In my practice, I like to start with the basic pillars of health to rebuild a strong foundation. These can include plenty of nutrient-dense meals (with enough protein, healthy fat and whole grains), adequate hydration, a strong village of support (friends, family, healthcare team), finding rest when they can and movement in nature. I also order blood work to rule out nutrient deficiencies (such as iron, folate, zinc, vitamin D and B12) or thyroid hormone imbalances. 6,7 In ad-dition to dietary counselling, an effec-tive way to prevent nutrient deficiencies is to continue taking a good quality prenatal supplement postpartum until nutrient status normalizes or until cessation of breastfeeding. The addition of an anxiolytic de-pends on the severity of symptoms and options for a pharmaceutical or herbal supplement should be reviewed on an individual basis. These agents will enter the breastmilk to some degree, so re-viewing observational safety data along with close monitoring of the infant is important here. Valerian root is an ex-ample of a herbal anxiolytic that can be made as a tea, tincture or bath soak. 8 Acupuncture is another effective strategy to relieve perinatal and post-partum mood disorders. A systematic review and meta-analysis of its effec-tiveness for a number of postpartum emotional disorders is underway. 9 patients can be found through Anxiety Canada and in the reference section below. REFERENCES (2019). Maternal Mental Health in Canada. Statistics Canada 2Angarath I. van der Zee-van den Berg., et al (2021) Postpartum depression and anxiety: a community-based study on risk factors before, during and after pregnancy, Journal of Affective Disorders. Volume 286 3 Zappas, M. et al. (2021). Postpartum Anxiety. The Journal for Nurse Practitioners. Volume 17, Issue 1. 60-64. 4(2022). Recognizing Post-Partum Anxiety. Anxiety Canada 5 Somerville, S., Dedman, K., Hagan, R., Oxnam, E., Wettinger, M., Byrne, S., Coo, S., Doherty, D., Page, A.C. (2014). The Perinatal Anxiety Screening Scale: development and preliminary validation. Archives of Women’s Mental Health. PDF Version: https:// drsarahallen.com/wp-content/uploads/2015/10/ PerinatalAnxietyScreeningScale2.pd 6. Lee, D. (2021). How are Micronutrient Deficiencies Associated with Outcomes of Postpartum Anxiety and Depression in Women? Human Ecology. Vol. 5 7 (2016). Guideline: Iron Supplementation in Postpartum Women. Geneva: World Health Organization 8 Nice, F. et al. (2001). Herbals and Breastfeeding. 9 Luo, N., Wang, Y., Xia, Y., Tu, M., Wu, X., Shao, X., & Fang, J. (2022). The effect of acupuncture on condition being studied emotional disorders in patients with postpartum: A protocol for systematic review and meta-analysis. Medicine, 101(4), e28669. RESOURCES AND ONGOING MANAGEMENT Raising awareness, providing resources and implementing regular screening can help prevent and manage postpar-tum mood disturbances including anxiety. Parents may not report these feelings due to shame, quilt or not recognizing the severity of their symp-toms. As clinicians, we have the oppor-tunity to hold the space for new parents that may be feeling this way and to start a conversation that enables informed decision making around a treatment protocol. Resources for clinicians and ADVANCED CLINICAL NATUROPATHIC MEDICINE Advanced Clinical Naturopathic Medicine engages the reader and evolves their knowledge and understanding from the fundamental Clinical Naturopathic Medicine to a more specialized focus. This new title showcases how transformative and effective naturopathy is and offers insight into the depth of naturopathic practice and its vital role in the healthcare system. With the profession constantly evolving and naturopathy more-often incorporated into specialty practices, this publication is a timely resource. Scan Code to Buy Book $141.75 Item #0729542654 877-267-3473 annexbookstore.com www.Cndoctor.ca CND_Bookstore_HP_JulAug22_CWM.indd 1 July/August 2022 Chiropractic and Naturopathic Doctor 19 2022-06-27 8:28 AM
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