Puffy Feet, Swollen Hands

Edema 101


Puffy feet and swollen hands happen to men and women year round, but they're especially common for pregnant women in hot weather. Considering it's been scorching these last couple weeks, I bet there are a whole lot of pregnant ladies out there who feel like the Stay Puft Marshmallow woman.

What causes swelling?

The official medical word for swelling is edema. Any part of the body can get edema or become edematous in response to inflammation. For example, when you bang your leg on a drawer and you develop a bump, that's a type of edema. The type of edema pregnant women experience in their feet, ankles, calves, hands and face is a bit different, since it doesn't involve injury. In fact, most of the time, edema is a normal part of a healthy pregnancy.

Women circulate about 50% more blood and body fluids during pregnancy and the body doesn't always need all of it at the same time. If it's hot or we're a little dehydrated and our body needs more fluid to stay cool, it communicates with our kidneys and makes a request. The kidneys then process body fluids to give the right body parts what it needs by shifting fluids back into the bloodstream or eliminating what it doesn't need by shunting it out of the body through urine production. If it's hot for a while, our body might decide that in addition to providing our body with the fluids it needs, it's going to store a little for later. Hands and feet make perfect storage containers. That's why, when it's hot, we get puffy.

You might also notice a little swelling when you've exercised, been standing or walking a while, you're particularly tired, or you've been eating a lot of salty foods or drinking caffeinated beverages. Gravity can make excess fluids pool in our hands and feet, which is why standing and walking make your hands and feet feel heavy. Salty foods make a lot of people retain fluids and caffeine makes us dehydrated.

What's the solution?

- Drink more water. It keeps the kidneys from thinking you're going to be chronically dehydrated and helps flush salt out. I know, that seems counterintuitive – drinking water to eliminate water – but trust me on this one...it works.

â–ª Fight gravity with gravity – Whenever possible, put your feet up on a stool or lie down at night with your hands and feet on pillows.

â–ª Drink less caffeine – Even though caffeine makes you pee and that's how you eliminate excess fluids, it also causes dehydration. When you're dehydrated, your kidney's say, "hey, she's moved to the dessert! Hang on to all the water you've got," so you retain fluid.

â–ª Watch the salt – Not too much, not too little. Keep your salt intake just right. Almost no one in America is at risk for consuming too little salt (sodium). Instead, we're more likely to get way too much. Read your food labels and minimize your sodium intake.

- Exercise – it keeps your circulatory system running at maximum efficiency. Again, it seems illogical that if you get puffy while exercising, that exercise is a solution, but physiology is tricky that way.

Swelling isn't just a pregnancy thing. We can get edematous any time our body has excess fluid to process, for example, after we've had the baby. That extra 50% of fluid we've been packing for nine months has to go somewhere. While the kidneys are extremely efficient at eliminating it within a few days to a week or so after birth, it might need to take care of it in batches. So what does it do with the rest? Storage! That's why many women get puffy feet and/or pee like a fire hose after delivery, especially if they've received a lot of IV fluids during labor.

When is edema not normal?

When it comes on suddenly or is associated with other symptoms, like severely decreased urine production, high blood pressure, vision changes, stomach pains, headaches, exhaustion and more. All of these symptoms signal trouble and might mean the kidneys, heart, lungs or other vital organs aren't functioning properly. Let your doctor or midwife know right away if this happens.

To all of you ladies who are pregnant during this super hot summer and especially those of you who don't have air conditioning, a lovely swimming pool and a fresh package of Popsicles, I'm sending you my coolest wishes. Hang in there. Bathing suit season today – sweater weather tomorrow. You deserve extra support, an extra Popsicle and a day at the beach because no one is hotter than a pregnant woman.

Jeanne Faulkner, R.N., lives in Portland, Ore., with her husband and five children. Got a question for Jeanne? Email it to labornurse@fitpregnancy.com and it may be answered in a future blog post.

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This Fit Pregnancy blog is intended for educational purposes only. It is not intended to replace medical advice from your physician. Before initiating any exercise program, diet or treatment provided by Fit Pregnancy, you should seek medical advice from your primary caregiver.