This week I was interested to read a new study in the American Journal of Obstetrics and Gynecology which showed that ear acupuncture can significantly reduce low back and pelvic pain in pregnant women. You can read the full text of the study here. This is not the first research study to look at this. In fact in 2005 I was interviewed by ABC news about a previous study in the British Medical Journal that also showed acupuncture can help with pregnancy back pain. You can watch that clip here.

Up to 1 in 5 women suffer from back and pelvic girdle pain in pregnancy. Usually our patients complain of pain in the low back and buttocks although some patients also feel discomfort at the front of their pelvic area. Some women also experience radiating pain down one or both of their legs. Most women tell us that the pain gets worse if they have to stand for a long time. In 7% of women the pain continues after they have given birth becoming a chronic lower back issue.

At the YinOva Center many of our pregnant patients are keen to avoid medication, if possible, and so they choose acupuncture as a gentle and safe way to treat their pain. We usually use a combination of ear acupuncture as described in this recent study and local acupuncture as outlined in the previous study. The local acupuncture works in three ways – the needles act on the nervous system to interrupt the pain signal, the combination of needles causes the body to release chemicals which act as natural pain killers and by needling the spasms we get the knots in the muscles to release.

In the recent study the patients only received ear acupuncture which has a long history of efficacy in China and has been found in clinical research to initiate an endorphin release. 152 women, in late pregnancy, were divided into three groups one of which had small acupuncture needles held in place by tape and retained in three ear acupoints for one week. Another group received sham acupuncture and the final group acted as a control and received no acupuncture at all although they were instructed to rest and take painkillers if necessary.  81% of women in the ear acupuncture group reported a significant reduction in pain as oppose to 59% of the women in the sham acupuncture group and 47% of the women in the control group.

Acupuncture is a time-tested therapy for pain relief and because it has few side effects is one of the safest ways of releiving pain in pregnant women. Most of our patients get relief from the combination of ear and body acupuncture and usually feel much better after 2 or 3 treatments. Other helpful treatments include gentle stretching exercises as well as massage by a qualified prenatal massage therapist and we usually suggest that women do one of these in conjunction with their acupuncture treatment.

I recently wrote a blog entry that was all about influencing the sex of your baby. All that talk about X and Y chromosomes prompted one of my patients to ask me about Fragile X syndrome. She had just been diagnosed as a carrier for this disorder and wanted me to help her sort through her options.

What is Fragile X Syndrome?

Fragile X is a genetic disorder and is the most common cause of inherited mental impairment and cognitive problems including some forms of autism. It is caused by a mutation of the FMR1 gene on the X chromosome. The mutation turns off the production of the FMR1 protein which in turn affects brain development. People with Fragile X suffer from mental impairment which can take the form of anything from very minor learning difficulties to severe cognitive problems. They may be hyperactive or over sensitive to stimuli and they may have short attention spans. Physically people with Fragile X may have a long narrow face, prominent ears, enlarged testicles and loose joints. Approximately 1 in 2000 boys suffer some kind of mental impairment due to Fragile X. The disorder also affects girls but the incidence is lower and the symptoms tend to be milder. This is because girls have 2 copies of the X chromosome whereas boys only have one. This means that girls have 2 copies of the FMR1 gene so if one is mutated a girl has another copy of the gene to fall back on. Boys only have one X chromosome.

What does it mean to be a carrier of Fragile X?

Fragile X syndrome is carried on the X chromosome. Since men (XY) and women (XX) each have at least one X chromosome, both parents can be carriers.

If a father is a carrier, he can only pass the gene defect to his daughters, since he transmits a Y chromosome to his sons. All of his daughters will inherit the gene, but as far as anyone knows this inherited defect will be in the premutation stage which means that if a daughter inherits Fragile X from her father she will not be symptomatic although she can pass the disorder on to her children.

If a mother is the carrier, she can pass the gene defect to either her sons or her daughters, since she contributes an X chromosome to each. If, as a woman, you are a carrier you have a 50% chance of passing the gene on because you have two X chromosomes and only one of them is affected. So if you are a carrier you may not pass on the defect at all or you may just pass on the premutation or your child could inherit the full syndrome. Sons who have fragile X are at high risk of intellectual disability but daughters who receive the fragile X gene may appear normal because the have two X chromosomes and only one is affected.

If you are a carrier how is risk assessed.

A simple blood test can establish if you are a carrier of Fragile X and the degree to which this mutation is likely to cause problems for your child. Geneticists classify the gene mutation into three categories based on the number of repeats of a pattern of DNA called CGG repeats. Individuals with less than 60 CGG repeats have a normal gene. Individuals with 60-200 CGG repeats have a premutation which means they do have a small risk of their child suffering from Fragile X syndrome and that risk is directly related to the number of CGG repeats. Parents with over 200 repeats have a full mutation which causes fragile X syndrome.

As for my patient. She fell into the middle ground in that she had the premutation and so was at a small risk of passing on Fragile X. Fortunately we live in a time when we have access to good genetic testing and advice. Her doctor was able to reassure her that, because the number of CGG repeats was low her risk of passing this disorder on to her child was minimal. An amniocentesis at 16 weeks was able to confirm her doctor’s prediction and she was relieved to hear that her baby was just fine.

Although it’s scary to find out that you are a carrier for a genetic disorder such as Fragile X, it’s important to find out more about your own situation. You may find that with a combination of genetic and prenatal testing you , like my patient, receive reassuring news.

I enjoyed this video by Alice Eve Jones performing an extract from her book, What I Thought I Knew. In it she describes how, after a long struggle with infertility, she was told she was in menopause, only to find out that she was pregnant. Recently Dr. David and I were consulted by a patient in her mid-thirties who was told she was menopausal and that she should give up all hope of bearing her own child. She’s now four months pregnant. Miracles do happen. In fact they happen all the time.

