#93 | Intuitive Eating For Pregnant & Postpartum Moms with Jaren Soloff, RD, IBCLC

Not categorizing food into good or bad or healthy or unhealthy trying to really stay away from that language. And in fact, there's research to support now that pregnancy and postpartum are a very risky time for relapse for individuals who have a history of you know, disordered eating, or an eating disorder. And even if you have it, it's just a really vulnerable time because there's so much attention on nutrition and weight and body image during that time.

I'm Cynthia Overgard, owner of HypnoBirthing of Connecticut, childbirth advocate and postpartum support specialist. And I'm Trisha Ludwig, certified nurse midwife and international board certified lactation consultant. And this is the Down To Birth Podcast. Childbirth is something we're made to do. But how do we have our safest and most satisfying experience in today's medical culture? Let's dispel the myths and get down to birth.

Hi, my name is Jaren and I'm a registered dietitian and international board certified lactation consultant. And I help women to trust their bodies after birth and help them be attuned with their bodies and with their babies. And help them relearn how they were born to eat. One of the pieces that I see in my practice most has really, you know, a difficult relationship with food and body image and not only struggling with trusting their body after birth, but really trying to change their body and look to make it a different way. So that usually manifests not only in weight, but also in their nutrition behaviors and their body image how they hope to feed their baby. And so as a nutrition therapist, I really kind of helped dissect all those different pieces for them.

And what you practice with them is intuitive eating. So can you tell us a little bit about that.

So intuitive eating is what I call the way we were born to eat. We're all born as intuitive eaters, and it's one of the reasons that I always say our babies are amazing mirrors for us and relearning to trust our bodies. And so it's at its basic core, a feeling of being mindful and attuned with your body eating when you're hungry, stopping when you're full, and eating foods that are nourishing and satisfying. And not using what I call external guidelines. So a lot of us are taught, you know, we live in diet culture, so that can be calories or BMI, or certain types of foods and categorizing them. intuitive eating is really trusting that our bodies are going to help guide us to get just the amount that we need and support us in being a weight that is supportive of our genetic blueprint.

So you work mostly with postpartum women, but I imagine that this is this would also apply to women and when they're pregnant. That's right.

Yes. So my experience, before I became a lactation consultant was working with eating disorders, you know, more clinical kind of diagnoses. And there's really a spectrum and you know, which kind of starts with maybe your, your just an individual who's dieting, or chronically dieting and weight cycling to more subclinical disordered eating, and then up to, you know, full blown eating disorder. So I deal with anyone along that spectrum. And we know that individuals in their reproductive years are at really high risk of you know, food and body image concerns, just because our bodies go through so much, and so many changes during that time. So it's a really risky time period, and all the way even from preconception. So a lot of times I'll work with individuals that are having trouble conceiving or dealing with infertility or losses. And that can really cause us to be really hyper aware of our nutrition and our bodies. And then I follow and support them all the way through postpartum as well.

So when we're pregnant, it's one of these times in our lives when suddenly we have these food restrictions that somebody is putting in front of us food parameters, food restrictions, calorie requirements, protein requirements, weight gain guidelines. So it's a time where you know, that might be the first time that a woman is dealing with those kind of parameters. So how do you help a woman understand what it means to be to eat intuitively like what how do they tap into that if they have these parameters around them.

It's such a an amazing time to be in touch with your body and it could be one of the most challenging times if you haven't already been in touch with your body. Because you really have to, I would say that pregnancy is the ultimate test of intuitive eating. So even if you maybe have been on the journey of trying to be in touch with your body needs beforehand. We know that specifically like the first trimester, you know, when nausea hits or food aversions happen, hormones are on a roller coaster that it can be really difficult to try to be in touch with what our bodies might need. So it really is about this practice of learning mindfulness and getting in touch, which I always say that most of my clients live from, you know, their neck up, we're not actually integrating what goes on in our brains into our bodies. And really using that information to inform what we eat, how we move, how we take care of ourselves. And so it's this kind of complex combination of it. But you know, if you are entering pregnancy for the first time, and you're interested in learning about intuitive eating, it's a wonderful time. And I always say such an amazing foundation for you as a parent for learning how to feed your children as well, because our job as parents is really to preserve that intuitive eater. So our kids aren't leaning away from trusting their bodies and using external guidelines, but really believing in the messages that their own bodies give them.

