Vitamin D

Vitamin D is an important nutrient for overall health. It is an important factor in bone health because vitamin D aides in the absorption of calcium and phosphorus. It has also been shown to be important for the immune system, muscle function, cardiovascular function, respiratory system, brain development, and might have cancer fighting effects. It is also believed to be connected to emotional/mental health.
Lack of vitamin D in the winter months has been connected to depression in some people. A major problem that can come from being deficient is rickets. While it isn’t as common in developed countries any longer, it can still happen if a child is not getting enough vitamin D. Rickets happens when bone tissue fails to properly mineralize, causing soft bones and skeletal deformities. This can be mild or extreme.
**Important to note here** Do not freak out that your baby/child has rickets just because they are bowlegged. Baby’s legs are naturally bowlegged and as kids grow, this changes. It isn’t uncommon to go from bowlegged to knock-kneed and then eventually have things even out and look normal. So don’t freak yourself out.
It’s also one of the most common deficiencies. For some people it can be as simple as getting enough sun every week to have optimal levels of vitamin D. It isn’t always that simple though. There are a few factors that affect our ability to have adequate levels from sun exposure; such as, time of day, distance from the equator, skin tone, season, amount of skin exposed, and sunblock use. The link below in the sources section for the Vitamin D Council has more detailed information on this.
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Because vitamin D deficiency is so common, many doctors automatically say that an infant needs to be supplemented. This isn’t always true. If the mother has sufficient levels and both the mother and baby get some sunlight regularly, the baby is likely fine without supplementation. Since it is a common deficiency, many doctors simply assume that no mother will be able to provide enough vitamin D through breastmilk and they recommend supplementation. Your doctor may even say that it isn’t passed through breastmilk at all, which is not true. A simple blood test can be done to test the vitamin D levels in any child or adult. If you are concerned, ask your doctor to do the test and see if you or your baby need to be supplementing.
If you do choose to supplement, there are a variety of brands available, some of which offer the recommended daily dose in as little as one drop.  There are also two types of vitamin D you choose from to supplement with, D2 and D3. D3 is more easily absorbed by the body. However, if you are vegan this may come with an ethical dilemma as it is derived from animal sources. It that applies to you, it is something to take into consideration when choosing a supplement.
Sources:
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Galactagogues (Supply Boosters)

A galactagogue is a substance that increases milk supply. There are herbal galactagogues, like fenugreek, and prescription medications. Before you decide to use a galactagogue, ask yourself why you think you need to.

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  • Do you think your supply is low? Many women think they have low supply when really their supply is perfectly fine. Babies — especially newborns — nurse often; they nurse for long periods of time, they enjoy comfort nursing, and they nurse for everything (not just food). As long as baby is having plenty of wet and dirty diapers, is gaining weight, and is happy, there’s no supply issue to worry about.
  • Click here to read about what to expect in the early weeks of breastfeeding  http://kellymom.com/bf/normal/newborn-nursing/.
  • If your baby isn’t having adequate output, isn’t gaining weight, and isn’t happy, you should see a lactation professional for an in-person evaluation.
  • Click here to find an IBCLC in your area http://www.ilca.org/why-ibclc/falc.
  • Click here to find a LLL leader or group near you http://www.llli.org/webindex.html.
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The average mother does NOT need galactagogues to increase her supply. Here are some examples of situations when galactagogue use may be helpful:
  • Some working mothers use herbs to increase their pumping output, even though their supply is fine when baby nurses.
  • Some mothers with a genuinely low milk supply use galactagogues in combination with increased nursing/pumping to increase supply.
  • Adoptive moms may use galactagogues to increase the amount of milk they are able to provide for their babies.
Using galactogogues can often be, at best, a bandage, covering up the actual problem, which doesn’t get resolved and may cause problems in the long run.
  • Galactogogues may cause side effects for mother, baby, or both.
  • The quality and quantity of herbal preparations is not consistent.
  • Galactogogues cost money and time.
  • Suggesting galactogogues reinforces the notion that breastfeeding requires special stuff in order to work.
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The usual, non-herbal, non-medication methods for increasing milk supply are sufficient for most mothers. Click here to read more about Increasing Milk Supply without galactagogues.
If the usual methods have not proven sufficient and you feel that a galactagogue is needed, keep these things in mind:
  • Remember that any galactagogue will be most effective in increasing milk supply when combined with increased breastfeeding frequency and milk removal.
  • Some types of galactagogues work better in particular situations and not in others. You should be working with someone who is knowledgable in their use.
  • All of these galactagogues, whether herbal or prescription medication, have potential side effects and drug interactions that must be considered for each individual mother. You should talk to your health care provider and/or a knowledgable herbalist about whether a particular galactagogue is safe for you.

