Prenatal Reflux – Holistic Relief

When I was a little girl, I would stick a pillow up my shirt and parade around madly giggling with my sisters, all the while pretending to be pregnant. I would eventually get bored and “give birth” to my precious baby, fawning over it for as long as my short attention span would allow. What innocence. What FUN!! However, the reality of pregnancy can be anything but. Women do not necessarily all experience pregnancy as a slew of discomforts and complaints, as each blessed mother on this planet is different (and for that matter, each pregnancy can be wildly different as well). If you’ve been lucky enough to avoid prenatal doldrums, fantastic! – no need to read on. But for many of us, it can be a shock to discover that our romanticized visions of pregnancy were as far off-based as our staunch belief in the Tooth Fairy.

What you may have discovered is that frolicking while carrying that fluffy little pillow tucked under your shirt has been replaced by groaning while merely attempting to sit up or turn over in bed. Sneezing? Coughing? A virtual guarantee of gut wrenching uterine ligament pain. I know for a fact that your mommy never told you that morning sickness could last all day. And I’d imagine, as a girl, you never dreamt of waking all night long in order to relieve your over-cramped bladder! Your skin will itch. Stuffy nose? Headaches? SCIATICA?!?! WHAT?!?! There are so many potential pregnancy complaints, it’s impossible to address every one in such a short-feature blog. However, if I leave you with anything today, I hope to A) make you laugh, because I truly believe that humor is a special kind of medicine (and learning to laugh at absurdity now will surely help to get you through those long days cleaning spit-up and dirty diapers and the long sleepless nights), and B) give you hope that there ARE many miraculous tools with which to ease your prenatal discomforts. And you’ve made it this far, so you’ve probably figured out that the P-Knot is one of my favs. So today, let’s talk about my least favorite prenatal complaint and the power of the P-Knot.

I had the most horrific acid reflux while pregnant with my first son. By the by, they say reflux means you’ll have a hairy baby – “they” were wrong. Prenatal reflux occurs for many reasons. The hormone, relaxin, peaks during the 14 weeks of your first trimester, and again during labor. Relaxin is an amazing hormone, which serves a virtual cornucopia of purposes – it is responsible for everything from preparing your uterine lining for pregnancy to regulating the mother’s cardiovascular and renal systems to help her adapt to the increase in demand for oxygen and nutrition for the fetus (and subsequent waste removal). Another important role is to loosen your pelvic ligaments, allowing your cervix to soften and dilate, and your hips to widen, permitting passage of your little one. I have news – relaxin softens ALL of your ligaments. Word to the wise, wear supportive shoes through your pregnancy unless you want to go up a shoe size! It may also cause laxity in the ligaments which normally keep the sphincter between your stomach and esophagus closed. Alas, stomach acid isn’t meant to backflow into your esophagus, but for many unlucky women, it is inevitable. Additionally, as your pregnancy progresses, your wee lad or lass (and your now ginormous uterus and accompanying placenta) rises in your abdominal quadrant, squeezing your vital organs, further encouraging the backflow of stomach acid. These are unfortunate, but normal, physiological factors which are part of the natural progression of pregnancy. And there’s very little you can do to change them. However, there is one factor which you CAN change – the structural component.

Prenatal Reflux - UltrasoundAs your baby grows, your added weight forces your body to distribute differently through your structure. And that pesky hormone relaxin is at it again, relaxing ligaments from head to toe. Your hips rotate forward in an anterior pelvic tilt, putting strain on your gluteal muscles to stabilize tighter hip flexors. Your baby-belly bulges forward, weakening your core (or as I prefer, your “deep anterior line” – but that’s a subject for another blog), your thoracic spine compensates by curving kyphotically (aka hunchback), which forces your anterior ribcage and pectoral groups to shorten, and most unfortunately, putting additional flexion in your already overburdened upper GI tract. Your cervical spine curves more dramatically and your head protracts forward to steady the staggered weight below. Your perfect plumb-line of posture, in short, begins to resemble the zig-zag patterns of that lovely Minky Chevron sheet set you’ve chosen to adorn the baby crib. Have faith, ladies (and gentle-creatures, those sweet future fathers who care enough to read a blog about reflux – for you surely love your partners!), this is where the P-Knot comes in.

The most effective relief for acid reflux (besides eating papaya!) can be achieved by addressing your posture. Consequently, this catch-all solution has the added benefit of relieving (drum-roll)… leg and foot cramping, sciatica, low back pain, thoracic pain, tightness of breath (that feeling you get when you try to talk and move at the same time, and realize that somehow you’ve lost the coordination to BREATHE as well!), neck pain, carpal tunnel syndrome, tension headaches, and more. But the reflux, as it is my extraordinary nemesis, I will take a bit more time to explain. For simplicity’s sake, we’re just going to stick with P-Knotting for prenatal reflux, for now. I’m going to make life a lot easier for both of us, and save a fair amount of time in the process by posting a how-to video. After all, you have a nursery to organize and stock, hospital bags to pack, OB appointments to get to, hopefully a massage or two to get to, and time is of the essence.

