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Clinical Diagnosis in Ayurveda (A Practical book of Ayurvedic Diagnosis in the Light of Modern Medial Science)
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Perinatal Nutrition and Ayurveda by Dr. Jessie Mercay

Childbearing is a celebration of Love and uncovers for us Ma Nature's many ways to expand it!  She of course does most of the work.  Students of Ayurveda must remember that she offers her often simple guidance in cross cultural terms.  Parents experience many turning points in the childbearing year to better care for the soul they invite and nurture in1.2 Many they are not aware of from Western models of care.  Ayurveda offers special guidance to prevent the all too prevalent problems, and build good life for Baby as well as Mother and through them, all their relations.  Here we will begin to look at the impact of Ayurvedic principles around major perinatal issues.  
Mothers often know when we are not in harmony with our inner and outer Nature. How can Ayurveda help read the signs?  Many client experiences demonstrate that ayurveda offers both simple understanding to sometimes major issues, and amazingly effective guidance on perinatal nutrition that agrees with much general western thought and goes much further than midwives or doctors know.  Ayurveda being so "new" to the West, educated practitioner guidance is especially important to help parents understand the all important not just what, but when, how and whys.  
We know the most important thing around having babies is TLC (that's tender, loving care).  Ayurveda tells us also, that what we eat…and HOW we eat it are the next most important choices for Ma Nature's good work through us.  This means then, mothers must eat in harmony with their "own" inner and outer nature and with Baby's needs.  They may be felt in the first days as a need calm pitta especially and vata too, to purify in some way, and rest.  She not only has brilliant maps for growing a baby within her own body intelligence.  Mother has to be receptive to the intricate, delicate and subtly timed communications between Baby's DNA blueprint and subtle body koshas (sheaths) as they unfold their plan for incarnation.  And to her instincts to help guide them.
Mothering is very much a two way communication.  A baby's energy brings the innocence and purity fresh from universal Bliss consciousness, where it was unencumbered by physical conditions and impurities.  As baby's body begins to form, what both Mama and Baby desire, eat and do affect the foundations for stable, healthy, comfortable and happy bodies for both of them, regardless of soul levels of evolution.  We can look to the 12 factors outlined by Dr. Lad, contributing to the baby's growth in this way also, to see where we have responsibility in wise choices.    
Those students who have studied the following should see many ways to contribute to the baby's best beginnings, particularly if preconception preparation is an option.:  Paternal (pitruja), Maternal (maatruja),  Soul/ past life karmas (aatmaja),  Agni – Tejas, Soma – Ojas,  Vayu – Prana,  3 Gunas - Sattva, Rajas, Tamas,  5 senses,  Mind,  Buddhi (intellect),  Smruti (memory), 5 elements.  Shukra (sperm) & Artava (egg) contain maternal & paternal elements of the 7 dhatus, SRT, VPK, OTP, 5 elements, & 20 Gunas that shape the embryo (basic units of hereditary).3  It is notable that between Panchakarma and rasayana before conception, and use of Sattvic and key
foods, one can influence all of these through nutrition.  This is considering that external and basti as well as dietary oleation therapies are effective nutritionally.
This is just another example of the ways Ayurveda can work:  When Baby's heart begins beating around 4 months and his/her desire nature (Manomayakosha) is connecting to the food sheath (Annamayakosha) or physical form, Baby's desires are Mother's desires.  She has to use wisdom with her emotional and mental relations as well as food cravings, taking a little then seeing results, and choosing from best quality foods which meet the craving (e.g., sour try limes with salt maybe instead of tamasic pickles; ice cream, eat the best quality!, better is take some whipped cream with honey and vanilla at room temperature; chocolate, take a little then increase leafy greens, butterfat and healthy sweets).  See what happens and be loving with oneself.   
