Moxibustion for breech babies explained

Babies lying bottom first or feet first in the uterus instead of in the usual head-down position are called breech babies. Breech is common in early pregnancy, and by 36-37 weeks of pregnancy, most babies turn naturally into the head-down position. If your baby remains breech, it does not usually mean that you or your baby have any problems and if attempts to turn your baby into the head down position have not succeeded, your birth options are either an elective caesarian or a planned vaginal breech birth.

In the UK, if your baby is in the breech position you will be offered an External Cephalic Version (ECV), a procedure to turn your baby to a head-down position. It involves an experienced obstetrician placing their hands on your abdomen to manually move the baby up and out of the pelvis. They will attempt to turn the baby through a forward or backward somersault to a head-down position. Attempting ECV is performed to increase your chances of having a vaginal birth (80% chance) and lower the chances of a caesarean section. Up to half of all attempts are successful, but ECV success rates differ in each hospital. Women who have this done describe it as being uncomfortable.

Another technique called ‘moxibustion’ is used in traditional Chinese medicine to encourage version of the foetus in breech presentation. It is a method that is suggested as an alternative to ECV by the Royal College of Obstetricians and Gynecologists (RCOG) and an increasing number of maternity units across the UK refer patients for moxibustion. So what exactly is moxibustion and how can you seek treatment?

What is Moxibustion?

Moxibustion is a traditional Chinese method of acupuncture treatment, which consists of burning the dried leaves of a plant called Moxa (also known as Mugwort) and use the heat generated to stimulate specific acupuncture points on the body.

The method

There are various forms in which moxibustion can be applied. One form used to correct the baby’s position in case of breech position during pregnancy is called indirect moxa – with this method the moxa leaf is pressed into a stick, which can resemble a cigar or small rolls.

The technique consists of lighting a moxa stick and bringing it close to the skin close to the acupuncture point located at the tip of your fifth toe, until it produces hyperaemia (increase of blood flow) due to local vasodilatation. The heat felt should be warm but not uncomfortable.

Women with a breech presentation may seek treatment with moxibustion from 32–38 weeks but it is preferably performed around 34 weeks of pregnancy. The baby at this stage is small enough to turn and big enough to remain in the head-down position.

Moxibustion may be administered for 15–20 minutes each time. Ten treatments comprise a course, and can be carried out once or twice a day.

There are usually increased foetal movements during the treatment and for a while afterwards. A possible mechanism is the influence of moxibustion on maternal cortisol levels leading to increase in foetal movements.

The benefits

Generally, moxibustion is used to warm areas of the body with the intention of stimulating circulation and lymphatic flow. It also helps to smooth the flow of Qi and blood and expel pathogenic influences. The scent of moxa is very distinct and many people find it to have a therapeutic and relaxing aroma.

Published evidence suggests that moxibustion has a positive effect and play a part in reducing the number of breech presentations at term. Therefore, it is effective in reducing the need for an external cephalic version (ECV) and contributes to a reduction in the number of caesarean sections which are so often advocated in breech presentation. There have been no reported side-effects for mothers or babies.

Contra-indication:

The exclusion criteria apply for those women with the following conditions:

1. Placenta previa.

2. History of ante-partum haemorrhage.

3. Multiple pregnancy.

4. Known abnormality of the uterus or pelvis.

5. History of premature labour or premature ruptured membranes.

6. Previous Caesarean section if more recent than 2 years.

7. Oligohydramnios.

8. Rhesus antibodies.

9. Known hydrocephalic fetus.

Those in whom none of the above conditions apply can attend online consultations (preferably with a partner) and learn how to apply moxa in the comfort of their home.

Consultations:

In a face-to-face consultations, I give a treatment and demonstrate to my patients how to self-administer moxibustion at home. Applying moxa is simple to do and it does not involve any needles. I give clear verbal and written guidelines covering method and safety to enable mothers to continue the course of treatment in the comfort of their home for up to 10 days.

