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Lactation


As most of you know by now, we welcomed Luca, our baby boy last week. Because I could no longer carry a baby, we turned to surrogacy to be able to have our long-awaited second child. Since we started the surrogacy process, I had yearned to be able to breastfeed my new baby, just like I did with his older brother Nico. I did some research and although it would definitely involve more work, it was not an impossible idea, and it actually has a name- "induced lactation". Most commonly used by mothers of adoptive children and through surrogacy.


Why induce lactation?

As a holistic nutritionist, I have spent countless hours researching the benefits of mother's breastmilk. Not only is it the best source of nutrients for a human baby, it is easiest to digest and boosts infant's immune system with its multiple immune-boosting compounds. As many people refer to it, breastmilk is liquid gold. I wanted to provide my baby with the best nutrition possible and give him the same gift I gave to his older brother. But aside from all this, I also wanted the bonding experience that breastfeeding provides. Since I didn't carry Luca in my womb for nine months, I wanted to nurse him so I could develop a more intimate relationship with him.


The Process

Induced lactation may not be a very common practice, but there is plenty of information out there and lots of successful stories to learn from. I first joined an induced lactation Facebook group and bought a book about it. I then hired a lactation consultant to guide me through the process and hold my hand. Surrogacy is such an emotional journey, and I needed all the support I could get.


Upon the first appointment with my lactation consultant, we determined the Newman-Goldfarb protocol would be the right approach for me. We had 6 months before baby arrived and I was willing to take hormones and other medicine to stimulate production. This was the protocol with the highest success rate (production of 40%-95% of breastmilk requirements) and since I had already breastfed my older son, I was optimistic that I would be successful. Success on my book was producing milk, even if not a full supply.


The process takes about six months, and there are basically three stages:

Phase 1: Preparation by growing breast tissue and milk ducts through taking continuous birth control (BC) pills, herbs and a medicine called Domperidone. This phase takes about 4-5 months.


Phase 2: Starting to build a supply by mimicking birth by stopping BC, start pumping every 3 hours, taking lactation supporting herbs, and continue with the Domperidone. It is recommended to start this phase about 6 weeks before the due date.


Phase 3: Once the baby comes, breastfeeding as much as possible and continue pumping to increase supply. Continue with the Domperidone and herbs.


The continuous birth control pills simulate pregnancy and breast growth via estrogen and progesterone, and the Domperidone increases prolactin to start creating breast milk. Domperidone is a medicine that is not available/approved in the US, so it needs to be ordered from another country, mainly from an online pharmacy in Canada.


I started with birth control and then added the Dom. The side effects from taking Dom were pretty severe for me (nausea, vomit, diarrhea) and after trying to to make it work for about a month, I decided to stop taking it, and hoped that the birth control would be enough. Birth control was not without its side effects either; weight gain, moodiness and fatigue, but I felt like I could handle those for a few months. Birth control pills deplete our bodies from B vitamins and mess with you gut bacteria, so I started taking a B vitamin complex and doubled my probiotics. I took the pill for 5 months until it was 6 weeks before baby's due date.


Pumping


When I stopped the birth control, I rented a hospital grade pump, a Medela Symphony. I also started taking herbs and supplements to increase milk production and made sure I was pretty hydrated. On my first pumping day, I pumped for 15 minutes 7 times a day, but nothing happened. I heard it was pretty normal for it to take about a week or so to produce even one drop of milk, so I just kept going. By the third day, I finally saw one drop out of each breast! That one drop was so encouraging because it meant that this was working.

I continued to pump every 3 hours during the day and woke up once between 3:00 – 5:00 am to pump at night. My lactation consultant told me that is the time when prolactin – the h

Even though I was producing milk, I didn’t produce colostrum. I’ve been told you can only produce colostrum when you are pregnant because colostrum production starts with the placenta. The characteristics of the milk that you produce with induced lactation is the equivalent of what a mother of a 6-month old would produce, not in quantity but in composition.

My production started increasing every day and by weeks 3-4 I was producing 4.5 ounces, but then it kind of stabilized there. I then realized this was caused by my period returning after 6 months! It is considered normal, even for breastfeeding mamas, to see a dip in supply when they get their period. I continued pumping and added one power pumping session and more herbs and supplements to boost supply. Power pumping means, instead of your regular 15-20 minute pump session, you pump for 20 minutes, then rest for 10, then pump for 10 minutes, then rest for 10 and then do a final 10 minute pump. This is the equivalent of cluster feeding in babies and stimulates more production.


