Maternity Insurance|Maternity Care|Postpartum Care

Breastfeeding is a special time in the life of both mother and child and experts agree that breastmilk is far superior to artificial feeding, which is associated with a general decreased state of health and more infant deaths from diarrhea in both developing and developed countries.

The World Health Organization recommends exclusive breastfeeding for the first six months of life, with solids gradually being introduced around this age. Supplemented breastfeeding is recommended until the age of two.

Studies show that in addition to the bonding that mother and baby experience, breastfeeding is associated with increased intelligence in later life and significantly lowers the risk of many illnesses including:

• sudden infant death syndrome (SIDS)


• middle ear infections, colds and flus


• childhood leukemia


• childhood onset diabetes


• asthma and eczema


• dental problems


• obesity


• psychological disorders

Breastfeeding is also beneficial for the mother in the following ways:

• Helps the uterus return to its pre-pregnancy size and position


• Reduces postpartum bleeding


• Assists in returning to pre-pregnancy weight


• Reduces the risk of breast cancer in later life

Unfortunately even though mothers may choose to breastfeed, they often experience difficulty in the supply and production of breastmilk. They may also unknowingly have a problem with low quality breastmilk which can result in the baby not being completely satisfied with feeds.

Breastmilk production and supply are not the same thing and each is influenced by different factors. A mother can have either a problem with production (usually hormonal, obstructive or due to improper feeding habits) or supply (most often due to poor nutrition or weak constitution) or both. Sometimes there can be no problem with supply or production of breastmilk but the quality of breastmilk may not be sufficient to satisfy the baby. Traditionally modern medicine only accepted problems of insufficient production but now with advances in technology that enable us to measure the quality of breastmilk it is now accepted that these three problems mentioned above are all real conditions that need to be addressed appropriately in the breastfeeding mother.

In order to understand how to address problems of low breastmilk or insufficient lactation we need to understand how and when breastmilk is produced and what factors are involved in the production, supply and quality of breastmilk.

How and when breastmilk is produced

Breastmilk is produced under the influence of certain hormones that are released after birth, these include prolactin and oxytocin. The release of these hormones is directly related to the act of the baby suckling on the breast which in turn stimulates the nerve endings present in the areola of the breast and cause the release of these hormones by the pituitary gland. Prolactin causes the alveoli or glands within the breast to take nutrients from the blood supply and turn them into breastmilk. Oxytocin on the other hand is responsible for the contraction of cells around the alveoli and subsequent release of the breasmilk through the breast ducts and out through the 15 to 20 openings in each breast.

There are a number of factors that can affect production and therefore result in no or insufficient breastmilk, these are categorised as follows:

1. Problems with secretion of either prolactin or oxytocin


2. Obstruction of the breast ducts


3. Fatigue and/or stress resulting in the inability of the muscles to contract and release breastmilk

Problems with hormonal secretion

It is rare that insufficient lactation can be caused by a problem of the pituitary gland, more often cases of non-secretion are due to insufficient stimulation of the nerve endings by the baby not latching or sucking appropriately or indeed not suckling at all in cases where the baby may be unable to feed or the mother is unable to. In these cases it is encouraged to use proper posture and also use a pump in between feeds to encourage breastmilk production.

Obstruction of the breast ducts

Obstruction of the breast ducts is a fairly common occurrence and usually is associated with inflammation of the breast (mastitis) but may be due to other causes such as injury or previous surgery to the breast etc. Fortunately it is easy to treat, a doctor could prescribe an anti-inflammatory or you could use natural herbs such as mu tong or fenugreek which has been traditionally used to open the breast ducts, reduce inflammation and promote milk production and flow. Some of the natural supplements to increase breastmilk contain these ingredients and will be discussed later in this article.

Fatigue/Stress

Fatigue and stress can play a part in any illness and is a common occurrence postpartum. For some this may even be serious enough to be considered postnatal depression. Both stress and fatigue can affect the function of both prolactin and oxytocin as energy is required for all bodily functions to occur including contraction of the muscles responsible for promoting the flow of breastmilk. Mothers should get sufficient sleep and also eat healthy to combat fatigue. Stress can be eased by getting help in managing the baby from friends and family. Some natural postpartum supplements can also assist in reducing fatigue and stress. These will be discussed under the supplements section.