Mothers come to their practitioner from diverse cultures, resources, challenges, knowledge, desires but all walk in the same laws of Ma Nature's organizing power.  "Guna guidance" is one of the important ways to understand the sometimes unusual or controversial recommendations of Ayurveda for mothers.   Sattva guna is highly favored for both pregnancy and postpartum, in fact almost exclusively after birth except special uses of roasted garlic and the digestive virtues of hing.  For all 4 trimesters, sattvic cow's milk is among staples, also for pitta and vata reducing and calcium support; in the first trimester, preferred cool-room temperature (boiled or raw).
Note that the 3 gunas don't balance each other out by negation, like doshas can. The qualities of sattva protect the fetus during fragile and delicate work, lending clarity, purity, peacefulness and calm. Baby's nutritional needs are small in quantity but critical components and timing are needed by the DNA offered by Mom and Dad as it unfolds, and Baby's Vital Energy sheath (Pranomayakosha) whose nadis, chakras and vayu already are beginning to express their forms and past life karmas through Mother's energy field and this DNA.  The maternal role of "bridging the worlds" between spirit and matter as well as neonatal modern science confirm our responsibility in choices in this delicate time.
Within 1-2 weeks also placenta is working giving oxygen.  Prana must be refined and delicate, not intense or jarring. Rasa dhatu (plasma) should be sattvic for this intricate process.  The rasa wants to be clean of ama (toxins) or anything that may obstruct the tiny but critical developments.  Pitta toxins and kapha phlegm both particularly tend to give nausea.  The invisible work of mothers now is harmonious immediate and constant energy field and biological communication.  
Timing and specifics are critical; by 6 weeks Baby has a microscopic brain, thread-like spine cord, spider web-like CNS, and a tube from mouth to tail bone that becomes the GI tract  Maternal sattvic choices create much more successful results; rajasic or tamasic ones can put Baby at risk and make Mama very uncomfortable; we can nourish wisely this way without knowing any more specifics.  Sattvic dairy gives important calcium, good cholesterol, proteins and vitamin D and pitta reduction; milk served cool first three months!  Dairy does not provide the highly needed to prevent birth defects for first days, and throughout pregnancy folic acid5, biotin, and important magnesium but leafy greens do provide these plus iron and other advised foods give important zinc, iron, folic acid, proteins et al.  Healthy sweets may give iron, calcium, sattva and doshic balance too. Many of these nutrients work in synchrony with valuable ghee and EFA3s.
From first to second month, sense organs are seeded.  Nose is formed from what the mother smells, eyes are formed from what the mother is seeing, sound is formed from what the mother is listening to, etc.  Different foods, preparation and eating habits give different guna quality of digestion and elimination of wastes and differing quality of life with far reaching effect on this child's and mother's life.  We can simplify to a dietary plan, requiring wholesome balanced pure foods, guna and dosha appropriate diet with some special focus by month with foods, herbs and lifestyle for pregnancy.  
Preconception preparation
Although in the West, parents may choose on physicians advice to also do some herbal bowel, parasite or heavy metal cleansing before conception, Ayurvedic cleansing methods (Panchakarma or PK) cleanses also the deeper tissues not easily accessed by most natural cleansing protocols.  Oleation and other methods nourish and cleanse together much more than other cleansing styles in the west.  Remember that Meda (fat, which stores petrochemical and many drug toxins, neutralizes excess acidity and is important in creating hormones), Asti (bone, often depleted or mistreated by insufficient magnesium, calcium, stress, accident, acidity and weak Meda agni), Majja (marrow and nerve, critical for mental health too, dependent upon strong meda/agni and other precursors) and Atharva (reproductive, dependent upon the other tissues for good health and often storing petrochemical and emotional toxins) benefit from PK cleansing also of modern day pervasive pollutants.  This leaves parents hormonally and emotionally more ready to conceive with healthiest semen and ovum.