After your treatment you go home with

o 2 Moxa sticks

o Instruction sheets (incl. list of equipment needed and method, and safety guidelines)

If you would like to know more and learn how to use this simple technique, please contact me via email at sophies@silverwoodacupuncture.co.uk

References:

Moxibustion for breech presentation – Sarah Budd SRN, SCM, Dip Ac, B Phil (Comple.Health Studies), Midwifery Sister / Acupuncturist

https://www.rcog.org.uk/en/patients/patient-leaflets/breech-baby-at-the-end-of-pregnancy/

https://www.stgeorges.nhs.uk/wp-content/uploads/2013/05/SGH-Breech-Leaflet-PING-approved.pdf

Sophie Silverwood-Cope BSc(Hons) Chinese Medicine Acupuncture, Member of the BAcC

Tel: 07809 828 402

sophies@silverwoodacupuncture.co.uk

Consultations at Make Me Feel Pharmacy in Clapham (SW4 London), 2Me Clinic in Marylebone (W1 London 2meclinic.com)

What Is Cupping Therapy?⁠

⁠If you watched the swimming events at the Rio Olympics in 2016 you might remember the dark purple circles dotting some swimmers’ backs and shoulders and running all the way down their legs. In fact, they were rather hard to miss.⁠
⁠
Those perfectly circular marks are the result of cupping, a type of alternative therapy that originated from China that involves placing cups on the skin for a short period of time to create suction. The suction pulls the skin away from the underlying muscles in order to stimulate blood flow and facilitate healing and reduce pain. For athletes, it is a way to promote faster recovery and to get rid of the build up of lactic acid in the muscles that can lead to soreness.⁠
⁠
What does cupping treat?⁠
⁠Cupping increases blood circulation to the area where the cups are placed. This relieves muscle tension, which can improve overall blood flow and promote cell repair. It may also help form new connective tissues and create new blood vessels in the tissue.⁠
⁠
Cupping has been used to treat a wide variety of conditions. It may be particularly effective at easing conditions that create muscle aches and pains.⁠
⁠
Since the cups can be applied to major acupressure or acupuncture points, the practice can be effective at treating digestive issues, skin issues, and other conditions commonly treated with acupressure or acupuncture.⁠
⁠
Cupping is a long-practiced treatment that may help ease the symptoms of both temporary and chronic health conditions. If you would like to know more about cupping and whether it is right for you, please get in touch with me and email sophie@silverwoodacupuncture.co.uk. ⁠

Acupuncture for morning sickness

C9 Chinese obstetrics text, C19 re-edition, Woodblock print

Nausea and vomiting in pregnancy – the facts

Nausea and vomiting in pregnancy is believed to occur in about half of all pregnancies, usually between the sixth and the sixteenth weeks and is at its most intense at eight to twelve weeks.

Although it is commonly called morning sickness, nausea and vomiting in pregnancy can happen at any time of the day or night. The degree to which women experience morning sickness hugely varies: a woman can have nausea only or accompanied by vomiting. The intensity or the time of the day it is felt can also vary. But it can also be constant, including on waking at night.

 Although women are often eating less and possibly lose weight while experiencing nausea and vomiting early in pregnancy, the real concern is the possibility that excessive vomiting (hyperemesis gravidarum in scientific terms) can lead to dehydration and the woman may then require hospitalisation to receive intravenous fluids. Doctors or midwives who suspect dehydration in pregnant women often give them blood tests to check their electrolyte levels or urine testing sticks to measure their ketone levesl.

 The Causes

There are many theories as to why nausea happens in pregnancy:

Hormonal reasons  - HCG the hormone used as an indicator in pregnancy test and rising oestrogen levels are cited as the main culprit

Brain stem – this part of the brain is believed to be the control centre of nausea and vomiting. The way it responds to the hormones produced in pregnancy might influence the level of nausea and vomiting a woman experiences

Stress levels and fatigue – they are believed to increase the risks of developing morning sickness

 Acupuncture to treat nausea and vomiting in early pregnancy

Women’s experiences of morning sickness varies as much as their experience of labour: some are bedridden and might need hospitalisation, some damage blood vessels in their throat from vomiting so often and violently, some are not vomiting but feel that if they could, it might help them. Finally some carry on with their normal daily routine whilst feeling absolutely awful.  There is no ‘normal’ and it certainly doesn’t support the myth that suggests that morning sickness is both mild and a normal part of pregnancy.

 Whatever the symptoms, acupuncture offers a real, safe, natural alternative to simply putting up with the nausea and vomiting in pregnancy.