Power pumps seemed to work and I started producing 6, then 8 and peaked at 10 ounces per day, on the week of my baby’s due date. I have been saving all my milk since I started producing 1 oz and freezing it. I am still in awe of what the human body can do. Every night as I poured the milk I collected during the day into freezer bags to store, I thought to myself: I can’t believe I made all this, and I thank my breasts for their hard work :-)



Supplementation


As the founder of a supplement company myself, I truly believe in the power of nutrients for overall health as well as to support lactation. Here is what I currently take:


· Prenatal / Postnatal by Mother Nutrient. I want to make sure the milk I produce has all the nutrients baby needs and also that I am not left depleted by milk production

· Cash Cow a lactation booster by Legendairy Milk. They are also an Austin based company that makes all kinds of organic lactation supplements without fenugreek, since fenugreek is a legume and can disrupt digestion in mothers and babies. The blend I am taking contains moringa, nettle, alfalfa and goat’s rue.

· Biotin gummies by Mother Nutrient. Biotin can do wonders for your skin, hair and nails, but it also helps with breast tissue renewal. My breast tissue is pretty dense, and biotin has helped in loosening the tissue and getting the milk to flow easier.


· Omega 3 by Mother Nutrient. Most Americans are deficient in Omega 3's, this essential fatty acid is super important for baby's brain development and mother's mental health, as well as a powerful antioxidant. On days when I don't eat fatty fish I take one capsule.

· Women’s probiotic by Mother Nutrient. Studies have shown that breastfed babies of mothers that took probiotics during pregnancy and lactation, suffered a reduction in colic, spit up and were 27% less likely to develop eczema, compared to babies of mothers who took a placebo. I didn’t take probiotics with my 6 year old and he was pretty colicky, so I am not risking it this time around.

· Breastfeeding probiotic by Mother Nutrient. When I breastfed my older son, I had 5 bouts of mastitis, not fun. I know I’m prone to mastitis, given my history and my dense breast tissue, so now I am taking this probiotic that has specific strains to prevent and help relieve mastitis.

· Endura by Metagenics. I did a lot of research on what to do to increase production and hydration is key. Some experts recommend nursing women to drink Gatorade, coconut water or electrolyte powders, but those are full of sugar. I found this awesome electrolyte powder that only has 2 gr of sugar and is sweetened with Stevia and it also tastes great. One packet of Endura in a glass of water is the equivalent of drinking 3 glasses of water!

· Mother’s Milk tea by Traditional Medicinals. I usually drink 2-3 cups per day, and have noticed how it helps keep my supply up.

· Lactation bites by Majka. These do have fenugreek but not in huge quantities, I like that they are made with organic unprocessed ingredients, are gluten-free and sweetened with dates.

· Organic Ashwagandha by Mother Nutrient. It is an ayurvedic herb that has been used as a galactagogue in India and reduces stress by decreasing the stress-hormone Cortisol and supporting the adrenal glands. It has really helped me when dealing with stress and anxiety about COVID-19 and having a baby in the middle of the pandemic.


· Organic Golden Collagen by Mother Nutrient. A delicious blend of superfoods and herbs that increase breastmilk production (moringa, fenugreek, cinnamon, ginger, cardamom) plus the powerful anti-inflamatory turmeric, and grass-fed collagen. I drink it hot or cold with coconut milk, add it to pancakes and smoothies.


Baby is here, now what?

Our surrogate had a beautiful home birth and both my husband and I were able to attend.

I actually caught my baby and did skin-to-skin as soon as he was born. He then latched right away to my breast and I've continued to breastfeed ever since. It felt so magical to be able to breastfeed my baby! We developed an instant connection and I fell deeply in love with him! The love I feel for him is the same as I feel for my 6 year old, there in one instant, my loved doubled and it no longer mattered that I didn't carry him in my womb.



In the first few days after birth, babies don’t need that much milk, but around day 4-5 they need the 10 oz the milk I was producing at that point, so I needed to breastfeed and keep pumping to continue increasing my supply. This sounds easier said than done, when in reality baby is cluster feeding, not sleeping and you are dealing with figuring out how to latch and all that. I haven't been consistent at pumping after baby came but I try to do it 2-3 times per day.

Most mothers that do induced lactation end up producing only a portion of baby’s needs. An average baby needs about 25 oz of milk per day. Since I was producing 10 oz, I expect my supply will increase, since suction is so much better with a baby than a pump. Babies also breastfeed more often, so that should help as well. Our baby is now 1 week old and we started supplementing him with colostrum that our surrogate graciously pumped for him. We were also lucky enough to get donated breastmilk from a local mama, for when his need increases even more.


