Managing Lymphedema During Pregnancy: Tips and Insights

During pregnancy, many women experience swelling in their feet, ankles, and legs due to fluid accumulation. Living with lymphedema already entails continuous and progressive swelling if not properly managed. Therefore, when I became pregnant with this chronic condition, I decided to do everything in my power to prevent my leg from worsening. In this blog post, I’ll share my journey and tips for a comfortable and confident pregnancy with lymphedema, prioritizing you and your baby’s well-being.

During those nine months, I applied what I’d learned from both medical experts and my two decades experiences as a professional dancer and yoga instructor. My goal was to prevent my lymphedema from worsening and to nurture my physical, mental, and emotional well-being. At one of my annual check-ups, when measuring my leg’s circumference, I received confirmation that my efforts had been effective — my edema had improved.

Here are my top advices that had the most impact in my experience during this time

1. Keep Your Multilayer Bandages on for as Long as Possible

Low-elasticity multilayer bandages are especially recommended..

1. after receiving lymphatic drainage massages to prevent – reduce fibrosis and maintain the decongestive effect, and
2. when sleeping at night as these bandages are well tolerated during rest.

In the Földi method, one of the four main methods for lymphedema treatment, bandages and exercise are combined, as these bandages increase lymphatic drainage when we are in motion. Every time I’ve had rehabilitation at the clinic, lymphedema (and lipedema) patients wear bandages 24 hours a day (only removed for showers) for a minimum of 3 weeks to see results. During your pregnancy, extend the time you wear your bandages as much as possible; go for walks with them in the evenings or leave them on during the weekend.

2. Embrace Compression Stockings for Expectant Moms

Consider investing in pregnancy-specific compression stockings, such as those offered by Medi. These stockings come with flexible waistbands and are designed for comfort during everyday activities. Thanks to the German healthcare system, I was fortunate to acquire a stocking for pregnancy with a toe cap for only €10. Consult your healthcare provider and visit an orthopedic supply store for suitable options.

3. Move Every Day, and If Possible, with Your Bandages On

In the treatment of lymphedema, movement is one of the pillars of complete decongestive therapy (CDT). Many people, like me, were advised by some doctor to avoid exercise when diagnosed with lymphedema, with statements like “forget about dancing.” Over time and with scientific evidence, it has been shown that disciplines such as yoga and dance are moderate exercises that help:

• Reduce swelling
• Improve lymphatic drainage
• Increase mobility in the affected limb
• Optimize skin condition, reducing fibrosis and the risk of infections
• Improve mood by increasing happiness hormones (serotonin and dopamine)
• Lose weight and maintain overall health

Prenatal yoga is a recommended tool to stay healthy, prepare for childbirth, and connect with your baby. You will feel physically, mentally, and emotionally stronger. However, consult your gynecologist before practicing it, as every woman and every pregnancy is unique.

4. Manual lymphatic drainage MLD:

Also known as the Vodder technique, MLD is crucial in lymphedema treatment and recommended during pregnancy to stimulate the lymphatic system and relieve the sensation of heaviness and pain typically associated with leag swelling. Avoid the abdominal area and postures that involve lying on the abdomen and back, especially in the third trimester.

5. Take Care of Your Skin

During pregnancy, our skin requires extra care. When the lymphatic system fails, its immune function and the skin’s immune barrier weaken. Controlling edema, maintaining proper hygiene, and creating a skin self-care ritual help prevent infections and problems such as lymphangitis, erysipelas, or cellulitis, which in some cases can be life-threatening. So:

• Drink water to keep your skin hydrated.
• Use a daily hypoallergenic and chemical-free lotion.
• Use talcum powder when your skin is irritated after bandaging. It absorbs moisture from sweat, prevents rashes, and reduces the sensation of burning or itching.

6. Diaphragmatic breathing

Studies by specialists in Lymphology such as Dr. Földi and Dr. Jack Shields among others confirm the importance of diaphragmatic breathing to stimulate and cleanse the lymphatic system.

Breathing is fundamental to life. However, although we all breathe unconsciously and involuntarily, most of us use only shallow clavicular breathing, which causes toxin accumulation in the body and physical and mental stress. This is the rapid, chest-level breathing we experience during anxiety, stress, or rushing from one place to another. It feels like we’re running out of air because we’re not using our full lung capacity.

Hence, the importance of learning to breathe correctly and consciously. Yoga and controlled breathing exercises, also known as Pranayama, are valuable tools for learning to breathe slowly and deeply.