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Weight Loss and Dieting for the Breastfeeding Momma

NOTE: This document (and any publication by Milky Mommas Inc.) is not a replacement for personalized medical advice from your healthcare provider. Before making any diet or lifestyle changes, including adding diet products or supplements to your diet, always contact your doctor to review their safety and appropriateness for your individual health.

It is commonly said that breastfeeding helps mothers lose weight. While some women find that nursing helps the baby weight fall right off, that is just not the case for everyone. It is true that exclusively nursing burns 500 calories a day, but not all
breastfeeding moms have an easy time losing weight. Hormonal changes, increased hunger, and potential thyroid issues after pregnancy can all contribute to troubles losing that extra baby weight.

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It is also very normal for a nursing mom’s body to hold on to around 10 lbs of “extra” weight. This is a biological mechanism to protect you and your baby in case of a famine—this 10 lbs could help ensure both of your survival if food were to suddenly become unavailable. Some women find they have the opposite problem, and lose more weight than is healthy or safe. This too can be a sign of thyroid or other health issues, and women experiencing this should see their healthcare provider. The healthiest, safest way to lose weight while nursing is to maintain a healthy, balanced diet of whole foods in moderate portions, and keeping an active lifestyle.

From Dr. Abbey at InfantRisk- “Herbal products are not regulated by the FDA and there can be significant variations in the potency and purity between different products or even between different lots of the same product. Herbs can also interact with each other and with prescription medications, so we tend to advise not taking them at all. As a general rule, breastfeeding is a time for simplicity. Focus on eating a balanced, nutritious diet and minimizing your use of extraneous stuff”

If you are interested in adding herbs to your diet, consult a licensed/certified herbalist familiar with lactation so that you can get personalized, safe recommendations.

Exercise while Nursing

Always wait for the OK from your OBGYN or midwife to begin exercise after your baby is born. The current recommendation is not to exercise until after 6 weeks. It is a common myth that exercise will decrease the milk supply of a nursing mother. This is not true. To quote from Kellymom, “Research has shown that moderate exercise does not affect milk supply, milk composition, or baby’s growth​. Exercising to exhaustion may have a short-term effect on lactic acid and IgA content of a mother’s milk.”

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You can find more info here:
http://kellymom.com/bf/can-i-breastfeed/lifestyle/mom-exercise/
http://www.llli.org/nb/nbexercise.html

Cleanses

Any product or lifestyle change that claims to detox your body should be carefully examined. More times than not, this is a marketing ploy buzzword used to sell
a product when there are no true “detoxing” ingredients in the food or drink. Most humans with working livers do not, in fact, store up “toxins” in their bodies that need to be cleansed or released; we would all have been dead far before the detox craze hit, if this were the case. “Detox Water” recipes, for instance, are often just fruit mixed with water. This is absolutely not dangerous, and the use of the word “detox” here is simply taking advantage of this current fad in the diet world in order to get more likes/pins/attention.

A product or change that TRULY encourages your body to release
toxins should absolutely NOT be used while breastfeeding. Anything that is released into your bloodstream (such as potential toxins) is also released into your breast milk and can be passed on to baby.

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Meal Replacement Shakes & Bars, and Protein Powders

Meal replacement products are generally nutritionally inferior to healthy meals comprised of whole foods. Most contain artificial flavors, colors, sweeteners, and genetically modified ingredients as well as other questionable ingredients. The ideal diet for any person, including breastfeeding mothers, would be comprised of natural, high nutrient, whole foods such as fruits, vegetables, protein from animal and/or plant sources, whole grains or other complex carbohydrates, and healthy “good” fats. If you do choose to consume protein/meal replacement shakes or bars, note that these products should only be used as snack-style additions to your already healthy diet, and should never replace a healthy meal.

For more on the “ideal” diet for nursing moms, check out these links:
http://www.llli.org/nb/nbmarapr04p44.html and
http://kellymom.com/nutrition/mothers-diet/mom-diet/.

Fat Burners & Pre-Workout

Most workout supplements contain branch chain amino acids, BCAA, and a fat burner or metabolism enhancer, all designed to speed up the recovery process or give you the “high” to get through a good workout. These additives may pass through breast milk and cause side-effects including weight loss in babies, and as it is not well studied, nursing mothers should avoid them for baby’s safety.

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Artificial & Natural Low Calorie Sweeteners

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Many popular diet products contain artificial sweeteners, and there are passionate feelings on both sides of the fence regarding the safety of these products. Artificial sweeteners are by no means part of a healthy, whole-foods diet, and should ideally be avoided for one’s general well-being. Here is what the current experts say about some popular sweeteners, regarding safety for use during lactation:

Nutrasweet (aspartame)
According to Hale (Medications and Mothers’ Milk, 2012), Nutrasweet (aspartame) levels in mother’s milk are too low to produce significant side effects in infants who do not have PKU (phenylketonuria). It IS contraindicated in babies with proven PKU. Hale lists aspartame in Lactation Risk Category L1 (safest), but L5 (contraindicated) if baby has PKU.