He is definitely a hungry little caterpillar and we want to make sure we meet his needs whether it comes from my breast, my freezer supply or eventually formula. We use an SNS (supplemental nursing system) to give him additional milk. It is a container that can be placed on the mother's chest or on a pole. The very thin, flexible tubes are fixed alongside the mother's nipples and release additional milk and supplements as the baby feeds. This allows for the baby to get additional milk, while still stimulating the breast to produce more milk. When my breasts are tender or need a break from cluster feeding, my husband feeds baby through the SNS using his finger.


Would I recommend it?

Pumping is not for the faint of heart, I almost quit twice when I had to deal with thrush likely caused by having taken BC for so long, and vasospasms, caused by my ill-fitting flanges. It has made me realize that even though breastfeeding is natural, there are a lot of nuances when it comes to producing and providing milk to babies. It can be very complicated and tiring, so no wonder many mamas decide to end their breastfeeding journeys early. Let’s be honest, it is hard work and we as a society should do a better job of supporting nursing mothers. I can’t imagine after going through all this, having to deal with shaming for breastfeeding in public.

I feel so blessed to have had such an awesome support system during my induced lactation journey. I am so grateful to my amazing lactation consultant, my super supportive husband, my very patient 6 year-old who has seen more than his fair share of dangling breasts, and all the encouraging messages from my friends and family when I shared my progress.


I hope my story inspires and motivates those of you thinking about inducing lactation, please feel free to share it with someone you think would benefit.


Love,

Mirelle





When I coached my clients I got these questions a lot: "Do I really need to take supplements?" or "I eat a healthy diet, why do I need to supplement?" I don't blame them because before I became a nutritionist, I was thinking the same thing!


While eating nutrient-dense foods is always the best way to get your daily nutrients, this is most often not enough. Especially considering how being a mother impacts your nutrient stores and ability to replenish them. It is extremely difficult for the average mother to be able to plan, cook, and eat perfectly balanced, nutrient-rich meals every single day. Having that expectation is simply unrealistic, and places an unnecessary burden on ourselves and mothers in general. After extensive research on the nutritional status of mothers before, during, and after pregnancy, it is clear that mothers need more than just "healthy food." That is why I created my line of supplements, probiotics, and superfoods so that mothers can get help replenishing their depleted nutrient stores and can feel better and not have the nagging worry that they are not "getting enough" to provide for their babies and themselves.


When people ask me why they should take a supplement, I usually respond with these reasons:


1. Mothers go through incredible physical, emotional, and mental transformations during pregnancy that leaves them nutritionally depleted. 


In fact, over 80% of mothers are considered to be nutrient depleted as a result of pregnancy, birth, and lactation. It's no surprise that as a woman grows an ENTIRE little human (sometimes more than one!) inside of her body, she needs many more nutrients compared to the pre-pregnancy period. It takes a LOT of energy to not only grow a baby, but also to birth a baby and create breast milk to nourish your baby and to reverse all the changes of pregnancy back to a non-pregnant state. While many pregnant and postpartum women try their best to eat nutritious foods, unfortunately, the vast majority of people are unable to meet the nutritional demands of pregnancy and lactation without supplemental support. Take iron, for example. In the U.S., over 24% of women experience anemia during pregnancy, often due to the fact that many women have insufficient stores even before their pregnancy begins (WHO, 2010, Turner, 2003). An iron-deficient diet, an increase of 50% in iron needs, poor iron absorption in the gut, and blood loss from menstruation before pregnancy are some common reasons why women can't keep up with the increase in demand for iron during pregnancy (Abbaspour, 2014). 


Another example is folate, an essential nutrient required for cell division during pregnancy and the synthesis and secretion of breast milk during postpartum, which leads to a decline in its concentration from mid-pregnancy until 3-6 months after birth. In fact, 20% of women in developed countries have been reported to have low serum folate levels 6 months after delivery (King, 2003).


Like iron and folate, many of the nutrients required for pregnancy and lactation are mobilized from maternal stores. So when you start from an already depleted state, it becomes nearly impossible to increase your nutrient intake without taking supplements, especially as the nutritional demands increase throughout your pregnancy and continue to remain high during lactation. 