In any case, when a mother is pregnant, she is usually enthusiastic to live healthier for her baby.  Students who are timid with clients to give them "another new thing" with so many new expenses and things to do around having a baby, are advised to let "the Mother of Healing", Ayurveda, speak for herself with terms your client can understand.  Explain the 3 guna influences, the elemental qualities, manifesting in the 20 gunas,  just a little about it and how we can help restore balance.  They are already practicing Ayurveda anyway and seeing how it works will trust it.  
Maternal/Baby needs
A wholesome pure balanced diet familiar to the mother is standard,  favoring unprocessed fresh organic foods richer in easy to digest sattvic proteins, good cholesterol and EFA3  fats, leafy and succulent long green vegetables, antioxidant and vitamin C rich sweet fruits, rice, wheat, oats, quinoa and similar whole or simply prepared less vata increasing grains.  Cream of rice or wheat is often cooked with ghee and special herbs to target and build needed tissues in development; thin for ama or low agni.  Women tend to need food about 5 times a day, plus often milk or almond milk at bedtime.  
For pregnancy see more month wise variations on 4 key sattvic foods to use all 9 months (new rice, and pure ghee, butter and milk) in session handouts.  Special nutrient access in the first trimester dictate cooler temperature and lighter/soupier foods6.  Folic acid, Biotin, antioxidant and vitamin C rich foods and electrolites are notable the first trimester and onward.  During pregnancy,  the unusual, and soon tremendous demands on our system create extra sensitivity to digestive influences.  Perinatal digestion is unusually weak.  Not just what but how we eat in the west such as food combining, cooking, emotional ways seed health problems, sometimes sooner and sometimes later.   After birth maternal digestion is especially weak and needs extra babying.  Body energies have been reallocated for
labor or with surgery.  Digestive fires shut down and the normal 28 days for a healthy system which is required to digest and nourish to the body's deepest tissues (Atharva/reproductive, and Ojas) shifts to about 42 days, even longer with a C birth7.  
After childbirth foods must be more vata reducing, warm, easy on digestion, with no fermentation or raw except sweet fruits when desired. (See  Oleation therapy is exemplified with the Indian practice of considering your rejuvenation window is not complete until you have consumed 30 lbs of ghee in 3 months!8  Something like 1.25 kg ginger is also advised for the first 6 weeks.9  Postpartum we cook, spice and plan to support all the agnis to function in good sequence.  We speak in terms of food to favor by approximate 2 week blocks, starting selectively spicy, hot temperature, moist, oily, iron rich, sweet, sattvic and digestible the first 3 days. 
A few more notes must satisfy the limitations here.  As Ayurveda is controversial in the west, particularly around  vata pacification and use of sweeter and dairy based sattvic foods, fats, salt,  leftovers, frozen foods, raw foods etc, we must be prepared to educate our clients in the very important correct use of each.  A longer discussion is possible and hopefully in the reader's education already.  
The emphasis on dairy in pregnancy and more, after birth, raises red flags for western health and allopathic practitioners, who are seeing so many problems from misuse of dairy.  Doctors and midwives alike are telling mothers to avoid milk not knowing the balance.  See Author's three page article on correct use of milk and many reasons why for so many,  milk as used in the west is problematic and when it does give great value for mother and baby; at  
Quite notable are the fats discussions and recent research.  Confirming citations are abundantly available.  Vata pacifying, we often crave them, eating whatever feels oily.  Hydrogenated, homogenized, low fat foods, fried foods, trans fatty acid vegetable oils, and extreme EFA 6 to 3 ratio fats are creating many problems.  Studies are showing those women avoiding good cholesterol butter and/or meat fats linking also with hormonal problems.10   Many non- organic fats have concentrated environmental pollutants as well.  This big fat story is linked in the research to many problems listed below.  Insufficient good fats (EFA3s and good cholesterols as in ghee and butter) are at issue
according to both western research and Ayurveda with obesity, diabetes, overeating, edema, ADD/ADHD, depression and other nervous system and hormonal problems. 