So how do you distinguish between an intuitive hit about what you might be needing to eat or what your body might need? versus a great question? So cravings, I always say are our little like cues or clues that we can kind of tap into. And when I think of cravings, I always think of carbohydrates. That might not always be true for everybody, but it's pretty common. And a lot of times, it can be you know, for one, I always think of blood sugar. So if your body is telling you that you're craving carbohydrates, it's probably a sign that your body wants to increase its blood sugar during that time, there are times where maybe you have a sense that you need a little bit more protein that can also be related to blood sugar. So our body can give us these cues, you know about what's going on for us physiologically, and sometimes it is, you know, more emotionally driven. So part of intuitive eating is really learning to tease out, you know, what's a physical sign of nutrition, and what's more emotionally driven? And then from that point, it's like, well, what do I do with all the emotions? If I can't use food to soothe we have to then start to build up our resources for coping and tolerating difficult and uncomfortable emotions. Let's talk about that. So how do you do that?

Yes, I mean, lots of things. Lots of skills, I use a combination of different kinds of therapy modalities, were probably most familiar with CBT, which is cognitive behavioral therapy. So it's about changing your your thought processes, right. And when I think of emotions, specifically, especially during pregnancy and postpartum, I do think about, you know, being mindful of our emotions, and really acknowledging them. So for example, if you know you're having sadness or grief, maybe you've navigated pregnancy during a pandemic, and there's been a lot of loss, there's been a lot of grief around maybe not having experiences that you might have had outside of a pandemic as a pregnant individual. And so instead of using other means to really cope and soothe, and it's really important to acknowledge it, you know, I'm experiencing sadness, I'm experiencing grief. And that's called, you know, witnessing first and really kind of validating it for ourselves. And then you can meet the need. And that's going to look different for everyone. And, but it's important to just have that insight and awareness first, so that you can actually get that need met. I'm feeling uncomfortable, I'm feeling sad, I don't know what's going on with me. So I'm going to eat everything in my pantry to feel better, because that's what I know, boosts my serotonin at the time, I always share with my clients that food is a mood altering substance, which I think is just so powerful. You know, it has the ability to impact our mental health and the way we feel in our bodies and you know, our energy and space throughout the day. So, you know, it's important during what I call more vulnerable times, specifically during pregnancy and postpartum because we have hormones that are also impacting our appetite or cravings our mood to be really aware and mindful of our body is so I was mentioning serotonin specifically, which is really important to tap into during this time because you know, we know that carbohydrate intake specifically acts on serotonin which is that feel good chemical and our brains. So if you are navigating a really difficult time in terms of your mental health or you are for the first time really starting to get in touch and honor your emotions. It It always makes a lot of sense to try to move towards food because you're trying to regulate your mood. And but the hope is that you are gaining enough tools in your toolbox. And in terms of other coping skills that are going to help regulate and boost your mood, to where you don't need to use food. And that way, you know, I mentioned to kind of touching on postpartum a little bit, which is that a big theme that I see is, you know, having a lot of needs during postpartum, whether it be physically, like recovering from birth and feeling uncomfortable, or just emotional needs, you know, postpartum and birth are huge times of transition and huge identity shifts. So, I always think, you know, the common example that I hear from women after birth, which is that, like, I just want my body back, or I just want to feel like myself. And I always, you know, of course, get really curious about that and say, you know, tell me, what would be different or, you know, is there something else in there that you're hoping for, and, and part of it is, you know, this huge transition of, I don't know what I'm doing. And I don't feel like I have mastery, and I am overwhelmed and tired, and I'm not getting enough sleep, or I'm not getting enough food. And those are different needs than the need to feel a certain way in our body, if that makes sense. I think it's the norm in that period of life for women, especially if they're home with the baby. And those really bonds, and especially if they're isolated to use food as a mood lifter, as you were saying, so what's the process for that? It just sounds like such a challenge. How do you help your clients identify their emotion that they're experiencing before they reach for that food that's going to shift their their mood? Do you tell them to pause? What do you tell them to do in that moment? How do they recognize it?