You might be asking yourself, where on earth am I supposed to place the P-Knot to address acid reflux? The simple answer is the diaphragm, sternum and pectoral girdle. The diaphragm stretches up like a balloon underneath your ribcage, but rolling any portion of your lower ribcage will help to loosen it – IF you’re diaphragmatically breathing while you’re on the P-Knot. Breathe with your BELLY, NOT your ribcage!! These areas can be particularly sensitive, so even if you’re a hardcore P-Knot Starfish-thrower, I strongly advise rolling against a wall, not the floor. Your breast tissue may be tender, your belly will likely be too much of an obstruction by the time you develop reflux, and you don’t want to be in a compromised position down on the floor with excess pressure on sensitive areas – and have to struggle to extricate yourself, potentially causing more damage in the process. So let’s save your sacroiliac joints and work vertically. My go-to location is not a flat wall, but rather a door frame. Reason being, you can lean against the P-Knot placed on the door frame, and extend your head to either side as opposed to mashing your face into a wall. But to each her own. Additionally, within the space of a door frame, you can also put traction against the opposite side of the door jamb to enhance the pressure, if so desired.

While P-Knotting, particularly if you dare to try doing it against the floor, try to engage your transverse abdominis (in the middle of your abdomen). Pretend your belly button is a sphincter muscle, and gently “kiss” the front of your spine with your belly button. It’s not a make-out session, this a very small contraction, so think “pucker inwards”. This deep abdominal muscle creates greater integrity in the core when engaged, and it will help to prevent strain while in compromised positions. So, engage your transverse abdominis when you’re rolling over in bed, bending down to pick something up, reaching across your body, sneezing, coughing or any time you’re likely to feel the tug of uterine ligament pain. If you don’t know if you’re doing it right, think less than more, and fake it until you make it.

PLEASE, before P-Knotting, a word of caution!!! For healthy pregnant mommies, I would like to strenuously request that you take it SLOWLY in your first “reflux” session, or any body-rolling session for that matter. Your body is not your own at the moment. Keep in mind that pressure you may have been able to withstand before pregnancy no longer holds water… like you do. The key word is baby steps. Go lightly and see how you feel. Tomorrow, add a bit of pressure if you’d like. But don’t go full- tilt-boogie like a Type-A personality. Pain (or discomfort) is not a symptom to eradicate like some sort of infectious disease; it is a powerful form of communication from the body. Listen to it. Honor it. Respect its boundaries.

Below is an image of lines of tension and trigger points to address prenatal reflux. P-Knot along these areas with the speed of a very hungry caterpillar – ok, a moderately hungry caterpillar. And if you have yet to order a P-Knot, you may use a tennis ball or a pinky ball (usually you can get them for a buck at the Dollar Store or some equivalent). Though personally, I stick by my preference for the P-Knot. It is the best self-care tool I have discovered – and I’ve tried my fair share. As far as any personal gain disclosures are concerned, I gain nothing from promoting the P-Knot, with the exception of healthier, more pain-free clients. And giving my clients access to self-care tools which contribute to their wellness is the foundation of my business.

Prenatal Reflux - Diagram

There is also something else to consider. Common reflux can be the result of acid backflow through the lower esophageal sphincter, but it can also be caused by slower gastric emptying (from the stomach into the duodenum). Evidence-based research demonstrates that gastric emptying can be improved by lying on one’s stomach. Yup, you read that right. Keeping your body upright after eating in order to avoid reflux and regurgitation is not always the answer. And this goes for baby, too. Pressure to the abdomen in the prone position (face down) triggers interoception (our sensitivity to sensations originating within our bodies, such as pain, hunger, breathlessness, organ sensations, etc) and the relaxation response. Unfortunately for those of us who are well into the 2nd and 3rd trimester, lying prone is not possible. However, you CAN kneel and lean over a physio ball with the pressure on your upper abdomen and ribcage. Please make sure that the pressure is well above the fundus height (top of your uterus). If you are unsure where your fundus measures, be conservative and stick to the ribcage. Hang out and diaphragmatically breathe – big belly breaths.

I hope I’ve been able to shed some light on the storm cloud of prenatal reflux. So be well, mommas. Drink water! And don’t forget to check in for the next blog on labor preparation, coming soon!

Disclaimer: This blog is not designed to take the place of a physician’s advice. If you have any questions or concerns regarding your health and ability to perform these gentle exercises, please speak with your obstetrician or general practitioner.

Sara Riley
Sara Riley

Sara Riley is a licensed massage therapist who has 14 years’ experience in private practice treating acute and chronic pain and over 10 years’ experience working with prenatal and perinatal clients, including labor preparation and several occasions of facilitating childbirth. Sara is certified in MotherMassage™ and is also a certified TummyTime!™ instructor.

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