The changes that occur to your body during and after birth can also contribute to your nutrient depletion. Your entire digestive system shifts and as a result, your microbiome is affected and the digestive process (and therefore the absorption of nutrients in your gut) can be slow and inefficient. While many people view the postpartum period to sometimes be as short as 6 weeks after delivery, the truth is, nutrient depletion can last for much longer. A study by Janet King concluded that it takes approximately 18 months to replete nutrient stores after pregnancy and therefore that mothers with closely-spaced pregnancies are at increased risk of adverse maternal and baby outcomes (King, 2003). 


Pregnancy and postpartum is a truly unique time that places extra stress on your body, so you want to make sure that you are getting the most important nutrients to support your pregnancy and birth, including folate, vitamin D, omega-3 fatty acids, choline, B-vitamins, iron, and collagen. Taking a multivitamin in addition to single nutrient supplements is often the best way to meet the elevated nutritional requirements during this time.


2. Many health issues are linked to nutrient deficiencies.

When we don't have the necessary vitamins, minerals, and other nutrients that our body needs, the biochemical processes in our bodies are unable to work efficiently, which applies chronic stress on our bodies. For example, we all know that omega-3s are key in baby's brain development, but it does a lot more than that. Deficiencies in omega-3 fatty acids like DHA have been linked to auto-immune conditions, postpartum depression, anxiety, and pregnancy complications like preterm labor and hypertension. Low folate during pregnancy has been linked to higher risks of neural tube-related birth defects. Vitamin D deficiency has been linked to osteoporosis, pregnancy complications like gestational diabetes, pre-eclampsia, preterm birth, and data from the CDC Nutrition Report shows that almost 90 million people do not meet the standard required levels of vitamin D (Serrallach, 2018, Nichols, 2018, CDC). Vitamin B12 deficiency, which has been reported in 3.4 million women in the U.S., can lead to anemia, depression, nerve damage, dementia, and increased risks for neural tube birth defects, preterm delivery, and miscarriage (Nichols, 2018, CDC).


For mothers, many of these health risks can have serious consequences for their health and the health of their babies. Conditions like postpartum depression, which is diagnosed in 10-15% of mothers, can be especially crippling (NIMH). While there are many factors that result in mental health struggles, for many mothers, there's often a nutritional component that compounds the issue. Aside from Omega 3's, deficiencies in vitamin D, calcium, iron, selenium, and zinc have also been linked to negative impacts on mood (Leung, 2009).


Addressing nutrient deficiencies through supplementation can be the first step towards feeling better, both physically and mentally.

It makes sense, doesn't it? The more nutrients we can fuel our body with, the more enzymatic processes go smoothly, and the more energy we can get and have.  


3. The nutrient content of the soil in the U.S. has declined greatly over the last few decades. 



Due to modern farming practices, which greatly impacts the soil's natural processes, the soil in the U.S. has lost almost half of its original mineral and vitamin content over the last few decades. A 2004 study which looked at over 40 crops from 1950-1999 found that nutrients including protein, calcium, potassium, iron, vitamin C and riboflavin have all declined significantly, some by up to 38% (Davis, 2004). The decline in nutrient-dense soil has a negative impact on the nutrient content of food, which decreases the amount of bioavailable nutrients for us to absorb into our bodies.

That means that compared to a decade ago, the same vegetables are providing us with less nutrients, so we need to get the extra nutrients elsewhere to make up for it. 


4. The longer you supplement, the better your long term health is. 


One study comparing supplementation of mothers for 2 months vs. 5-7 months after birth between consecutive pregnancies concluded that the group that supplemented for longer had a higher mean hemoblogin status at the onset of their second pregnancies. Their babies also had higher birth weights and lengths and a lower risk of low birth weight compared to the 0-2 month supplementation group, demonstrating that longer supplementation periods between pregnancies can improve the outcome of subsequent pregnancies even among reasonably well-nourished women. We also have to keep in mind that as we age, our bodies naturally decline in nutrient stores. This is especially true for collagen, which declines to about 50% by the time we are 40. While many consider collagen to be helpful for skin health, it is also an important nutrient for your pelvic floor, gut, joints and scar healing.


5. Your babies benefit from your supplementation


You're not the only one who benefits from the nutrients your body absorbs from supplementation, especially if you breastfeed your baby. In a 2012 study on probiotic supplementation, women who were given probiotics during the last 4 weeks of pregnancy and throughout lactation produced breastmilk with double the levels of immunoprotective

compounds. The rate of eczema in their infants during the first 2 years of life was also

decreased for that group of women (15%) compared to 47% for those who did not receive the probiotic supplement (Pelucchi, 2012). Other studies have shown that probiotic supplementation can protect against infant colic, spitting up and overall digestive discomfort. (Nichols, Lily. 2018).