The quantity and quality of breastmilk is largely influenced by the health and nutritional status of the mother. Studies have shown that nutritional status affects more the quality than the quantity of breastmilk so that often a mother will be producing enough milk but the quality and nutritional value of that milk may not be sufficient to provide optimal growth for the baby. Often the body will be able to provide sufficient protein and fat content for inclusion in breastmilk by taking this from the mothers blood supply and if necessary by breakdown of the mothers own protein and fat stores. However the inclusion of vitamins, minerals and other essential substances will be directly affected by the mothers intake of these substances. Besides a healthy and varied diet, dietary supplementation is also recommended to increase the production and supply of quality of breastmilk, especially so when the mother is experiencing insufficient breastmilk quantity to begin with. In the next section I discuss some available postpartum herbs and supplements for increasing breastmilk production and supply and which are the best to use.

Herbs and dietary supplements to increase breastmilk production and supply

Fenugreek

Perhaps the most commonly used herb for increasing breastmilk is fenugreek, however it is not the best and certainly not the safest to use. Fenugreek is known in herbal medicine as a herb that is hot in nature, influences the liver and stimulates contraction of smooth muscle, hence its use in low breastmilk conditions where it encourages contraction of the breast ducts and therefore release of breastmilk. You will note however that this is not the only reason for low breastmilk and therefore despite its high use it is not very effective in most cases and has a number of side effects that should be noted:

• It may cause nausea, diarrhea and stomach cramps.


• Fenugreek can also cause a maple syrup odor in urine and sweat.


• Fenugreek can interfere with iron absorption so people with anemia should avoid it.


• It can alter balances of various forms of thyroid hormones.


• Fenugreek can aggravate asthma, allergies, and diabetes


• Fenugreek should be avoided by women who are pregnant since it is known to stimulate uterine contractions in animal studies and can therefore lead to miscarriage

Fenugreek is useful where stress may be a significant factor in causing low breastmilk however we do not recommend that it be used alone due to its other effects described above. In fact traditionally herbs were more often combined with others so as to limit their toxicities and harmful effects while retaining their beneficial ones. For this reason we recommend one of the two synergistic formulas below for low breastmilk and in fact the second supplement can also be used as a general postpartum supplement.

Mothers Milk Tea

This tea is something you can make at home and is a combination of fenugreek, fennel, coriander, blessed thistle and aniseed. Though it is better than using fenugreek alone, the tea still retains as its primary function the ability to stimulate smooth muscle contraction. It does however contain aniseed and blessed thistle which have the ability of improving digestion and therefore indirectly improving breastmilk quality as well. For more information on mothers milk tea see: http://www.breastfeeding-problems.com/mothers-milk-tea.html

Lactaboost

Lactaboost is a relatively new supplement for postpartum mothers but is based on ancient chinese wisdom as well as recent scientific evidence that supports the use of this formula for nursing mothers. It is not only good for increasing quality and quantity of breastmilk as well as treating production problems, but it also has other benefits for mother and baby which include:

• Assists with postnatal depression, weakness and fatigue


• Enhances babies digestion and eliminates colic


• Assists with weight loss and return of the uterus to normal after birth

Traditional Chinese Medicine places a lot of emphasis on proper postnatal care and over a period of hundreds of years developed and refined herbal formulae for that purpose. Lactaboost is based on a number of these formulae and is supported by clinical research that confirm the benefits of it improving and increasing breastmilk.

It contains a number of different herbs including ones that can:

• Relieve mastitis and open the breast ducts (Caulis Akebia, Platycodon root)


• Enhance breastmilk quality and quantity (Angelica Sinensis, Ophiopogonis Radix)


• Strengthen the digestive system (Astragalus, Glycyrrhizae Radix)


• Assist with sleep (Caulis Akebia)


• Relieve cramps and colic (Vladimiriae Radix)

This supplement however while safe to use during nursing should not be used while pregnant and caution should be exercised in cases of hypertension.

More information here: Lactaboost

Other therapies

Sometimes the above approaches may not work and it is then useful to consult with a lactation consultant and/or other natural therapist who can work on an individual basis with you in order to prescribe a regimen, remedy or diet plan etc to address your specific condition.

As an example a practitioner of Chinese Medicine will take a history, look at your tongue and feel your pulse in order to determine what the root of the problem is. In cases of low breastmilk this may be due to liver qi stagnation, blood deficiency, liver fire causing mastitis or kidney and digestive weakness. After making a diagnosis the practitioner would compose an individualised formula to treat the root condition and may also add ingredients known to treat the branch or manifestation of the root problem.