Vitamins, Minerals, Supplements, and Herbal Formulas While Breastfeeding
By Carma Haley Shoemaker
Natural, herbal, non-dietary, dietary, remedies, supplements, vitamins, minerals: Walk into any local health food store or pharmacy and these are just a few of the terms you will hear or read. Trying to find what it is that your body needs while finding something your mind will understand can prove to be a challenge. But what if your body isn’t the only one you have to worry about?
If you’re breastfeeding, you may be wondering what you can take and what you should steer clear of. Lactating women have different needs and requirements than non-lactating women.
More Than One a Day
“For almost all essential vitamins and minerals, the simple 100 percent RDI one-a-day type of multiple vitamin/mineral products is not enough for lactating women,” says Luke R. Bucci, vice president of research at Weider Nutrition International in Salt Lake City, Utah. According to Bucci, the basic recommendation for lactating women is 150 percent of the recommended daily intake, or RDI.
It is best to check with your physician before taking any kind of herbal supplement while breastfeeding.
“For example, the calcium RDI for lactation is 1,200 mg per day instead of the usual 1,000 mg. However, this intake is almost impossible without supplementation—taking a daily vitamin,” Bucci says.
A few years ago, taking a daily vitamin would not seem so complicated. However, the choices of type, kind and brand of daily supplements are as varied as the supplements themselves. According to Pharmavite, the makers of Nature Made and Nature’s Resource dietary supplements, public knowledge of “natural” or “herbal” products has increased approximately 175 percent in the past two years.
“More and more people are wanting to make the change from manufactured vitamins and supplements to more natural products, such as herbal remedies,” says Lynn Moss, continuing education specialist for Pharmavite. “However, woman who are breastfeeding should not be taking an herbal medicine and they should still check with their doctor or health care professional before taking any medication, even over-the-counter ones.”
Safe or Not?
How is it determined which supplements are safe to take while breastfeeding and which are not? According to Bucci, it all depends upon how much “class” the supplement has. “In general, herbs have been classified by the American Herbal Products Association, or the AHPA, into four categories of safety,” Bucci says. “These range from class one—herbs that can be safely consumed even during pregnancy and nursing, to class three—herbs that are recommended to be used only under the supervision of any expert qualified in the appropriate use of the substance. In class four, the data available is insufficient for the herb to be properly classified.”
Bucci states that there are good herbals and supplements to take during breastfeeding. These supplements, such as DHA (docosahexaenoic acid), have been shown to have a positive effect when passed on to the baby through Mom’s breast milk. “There is a lot of good evidence that DHA improves brain development in infants,” Bucci says. “Infants get DHA only from mother’s milk. When the mother eats a daily serving of fish with colored flesh, such as salmon, tuna, sardines or herring, to get enough DHA, or when she takes fish oil supplements, the benefits available to Baby are optimized.”
Another example of a beneficial supplement to take while breastfeeding is soy. “Eating soy foods or taking soy isoflavone supplements will mirror Asian dietary practices,” Bucci says. “New research shows it is the childhood exposure to soy isoflavones that protects best against cancer later in life. This means soy for the mother is good for the long-term health of the baby. After all, soy-based formula is the choice for babies with milk allergies, and they do just fine on soy formulas.”
“My son was born prematurely, seven weeks early,” says Merrie Kelly, a nurse and mother of three from Chesterfield, Virginia. “He was small and the doctors were worried about how he would develop. My doctor recommended that I increase the amount of fresh fish I ate or suggested fish oil supplements since I was breastfeeding to help my son’s development. My son is now 5 and is very normal, very active, and very smart.”
Separating Fact from Fiction
While some things are recommended, it is best to check with your physician before taking any kind of herbal supplement while breastfeeding. According to Bucci, there are lots of theories that can often lead a woman astray from what’s really true. “Many herbs are rumored from folklore to help lactation,” Bucci says. “There is no science to confirm or deny this. Some of these herbs rumored to be helpful, but may actually be harmful, are green tea, fenugreek, and dandelion.”
There are many supplements breastfeeding women should avoid. “There are so many herbs in commerce, literally thousands, it is difficult to make a blanket statement,” Bucci says. “Some of the more common herbs that affect milk quality or are not recommended during nursing are Kava, Piper methysticum (a common relaxant herb that may make Baby sleep too much), apricot seeds (which may form cyanides toxic to babies), Chinese rhubarb (which may cause kidney stones at high doses, as does regular rhubarb), and Senna (a common laxative that may give Baby diarrhea). Keep in mind that, like foods, some herbs have distinct flavors that may or may not agree with Baby. This is not harmful, but a matter of taste.”
What do doctors recommend, and are they conveying to their patients the important message of what to avoid? According to Dr. Susan M. Kleiner, author of High-Performance Nutrition: The Total Eating Plan to Maximize Your Workout, medical professionals are not taking any chances. “There is virtually no research on the effects of herbal supplements or remedies on a fetus or breastfed newborn,” Kleiner says. “Universally, physicians and dietitians recommend that pregnant and nursing moms avoid all herbal supplements. What may have been helpful to them prior to pregnancy may be a time bomb to their baby.”
“There were many herbs I would have been interested in trying, particularly to help with my postpartum depression,” says Crystel Riggs, a homemaker from Clemson, South Carolina. “But there are no studies, no FDA approval or regulation for their safety, so I was left without a lot of information. Anytime I considered taking something new, or making any changes, I consulted my doctor. Most doctors, in my experience, won’t advise taking supplements, herbs and vitamins beyond the usual multivitamin.”
Knowing what is acceptable and what is not when discussing supplements while breastfeeding can be more confusing than the average consumer would think. According to Bucci, the best way to be sure is to educate yourself as much as possible, but allow your doctor to guide you along the way. “The best advice for consumers is to read product labels,” Bucci says. “If there is a statement about not consuming during pregnancy or nursing, follow the recommendations. Most supplement products, especially from older, larger companies, pay careful attention to labeling. And if you still have questions, talk to your doctor; he or she is still the best resource available.”