 A traditional Chinese medicine viewpoint – Pattern differentiation and treatment

 From a traditional Chinese medicine perspective pregnancy brings up changes to the energetic balance of the body but these changes are not considered pathological developments.  It is therefore considered normal to see the following

 ·      Increase in blood

·      Increased heat

·      Increased dampness

·      Increased Liver energy

·      Decreased kidney energy

 (note that blood, heat, dampness, Liver and Kidney energy here are Chinese Medicine terms and concepts)

 However, because of constitution or lifestyle, the balance can be sometimes disrupted by one of the elements above. Too much heat or dampness, too much Liver energy or not enough Kidney energy for example can evolve in patterns of disharmony.

 In Chinese medicine each pattern of disharmony presents with specific symptoms. As mentioned before in the case of nausea and vomiting, a trained and skilled Chinese medicine acupuncture practitioner will see a different pattern in a patient who vomits her food soon after eating it, with a persistent thirst, a red tongue and a rapid pulse, and a patient who feels nauseous with no vomiting but with epigastric distension and fullness and who presents with extreme tiredness of the arms and legs, lethargy, weak voice, spontaneous seating, a pale tongue and a weak pulse.

 The acupuncturist is able to identify the causes of the imbalance and chooses the appropriate treatment (a combination of acupuncture points) tailored to address the particular symptoms of the patient but also the causes of her imbalance.

 The number of needles used in a single treatment is limited to 6 to 8 to prevent excessive stimulation and they are usually retained between 15 and 20 minutes

 Although not all women will flourish following treatment, the majority will see a dramatic improvement that put them back in control.  It is worth warning the patient that no matter how good she feels after the treatment, she needs to be aware of her body’s limit, stick to appropriate food, not skipping regular meals or snacks, or not staying up late for example.

 Patient advice

An acupuncture practitioner should also be able to help women incorporate life-style changes in their routine, rest and hydration being paramount. Again not everything will work on everyone but according to the specific symptoms each woman presents, a tailored list of food, snacks and beverages can be introduced in the diet to relieve the symptoms.

 Safety and effectiveness of acupuncture treatment in early pregnancy

Smith et al. (2002) published two articles from their research on nausea and vomiting during early pregnancy.  The study involving 596 women who were followed through their pregnancy until childbirth to record any adverse outcomes, confirmed the benefits of acupuncture and concluded that acupuncture was a safe and effective treatment for women who experience nausea and dry retching in early pregnancy.

 So if you’re pregnant and feel that your quality of life is impacted by morning sickness, it is worth considering acupuncture as a drug-free option to relieve your symptoms.

 For more information or to book an appointment, please contact sophie at sophie@silverwoodacupuncture.co.uk  

 References

Betts D (2006). The essential guide to Acupuncture in Pregnancy and Childbirth.

Smith C, Crwother C, Beilby J (2002). ‘Acupuncture to treat nausea and vomiting in early pregnancy: a randomised trial”. Birth. 29(1):1-9

 Smith C, Crwother C, Beilby J (2002).  ‘Pregnancy outcome following women’s participation in a randomised controlled trial of acupuncture to treat nausea and vomiting in early pregnancy.” Complement Ther Med. 10(2):78-83

A delicious Winter dish - ROASTED SQUASH AND PUMPKIN SEED PESTO

ROASTED SQUASH AND PUMPKIN SEED PESTO

This is a richly flavoured autumn and winter dish that works beautifully with fish, lamb and even with your Christmas turkey leftovers. Squash is rich in natural sugars, carbohydrates and vitamin A. In Chinese Medicine, it has a warming nature and both squash and pumpkin seeds have a sweet flavour that improves qi energy circulation. It helps with what Chinese Medicine calls interior dampness conditions that can manifest as tiredness, aches in the limbs, digestive weakness or muzzy head.   

 SERVES 4-6

BUTTERNUT SQUASH - 1.5kg peeled, deseeded and chopped into 4-5cm pieces

OLIVE OIL - For roasting

SALT AND PEPPER

FOR THE PUMKIN SEEDS PESTO

PUMPIN SEEDS - 100G

FRESHLY GRATED PARMESAN – about 50G

FLAT PARSLEY LEAF – ½ small bunch, chopped

EXTRA VIRGIN OIL – 3-5 tablespoons

SALT AND PEPPER

Pre-heat the oven to 190oC /gas mark 5

Toss the squash with the olive oil in a roasting tray and leave in the oven to cook for 30 min or until nicely coloured or cooked through.