It's a great point, the pause is great. I think we all can continue to learn about, you know, pausing and starting to notice. But part of what goes along with intuitive eating is what we call introspective awareness, which is starting to be in touch with not only our body's cues, but also our emotions. And as you become even more skillful, around noticing what comes up in your body, you can start to even notice where emotions come up for you. Right. So sometimes we can like hold it in our chest, sometimes we feel it in our gut. And you know, when I'm angry, when I'm tense, I hold it on my shoulders a lot. So we can start to learn to feel and notice it in our bodies. And the first step in the process with the emotions is really learning to notice when it's coming up and having awareness around it. And then from there, it's this question of, Okay, I'm noticing that I'm going to the kitchen, I'm noticing that this thought or this preoccupation around food or body is coming up for me, could there be something else going on for me right now. And then from that point, getting really curious around like, Oh, I only had four hours of sleep, or I just got in a argument with my husband, or my mother in law continues to, you know, feel really intrusive, or, you know, whatever might be coming up, and you might genuinely be hungry. But I think it is that pause of could there be something else that's going on? For me right now, for us to gain a little bit of insight in that moment?

If someone is unsure in that moment, if they take that pause? Is there some sort of diversion that you recommend? Is there like, you know, start with a glass of water, make a cup of tea? Do you recommend that your clients choose one thing as their go to to, you know, give themselves more time before they move on to something? Yes,

it's a great question. I think we hear a lot about dismissing and delaying our hunger. And I really feel that it's attached to diet culture. You know, certainly, emotional eating is something that we want to, you know, work to try to get in attunement with and meet our needs other ways, but it also doesn't need to be demonized. In my opinion, you know, as part of normal eating, we all eat emotionally sometimes, and that's okay. If you end up eating emotionally, once it's not the end of the world. It's a data point, as I say, to kind of get curious around like, Oh, I ate a little too much. I'm feeling a little uncomfortable. And I missed something like something else might have been going on for me. So it doesn't have to be something that's the end of the world. And I always encourage specifically moms, or if you're in that period of pregnancy and postpartum is to be mindful about trying to plate your meals and snacks. I think we have a tendency, especially if we had young babies or young kids to like eat standing up in the kitchen or eat out of the cupboard or eat from the open bag, and it's really hard to get in touch with our bodies. If you Like frantic eating one handed you know from a leftover Tupperware right? So you know that would be one kind of pause is like if you if you are so compulsive to where you cannot plate your meal that's probably a sign that like something might be going on for you.

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How does someone know how to get back to restore themselves to recognize it what is intuitive and it might feel intuitive. Like, I once spoke to a woman postpartum who was like I am living on cookies? What if in her mind, she's like, no, every cell in my body is saying any cookies right now? How do you take that person and say that isn't actually what the cells in your body are saying? How does she restore herself to her intuition in those rights?

