March 25th 2006 - Feeding Breastfeeding Moms to Promote Lactation
Copyright by Karen S. Vaughan, L.Ac., MSTOM
Most new mothers expect that nursing will be something natural and easy. In fact there is an art to breastfeeding and we no longer live in a society surrounded by nursing mothers and aunts who can teach us the basics.
There may be lactation consultants at the hospital, but if the child is brought to us on a rigid schedule, is fed sugar water in the nursery and is taken away just as the two of us have mastered basic positioning but not started to feed, a mother can feel discouraged. With my first we did not figure nursing out until we got home. And then had to relearn breastfeeding positions as his relative size changed.
One can find La Leche League chapters with lactation counselors, although it really helps to find a group before giving birth. It is worth finding a group and staying for the long haul because breastfeeding changes over time, and it helps to have a support group of other mothers for all kinds of issues. A doula, CLE (Certified Lactation Counselor), IBCLC internationally board certified lactation consultant through the International Board of Lactation Consultant Examiners.or midwife may be able to help you as well. If you have serious problems with milk supply find a IBCLC consultant and visit MOBI, (Mothers Overcoming Breastfeeding Issues) at http://www.internetbabies.com/mobi/ . And there is invaluable information in the classic book, “The Womanly Art of Breastfeeding, ” by La Leche International although I do NOT recommend the dietary advice.
In every classic culture there is special food for new mothers that helps the baby thrive. Chinese women were traditionally fed 10 eggs a day while breastfeeding, which provided nutrients useful for brain growth. The feeding of special, nutrient-dense foods to pregnant and nursing women is a practice found among all traditional peoples. ... These special foods were invariably animal products, rich in fat, foods like fish eggs, shellfish, fish liver oils, carp, butter, whole milk, organ meats, bear fat, eggs and pickled bones. Maintaining the same “healthy but low fat” diet will not provide your baby with her optimal needs. I think statements like that are meant to keep women from being scared off of breastfeeding by the idea of a special diet. But the special diets help the mother recover from the real work of giving birth as well as to nourish the baby.
Many books discuss the foods or herbs you should avoid while breastfeeding. But I want to address the care and feeding of the mother to preserve and enrich her milk supply. This frequently dips after the baby is a few months old and the mother has left lactation consultants far behind. She may believe that she is drying up and it is time to wean. And many women needlessly give up on nursing, just as the process is ready to get easier, to the detriment of their baby’s health and their own sleep cycles.
• First, are you getting enough fluids? It is easy to let liquids slip when you are dealing with a new baby. Fluid intake is essential for a reasonable volume of breast milk.
o Remember, sip, don’t gulp your fluids. More than a cup at any one time triggers your bladder and the fluid goes right through. You want to incorporate the water into your body fluids, not to flush your system. (you can also do that, but absorb the liquids first.) I used to make up a liter of Traditional Medicinals Mother’s Milk tea, put it into a water bottle and sip it as I did errands.
Fresh juices can be especially good sources of liquid while nursing. . My favorite galactagogue, which I've never found in the literature, is freshly juiced carrot juice. I empirically hit upon the carrot juice when I was nursing my first son. The carrot juice seems to have the sweetness, pungency and other overtones of the related umbrellate galactagogue seeds like fennel, anise, and cumin. They all contain calcium, B and E -vitamins, phosphorus, calcium, bioavailable iron, copper, magnesium, cobalt and iodine, which should help the nutrient value of the milk. The sweetness helps stimulate the baby to nurse more, which itself increases the milk. (Too much can cause a slightly orange baby). I definitely perceived it as stimulating lactation- enough so that I would seek it out during dry spells. Carrots have been valued as an aphrodisiacs- possibly relating to hormonal effects. As a contractive food that is connected to the earth which can draw in and distribute nourishment, it may stimulate us to steadiness, earthiness and the ability to nourish.
I also recommend overnight infusions of green oats (sometimes sold as oatstraw), Avena sativa, sold through the Frontier Herb al Cooperative and other sources on the web. Take an ounce of the green milky stage oats and straw and boil in a liter of water for 20 minutes. You can add other herbs to taste or just cover and let sit overnight. In the morning strain and drink throughout the day. This nourishes your nerves, balances hormones, relieves postpartum depression and increases milk. You can substitute up to a quarter of the oats with nettles, catnip, red clover, mint, vervain, dandelion or anise hyssop. Or you can add a tablespoon of galactagogue seeds like fennel, fenugreek, anise seed, cumin, nigella, milk thistle or blessed thistle.
