and it tastes really good.

    Thanks for taking the time to put this together. Great list.

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  2. Any suggestions for moms that have a tendency for low blood sugar?

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  3. Great post Sarah! I've got some of those Crystal Light with Stevia things.. packing them in my birthing center bag now! :-) (as well as a few of the other snacks you mentioned :-) Thank you!

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  4. Anonymous, of course this comes with the standard caveat of "Double check with your care provider. I don't give medical advice. Don't sue me." My understanding of low blood sugar tendencies is that it can be helpful to eat smaller meals/snacks more often (any time your body has tendencies toward low blood sugar, whether it's during pregnancy, labor, postpartum, etc.). It can also be helpful to combine a healthy protein WITH a complex carb. Simple carbs can spike your blood sugar, then cause a plummet, but a complex carb will bring your blood sugar up in a more healthful way, then when that wears off, the protein begins to kick in to help sustain. I hope you find something that works for you.

    Sherah, I'm so glad! Have a great birth. :-)

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  5. With my last birth (first home birth) I didn't plan for this but my midwife had "GU" which is like an athletic electrolyte and I think protein kind of gel that is very easily consumed....it kept me going just long enough to push my sweet sunny side up girl out!! I'm due with my third baby in 19 days and am picking up some this weekend for when it is time...

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  6. That sounds like a great option, Kristin. Thanks for sharing. I hadn't heard of that brand before but will keep that in mind. I'm guessing it's this line of products:
    https://guenergy.com/
    I like to keep items like that in my doula bag, too, either for laboring mom, for dad, or for myself.
    Congrats on your awesome sunny-side-up homebirth and best wishes for your newest baby soon to come! I'd love to hear your birth story when he or she is here.

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  7. I plan on taking some soy milk with me. It's super gentle on the stomach and full of protien, so it should keep me going for a while!

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  8. Coconut water is an essential in my doula bag :)

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  9. I know this article is old, but I just wanted to say thanks for the info and suggestions!! My first labor was 41 hours in the hospital, and I hadn't eaten prior to being admitted for probably 8 hours ... and no, they did not let me eat at all. All I could have was whatever sugary drinks they offered and water. Now I see that it's possible (probably likely!) that their withholding food, despite my approved birth plan and begging, caused my labor to be longer than it had to be, and a "need" for pitocin. I was so lightheaded during pushing I had to only push on every third contraction (pushed for 3 hours), but I'm very grateful I was able to birth my daughter vaginally and with no pain meds! Now I'm due in a month with my son, will be at the same hospital, and I've already informed my doctor I'll sign an AMA so I can eat. Not being able to eat for 2 days was far worse than any labor pain, and I refuse to go through that again! I can't eat gluten or soy so I'm thinking I'll make my own peanut butter crackers using mini rice cakes, organic PB, and raw honey :) And I'm so excited to have an "excuse" to drink coconut water! Thank you again, just being nourished will make this so much better of an experience for me, and my baby I'm sure.

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