The effects of Omega 3 supplementation in breastfeeding mothers' babies has been studied in depth. Getting enough DHA during pregnancy and lactation can improve behavior, attention, focus, and learning in children. Other benefits that have been found by having adequate DHA during pregnancy is a reduced risk of allergies in infants and a positive influence on immune development.


It's clear that to support the high nutritional demands of pregnancy, birth, and lactation, and recovering postpartum, mothers need the help of supplements.


But knowing what kind of supplements to take can be incredibly overwhelming, especially in a market that is saturated with choices. 


Here are a few things to remember:

  • Getting your levels tested by your primary care doctor is crucial to knowing exactly which nutrients you are deficient in. Having hard data on how deficient you are can help you make decisions on what to supplement with.

  • What matters is the quality and form of the supplements, in addition to the dose. It is a waste to take supplements if they provide nutrients that are unable to be absorbed by our bodies. That is why looking at the specific forms of vitamins, minerals, and other nutrients is important and why all of our supplements were created using bioactive forms (like folate, D3, chelated iron) that are most easily absorbed by the body. Many of our supplements also include ingredients that enhance absorption, like our Organic Ashwagandha with black pepper, and our Vitamin D3 with K2. Sourcing from pasture-raised and organic animals also ensures that the nutrient content is as high as possible. 

  • In addition to single nutrient supplements, look for a multivitamin that contains vitamin A, all the B vitamins, vitamin C, vitamin D, vitamin E, vitamin K, Alpha Lipoic Acid, choline, inositol, boron, calcium, chromium, iodine, iron, magnesium, manganese, molybdenum, potassium, selenium, and zinc.







Not sure where to start?


Take our free Wellness Quiz to get a personalized nutrition report based on your answers about your pregnancies, diet, lifestyle, symptoms and other areas of concern. In your results, you will find out what supplements you could benefit from taking. 


For high-quality products that use the most bioavailable forms of nutrients, explore our online shop. You can find a wide range of products, from prenatal and postnatal multivitamins, potent probiotics for women, to a delicious golden milk mix with collagen (Golden Collagen)!




Did you take supplements during your pregnancy and postpartum? What was recommended to you to take? Tell me in the comments!


References

De Benoist B, McLean E, Egli I, Cogswell M, editors. Geneva: WHO Press, World Health Organization; 2008. WHO/CDC. Library Cataloguing-in-Publication Data. Worldwide prevalence of anaemia 1993-2005: WHO global database on anaemia; p. 40.


Turner RE, Langkamp-Henken B, Littell RC, Lukowski MJ, Suarez MF. Comparing nutrient intake from food to the estimated average requirements shows middle- to upper-income pregnant women lack iron and possibly magnesium. J Am Diet Assoc 2003;103:461–6 


Abbaspour N, Hurrell R, Kelishadi R. Review on iron and its importance for human health. J Res Med Sci. 2014;19(2):164–174.


King JC. The Risk of Maternal Nutritional Depletion and Poor Outcomes Increases in Early or Closely Spaced Pregnancies. The Journal of Nutrition. 2003;133.


Serrallach, O. (2018). The Postnatal Depletion Cure: A Complete Guide to Rebuilding Your Health and Reclaiming Your Energy for Mothers of Newborns, Toddlers, and Young Children. New York, NY: Grand Central Publishing.


Nichols, L. Real food for pregnancy: the science and wisdom of optimal prenatal nutrition. United States: Real food for Pregnancy; 2018.


Second Nutrition Report (2012) [Internet]. Centers for Disease Control and Prevention. Centers for Disease Control and Prevention; 2012. Available from: https://www.cdc.gov/nutritionreport/report_2012.html


Postpartum Depression Facts [Internet]. National Institute of Mental Health. U.S. Department of Health and Human Services; Available from: https://www.nimh.nih.gov/health/publications/postpartum-depression-facts/index.shtml


Leung BM, Kaplan BJ. Perinatal Depression: Prevalence, Risks, and the Nutrition Link—A Review of the Literature. Journal of the American Dietetic Association. 2009;109:1566–75.


Davis DR, Epp MD, Riordan HD. Changes in USDA Food Composition Data for 43 Garden Crops, 1950 to 1999. Journal of the American College of Nutrition. 2004;23:669–82.


Pelucchi C, Chatenoud L, Turati F, Galeone C, Moja L, Bach J-F, Vecchia CL. Probiotics Supplementation During Pregnancy or Infancy for the Prevention of Atopic Dermatitis. Epidemiology. 2012;23:402–14.