• Choose foods and herbs that have been shown over the years to increase milk supply and nourish the baby. Hilary Jacobson’s book, “Mother Food for Breastfeeding Mothers”, is an excellent resource giving much previously unavailable information on galactagogues (breastmilk-enhancing foods.). (2) Disclosure- I was interviewed for the book.
o Not every galactagogue is right for you, but there are many to choose from. If you tend to run cold, nigella may be better for you than if you run hot because nigella is energetically warm.
o Fenugreek is a good, and very tasty galactagogue but can cause your fertility to return sooner. Make sure you use contraception if you rely heavily upon fenugreek.
o When I was in the hospital a Hispanic nurse suggested that I drink malta, a non-alcoholic malted beer. The sweet taste and the presence of barley helped encourage my newborn to nurse and kept the milk flowing while we were still figuring things out. Beer will also increase breastmilk, but watch the alcohol- no more than one alcoholic drink per day, with a few days off. It is better to drink Guinness than Bud lite if you are trying to build nourishing milk because dark beers have more nutrients
o Barley water will build breastmilk without alcohol. Like beer barley contains beta glucaans which stimulate milk production. Barley as food or in soup is also good and its low glycemic index relative to other grains can help postpartum weight loss.
• Nursing women should not avoid salt since salt is vital for the development of the baby's brain and nervous system. Human milk contains sodium chloride and other minerals for a reason, but there won't be much there if the mother is avoiding salt. Sea salt and mineral rich sea vegetables are excellent sources of minerals for nursing mothers.
• If your baby urinates a lot but is not having many bowel movements, your milk may be deficient in fat. Breast milk contains 50% fat and is necessary for the developing brain. (6)
o You should take cod liver oil that has DHA and ELA in it, (or fish oil in a sunny climate if you are regularly exposed to sun without sunscreen and hence produce enough Vitamin D.). Cod liver oil can be found with a pleasant lemon taste (Carlson’s brand oil) and helps brain development. This is your best source of Omega 3s and virtually all major brands are molecularly distilled to remove mercury.
o Flax seed oil does not have DHA or ELA and contains Omega 6 oils which are usually in overabundance in the diet. Many people cannot convert Omega 6 oils to Omega 3s. If you take it, get other sources of DHA and ELA, and make sure it is refrigerated as it rapidly degrades.
o Also take extra virgin olive oil, organic butter or pasture-fed dairy for CLA. And virgin coconut oil for cooking. (The studies condemning coconut oil in the 60s used hydrogenated coconut oils which lacked all essential fatty acids.)
o Avoid salad oil and seed oils like safflower, cottonseed, corn or canola which compete with the good fats, as well as all hydrogenated fats or trans fatty acids.
o Butter is an important source of nutrients but the trans fats in margarine and vegetable shortening are harmful for the developing infant.
o Nuts and avocados provide other sources of good fats and nutrients. If you don’t get nuts salted and roasted you will be less likely to overeat them.
o Eggs are an excellent source of fats and lecithin for breastmilk if you and the baby are not allergic. The yolk should be minimally cooked- soft boiled, poached or sunny side up is best. If you have a source of organic eggs you can even eat the yolks raw- salmonella occurs once every 40,000 eggs and usually in bulk cooking settings where vats of cracked eggs are sitting around for a period of time(5). Make sure the shell is intact if you choose to do this.
• Rotate your foods and spices so that the baby doesn’t overload on them and so both you and the baby get variety.
o Babies tend to drink more if the mother uses garlic according to one study (although some just get gassy). Culinary herbs can flavor the milk.
o Don’t feel stuck in a single food, bland diet rut- the baby needs exposure to many foods. By “mommy processing” the foods you are helping prevent allergic reactions later.
• You may have noticed while pregnant that the baby becomes restless after eating certain foods. And you may notice colic, crying, asthma, a runny nose or unusual discomfort in your breastfed child after you eat certain foods. Those are likely to cause allergic reactions later on, so avoid them or at least wait until your child is over 3 before introducing those foods directly to the child in small amounts. You should also avoid any foods that you are allergic to in order to avoid sensitizing your child.
o Dairy, eggs, corn, wheat (gluten) and soy are major dietary offenders for allergic reactions. Then comes nightshades, citrus, nuts/legumes, seafood (especially shellfish).
o If you can get certified raw dairy or goat milk, dairy is less likely to cause allergic reactions. The proteins are denatured during pasteurization and irritate more. Goat milk is closer to human milk than is cows milk. Cultured dairy foods like buttermilk, yogurt and cheese may be less likely to cause problems than regular milk.
o Alternatively eat foods that create some reaction in the baby in small, increasing quantities separated by at least a week when the baby is over 6 months of age. This strategy is to get small enough “mommy processed” amounts into the baby that its immune system can deal with them. Use your judgment. If you continue to get reactions then step back or eliminate them until the child is older.
o Skin tests do not identify all allergies, nor do blood tests. It is better to avoid foods or other toxins that cause bad reactions. You can do an elimination diet and challenge for your own allergies after breastfeeding has passed. (And you can do it for your child once he is eating regular food.)
o In allergies, the total load is important. With the exception of foods causing anaphylactic reactions, your child may have more tolerance if the total amount of immune stressors is reduced, and if he is well-rested, removed from environmental toxins, animal dander and dust and has not had a recent vaccination.
o If you are subject to allergies, keep your immune load down as well. This is especially important as you may be sleep deprived and under the stress of a new child. Don’t be afraid to accept help or to hire childcare so that you can sleep. Trade off with another new mother if finances are an issue. You, and your milk, will be the better for it.
o Environmental toxins get in breastmilk as well, so now is not the time for you to renovate your house or use toxic household chemicals. You can ingest toxins through your skin or by breathing, so avoid them, at least until your child is older.