Thanks to Njemile Carol Jones, an fabulous acupuncturist in Maryland for sending me this link. Njemile specializes in OB/GYN with a particular specialty in treating infertility. So if you are looking for an acupuncturist in the MD or DC area she would be an excellent choice.

Todays blog is written by YinOva Acupuncturist Margaret Sikowitz.

I’m very excited today. It is my daughter’s 7th birthday so there is an air of festivity abounding AND I just learned that one of our overdue pregnant mothers-to-be just gave birth. However, the patient in question was a bit disappointed. First she missed the cut off set by her hospital’s birthing center by going too far past her due date, then her doctor diagnosed her with low amniotic fluid and she had to be induced. (She responded beautifully to pitocin, labored for a few hours and gave birth to a healthy baby girl!)

I can relate. I am truly blessed with two healthy children. Still, neither wanted to come out and needed a fair bit of coaxing. Here at the YinOva Center we often get asked about our own experience of labor, especially by the soon-to-be moms. I’m happy to volunteer that mine were not easy, and that both needed an epidural and pitocin. While it wasn’t what I wished for or envisioned, it seemed the right move at the time and I definitely got the prizes in the end. I think the acupuncture treatments I had before labor definitely helped and I have no doubt that the ones I managed to squeeze in after aided my recovery (and my post-partum depression, more on that later.)

In Chinese medicine, female life cycles occur every 7 years (it’s 8 years for boys, they’re always a little slower…) So today I celebrate the birth of this new baby, the first cycle of my daughter and more importantly, the unpredictability of life! Toward this end, here’s a gem I often ponder, given to me by one of my first Chinese medicine teachers:

Be flexible like the tree and you can withstand all the changes of the seasons.

In our book Making Babies: A Proven 3-Month Program for Maximum Fertility Dr. David and I discuss the alarming fact that male sperm counts have halved since our grandfather’s generation. My patients are shocked when I tell them this and their next question is usually, “why?”. I always answer that it’s hard to lay the blame on one thing, but that our generation has been exposed to the kind of chemical cocktail that would have been inconceivable in our grandparent’s time.

So it was with some interest that I read a new report, authored by Professor Richard Sharpe, a reproductive biologist of the Medical Research Council in the UK, linking the use of chemicals found in food, cosmetics and cleaning products to an increased risk of birth defects, testicular cancer and infertility among unborn boys. You can read about this report on the BBC website here or download a PDF of the actual report here. Professor Sharpe, a reproductive biologist, discusses the threat to baby boys of chemicals that block the action of the male sex hormone testosterone, or mimic the female sex hormone estrogen, which can “feminize” male infants whilst still in the womb. He points out that chemicals that are harmless on their own may be having a cumulative effect that is more sinister.

There is no doubt that male reproductive health is deteriorating – more male babies are being born with birth defects effecting their penises, testicular cancer is on the rise and sperm counts are dropping. Collectively these symptoms are known as Testicular Dysgenesis Syndrome, which is a term used to describe the disruption of testosterone in boys. The report examines animal studies that link testosterone-disrupting chemicals to de-masculinization in wildlife.

So what can we do? It would seem that pregnant women are mostly at risk in weeks 8 – 10 of their pregnancies but it makes sense to avoid environmental toxins throughout pregnancy and if possible in the period before conception. As Dr. Sharpe told the Daily Mail. “You can’t do anything about chemicals in the environment but you can control what you expose a baby to through your lifestyle choices. Because we don’t know the complete list of chemicals that may be hormone disrupters, and we don’t know how they interact, we can’t point a finger at an individual chemical. The message is to avoid them, just as you should avoid alcohol and drugs.”

So at the YinOva Center here is the advice we give out Moms-to-be

• Avoid processed foods where possible. That means limiting foods that have been made in a factory.
• Eat as much organic food as your budget will allow. Patients often tell me that the cost of eating organic is what puts them off and I understand this from my own experience. In this YinOva blog entry from last year, I described how, in my own family, we cut down on food wastage in order to be able to afford to eat better quality food.
• Switch your deodorant to one that is made from natural ingredients. After trying quite a few natural deodorants, with mixed results, we decided we really like this one which you can get on Amazon – Alvera Aloe Based Roll-On Deodorant.
• Use natural soaps and cosmetic products. Tom’s of Maine is a great brand as is Kiss My Face. When I was looking for a good natural toothpaste I tried many brands and settled on the Triple Action Aloe Vera Toothpaste by Kiss My Face for it’s minty taste and clean feel.
• Each American family uses about 40lbs of toxic cleaning products every year. This site has some good advice about making your own non-toxic cleaning kit. In my own house I’ve been impressed with how much cleaning can be accomplished with vinegar, baking soda and lemon juice.
• Don’t panic! I know how overwhelming information like this can be and really all we can do is our best. There is no need to obsessively avoid every chemical out there. Just cut down the chemical load you are exposed to.

Are you sick of your pre-natal vitamins? One of our lovely YinOva “Moms-to-be” emailed me with this great suggestion. She has developed a taste for belly-bars from a company called Nutrabella. These tasty snacks are fortified with all the nutrients women need when they are trying to conceive or pregnant. When I looked at them I was impressed to see that not only do the bars contain all the vitamins and minerals you need but also omega 3 fatty acids which have been shown to be important to your baby’s development.

The bars come in the following flavors

• Baby Needs Chocolate, Chocolate Toffee Crisp
• Mellow Oat, Oat Graham & Yogurt
• Crunchy Nuts & Berries
• Burstin’ Chocolate, Deep Chocolate Orange

Tell me what you think.