Splenda (sucralose)
According to Hale (Medications and Mothers’ Milk, 2012), there has been little research on sucralose in breastfeeding women. Per Hale, it is poorly absorbed from the GI tract and is excreted unchanged in the urine. The United States FDA considers sucralose to be safe for use in breastfeeding women. Hale lists sucralose in Lactation Risk Category L2 (safer).

Sorbitol​
Sorbitol is a sugar alcohol found naturally in some fruits and vegetables and is used as a sweetener in foods and medications. It’s not listed in Hale, but is unlikely to be a problem breastfeeding-wise.​ It’s commonly used in toothpaste, sugar-free chewing gum, etc.

Saccharin​
Per Hale (Medications and Mothers’ Milk, 2012), milk levels of saccharin tend to accumulate over time, but still are considered minimal. Moderate intake should not be a problem for nursing mothers. Hale classifies it in Lactation Risk Category L3 (probably safe).

Stevia (​Stevia rebaudiana)
Stevia is a very sweet herb that is used by many as a zero-calorie sugar substitute. Rebaudioside A (purified from Stevia rebaudiana) is “generally recognized as safe” (GRAS) as a sweetening agent for foods by the US Food and Drug Administration, but no studies have been done on pregnant or breastfeeding women. Hale (Medications and Mothers’ Milk, 2012) recommends caution when it comes to using stevia while breastfeeding because many different herbs in the same genus are being used as natural sweeteners, and because there are no studies on the use of stevia in breastfeeding women. He classifies stevia in Lactation Risk Category L3 (probably safe).

(http://kellymom.com/nutrition/mothers-diet/mom-foods/#sweeteners)

Popular Diet Programs & Products

We do understand that some moms prefer to try diet programs, cleanses, or products to kick-start their weight loss journey. Some of these are safe for breastfeeding, and some are not. Here is a rundown of currently popular products, common ingredients, and programs, and their safety for use by nursing mothers. Please note that this list is far from exhaustive, and you should ALWAYS contact your doctor or IBCLC to discuss the possible risks and effects of a diet program on your health and the health of your baby.

Visit our file here for a table of popular workout supplements and programs.

Inducing Lactation & Re-Lactation

It’s worth noting that no matter which method of lactation induction you choose, working closely with an IBCLC is essential, and a strict and disciplined milk removal schedule is required. The only scientifically proven way to make more milk is to frequently remove milk. Throughout this post, we’ll refer to inducing lactation, but if you’re trying to re-lactate, the same principles apply.

There are several ways to induce lactation: hormone therapy, natural supplements, or even just frequent nipple stimulation.
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Hormone Therapy
This is the most aggressive method to attempt lactation induction. The most commonly used protocol is called the Newman-Goldfarb Protocol – as in Jack Newman and Lenore Goldfarb. If you’re going to take this route, you absolutely must be working with a health professional to determine the best course of action for your situation.
Ideally, you start making some milk by the time baby arrives, and then putting baby to breast continues the stimulation of milk production. Any supplementation to feeding the baby should be done with a supplemental nursing system to increase milk production.
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The above picture is a starter supplemental nursing system. It’s good if you’re supplementing a small amount. (link)
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Above is a larger one. If you’re just getting started pumping but you want to supplement baby at the breast, I’d get this one. (link)
You’ll need to replace the SNS (at least the tubing) every month or so, depending on how often you’re using it.
This website talks about the Newman-Goldfarb protocol in a LOT more detail.
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Natural Supplements
Some women can’t or don’t want to take prescription meds to attempt to induce lactation. In this case, there is anecdotal evidence about the efficacy of some natural supplements.
Even if you go this route, it’s important to work with your health care provider to be sure there won’t be any interactions with drugs you may already be taking. Even though these supplements are natural, there may still be side effects, so it’s important to pay attention. Before taking any natural supplements, please consult with your doctor — we are not medical professionals, and we cannot report on the efficacy or safety of these products.
As with the hormonal protocol, the most important part of using natural supplements to induce lactation is to pump, pump, pump. Strive to pump every 2-3 hours during the day and every 4 at night. Before any milk comes out, pump for 15 minutes; after you start making milk, pump for 5 minutes after the milk stops flowing.
Nipple stimulation
In this situation, you simply pump. Strive to pump every 2-3 hours during the day and every 4 at night.
In all of these situations, you want to use hand on pumping. Check out our post on pumping tips for getting the most out of your efforts.
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Here are some resources that we’ve found helpful:
Lenore Goldfarb’s website — www.asklenore.info
Jack Newman’s website — www.breastfeedinginc.ca
Jack Newman’s Guide to Breastfeeding – this book is so full of good info, and it is great to have a hard copy resource to look through. The revised edition (at the time of writing this) is only available on Canadian Amazon — www.amazon.ca