• Weight loss can release toxins stored in fat into your bloodstream and into milk. Rely primarily on exercise, water and breastfeeding to lose your extra pregnancy weight right now. Take herbal alteratives if you are losing much weight and make sure you continue to eat nutrient dense food.
o Cleavers, chlorella, nettles, red clover or alfalfa can be used if you are dieting. Echinacea is another safe alterative but tends to be drying so save it for disease.
o Lemon water and dandelion are also good to clear the liver system without dumping toxins into the milk.
• If you need medication that could reduce your breast milk, take more galactagogues. Hilary Jacobson’s book addresses this, as does Thomas Hale’s “Medications and Mother’s Milk.” (4) Hale suggests substitute medications for conditions that will not hurt the breast milk. Shelia Humphrey’s book “The Nursing Mother’s Herbal” also discusses herbal substitutes. (3)
o Pump a little extra milk after nursing when you are healthy and freeze it so that you have an emergency “bank” if you need to take a respite. Just make sure that the milk is NOT heated in a microwave because it kills off the antibodies, is hard to digest and the baby will not thrive.
o If you must take herbs or drugs that are safe but cause your baby to protest, take them immediately after nursing. They will be less likely to flavor the breast milk if the body has had time to process them. Drink additional water as well.
o If mastitis is your problem, drink massive amounts, take dandelion root and leaf tea, nurse around the clock and put cabbage leaves, peppermint or violet leaves in your bra for 20 minutes several times a day. Do not use cold compresses as the cold causes the plugged milk duct to shrink, making the obstruction worse. You can avoid antibiotics which lessen your milk production.
o If your child is over 8 months and the medication could possibly cause harm, then continue pumping your milk and discard it until your doctor or pharmacist advises you that it no longer affects the milk. You can use stored breastmilk or a hypoallergenic formula at this time. You will not dry up if you continue to pump. Take galactagogues afterwards, as pumping is not as effective as nursing in producing milk.
o If your child is younger, try to find a substitute for the medication as allergies can be triggered by formulas. Also investigate non-drug modalities such as acupuncture, hydrotherapy, massage or chiropractic.
Milk production is primarily related to the amount of liquid consumed, the suckling of the child which stimulates milk and stress. Milk production is normally cyclic and usually reflects the baby's hunger patterns, which may change. They seem to go on milk binges just before growth spurts and when teething- and the teething pain seems worse when the teeth are cutting through the internal gum layers, long before they emerge.
Your hormones will shift around 8-9 months and your head will feel clearer, especially if the baby is also sleeping more hours in the night. This may temporarily reduce milk production as you even out. It does not necessarily mean that you should wean. In fact you will probably enjoy nursing more after this time. Things do get easier.
If a woman has had several children she may not be making enough milk due to exhaustion. I know women, especially slim women, who find that doing errands and housework reduces the energy (calories) available for milk production. When they take time out to rest and eat enough, the production goes up. This is the time for some household help. Childbirth is depleting and making milk is real work for someone who has just gone through the experience
1. Judy Torgus, Gwen Gotsch et al. The Womanly Art of Breastfeeding (La Leche League International Book. Plume Books; 7th Rev edition (May 1, 2004) ) Excellent advice on the mechanics of nursing, but avoid their low fat dietary advice.
2. Jacobson, Hilary. Mother Food for Breastfeeding Mothers Pagefree Publishing. (May , 2004)
3. Shelia Humphrey. The Nursing Mother's Herbal (The Human Body Library) Fairview Press (January, 2004) More advice on what to avoid and herbal substitutes for drugs, but
4. Thomas W. Hale, PhD. Medications and Mother's Milk: A Manual of Lactational Pharmacology. Pharmasoft Medical Pub; 11th edition (April 1, 2004)
6. Sally Fallon and Mary Enig Nourishing Traditions: The Cookbook that Challenges Politically Correct Nutrition and the Diet Dictocrats
Acupuncture and Herbs by Karen Vaughan, L.Ac in Park Slope and Manhattan.
118 East 37th Street, New York, NY 10016
Brooklyn, NY 11215
Sally Fallon and Hilary Jacobson.