It brings up for me this concept of trust that I talk a lot about and has to be a huge part of the intuitive eating process. And we do need to take a few steps back here to talk about, you know, depending on where you are on that spectrum that I mentioned, right, which is anywhere from like, Oh, yeah, you know, I've done some diets, or I dieted when I was a teenager, and to, you know, having more disordered eating, or even possibly an eating disorder, which we know go undiagnosed. So even if maybe you've never received formal treatment, or never were screened for an eating disorder doesn't mean that you don't have signs and symptoms of, you know, a difficult relationship with food. So it's important to recognize that there might be times where you need more structure depending on where you're coming from. So that's part of what I do as a dietitian, is, you know, what I call meet people where they're at, right, so if I give you full permission to just eat whatever you want, which is what a lot of people think intuitive eating is, well, if you tell me, I can eat whatever I want, I'm just going to eat all the cookies, or I'm going to lose control. And I don't even keep these foods in my house. Because if I keep them in house, they're not there more than a day or two. These are really common things that I hear, which that's usually a response of, you know, deprivation or restriction that's been there somewhere along the lines of your relationship with food. So it's important to have a little bit of structure sometimes that looks like a meal plan. Usually it means making sure that you're eating enough throughout the day. And that you're having a good balance of macronutrients which macronutrients are like what we call those big ones, that's like your carbs, your protein, your fat, this is really important to pay attention to during pregnancy and postpartum to make sure that you're getting enough and you're satisfying those basic needs. So in the example, with the cookies, you know, that's a really common fear that my clients have, but I always kind of flip it on its head and say, you know, well, you also have unconditional permission to eat broccoli, are you going to eat broccoli all day. And it usually is this kind of interesting analogy of like, when you genuinely know that you have permission to eat what you want, your body is not going to drive you towards those things all the time. If you are genuinely feeling pulled, typically it's carbohydrates and sweets, because they get a really bad rap and hear a lot of things about sugar. But again, you know, sugar is designed to help increase and stabilize our blood sugar. So it's important as long as we're pairing it with different foods, but it's probably a sign that those foods have been off limit or restricted for you in some way. So if that's the case, then we've got a little bit of healing to to do in terms of your relationship with food first.

And I imagine that this can go back to early childhood. I mean, I can you know, my mom restricted all sugar and my family growing up, we were only allowed to have honey and carob. And let me tell you, all three of me and my sisters went through years of you know, eating a lot of sugar eventually grew out of it in adulthood. But yeah, it was kind of the thing you went to because you weren't allowed to have it all those years. Absolutely.

Well, and what happens and this applies in two different situations, right? So for the adult, you know, maybe individual who's like, well, I'm just not going to keep it in the house. That's always still a signal for me. It's like, well, what happens if you do if it's still going to disappear then it's probably a sign that You know, you haven't developed what I call neutrality around it. Because if you know that you can have something again, and it's available for you, there's not a need to continue to go to it, you know that it's accessible, you know, you can have it when you want. And, you know, versus something that is still on a pedestal. So our kids are great examples of this, right? Because in experiences I've had, where, you know, parents are telling you, when they had experiences similar to yours, Trisha, where maybe foods are restricted at their house, those are the kids that go to their friend's houses, and eat sugar and high rappers under their bed or, you know, lie to their parents about it, because they feel ashamed or because they know that they shouldn't be doing it. So it's not my belief, and my, you know, practice style is that it is, and research supports this in terms of, you know, feeding kids and developing their relationship with food, it's not our job to police, our kids, it's our job to help our kids be what's called, you know, competent around their foods to know how to handle those foods when they are around them. And that's the same thing I do with my clients or with their parents is, we need to build some trust around these foods. And you decide if you want to bring them into the house or not, because you're the one with the purchasing power, right? I don't, I don't purchase soda for my home. It's not something that you know, I'm comfortable with, or that's aligned with my values. But I know that my daughter, she's around soda, and she is not going to go bonkers on it. Because she knows, in special occasions that she can have it and I trust that she can regulate it for herself.

So how do you create that neutrality?

Well, it starts with you. And you know, as the parent for healing your own relationship with food, if you don't trust yourself around these foods, and you don't keep sweets, or you know, all of these different products, or carbs, or whatever it is in the house, you know, you're sending a message to your kids, right. So it really starts with you doing the work and making sure that you can tolerate those foods and you have a healthy relationship with food. Part of that starts with some of the CBT work we've been talking about, which is not categorizing food into good or bad or healthy or unhealthy trying to really stay away from that language and, you know, be neutral about it. And, and not having, you know, harsh judgments in terms of how we talk about body shapes or sizes. I'm not talking about weight loss. So being really mindful of the messages that we're sending our kids, because usually at a young age, our kids want to please us right? Or they want to mimic us. And so it can be really tricky to keep those messages separate.