Updated: Oct 2, 2019



We have all heard that “breast is best” and while many new mothers think that breastfeeding should be natural, the truth is it can be very, very hard to breastfeed. New mothers are often unprepared and discouraged with the challenges that come with breastfeeding their newborns. I know I was. After multiple rounds of mastitis, latching issues, nipple confusion and pumping mishaps at work, I got halfway through my goal of two years. What kept me motivated during that year was knowing the wonderful benefits we were both getting with nursing. This is the reason why I want to share these benefits with you.


Breast milk is the perfect food for your baby and a powerful medicine as well.

Its calorie content and composition changes with the baby’s needs, even across each feeding (1). It contains the ideal composition of nutrients, as well as antibodies like Immunoglobulin A to help fight off viruses and bacteria (2). Your milk is your baby’s best medicine.


Did you know that breast milk consistency changes during a feeding?

When your baby starts to nurse, the breastmilk (called foremilk) tends to be watery to quench the baby’s thirst, but as the feeding progresses, the breastmilk (called hindmilk) becomes thicker and more nutrient-dense. This progression during feeding is why it is important to empty one breast completely before switching sides.


Breastfeeding can protect your health.

The list of benefits for baby is extensive, but it doesn’t stop there! Research has indicated that nursing can also protect you from diseases like breast and ovarian cancer (3).


Lactation changes your body in big ways.

Breastfeeding affects your hormones tremendously. Thanks to that feel-good hormone oxytocin that is released right after birth and while nursing your baby, your uterus contracts to help in recovery. Right after birth, breastfeeding mothers generally lose less blood and their uteruses return to their normal size faster (4). Oxytocin is also associated with increased bonding, relaxation, and caregiving, which can all contribute to a lower risk of developing postpartum depression.

Nursing also suppresses ovulation, which means estrogen levels are low, resulting in potential vaginal dryness, night sweats, hot flashes, and low libido. But don’t be alarmed! As your menstruation cycle returns, these symptoms will become less severe.


Breastfeeding is a workout!

Don’t get me wrong, you won’t get toned abs by breastfeeding, but nursing is hard work! Making milk requires more energy, so you typically need to obtain about 500 more calories per day to keep up with the demands (5). While a few nutrients in breastmilk are unaffected by your diet, most of them may be directly impacted (6). That means it is even more important to eat a nutrient-dense varied diet that is rich in whole foods.


Producing high-quality breast milk requires lots of nutrients. The nutrient content of breastmilk depends on the foods you consume. A clear example is vitamin D. Most pediatricians will recommend vitamin D supplementation for breastfed babies. Why? Because the vast majority of the population is deficient. When a mother does not have adequate amounts of vitamin D, she can’t provide it to her baby through her breastmilk. However, a study of American mothers concluded that “maternal vitamin D supplementation with 6,4000 IU/day safely supplies breastmilk with adequate vitamin D to satisfy her nursing infant’s requirement and offers an alternate strategy to direct infant supplementation” (7).


How can you make sure that your milk is as nutritious as it can be without draining your nutrient stores?

If we could get ALL of our nutrition from foods that would be ideal, but the truth is, it’s extremely difficult nowadays. In fact, most postpartum women become nutrient deficient as a result of pregnancy and birth, and increased lactation needs do not help with this issue.

Fortunately, that’s where supplementation can come in to help support the process of healing and breastfeeding. While taking supplements should never replace a good diet, it can help improve overall health for you and baby during the postpartum and breastfeeding period.

A complete postnatal multivitamin like our Prenatal, Postnatal & nursing support can provide the essential vitamins and minerals that you may be lacking in your regular diet. The following 5 nutrients are particularly important (and scarce) during your breastfeeding journey:


1. DHA

DHA is an important fatty acid that supports cardiovascular, neurological, and immune functions. DHA levels in breastmilk can vary hugely depending on the mother’s consumption. Several studies have shown the impact of DHA on children’s brain development and cognitive function (even years down the road) (8). DHA is also crucial for mom’s brain and can improve symptoms of depression(9).

Food Sources: fatty fish like wild salmon, sardines and mackerel, eggs, and algae

Supplementation: Take a daily omega-3 supplement with at least 240 mg DHA and EPA. You can skip the supplement on days you eat DHA from food sources. Mother Nutrient offers a highly-purified Omega 3 DHA + EPA supplement that can help support both mom and baby.

