Feeling Puffy? 10 Ways to Reduce Swelling In Pregnancy

Edema, swelling in extremities such as the ankles and feet, is a common occurrence in pregnancy especially in the heat of summer. Women report more swelling in pregnancy during the last trimester.

Two Things That Cause Normal Swelling in Pregnancy

1. As pregnancy progresses, the increasing weight of the uterus from the growing baby, the placenta and amniotic fluid causes pelvic vein congestion that prevents effective return of blood from the lower extremities. The increased pressure forces fluids out of the veins into the tissues.
2. Also, the hormones of pregnancy cause veins to be more relaxed and less effective at helping blood flow back to the heart and kidneys. Sitting with the legs dependent for long periods of time like many women do at their jobs is a reason pregnant women have swollen ankles at the end of the day. After resting all night in a horizontal side-lying position, the swelling usually resolves. Typically, women have more swelling in their ankles at night and in their hands in the morning.

Some women experience swelling in pregnancy that is unrelieved by rest and position change. Again, when it is of gradual onset and remains in the legs or arms it is usually normal.

When you google “swelling in pregnancy” the word pre-eclampsia commonly pops up. The definition of pre-eclampsia is an elevation of blood pressure in pregnancy that is associated with protein in the urine, a headache unrelieved with Tylenol, hydration and rest, visual disturbances, epigastric pain or other lab abnormalities. Swelling can potentially be a side effect of this condition but it is NOT the way pre-eclampsia is diagnosed.

How to Relieve Puffiness in Pregnancy

1. Drinking plenty of water is key. It seems counterintuitive but more water intake reduces swelling (also called edema). Increased hydration reduces the fluids stored in peripheral tissues.
2. Foods that are natural diuretics (foods that increase excretion of fluids through the kidneys) include asparagus, celery, artichokes, carrots, watermelon, cucumber, tomato, parsley, eggplant, cranberry juice, cabbage, apple cider vinegar, beets, ginger, brussel sprouts, and lemon.
3. Increase potassium intake. Potassium and Sodium should be in balance with each other. When sodium is greater than potassium in the bloodstream, it can cause more edema. Foods rich in potassium include bananas, oranges, celery, romaine lettuce, figs and papayas.
4. Your protein intake needs to increase in the 3^rd trimester to at about 100 grams per day. Low albumin (protein) levels in a pregnant person’s blood can cause lower blood osmolality (“thickness”) and result in fluids “leaking” out of blood vessels into surrounding tissues (edema). Pregnant moms should eat protein every 2-3 hours in the 3^rd  trimester. “Thicker” blood will draw fluid back into your veins to be excreted by the kidneys.
5. Garlic and parsley oil pills (they come together in one gel capsule) can also help reduce edema. Take 3 pills by mouth at bedtime.  Available at our online store The Essential Market
6. Reducing your sugar intake can limit water retention. Remember sugar is in all carbohydrate foods (rice, pasta, bread, grains, dessert) as well as fruits. And tropical fruits have a higher sugar content than other fruits.  Avoid simple and /or processed sugars as much as possible.
7.  Compression stockings can also help. Compression stockings should be put on in the morning when your lower leg swelling is decreased. The pressure will promote the return of blood through the veins.
8. Immersion in water can decrease edema.  An expecting mom with puffy feet can soak her feet in a bucket of warm water with some Epsom salts at the end of the day. Hydrostatic pressure pushes fluids back into veins to be excreted. For generalized swelling, immersion in a deep bathtub or swimming pool several times a week will help the kidneys excrete excess water in the tissues.
9. Massage therapy can also return fluid to the general circulation to help excretion through the kidneys. Feet should be massaged from toes to heels to ankles. Choose a good massage oil and you can massage your legs or have your partner do so at home.
10. Posture matters. Avoid standing or sitting with feet dangling for long periods of time. Dependent postures will increase the edema. The swelling will decrease when a woman lays or sleeps on her left side (improves circulation through kidneys) or elevates her feet when sitting.

The pregnancy swelling will resolve after the birth, but  it can actually worsen before it decreases. The complete resolution of puffiness can take up to 2 weeks to completely resolve.  Buy some comfortable, easy to slip-on shoes to wear until your feet are slim again!