Jaren, How does CBT play into this? What's one of those strategies that you can teach a client?

So CBT is that cognitive restructuring, so it is catching that what we call unhelpful thought, right? of like, I just ate the cookie, I shouldn't have had the cookie, it's just sugar yet, like all the things that like we're kind of taught or judgments we have around it, and starting to catch it and notice it and then reframe it, you know, and I would say a reframe to that one particular would be I would teach my clients it is it that, you know, all food is good food, there are no good or bad foods. It's okay for me to you know, honor what sounds good in this moment. And no one food is going to make it or break it. I mean, I could go on and on. But you know, these are other helpful thoughts that are, you know, going to be more effective for you versus shaming yourself because we know that shame can just be so toxic. And guilt and shame are the two biggest pieces that diet culture has used to try to motivate people, right? You think about all the messages, we get around weight loss. And it's like, well, if it's not happening, you're just not trying hard enough. You just don't want it bad enough. willpower, yes. Right. So and they're all you know, based on guilt or shame. And that's what keeps the process going. So I also think about, you know, postpartum or when we're talking about feeding kids, which is starting to gain a little bit of objectivity on noticing our reactions. And I think it can be especially challenging as our kids grow up and to have more experiences with food. And you know, my daughter's nine now and thinking about how important it is for her to have access and variety to foods, but it is not the same when I was like making all of her own baby food and I could make sure that she had tons of greens every day and maybe there's things that would have made me more comfortable and how I would have liked her to be fed. But I have to really reassure myself that you know, I am making sure that she has the skills to feed herself. confidently, it's not my job to make sure she eats nutritiously. Her body knows how to do that. It's my job to make sure that she, you know, honors her body and I preserve the intuitive eater within her. And that could even go for our babies, too.

I think, I think that's where leading by example is so important. I mean, I have two teenage girls, and you know, there's no way in hell, I'm controlling what they eat anymore. But I do know, at the end of the day, that they see what I buy at the grocery store, that they see how my husband and I eat, and they see it as a lifestyle that day in and day out, we eat in a way that fuels our body. And so I can trust that over time, they will adopt those same habits, even if on a day to day basis, you know, they make some poor choices. That's right.

So just to circle back to a comment you made a few times about how a baby eats intuitively, are you talking about when they transition off of milk into their early foods, how they reach for foods, or is there something else too, that it can absolutely be at that transition time, I also work with a lot of moms, even during breastfeeding, you know, as a lactation consultant, I kind of get to use both parts of you know, my dietitian, brain and lactation consultant brain, which is that, for the most part, there are those babies that are going to need, you know, additional supplementation, or we're gonna have to watch them a little bit more, but they know how to regulate and their body's needs. They know how to get just enough we think about, you know, teaching moms to feed on demand or when babies are cluster feeding, I mean, that is their body's physiology telling them okay, I'm going through a growth spurt, I need to increase the calories right now. or open and get enough of that feeding. I'm going to go back for more in 20 minutes. And I think this is really important for me to build confidence in mom's because especially now you know, with like pumping being so common and wanting to like really see this external like in the bottle, how much is my baby getting, because we might feel anxious around us having enough milk or trusting our bodies to give our babies what they need. I think it's so important to go look, you know, your body, your baby tells you exactly when it wants to feed, it tells you how much tells you how long and it just can be such a huge foundation for that attunement not only for you as mom trusting your body. And but also for your baby to know, you know, it can get its needs met and self regulate in that way.

those parameters of knowing how many ounces your baby is getting, or how often they should feed or how long they should feed on one breast or the other breasts are exactly the things that get in the way of a mom and baby having a having supply and demand being in sync. It's exactly the thing that causes the problem of, you know, low milk production or over milk production and a huge reason that moms don't continue breastfeeding, because they just have such a hard time trusting that their baby is getting enough balances out.

