To carb or not to carb? That is the question....it seems like I'm asked about carb levels all the time and when I received an email from a client about a suddenly low milk supply after starting a Paleo diet, I knew her story would probably resonate with lots of other gals. So, here you have it.
My former (most wonderful client) is about 4 months postpartum. She started going to Crossfit mom's as a way of connecting with other women and it was the only program in town that made it easy for her to workout with her baby. Since the start of the new year, her Crossfit group decided to start a one month "Paleo Challenge". Of course, I support this kind of awesome nutritional reset ANYTIME, no challenge required, but I was thrilled to hear she was going to give paleo a good ol' college try.
10 days into the challenge, she had lost 6 lbs. She wasn't sleeping and neither was her baby, who previously slept through the night. She also noticed that her milk supply had significantly decreased. What was going wrong? Should she give in to the bread cravings that were taking over her life?
I asked her to punch her nutrition into an online app (I usually recommend My Fitness Pal) which it turns out she already did (she's so smart). When she told me her macro's I pretty much instantly knew what the problem was. Carbs were only making up about 20-25% of her diet. Not by choice, just by accident. This would explain the insane weight drop, often caused by rapid water loss when switching from standard carb levels of anywhere between 50-60% to lower levels. By far the most common mistake folks make when going Paleo is going too low carb by accident. While a Paleo diet is typically lower in carbs than the modern SAD, it isn't designed to be a "low carb diet". Going low carb can happen by accident when we replace the grain laden starches with more filling veggies, fats and meats.
What was going on?
Her body was STRESSED. While going low carb can result in weight loss, it also can result in systemic stress on your body. Cortisol levels will ramp up disturbing your sleep patterns and your body will begin limiting how much energy it spends on "unnecessary" reproductive functions like ovulation, menstruation and, in this case, breastmilk supply. After all, what body wants to sustain another growing life when it's having a hard time sustaining itself?
If this diet was to continue a bit longer, her lower carb diet may also cause her thyroid hormones to plummet. Low thyroid in a postpartum woman can cause postpartum depression, stall natural weight loss and cause breastmilk to all but disappear.
This would explain why both she and her baby were not sleeping through the night. Her body was holding on to extra calories by dropping her milk supply. Some studies have suggested that when a mom is calorie depleted, her milk may also decrease in fat content. This can cause babies to get hungry faster (aka waking up needing to feed more often) and may also cause them to miss out on critical DHA fatty acids they need for brain and neurological development.
What To Do if this is happening to you?
Eat Paleo Friendly Starchy Carbs! Breastfeeding women NEED carbs. Please ladies, eat the sweet potato, eat the white potato....eat all the potatoes.
While 20-25% may be a good level for an active male or to optimize body composition, it isn't enough to support fertility, pregnancy or lactation. I generally recommend 30-40% depending on activity levels and individual needs. Does she need to eat the bread? Well, no, but at the end of the day if you eat a slice of gluten free bread, will it really be the end of the world? Probably not. Dianne has a great post about starchy carbs found here with a handy chart, which you can downloadable chart to help you on your way.
Eat sufficient calories. When starting a Paleo challenge it's not uncommon for women to drop their calories down too low to support healthy womanly functions. When breastfeeding, this can lead to low milk supply and an unhappy baby. Never drop below around 1800 cals/day when breastfeeding, you'll likely need more if you're active.
Lose weight slowly. When women lose weight rapidly they are not only at risk for low milk supply (for the reasons stated above) but, it's also been documented that weight loss of more than 1 lbs or 0.45kg/week can increase the toxic load found in your milk. Say what? True story....
Environmental contaminants such as PCBs and pesticides, are stored in body fat. According to Breastfeeding and Human Lactation (3rd Edition, Riordan, pp 440), when a breastfeeding mother loses weight rapidly (>1lbs/wk), these toxins are released into her bloodstream, and the toxin load of her milk can dramatically increase. These toxins are directly offloaded to a growing baby. Not bueno.
What about Ketones? When a woman goes very low carb (20-50g/day) she may start producing ketones. Ketones are the waste products of fatty acid metabolism, aka when the body burns some of its own fat for fuel. Ketones will pass into the breastmilk and I wondered if these could be damaging to infants. Apparently not. When I asked famous Breastfeeding Physician Dr. Jack Newman about them, he said that they don't pose any dangers for infants. For more info on ketones during pregnancy, check out this post. Your biggest danger when dieting seems to be is low milk quality and overall supply.
Need more help?
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Take home message....eat the sweet potatoes and enjoy them!