TPV Podcast, Episode 60: Breastfeeding & Weaning

October 11, 2013 in Categories: , by

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Our sixtieth show!
Ep. 60: Breastfeeding & Weaning

In this episode, Stacy and Sarah tackle a number of breastfeeding questions from the queue, chat about the safety of kombucha while pregnant and breastfeeding, and share many tips that range from supply increasing to pump session eliminations.

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The Paleo View (TPV), Episode 60: Breastfeeding & Weaning

  • 0:00 – Introduction
  • 0:52 – News & Views
  • (12:52) Science with Sarah – The Health Benefits of Kombucha
    • Most of the health claims about kombucha have little to no evidence to support the claims
    • However, since kombucha is a fermented beverage with probiotics there are health benefits from the beneficial yeast and bacteria strains
    • You will also get a wide variety of unique strains of good bacterias, which benefit your overall health
    • The only metabolite of kombucha that may be of concern to a pregnant woman is the alcohol content, which a serving on average has between 0.5% to 2/3%
    • A non-alcoholic beer has 0.5% alcohol, so if you are having half a glass a day you are within your daily safety limits – but you have to make that personal conscious decision on what feels right for you
    • As a breastfeeding woman that level of alcohol is considered to be a non-issue because the alcohol content is diluted
    • It would take some work to get drunk off of the alcohol content in kombucha, and the trace amount in breastmilk is considered to be safe
    • If you are buying your kombucha from stores those are quality controlled and you are not being exposed to bad bacteria
    • If you are making your own kombucha it is important to check home-brew resources to understand how a SCOBY would mildew and how to prevent it from happening
  • (21:14) Questions & Answers
    • Jessica – What are alternative options to formula when one is dealing with low supply?
      • Please be sure to listen to previous podcasts where this topic is also discussed: episode 4, episode 33
      • Stacy notes that breastfeeding is very personalized and is driven by society and what medical experts can help you with, please be sure to surround yourself with supportive people both in a professional capacity and in your friends and family circles
      • Stacy’s common suggestions regarding supply would be stress management, adequate sleep, increased fat consumption, omega 3 rich foods, teas like Mother’s Milk, grain-free lactation cookies
      • It sounds like Jessica did all of these things, but it sounds like there was a genuine medical situation in this case that may be impacting her ability to increase supply
      • The only medical condition that Stacy is familiar with that impacts milk supply is thyroid conditions, and Stacy suggests looking to Practical Paleo on how to address thyroid issues
      • Stacy notes that if your baby has a latch issue that is impacting supply, there are tube systems to help you through the latch challenges
      • The Westin A. Price Foundation has some recipes for homemade formula
      • From Stacy’s experience, the flavor variations from the homemade recipes are of benefit to how your child develops their eating habits later in life
      • Circling back on the thyroid medical concern, Sarah is not sure if a thyroid condition is the only thing that can impact milk supply, but it is a candidate
      • If there is a low thyroid function the autoimmune protocol would be a good route to explore
      • Sarah recommends pastured egg yolk, grass-fed ghee and lots of seafood (check this post from Sarah on mercury content) for those who are dealing with an autoimmune condition while pregnant
      • Stacy reminds Jessica to be proud of all the effort you put in and to remember that you did the very best you could – your child can still lead a healthy life
      • Like all things in life, be positive and find what things you can impact, like first foods, etc.
    • (38:18) Kelly – how do hormones from breastfeeding impact adult acne? How do the hormones impact menstruation?
      • Sugar may be causing the breakouts, which is a common issue that people face, it may help to eliminate sugar first
      • Getting your baby enough milk is your biggest priority, so focus your elimination diet priorities so that you still get the abundance of micro and macronutrients that you need to keep your supply strong and rich in nutrients
      • Sarah notes that there could be a hormone connection – so many things change during and after pregnancy from the hormone fluctuations, and the hormones could be impacting food sensitivities, the functioning of the immune system and the strength of the gut barrier
      • Unfortunately there is not a good way to test what is causing your experiences other than dabbling in elimination dieting
      • Stacy has shared on her hormonal changes from weaning and you can find that post here
    • (49:40) Heather – what liquids should I provide my baby as I cut back on her breastmilk intake?
      • Stacy and Matt replaced breastmilk with water, the kids never received anything other than breastmilk in a bottle
      • Eleven months may be a little too young to wean because babies still rely on breastmilk at that age to meet all their nutrient needs
      • You could try bone broth in a sippy cup for more nutrients
      • In the beginning, Stacy and Matt put a very tiny bit of apple juice in the water to relate the flavor to the sweetness of breastmilk while transitioning them to drink water
      • If you are taking breastmilk out of the equation, make sure you are adding things into the baby’s diet that replace the nutrient density of breastmilk (think super foods like organ meats)
      • Sarah notes that there is a societal expectation to wean at a year and Sarah encourages Heather to explore extended breastfeeding benefits and baby-led weaning to see if it could work for her family
      • Stacy suggested eliminating the at-work pump sessions first, to cut down nursing time to night only so that her baby will still receive the breastmilk benefits
      • When Sarah weaned her older daughter they dealt with a challenging case of thrush, whereas her younger daughter gave up breastfeeding without any difficulties – both of Sarah’s kids were over two years old when they weaned
  • (1:03:24) The reviews in iTunes are awesome and Stacy and Sarah love them!
    • Each individual can only leave one review, so if you go on and leave a new review it replaces your old one
  • (1:06:48) Outro

