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There are few things more demoralizing than failing to feed your newborn despite your best efforts to breastfeed. In my practice and among friends, I have found myself asking repeatedly, “What is going on here? What’s with the supply drama?”
Statistically, a full 50% of women are not able to meet their breastfeeding goals. There are many reasons for this, some of which include:
- Aggressive promotion of formula-feeding in hospitals including supplementation in NICUs.
- Limited lactation support and resources including insufficient family encouragement and shared community wisdom.
- Workplace impediments to pumping, and unfinanced maternity leaves.
- Pediatricians who overvalue growth charts and encourage unnecessary supplementation.
- Alcohol, nicotine.
- Infrequent feeding.
- Use of pacifiers.
- Depression and anxiety.
- Medications.
I’ve long been interested in what may be promoting insufficient supply on a physiologic level. I’ve come up with two interesting considerations – one environmental and one dietary:
Environmental pollutants — xenoestrogens
It is a meaningful concern that the modern woman’s breastmilk is a conduit for toxic substances. A recent study explored the relative significance of gestational versus lactational exposure to persistent organic pollutants and found that pregnancy was a more significant window of exposure, more directly correlated with adverse developmental outcomes.
Nonetheless, endocrine disruptors contribute to cumulative changes in thyroid function and estrogen load so that a woman’s hormonal milieu is skewed and her feedback loop between the brain (hypothalamus and pituitatry) and her glands may not be optimal. We know that synthetic estrogens in birth control can interfere with nursing, so it is hardly a leap to assume that environmental chemicals may be doing the same. These are most frequently found in plastics, pesticides, and cosmetics.
Insulin resistance and low milk supply
A fascinating study recently identified a potential biomarker gene expressed in the setting of insulin resistance and low milk supply. The significance of their hypothesis resonates with me because of how many women, of all body shapes and sizes, I see with early stage indication of insulin resistance that far precedes a diagnosis of diabetes and can also manifest as reactive hypoglycemia. Indicators of this state are high HemoglobinA1C, high or low fasting glucose and insulin, high triglycerides.
Clinically, these are the women who crave carbs and sweets, wake up without an appetite, or who can’t go more than two hours without eating (without risking relationships). Additionally, the study elucidates the complexity of breastmilk and inferiority of a one-size fits all, best-guess-at-nutrients formula. The researchers describe the 3 stages of breastfeeding as follows: “immune defense is the hallmark of the colostral stage, massive development of the protein synthesis infrastructure…the transitional stage, and massive synthesis of lipids…the mature stage”.
What to do BEFORE Baby is Born
Based on these theories, here are some things that women can do, preventatively, to help ensure a plentiful supply of breastmilk after baby is born:
- Take chlorella: based on a Japanese study where women who supplemented in pregnancy had lower levels of dioxins in their breastmilk and higher levels of IgA, and important indicator of immune performance. Other natural detox options are turmeric, cilantro, and garlic.
- Avoid BPA, chlorine, pesticides, and parabens.
- Adopt a low glycemic diet high in natural fats and proteins. The most important culprits are processed and artificial sugars and refined flour-containing foods (check labels…it’s everywhere).
- Have a low threshold to recruit the help of a lactation consultant. They can be miracle workers. A helpful online resource for breastfeeding support is www.kellymom.com.
As a staunch advocate for the impossible-to-replicate complexity of breastmilk, as well as the anti-inflammatory benefits to the mother, I look forward to sharing additional studies that further elucidate environmental drivers of this incredibly trying postpartum complication.
I also look forward to when some mechanical genius dramatically improves the operation of the annoying electric breastmilk pump!
I think the fact that 50% of women can’t breastfeed is important information. Many women feel a great deal of guilty about their inability to breastfeed. It’s also important to work with your doctor to understand the underlying causes of low breast milk such as hormonal imbalances. Diet changes and supplements alone are not enough for most women. Kellymom looks like a great resource. Great post. Thanks.
This is very informative. I never tried chlorella before. My husband and I were planning to have a baby next year. I will try this. Thanks for sharing! 😀
I totally relate to the milk production problems as a result of insulin problems. I found a way to have a good suppy after having 2 scronny babies that constantly nursed….
It is more common these days, so EVERYONE won’t consider me crazy, but one thing that helped boost my tremendously for my 3rd and 4th kids was placenta encapsulation. I don’t know the why, but I know it worked!
Hello again – Here is another mechanistic study for those assessing the risk/benefits of chlorella. There isn’t much known about the way that it acts in the body. It is a source of multiple minerals, amino acids (notably cysteine), and vitamins. It may just help the body excrete more effectively by supporting cellular processes without a direct chelation effect like DMSA. http://www.ncbi.nlm.nih.gov/pubmed/22008543
and
http://www.ncbi.nlm.nih.gov/pubmed/20013055
Be well,
KB
Also, probiotics to improve quality of mother’s gut microbiota and therefore breastmilk?
Thyroid issue and/or too much estrogen can also contribute to low milk supply. With my first son, my milk supply dropped around 3 months (AND I didn’t figure it out until around 5-6 months), and I never was able to bring it up again. With my 2nd son, I worked hard to balance my thyroid (definitely still in the learning stages on this one!), daily use natural progesterone cream to offset my estrogen in balance, and took Dr Christopher’s “Mother’s milk” supplement (the only herbal remedy that has really helped me). Even with these measures, I found I had to nurse every 2 hours around the clock to give him enough milk, but I did not have to supplement, and he is still nursing at 19 months. I will say though, that experiencing these milk supply issues–even with the help of a professional lactation consultant–has greatly humbled me, and I realize that there are not always hard and fast or “easy” answers.
I loved kellymom.com. What a great website. The other resource that I wouldn’t have been able to continue nursing after the first week or so without was The Nursing Mother’s Companion. That book told me how to get a latch better than hospital lactation consultant, doula, and grandmas. Still nursing at 12 months!
Kelly,
I have heard mixed things about chlorella. As far as metals i heard it redistributes metals but they are not always pushed out of the body which can be dangerous. What do you think?
Also do you have any suggestions for the insulin type you describe? That is me to a T. A life long battle with chocolate, lemonade, iced tea, etc. homeopathy has not helped. Gaps diet destroyed my metabolism. Eating raw milk and grains really helped me to feel hotter and normal however made me gain 30 lbs
Raw milk– what could be a better food for lactating mothers?
Hi all! Tc – This is a good question, and generally, yes, a “detox” is recommended 6 months prior to conception. With food-based enhancers of redox pathways, ie detox (curcumin, garlic, cilantro, chlorella), I have less concern about mobilization than I do with chelation, oral or IV. We don’t know the answer, but if binding up pesticides and toxins is happening, or excretion is enhanced, that seems preferable to dumping it into the fetus and breastmilk as we know to be happening.
Warmly,
KB
I stumbled across traditional lifestyle while pregnant, and now my son is 3 months old. I am planning on having another (not for another year and a half at least) and will continue to breastfeed my son until he is no longer interested, likely into my next pregnancy. Will I have to wait until my *next* child is done breastfeeding to detox? I wish I had learned about this lifestyle before having children…ugh.