For the pumpkin pesto, lightly toast the pumpkin seeds. Watch carefully as the seeds can burn easily. Blitz the toasted seeds, Parmesan, parsley and olive oil in a food processor. You might need to add oil to get a slightly runny consistency. Season to taste.

To serve, arrange the squash on a serving dish and toss over the pumpkin seed pesto.

If you are interested in trying acupuncture to boost your energy and strengthen your immune system during the winter months, please call me on 07809 828402 to book in for an appointment. Appointments are available at Make Me Feel in Clapham South on Mondays 2pm to 6pm, and in Brixton Tuesdays to Fridays 8am to 6pm.

Acupuncture and Insomnia

Zhuangzhi, Butterfly dream 

If you are wide awake at 3'oclock in the morning and all you want to do is sleep - you tried fluffing your pillows, you sprayed lavender on you wrist, you tried sleeping tablets and even Andy Puddicomb's voice doesn't even make you blink - acupuncture might just be the thing that will help you completely relax and finally get the restorative night's sleep you need. Imagine not crawling to work like a zombie, feeling sharp and creative, thinking better, listening better and even managing a smile?

What is insomnia?

 If you suffer from insomnia, you may have difficulty in falling asleep or getting back to sleep when you wake up in the night. It may mean that you wake up very early in the morning. You may also find that sleeping does not refresh you, and that you feel constantly tired. You may experience disturbed or light sleep, or wake up and fall back to sleep several times in a night.

The effect of Insomnia on your health

 Lack of sleep has a whole list of effects on your physical and mental health. It

·       Reduces your cognitive faculties: Sleep plays a critical role in thinking, learning and remembering. Lack of sleep can impairs attention, alertness, concentration, reasoning, and problem solving. This makes it more difficult to learn efficiently.

·       Kills your sex drive

·       Can make you gain weight

·       Ages your skin

·       Can lead to serious physical health problems like heart disease, high blood pressure stroke, diabetes

·       Is depressing: In my practice, I see many people with various levels of anxiety and I can see first hand how mental health problems can be both a reason and a consequence of insomnia.

 Stress and anxiety can cause you to have thoughts racing through your mind, making it difficult for you to sleep. If you have sleep problems over a long period of time, you may also develop anxiety or phobias about going to sleep and a vicious circle has started.

With Depression you might find it very difficult to face your day-to-day life, and you may find yourself sleeping more in order to avoid them – either sleeping late in the morning or a lot during the day. Oversleeping can cause fatigue and lethargy, but make it also difficult to sleep well at night. If you experience difficult or troubling thoughts as part of depression, this can also cause insomnia. You may find it harder to fall asleep, or you may wake early and be unable to get back to sleep.

Over a long period of time, a severe sleep problem could lead to a mental health problem, or may make an existing mental health problem worse because tiredness reduces your ability to deal with difficult situations as well as the challenges of day-to-day life and may lower your self-esteem, make it harder to cope. You may feel lonely because you’re too tired carrying out your usual social activities, leading you to become socially isolated. You may also experience low mood or negative thoughts

So why not give acupuncture a try?

With acupuncture, the focus is on the individual, not the illness. The underlying principle of this highly individualised treatment is that imbalance, illness and pain occur when the body's qi, or vital energy, cannot flow freely.

 During your first acupuncture session, the causes of your insomnia are the first things I’ll try to uncover. Acupuncturists look at a patient holistically and I’ll spend the first 30 min of the consultation finding out about your sleep routine, your sleep environment, your sleep patterns, your eating habits, your work and family life, your thoughts and level of stress, worry and anxiety, mental health issues, infection, injury, pain or physical illness that might be causing your sleeping problem.  Our initial conversation allows me to organise your symptoms into a coherent Chinese medical diagnosis and devise a treatment plan.

Your treatment

 Each treatment involves inserting ultra-fine sterile needles into specific acupuncture points. I use a combination of body acupuncture and auriculo (ear) acupuncture points to re-establish the free flow of qi, release blockage, restore balance between your yang and yin energies and trigger your body's natural healing response. In order to restore balance I address your insomnia as well as its causes and the effects it has on you.

