“I make milk. What’s your superpower?” – Unknown
For the moms in your practice who decide to breastfeed, there is so much that you can do to encourage them to build the healthiest possible milk.
There are several factors to building healthy milk. Optimizing the early feeding environment is essential to reducing the baby’s long term risks for obesity, diabetes, and other manifestations of metabolic syndrome.
Breastfeeding provides babies with a nutrient dense food, a food that is high in immune factors, and that which is high in beneficial microbes, including Bifidobacteria which has been shown to be positively associated with improved glucose tolerance (1). In addition, babies with high levels of Bifidobacteria, have less risk for obesity and chronic inflammation. Breastfed babies also have high levels of beneficial Lactobacillus, while formula fed babies have more complex and varied microbiota which contain fewer beneficial bacteria.
The great news is that for mom to build a healthy breast milk microbiota (the symbiotic bacteria in the breastmilk), she simply needs to optimize her own gut microbiota (the symbiotic bacteria in her digestive system.) A healthy maternal gut microbiome is important for optimal postpartum recovery – physically and mentally – for mom, and a strong foundational immune health for baby.
Postpartum women who have a healthy gut microbiota have lower risk for chronic inflammation and stronger digestive health. This is great news for the new mom as emerging evidence is showing promise for her healthy gut microbiota to be protective for her against the consequences of chronic inflammation and leaky gut, such as allergies, postpartum autoimmune issues (like thyroiditis, interstitial cystitis, and rheumatoid arthritis), and postpartum depression.
This is all great news, but with so much chatter out there on what women should be eating, how can we counsel our postpartum clients to eat and take care of herself to optimize her gut health and to build the best quality breast milk?
Get support. That’s right, my first recommendation is not even about food. It’s about putting a support network in place (ideally before the baby arrives) that will allow the new mom to eat well, get plenty of rest, and bond with her baby with the least stress and the most joy. Who would your patient or client like to have around for her after the baby is born? What kind of support would she like – would she like someone who will cook, clean and care for her while she cares for the baby around the clock, or would she prefer help at night and a freezer full of casseroles? What is her ideal vision of postpartum support? In this pandemic age, can some of the support she needs be offered through your digital programs, local food delivery resources, neighborhood teenagers, or other low risk support strategies? Empower her to ask for and receive help, to really consider the depth of resources that she has available to her (often the resources are there, women just have not had the experience of deeply receiving that level of help.) Who else can be in her Web of Support for those unexpected times when she needs to reach out for emotional support, a home cooked meal, or an extra set of hands to hold her baby while she takes a shower?
Don’t forget that until very recently, mothers had and raised babies in an environment of community. It is unnatural to expect any one woman to birth a baby, recover from her pregnancy and delivery, and care for the household (including her other children) in isolation and without help. Think of your clients and patients who have had C-Sections… Is there any other time after a major abdominal surgery, when we send a woman home without any recovery assistance, and with the expectation that she will care for a helpless infant 24/7 for the next several months without help? Without good support, the nutrition recommendations below are likely going to be impossible for your client or patient to implement.
Eat much less sugar, and much more nutrient dense food. The goal here is simply to feed the postpartum woman the her beneficial bacteria the nutrients that they need, and to starve the infectious bacteria of the sugar and starches that they crave. Moms should be encouraged to eat a diet high in clean protein (animal protein is optimal if they are not ethically opposed because of the benefits to their recovering connective tissue), high in beneficial fats like coconut oil, avocado, olive oil, grass fed butter or ghee, and nuts and seeds, and high in a variety of vegetables.
Eat probiotic foods, and/or take high quality probiotic supplements. Eating probiotic foods and taking probiotic supplements helps to add beneficial bacteria to mom’s digestive microbiota. My favorite, simple recommendation is to add two fork fulls of sauerkraut every morning to breakfast. (I like hearty, savory breakfasts for postpartum moms like veggie omeletes, or leftover stews.) My personal favorite brands of probiotic sauerkraut are Bubbies and Farmhouse Culture. For a DIY option, here’s a good how-to video. These are my favorite probiotic supplements for pregnant and postpartum women.
What’s the clinical take home message here?
Empower your postpartum clients to put good support systems in place and recommend that they practice receiving help. Having the support that she needs will allow her to eat delicious, nutrient dense foods (without stress) that will nourish her body and provide her baby with the best possible milk. Give her recipes and help her to find local restaurants to make the process easier. Providing a postpartum wellness group digital program in your practice will provide a valuable emotional and practical support resource for all of the new moms in your community.
- Thompson, AL (2012) Developmental origins of obesity: Early feeding environments, infant growth, and the intestinal microbiome. American Journal of Human Biology 24:350-260.