I know it's such a it's so tricky. I think we just want those external markers. That's kind of just what we're taught, right?

Jaren, I think it says a lot about you that you have credentials, far beyond your dietitian credential, and that you went into the emotional and you went to the breastfeeding and all the things that touch this, but it just has me wondering what got you so passionate in this field? Where does that passion come from? Yeah, thank you so much. I mean, it is my journey of coming full circle with my own personal experience, which you know, I think is really, the hope for anyone in their career is to be able to use your own personal experiences, and to be able to offer that to others in your community and through your work. So this was my journey, you know, of recovering from an eating disorder, navigating pregnancy and postpartum and realizing how many triggers there were during this time and feeling really alone in you know, not thinking it was a common experience or thinking that, you know, pregnancy was going to just help me feel like now I have this child, and I'm going to, you know, just intuitively know how to trust my body, right? Or I'm going to be a mother. And I can't be preoccupied with this food stuff, or this body image stuff. And it's so not true. You know, we continue to have those experiences No matter if you've had a full blown eating disorder or not if you've just had concerns around weight and food throughout your journey. And in fact, there's research to support now that pregnancy and postpartum are a very risky time for relapse for individuals who have a history of you know, disordered eating, or an eating disorder. And even if you have it, it's just a really vulnerable time because there's so much attention on nutrition and weight and body image during that time. So That's really, you know, valuable to me. And part of the full circle is knowing that if I can support moms and support women and healing their own relationship with their food, I get kind of two for one, because I have this like intergenerational impact of another kids aren't going to be carrying on this diet culture, either, you know, we're creating a whole different experience, you know, that maybe we had previously were like, our parents were on Weight Watchers, or no fat allowed in the house. And it's really damaging and can be really impactful.

So where is a woman to look if they are wondering if they might need more support about body image and diet because I during pregnancy and postpartum because they are probably not going to get it from their ob, maybe a little from their midwife. But this whole piece that the side the psychology part of it that you are integrating in the intuitive eating part of it? Where do you recommend women begin?

So I think working with a dietitian would be helpful for anyone navigating pregnancy and postpartum just because there's so much coming up during that time. But, you know, specifically, my training is because of my experience in eating disorders. And so even if you haven't had an eating disorder in the past, and it's just helpful to work with someone who might be specialized in eating disorders, because we have more of this counseling based training. So you'll get an A provider who has a little bit more of that, you know, therapeutic skill set and guidance to be able to support you. And you can also usually find an eating disorder dietitian is very well versed in intuitive eating, because that's part of the the framework of treatment. So it doesn't matter if you know, you've never kind of crossed over into that you just simply want to learn more or work on intuitive eating, a dietitian specializing in that field can really support you with that. I mean, I would love to be a part of that, if that's been something that's part of your journey doesn't have to be me can be, you know, another dietitian that's specializing in this area, but it's a good place to start. And, you know, I'm hopeful that we can start to help providers and other health care providers, OBS midwives, doulas learn to start screening a little bit more for some of these concerns. There's, you know, like a five literally takes 30 seconds, five questions that could help kind of trigger a referral to a dietitian, if someone is having concerns around food or body image, and we do tons of screening for gestational diabetes, and eating disorders and disordered eating is you know, just about if not more prevalent. And so, you know, it's my hope that we can start to just get more providers also screening and bringing more awareness to it. And this way, if you are at all struggling with your relationship with food or body image, you know, you deserve support, and it's something that we're not talking enough about. But there is a whole field of providers similar to myself that really support individuals in their relationship with food and body image. It's hard to live in our culture and to not be affected by messages we get around food and body so it just do encourage you to reach out for support and, you know, continue to lean into trust and intuition that you have within yourself, you're born with that way to eat so, and it's something that you have already available to you.

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