Along with your acupuncture treatment you might need to make changes in your lifestyle to support your return to good sleep and good health in general. Different things work for different individuals so during sessions we also discuss a wide range of routines, relaxation techniques, changes in diet and physical activities that can work for you and can ultimately make you feel better if you’re able to implement the appropriate changes. 

 If you are interested in trying acupuncture and how it may benefit you, please book in for an appointment or email me with any questions, sophie@silverwoodacupuncture.co.uk

Migraine Awareness Week 2016

This week, 4th to 10th September, is Migraine Awareness Week. 

*In the UK 1 in 7 people at any one time experience a migraine attack.

A migraine is a complex neurological condition, which can affect the whole body and can result in many symptoms, sometimes without a headache at all. Migraines can be easily overlooked or mistaken for other conditions and can affect people in many different ways.

A migraine can involve recurrent attacks that can last up to three days and sufferers may also experience double vision, nausea and vomiting. Migraines are often thought to be caused by emotional strain, stress, hormonal imbalances, and lack of food and/or sleep or by a reaction to some foods or medications.

Research has shown that traditional acupuncture can be very beneficial in the treatment of migraines as it tends to lessen the frequency and severity of attacks. In fact, NICE (National Institute for Health and Care Excellence) recommends acupuncture for headaches and migraines (http://www.nhs.uk/Conditions/Migraine/Pages/Treatment.aspx)

If you want to know more about how acupuncture works and how it can help you, please contact me at sophie@silverwoodacupuncture.co.uk or give me a call on 07809828402. 

*www.migraine.org.uk

Food as medicine

Last month, a few friends and I went on a cooking course at the CookHouse in Battersea run by Emma and Stephanie. We went for the Dinner Party Nibbles course and learnt how to prepare appetising canapés and mouth-watering dips.  Held in Emma’s kitchen, the evening was a perfect balance of hands-on cooking, sharing of useful tips, chatting, sampling our creations and drinking wine.

We spend an enjoyable evening talking about food, making food and of course eating! It reminded me what a central part food plays in traditional Chinese Medicine.

Did you know that according to traditional medicine, food is considered the first choice for prevention and treatment of health imbalances or illness?

In the West, food is described according to its chemical ingredients, protein, fat, minerals, vitamins and so on. According to traditional Chinese medicine, foods are classified according to their characteristics and the effect it has on the human body after the food has been consumed. These main classifications are the flavours, the energetic temperature, the effects on energetic direction, and the relationship with meridians.

Flavours

There are five flavours: sour, bitter, sweet, pungent and salty plus a neutral flavour, and each flavour corresponds to and affects an energetic organ system.

·      The salty flavour belongs to the water element and affects the Kidney

·      The sour flavour belongs to the Wood element and enters the Liver

·      The bitter flavour belongs to the Fire element and enters the Heart

·      The sweet flavour belongs to the Earth element and enters the Spleen

·      The pungent flavour belongs to the Metal element and enters the Lung

What does this mean exactly? Let’s take the sweet flavour for example related to Earth and to the Spleen/Stomach. The Spleen in Chinese medicine is not just the obscure little organ than most of us are hard-pressed to locate and define. It is the centre of all digestion and transformation of food to energy, the absorption and digestion of ideas as well as an essential element in the production of blood. Food with a sweet flavour helps support a deficient spleen and stomach whose function of transformation and absorption is impaired. In this respect a craving for sweetness is an accurate message that our spleen is out of balance and needs rebalancing. Unfortunately, with cravings for the sweet flavour we tend to overwhelm our system with processed sugar, the ‘Pure, White and Deadly’ stuff of John Yudkin’s book (1986) that alters our metabolic processes and increases plasma concentration of cholesterol and triglycerides, and we create further imbalance. Instead we should choose non-processed alternatives like sweet potatoes, carrots, grapes, avocadoes, courgettes or even spinach that according to TCM, all have a sweet flavour.

Thermal properties:

Is the food we consume Hot, Warm, Neutral, Cool or Cold? According to traditional oriental medicine, it is not a measure of how hot or cold the food feels when consumed but its effect on the body after digestion. Does it warm us or cool us down? Root vegetable soup is surely more appealing on a cold winter evening than a on a hot summer day!