Note: check the label on your prenatal / postnatal supplement, as most don’t include DHA. Omega 3’s coming from flax seeds contain ALA which needs to be converted into DHA. The National Institute of Health says “your body can convert some ALA into EPA and then to DHA, but only in very small amounts. Therefore, getting EPA and DHA from foods (and dietary supplements if you take them) is the only practical way to increase levels of these omega-3 fatty acids in your body.”


2. Vitamin D


Vitamin D requirements during lactation are increased compared to pregnancy. Vitamin D supports calcium absorption and bone growth and helps maintain healthy glucose levels, neuromuscular function, and cognitive performance. Very few foods contain vitamin D, but humans can “manufacture” it when our skin is exposed to the sun. However, most people living in countries in the northern hemisphere do not get enough (or strong enough) sun exposure and therefore the majority of the population is deficient. Individuals with darker skin have even higher requirements. I had mine tested and sure enough, I was deficient even though I eat plenty of seafood, so I started supplementing.

Food Sources: fatty fish like salmon, tuna and mackerel are the best source. Egg yolks, beef liver, and butter have a small amount.

Supplementation: Most pre/postnatal multis include small amounts of vitamin D, but not enough. Take 4,000 – 6,400 IU of vitamin D3 (not D2) daily, preferably with fats as vitamin D is a fat-soluble vitamin. Our liquid Vitamin D3 comes already mixed with MCT oil (coconut oil) for easy absorption. We also offer Vitamin D3 + K2 capsules that provides 5,000 IU.


3. Choline


Lactating mothers have the highest choline requirements - even more than during pregnancy or any other time in their life - at 550 mg per day. This need is most likely due to the fact that large amounts of choline are passed to the infant through breast milk. Choline is a key nutrient for baby’s brain and nervous system development and one of those nutrients directly affected by maternal levels. A 2010 study found that “existing data shows that the majority of pregnant (and presumably lactating) women are not achieving the target intake levels and that certain common genetic variants may increase requirements for choline beyond current recommendations.” (10)

Food Sources: eggs, beef liver, grass-fed raw dairy and cruciferous veggies

Supplementation: Take a daily choline supplement to complement your daily food intake. Check your postnatal multivitamin as most do not include choline. Mother Nutrient’s Complete Postnatal with Nursing Support multivitamin contains 175 mg of choline.


4. Probiotics

What can’t they do? These good bacteria powerhouses can help resolve digestive issues, protect from yeast infections, support the immune system and even improve your mood. I recommended them to all mothers but in critical need are those who had C-section deliveries, or were given antibiotics for GBS, mastitis or other reasons during pregnancy, birth or lactation.

The benefits of probiotics are still amazing for mothers who didn’t take antibiotics. One study found that women who were given probiotic supplements from 4 weeks before birth and throughout breastfeeding had more than double the levels of immuno-protective factors in their milk, than those who received a placebo. The benefits translated to their babies in a significant reduction in risk of eczema, as only 15% developed eczema, compared to 47% of infants whose mothers did not receive the probiotics (11). If you have a colicky baby, probiotics might help too!

For baby, supplementing with infant probiotics helps populate the baby’s gut with beneficial bacteria for better digestion, avoiding thrush, and strengthening the immune system.

Food sources: sauerkraut, kimchi, kefir, yogurt, kombucha, beet kvass, raw fermented cheeses, raw apple cider vinegar

Supplementation: Take a daily probiotic of 20 Billion CFUs or more. Mother Nutrient offers a whole line of probiotic supplements to support mothers and babies, including the Women's Probiotic 40 Billion and our new hypoallergenic infant probiotic powder containing 10 strains of bacteria.


5. Iodine

As is the case with most nutrients in this list, iodine requirements are highest for postnatal and lactating women, and your breastmilk levels are directly impacted by your consumption. Iodine is important for your thyroid, brain, and metabolic health and for the infant’s proper neurodevelopment as well as their thyroid storage (12). As I discuss in my autoimmunity blog post, thyroid malfunction is very common during the postpartum period and can affect your energy levels, weight regulation, and fertility. A meta-analysis looking at thirty-six articles found that iodine levels in breastmilk were adequate in the United States, China, and Iran, but were low in most European countries (13).

Food Sources: mostly found in seafood and seaweed

Supplementation: Guidelines for breastfeeding mothers recommend taking a multivitamin containing 150-250 mcg of iodine daily. Our Complete Postnatal with Nursing Support supplement includes 175 mcg.



If you're suffering from mastitis...

