Feet First - tender loving care for your feet during pregnancy

Every day your feet take on average 5210 steps, although on busier days this can rise to over 10,000. Despite this, your feet are the most neglected part of your body. When you're pregnant, the extra weight is even more work for your feet. It's no wonder then that so many expectant mums really feel the day in their feet.

• The pregnant changes in your feet
• Aches and pains
• Treating your tootsies right

The pregnant changes in your feet

Changes in your feet are normal during pregnancy, and you've probably heard many mothers say that they went up a shoe size - or more - when they were expecting. There are three main reasons why pregnancy affects your feet;

1. Weight gain - as your bump grows, your centre of gravity is thrown off-course. Your pelvis thrusts forward and the curve in your lower back gets larger. It's thanks to these changes that we all develop the 'pregnant waddle', as we try to adjust to and accommodate our growing bumps without falling over. This change in the way you walk means muscles in the legs and feet are used differently.
2. Swelling - Swelling in the ankles and legs is an unpleasant side effect of pregnancy usually caused by sluggish circulation. Babyworld midwife, Hannah Hulme Hunter, explains, "One of the side effects of the hormones of pregnancy is the relaxation of smooth muscle fibres in the wall of blood vessels. This means that circulation tends to be less efficient, leading to problems such as swollen ankles, varicose veins, and aching legs."
3. Hormones - Right from the early days of pregnancy your body is preparing for the birth, producing a hormone relaxin, which loosens the ligaments in the birth canal. Unfortunately, your body cannot target only your pelvis, so this hormone also relaxes the ligaments in the rest of your body, including your feet. Each foot has 26 bones, held in place by 106 different ligaments which, as they loosen, can cause the arch of your foot to collapse. According to Sole Support, who specialise in orthotics for pregnant women, these hormones "cause the feet to flatten and spread out from side to side and length-wise."

Aches and pains

• Redness and itching - it is common for pregnant women to experience redness and itching on the soles of their feet. It is thought this is due to the increase in hormones, such as oestrogen.
• Pain - changing the way your feet carry your weight, especially as your baby grows, can put extra pressure on the balls of your feet and your heels. This along with the loosening of the ligaments in your foot can lead to pain, either in the whole foot or just parts.
• Oedema - swelling in your feet, or water retention, can be very uncomfortable, making the skin feel tight and throbbing, as well as making footwear tight and uncomfortable.
• Hard skin - hard skin on the heel or ball of the foot is caused by pressure. Because when you're pregnant you are carrying more weight, as well as putting more pressure onto your heels as you walk, you could find that you're more likely to get hard skin, which can crack and become painful.
• Toenails - Pregnancy can do wonders for growing hair and nails, but when it comes to toenails you probably don't want them to grow any faster, especially towards the end of your pregnancy when reaching your feet proves to be very difficult. Unfortunately, many nutrients go to your baby which can cause your toenails to suffer and become dry, brittle and discoloured, or even fall off.

Treating your tootsies right

There are plenty of things you can do to ease and prevent foot discomfort in pregnancy, some are simply practical, and others are completely indulgent.

• Posture - One of the biggest causes of foot pain in pregnancy is caused by the change in your posture to compensate for your growing bump. Think back to when you were growing up and your mother frequently told you to sit or stand up straight - she was right! Try to keep your shoulders back and your ribcage lifted, to help regulate the pressure going through your feet.
• Footwear - When we walk, we step first with our heels, then the balls of our feet, and finally the toes. Every step places pressure, equivalent to four times your weight, on your heels, so it's really no wonder that pregnant women suffer with heel pain. According to podiatric surgeon and spokesman for the Society of Chiropodists and Podiatrists, Michael O'Neill, pregnant women should;

1. avoid high heels because they put pressure on the ball of the foot, causing you to lean even further back
2. avoid wearing completely flat shoes, such as flip flops
3. your shoes should grip your foot for support
4. the ideal footwear for pregnant women is a pair of good running shoes made from a breathable fabric.
• Foot health - As your pregnancy progresses, and your feet become obscured from your view, it's quite easy to neglect their general health. Some simple things you can do include;
  
1. Avoid injuries (stumped toes, cuts etc) by not walking around in bare feet
2. Keep nails short to prevent brittle nails from splitting
3. As you get larger and reaching your feet gets harder, think about using a foot bath.
4. Ask your partner, or a friend or relative, to rub your feet with a moisturising foot cream
5. See a podiatrist to check out your foot health and spot any problems
• Pedicures - A professional pedicure can work wonders on tired, aching feet, especially when you can't reach them yourself. There are some things to remember though;

1. Make sure you tell the staff you're pregnant (if it's not obvious!) Some treatments, such as some aromatherapy oils, should be avoided during pregnancy.
2. Try to avoid nail polish as some small studies have shown the chemicals may be harmful to a developing baby. Babyworld midwife, Sarah Ifill, says, "If you must wear nail polish, limit its use to special occasions, after 12 weeks of pregnancy when your baby will be fully developed."
3. Try to avoid treatments that massage or put pressure on some areas of the foot, as some trigger points are best avoided during pregnancy.
• Blissful treatments - Spa treatments are becoming evermore popular, and many salons offer foot treatments specifically aimed at pregnant women. There are also numerous luxurious foot creams designed for expectant mothers:
  
1. Mama Mio Lighten Up - A warm, fragrant mineral salt-rich Mama Mio Foot Soak to energise, reduce swelling and stimulate circulation. Includes a gentle hand, lower leg and foot massage. 30 Min £17-£45. Available in most spas.
2. Reflexology - Soothing massage, pressure, stretching, and movement of the foot and ankle, to find blockages and break up patterns of stress, restoring balance and relieving tension. Visit The Association of Reflexologists to find one in your area.
3. Decleor Circulaspray - A natural treatment to revive, cool and energise tired legs, and reducing the feeling of heaviness. £16 for 50ml from www.decleor.co.uk
4. Mama Bee leg and foot crème - Instant relief for your feet in a tube. 100% organic, this cream from Burt's Bees has rosemary leaf to encourage circulation, and peppermint to relax, soothe and relieve hot, tired feet. £11 for 100mls www.salonskincare.co.uk
5. Erbaviva Refreshing Foot Balm - This 100% organic balm is especially designed for pregnant women and contains stimulating Grapefruit to boost circulation while warm, woody Cypress relieves tired and swollen limbs. It is petroleum free and can be rubbed in several times a day. £13 for 40g, available from www.harveynichols.com

Where to next?

• So spa, so good: 10 spas tried and tested by mums-to-be.
• A guide to reflexology during pregnancy.
• Early pregnancy concerns - what's OK and what's not.
• Complementary medicine - a guide to what's good for pregnancy.