Effect and Directions

Food can move the energy of the body in four different directions: upward, downward, floating and sinking. Cooling foods tend to direct energy inwards and downwards by cooling the upper and outer parts of the body first. Warming food move energy upwards and outwards from the core and warm us from the inside out. Think about the effects of a hot curry on your body and how cucumber and yoghurt counterbalance the heat of a curry. 

Preparation and cooking methods can influence flavour and thermic nature of food. For example, cooking in hot oil has a heating effect. Longer and slower methods of cooking also produce more warming effect than the steaming method.  

You can see how someone who feels cold all the time for example would benefit from more warming diets.

Relationship with Meridian

Each food is also said to enter one or more meridians directing its effect towards particular Organs. Pears for example enter the Lung meridian and walnuts enter the Kidney meridian. Pear in Chinese Medicine has a cooling effect, and a sweet and slightly sour flavour. It specifically affects the Lungs, it moistens the lungs, throat and dryness in general, eliminating heat and excess mucus. Classic symptoms of heat on the lungs include chills and fever, dry cough, shortness of breath, sore throat and yellow nasal discharge.

Looking at this model of nutritional therapy, it becomes evident that one diet does not fit all. Chinese dietary therapy always yields a highly personalised list of dietary recommendations. A healthy diet to prevent illness or recover balance depends on each individual’s desired outcome. It takes into accounts the presented signs and symptoms, the seasons, each individual imbalance tendencies.

Finally, remember to relax and enjoy! When eating, please focus on just eating! Don’t work, don’t read, don’t walk, don’t travel… just eat!

If you want to know more about Chinese Nutritional therapy, contact me @ sophie@silverwoodacupuncture.co.uk

Why things hurt

Battle of Oroi Jalatu, (China, Qing Dynasty), 1756

If you have 15 min to spare, listen to this guy explain how pain is essentially an output of the brain designed to protect you. Your perception of pain is real but it is a construct of the brain that is not always related to the level of damage to the tissues of your body...  Interesting theory! 

New year resolutions... How are you doing so far?

I don't like new year resolutions much. By the time it's March, not only have I given up on them, I've actually forgotten what they were. For years, I avoided having new year resolutions so that I didn’t feel disappointed with myself for not sticking to them. However, I think this year I've nailed it. It's all about routine and sticking to the schedule. Sounds a bit obsessive? Please read on to decide.

Habits are very hard to shift because they are not decisions they are automatic behaviours - if you want to know more about how habits work and how they can change, I recommend reading this book, ‘The Power of Habit: Why We Do What We Do, and How to Change’ by Charles Duhigg. It’s fascinating - So the idea behind a schedule is to support change and replace old habits by new ones, the ones that support your goals. It compels you to achieve your tasks the same way you go to work everyday. So, here is the idea

1.     Set specific goals

   - eg: run half a marathon next April

2.     Create specific tasks –

               - eg: go for a 5km run twice a week for 6 weeks

3.    Include the tasks in your schedule

-       eg: run on Mondays at 7pm and Thurs 7pm

-       It does feel more achievable than a general 'get fit' or 'loose weight' doesn’t it? and if you can, do the run with a friend so that you're accountable to someone else... And you might even have fun.

4.    Share your ideal week with your partner, children, friends, boss… they need to be aligned on your intentions otherwise you might find your plans difficult to implement. Does the ‘partner still at work, no childcare, can’t go for a run’ scenario sound familiar?

But how about chilling I hear you say? How about relaxing, doing nothing, nada, rien? Well this is important and healthy as well. Remember rest after activity, calm before the storm, Yin and Yang and all that? In fact, speaking of free time, I really enjoyed this opinion piece titled, “You Don’t Need More Free Time.” In the article, this sociologist at Stanford argues we need more constraints over our time—not less—in order to properly enjoy the free time we *do* have. So back to our schedule!

Finally, don’t disregard small changes you make towards a healthy lifestyle, they have greater mental and physical benefits than you think.

Now, want to get rid of back pain? Want to feel less stressed, more focussed, or sleep better? Why don’t you include a 45 min session of acupuncture in your weekly schedule? Feel free to contact me at Sophie@silverwoodacupuncture.co.uk for more information on what acupuncture can treat.