Mastitis is the extremely painful inflammation of the breast that can be caused by infection, obstruction, or allergy. and is one of the most common lactation issues postpartum mothers experience (20% of Western mothers experience postpartum mastitis). Aside from the symptoms themselves, mastitis can lead to a cascade of other problems, including the negative impact on the nutrient intake of baby and the depletion of good bacteria in both mom and baby during antibiotic use.


For mothers with mastitis or who have had repeated bouts of mastitis, getting the proper rest, treatment, and nutrition is paramount to a smooth recovery. A balanced nutritious diet and supplementation with a large dose of vitamin C and a probiotic can help replenish depleted gut flora in both mom and baby. Fortunately, we have a new Breasting Probiotic that is designed to help prevent and support mastitis and other lactation issues in mothers while supporting the immune health of the baby.



Other things to remember during your breastfeeding journey:

  • Drink plenty of fluids - nursing sucks away your moisture so staying hydrated is key to prevent issues like constipation

  • Ask for help - Take advantage of help from lactation consultants who can problem solve issues relating to lactation and from organizations like La Leche League. Your partner, family, and friends are also valuable resources to reach out to so that you can focus on recovery after birth and establish a positive nursing relationship with your baby.

  • Lower your expectations - Let’s face it: life after baby is not going to look or feel the same, so try to reframe your expectations to revolve around the basics. Take a break and relax! Everything else can wait!

  • Find your “village” - Finding a community you can feel connected with is a great way to feel supported and commiseration during the challenging moments. There are many places to look for these communities, whether it’s through your gym or pre/postnatal classes, baby groups, or even local groups online.



Want to know other ways you can support your postnatal journey? Mother Nutrient can help you!

Sign up for our mailing list to get promotions, discounts, and access to awesome nutrition tips and recommendations. When you join, you will receive a free postnatal nutrition guide!


If you're not sure where you stand nutritionally, take our free 3-minute free wellness quiz for a customized nutrition report, including targeted diet, lifestyle, and supplement recommendations based on your results.

Do you have questions on how to improve your breastfeeding journey? What is your biggest challenge during breastfeeding? Tell me in the comment section below! If you know a mama who can benefit from this post, click the dots next to the title!



Content found on this website is not considered medical advice. Please consult with a physician before making any medical or lifestyle changes.

References

1. Ballard O, Morrow A. Human Milk Composition. Pediatric Clinics of North America. 2013;60:49-74.

2. Hurley W, Theil P. Perspectives on Immunoglobulins in Colostrum and Milk. Nutrients. 2011;3:442-474.

3. Ip S. Breastfeeding and maternal and infant health outcomes in developed countries. Rockville, MD: U.S. Dept. of Health and Human Services, Public Health Service, Agency for Healthcare Research and Quality; 2007.

4. Breastfeeding and the Use of Human Milk. Pediatrics. 2012;129:e827-e841.

5. Butte N, Hopkinson J, Mehta N, Moon J, Smith E. Adjustments in energy expenditure and substrate utilization during late pregnancy and lactation. The American Journal of Clinical Nutrition. 1999;69:299-307.

6. Allen L. B Vitamins in Breast Milk: Relative Importance of Maternal Status and Intake, and Effects on Infant Status and function. Advances in Nutrition. 2012;3:362-369.

7. Hollis, Bruce et al. (2015). Maternal versus infant vitamin D supplementation during lactation: a randomized controlled trial. Pediatrics volume 136 / Issue 4

8. Raffelock D, Roundtree R. A natural guide to pregnancy and postpartum health. New York: Avery; 2002.

9. Horrocks L, Yeo Y. Health Benefits of Docosahexaenoic Acid (DHA). Pharmacological Research. 1999;40:211-225.

10.Caudill M. Pre- and Postnatal Health: Evidence of Increased Choline Needs. Journal of the American Dietetic Association. 2010;110:1198-1206.

11.Rautava S, Kalliomäki M, Isolauri E. Probiotics during pregnancy and breast-feeding might confer immunomodulatory protection against atopic disease in the infant. Journal of Allergy and Clinical Immunology. 2002;109:119-121.

12. Nichols L. Real food for pregnancy: The science and wisdom of optimal prenatal nutrition. Lily Nichols; 2018.

13. Azizi F, Smyth P. Breastfeeding and maternal and infant iodine nutrition. Clinical Endocrinology. 2009;70:803-809.

Content found on this website is not considered medical advice. Please consult with a physician before making any medical or lifestyle changes.

© 2019 Mother Nutrient

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