Breastfeeding is a unique time in a woman’s life, and presents distinct requirements with regard to maternal nutrition.
A nursing mother produces on average about 750mls of milk per day, though there is considerable variation from one woman to another, and even within the same woman from time to time. As such, energy requirements increase by approximately 2,000kj per day during lactation, and on average lactating women require an additional 500mls water per day.
Some nutritional approaches to common breastfeeding issues include:
As breast milk is made from the blood, to increase your supply, it is necessary to ensure you are drinking adequate water. Aim for 3L per day, but also understand that if you aren’t drinking enough water, your supply will be affected; but simply drinking enough water is does not guarantee a large supply of breast milk.
Some foods are considered galactagogues, meaning milk producing, and so have been used traditionally to increase milk supply for centuries. These foods include oats, milk, brewers yeast, flaxseeds, cashews, sesame seeds. You will likely find many of these ingredients in lactation cookies, which some women swear by. You might also see breastfeeding teas containing fenugreek, dandelion, fennel, thistle, caraway & anise. These teas should be used with caution as some mothers report their baby is more unsettled following fenugreek being included within the mothers diet.
Given most of the foods suggested to increase milk supply are healthy and nutritious, they should continue to be included in the postnatal diet, however realistically simply ensuring adequate calories are consumed and eating a wide variety of nutrients obtained from wholefoods is the best way to support healthy breast milk supply.
In the early days of breastfeeding, supply can take some time to regulate, and many women find themselves with an oversupply. This can cause engorgement, pain, and if the milk is not removed adequately from the breast, can result in blocked ducts and / or mastitis. Cold, bruised cabbage leaves have traditionally been used to soothe and calm oversupply, as has peppermint – both in tea and essential oil form. Both of these approaches are anecdotal, however worth trying before turning to pharmaceuticals that have many side effects.
Almost every breastfeeding mother will complain of cracked nipples at some stage. Lots of people suggest using breast milk on the nipples following a feed, but ensure all the breast milk has dried before putting a bra back on, as warm sugary milk on the skin is the perfect environment for candida (thrush) to grow.
Nipple thrush during breastfeeding is extremely common. Human breast milk contains many sugars, which thrush uses for fuel. Couple this with the warm environment of the skin and you have a perfect storm.
Nipple thrush will feel like a slightly burning, stabbing pain that comes and goes. It can happen during or after a feed. If you have been diagnosed with nipple thrush, some coconut oil on the nipple followed by exposure to sunlight can be enough to stop the growth (if caught early). Reducing sugar in the diet can reduce the incidence of thrush, as can Vitamin D supplementation, however the best approach is to avoid thrush by ensuring the nipples are completely dry of milk before putting a bra or other clothing back on. Always use a breast pad or change bras if you are not dry – especially important in those first few months of breastfeeding.
Supplementing with a multi-strain probiotic may also prove helpful in keeping opportunistic pathogens (like candida) under control.
Persistent blocked ducts can result from either a physical blockage that needs to be cleared, or milk that has started to thicken as it has not been cleared from the breast adequately. It’s important to keep your water intake up when ducts begin to become blocked (aim for 3L daily). Supplementing prophylactically with 1,000mg Lecithin per day can also be helpful. If blocked ducts become a problem, massaging the affected breast toward the nipple with lavender & frankincense oils diluted in coconut oil can also help to provide some relief.
Mastitis occurs when a blocked duct does not clear, and the tissue within the breast becomes infected. Inflammation occurs and the area becomes red, hot, and painful.
Mastitis is marked by it’s flu-like symptoms – you feel as though you have been hit by a bus. Aching muscles and joints, burning hot temperature, yet feeling shivering cold, zero appetite, fatigue and generally just not wanting to leave your bed. It is genuinely the pits.
If mastitis hits you want to ensure you keep your water intake up to help clear the blockage. Lecithin supplementation and essential oil massage as outlined for blocked ducts can help and relieve some pain, but also ensuring you keep eating adequate calories to continue producing breast milk is the key here. Consider soups, yoghurt, chia puddings – things that are easy to prepare and easy to digest.
Hot compresses over the affected area of the breast can help relieve pain and encourage effective drainage (so recommended before or during a feed), and then ice is recommended following a feed to reduce heat and inflammation.
Incorporate omega 3’s into the diet through oily fish (or opt for supplements) to help reduce inflammation following infection, reduce caffeine and dairy in the diet as both are inflammatory, and increase your intake of vegetables for the polyphenol content. Mothers should also maintain their Vitamin E, Vitamin A, Vitamin C and Zinc intake – by eating plenty of vegetables, nuts and seeds.
I also visited a physiotherapist who was able to use ultrasound and lymphatic drainage to help remove the blockage at the cause. I saw Heather at Sutherland Shire Physiotherapy Centre and cannot recommend her highly enough!
Raynaud’s / vasospasm doesn’t just happen in the extremities, and when it occurs within the nipple it can be extremely painful. It is considered both a circulatory and autoimmune reaction, that can be triggered by changes in temperature (from hot to cold), resulting in spasm of the tiny blood vessels within the breast and nipple, which ends up stopping blood flow to the nipple.
Characteristically, the nipple turns white at the tip as the blood flow stops, then turns purple and then bright red as it is once again flooded with blood. As it turns bright red, it feels burning hot to the sufferer. I would describe the pain of Raynaud’s as feeling like a lit match is being held up to the nipple. Ouch!!! Often Raynaud’s will go undiagnosed, as it is mistaken for Thrush (though once you have experienced both you will know they are very, very different sensations). This is a huge issue for sufferers, because managing Raynaud’s requires you to do the complete opposite to what we’ve outlined above for treating thrush.
When it comes to managing Raynaud’s in the nipple – forget everything you have heard so far!! Allowing your nipples to air dry is a no-no. You want to keep the nipple warm, so it’s best to dry the nipple after a feed with a dry cloth, change breast pads as required, and get back into a bra quickly. Bra warmers can also make a world of difference. Worn inside the bra, but outside breast pads, the bra warmers contain material that reflects body heat back onto you. I personally used these for the first 8 months of breastfeeding my daughter, even in summer. Moving from demand feeding to timed feeds can ensure the nipples have some time to recover between feeds, and ensuring you break your bubs latch to stop comfort sucking can also make a world of difference.
Some dietary approaches to managing Raynaud’s include increasing magnesium (which is a vasodilator) both in the diet or through supplementation, and increasing Vitamin B6 – however too high a dose of B6 has been shown to reduce milk production, so obtaining B6 from food is your best option. Vitamin B6 can be found in beef, tuna, salmon, chicken, potato & sweet potato, carrot & chickpeas.
Peppermint is believed to help reduce supply when trying to wean. There is really only anecdotal evidence for this, however including some peppermint tea, or using peppermint essential oil when looking to wean definitely won’t cause any harm.