Effects of HOW, and what we eat
Commonly we look with Ayurveda at doshic appropriateness and give a list of foods, evaluated for signs of poor digestion, such as constipation or diarrhea, belching, gas and discomfort.  We know also that food combining, how it is eaten (rushed or enjoyed), how it is presented (color, shape, texture, environment), temperature (cold breaks digestive strength and mind-body coordination for it), seasonal, freshness, how it is cooked (sauté, fry, steam, microwave, bake, qualities of the cook), presence of all 6 tastes (balanced for individual), how it is seasoned (also often very important for doshic balance, digestion and absorption), liquid vs. dry influences, the level of processing, toxic ingredients, leftovers, all related habits may have far reaching effects, especially for more delicate perinatal
bodies and their babies.  Ayurvedic cooking classes or postpartum meals in your own home are a valuable way to learn in sattva, by enjoying!  
Ayurveda is equipped to address in detail issues unfortunately not prevented for childbearing women and their babies by western nutrition.  The result includes an attention getting list we as practitioners are in position to either support or wisely refer clients for support around.   The following notes in parenthesis are not meant to be thorough and come from minimal educational deduction as well as cited professionals.  Miscarriage (high pitta or vata)11, epidemic obesity (research is linking to over and under nutrition, both often related to how we eat12), emotional and hormonal imbalances (at this time usually vata imbalances, low sattva and low ojas13), gestational diabetes (imbalance of quantity and quality of fats, carbohydrates, proteins and low EFAs14, ama, agni, food combining15),
edema (toxic accumulations interfering with elimination and low organic sodium – drink zucchini steaming water16), pre-eclampsia (again low EFAs, toxins, poor digestion)17,18 C-births from oversized babies19, low birth weight babies20, low Thyroid mothers21,  postpartum depression (high vata and ama, low fats and agni22), colic (if breastfeeding, look at vatagenic influences and incorrect use of dairy23 and birth traumas with sudden onset), ADD, 50 year old women with too many health complaints24, and a host of lesser plus more serious issues. 
Ayurveda has many gifts in assessment, preventions and management around all these issues.  Even to this student of Ayurveda, it is easy to see somehow all of these issues can be evaluated in terms of doshic imbalance, habits and cravings from high Rajasic and Tamasic choices, and how we truly digest.  Time and space prevent going deeper in this paper; however Vaidyas report successful management.  Many problems have related sources or different kinds of poor digestive products,  with surprising correlations to the big fat story.   
Ayurveda offers a mother to reestablish balance between her body and its own inner intelligence through knowledge and application25- we must remember the self-referral knowledge dynamic.  We must take the time to ask the right questions preventatively and to assess someone's difficulties in ways that empower with self knowledge and life skills.  Help mothers shift their poor dietary habits within their resources with the knowledge of Nature's qualities everyone can use in some way.  Even cheaper wholesome foods (not organic) will give many of their guna qualities and doshic influences with surprising results, while the longer term homework of manifesting a lifestyle and
preference for pure foods filters into the mother's life.  Offer your professional medical Ayurvedic care too if you are qualified or learn enough to understand and translate Ayurveda's gifts to your friends and clients so you know to refer up when needed to the valuable services of Ayurveda, and help build the network of good care.  
Nutrition has even been shown to set the genes for future generational health, in the most influential time periods of pregnancy and the first 7 days after birth.26  It is the most important component of garbhini paricharya (Antenatal care), the child's health patterns for life,  post delivery lactation, and postpartum rejuvenation influencing a mother's next 42 years to parent and partner in good health and heartfelt awareness27.  During pregnancy and, Ayurveda claims, even more after birth, mothers have important choices to provide an environment for Baby's awareness to grow in sattvic integration of physical body with mind, emotions and intellect.  The results are much greater immune strength, vitality, contentment, health, intelligence, success, awareness and Love in Life.

For more information, please visit this articles web page.
This article was published on Monday 11 May, 2009.
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