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I was listening to Jessica’s story, and I have some additional comments that may help her.

I breastfed my twins 6 years ago. When I had my son, 1.5 years ago, I thought for sure it would be easier than with twins. I was wrong. My milk never came in, even after pumping for three months. I asked the lactation consultants, was prescribed domperidone (it’s considered safe in Canada) and eventually was sent to an endocrinologist. That’s where I found out I had suffered from Sheehan syndrome using an MRI. That’s a condition that affects the pituitary and is usually, but not always, associated with significant blood loss during delivery. In my case, the blood loss was normal, but I had a massive headache (that no one could explain) shortly after delivery. I repeat (because I don’t think most lactation consultants know this):

Sheehan syndrome can occur even when there isn’t significant blood loss.

So, while the thyroid function is one of the conditions that will prevent the production of milk, you should also look upstream as the pituitary. Normally, the pituitary produces TSH (thyroid stimulating hormone) that tells the thyroid to please do it’s job, and the the thyroid produces various hormones, including T3 and T4. Through this, my TSH was normal, but the levels of T3 and T4 were low. In other words, the thyroid wasn’t doing it’s job, but the pituitary didn’t push it to work harder.

Jessica, before you get pregnant again, see if you can’t get your doctor to check your TSH and T3/T4. Most labs will not do T3/T4 when the TSH is within the normal range. Make sure they perform the test anyway. If the T3/T4 don’t match up with the TSH, it’s quite possible that the problem is at the pituitary level. If the pituitary is affected, other systems may also be affected, but you may no notice symptoms for some time. It could affect the adrenal glands, for example. They may also be left to slack off without pituitary oversight. It may also affect your ability to get pregnant again.

I don’t know if Sarah’s thyroid protocol works when there’s insufficient TSH.

I know what you’ve been through, and it sucks. And even today, I’m still annoyed I couldn’t breastfeed, and had to use formula. Is that why he is sensitive to cow’s milk and beef? At least, he’s really good about eating different foods.

Good luck!

Jessica, your story is so similar to mine with my first. Traumatic emergency c/s and then no milk, domperidone, etc. That was 5 years ago. I have a 5 month old now and have more milk than I can believe. The differences? Eating more healthy fat, fermented cod liver oil- I really think this might be it, and a less traumatic birth (VBAC). Also taking a higher quality vitamin D and probiotic and eating cultured food and drink. The difference is really night and day. If I could suggest one thing it would be the FCLO – I take Green Pasture’s butter/FCLO blend. Took 1 tsp/day during pregnancy and now during breastfeeding. Oh, and I also pumped every day for the last few weeks of pregnancy. Collected a tiny bit of colostrum and I think it really helped get my milk supply going. Can cause contractions but did not bring on labour for me and I was very overdue. You can freeze the colostrum to feed baby if needed.
Good luck to you!

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