How to practice diaphragmatic breathing:

1. Lie on your back with your knees bent and feet flat on the ground at hip width.
2. Place one hand on your abdomen and the other on your chest.
3. Inhale slowly and deeply through your nose, focusing on feeling your belly rise and expand like a balloon.
4. Exhale slowly through your mouth, pushing your belly toward the floor.

You can do this exercise for 5-10 minutes with your legs elevated, supported by a chair or a bolster under your knees, to promote lymphatic flow.

7. Rest and Sleep Well with Mindfulness

Pregnancy often brings sleep difficulties due to hormonal changes and discomforts, particularly in the third trimester. These discomforts include leg cramps, fetal movements, and frequent urges to urinate. When combined with the discomfort of wearing bandages at night and the potential for maternal anxiety about the uncertainties of motherhood and worries like “will my baby inherit my Lymphedema?” or “can I manage my chronic condition and care for my baby simultaneously?” — ensuring quality sleep becomes crucial.

Prolonged stress and sleep problems not only impact your pregnancy and the baby’s development, potentially leading to issues like premature delivery and high blood pressure, but they can also worsen edema and weaken your immune system.

Here are some practical suggestions that helped me to improve your sleep quality:

• Try mindfulness meditation exercises and deep breathing techniques to manage emotions, relieve stress, and reduce anxiety, ultimately enhancing your sleep.
• Consider calming rituals like taking walks in nature, which is a form of therapy in Japanese culture known as shinrin-yoku or forest baths. Research has shown that spending time in nature can lower stress hormones, reduce anxiety, improve insomnia, boost the immune system, lower blood pressure, and elevate your mood.
• Create a relaxing bedtime routine free from screens at least one hour before sleep. Blue light emitted by electronic devices such as phones, tablets, and TVs can disrupt sleep patterns by suppressing melatonin, the sleep hormone, and keeping your brain active. Instead, opt for activities like lighting candles, having a pleasant conversation with your partner, taking a relaxing bath, reading, or indulging in a self-massage to help you fall asleep.
• Explore breathing exercises or pranayama, as I’ve detailed in my post on relaxation techniques. These exercises can promote relaxation, regulate the parasympathetic system, slow your heart rate, and stimulate sleep-promoting hormones.

By incorporating these strategies, you can improve your sleep quality during pregnancy and enhance your overall well-being.

8. Eating Well: A Balanced Approach

A healthy diet is important for everyone and especially for pregnant women with lymphedema or at risk of suffering from it. It is not about obsessing about calories but about bringing our eating habits to a conscious level (once again!).

Here are some dietary recommendations I’ve followed during my pregnancy (at least most of the time):

Foods to Avoid: Certain foods should be avoided, including:

• Cheeses like blue cheese, fresh unpasteurized varieties, brie, and camembert.
• Processed meats like sausages.
• Undercooked meats.
• Raw fish, such as sushi.
• Marinated and smoked foods.
• Pastries made with raw eggs, like tiramisu.
• Liver-based pates and foie gras.
• Homemade mayonnaise or sauces.
• Alcohol.

Low Salt Diet: Reduce salt intake as excessive salt consumption can make the body and blood more acidic, leading to fluid retention.

Hygiene Matters: Ensure you wash vegetables and fruits thoroughly to prevent infections and diseases such as toxoplasmosis and listeria.

Variety is Key: Opt for colorful meals as a rule of thumb – the more colors on your plate, the more nutrients you’ll receive.

Fiber-Rich Diet: Incorporate fiber-rich foods into your meals, such as whole grains like rice, whole wheat bread, pasta, quinoa, and oatmeal. A well-functioning intestinal system promotes a healthier lymphatic system.

Avoid Processed Foods: Steer clear of processed foods, which are often lacking in essential nutrients and contain high levels of salt, artificial additives, preservatives, trans fats, and added sugars. These can be harmful to your body and overload the lymphatic system. Additionally, processed foods are linked to obesity, a known risk factor for lymphedema. If you already have this condition, processed foods can exacerbate it.

Stay Hydrated: Remember to drink at least 2 liters of water daily to stay well-hydrated throughout your pregnancy.

By following these dietary guidelines, you can maintain a balanced and nutritious diet during pregnancy while managing lymphedema effectively.

9. Mindset

The book ‘Hypnobirthing: Preparing for a Positive Birth’ written by Carmen Moreno guided me in adopting a positive mindset for childbirth, emphasizing knowledge and scientific evidence over fear. I strongly recommend you read it.

Challenge to practice

If you want yoga and meditation to accompany you in this special stage to take care of you, your baby and your lymphedema I invite you to take my free “Mindset Mastery” a 10-day challenge. Remember to consult your doctor or gynecologist before and always listen to your body.