Post-Partum and Post-Lactation Health Optimization
This is an article in a series I am doing in response to the load of questions I received for my first AMA. Thanks to all who sent! I’ll be keeping these articles short and to the point. Excuse any typos here as I am typing/formatting fast so I can get through all your questions.
Near verbatim text of the question I received:
“Post partum recovery: My bloodwork showed a similar result after I stopped lactation. Cholesterol and triglycerides were elevated, and my sex hormones levels (estrogen, testosterone, and progesterone) were low. What is the best way to restore (revitalize, replenish, etc.) back to my pre pregnancy levels?”
(let me focus on the breastfeeding/lactation element of this question for now, though this will also apply to pregnancy by extension.)
…
I think the best way to answer this question is to post an excerpt from my Breastfeeding Optimization Roadmap! (and yes, I do have a breastfeeding roadmap):
The Specific Nutritional Demands of Breastfeeding
Breastfeeding puts massive nutritional demands on your body. Producing breast milk requires (per day) an additional 500 calories, 20-25 grams of protein, ~210 grams of carbohydrates, and a major increase in key micronutrients (many of them overlooked, often in even higher amounts than during pregnancy.
It’s energetic work, requiring a complex mixture of specific amino acids, fatty acids, micronutrients, and of course your energetic wherewithal to do all that.
If you don’t get what you need:
Your milk will lack key nutrients - Choline, DHA, iodine, B12, selenium, and vitamin A drop proportionally with maternal intake, compromising infant neurodevelopment, immunity, and thyroid function.
Baby’s brain and overall growth will be suboptimal - Low DHA and choline delay myelination; low iodine and selenium impair thyroid axis; B12 deficiency linked to hypotonia, apathy, and poor growth.
Baby is at higher risk of infection - Reduced vitamin A, D, and zinc in milk weaken mucosal immunity, increase respiratory and GI infections.
Your recovery will be prolonged - Low iron, magnesium, and B-vitamins prolong fatigue, wound healing, and hormonal normalization.
Your bones become brittle - Calcium and magnesium are diverted into milk; low intake accelerates bone loss and impairs post-weaning recovery.
Your brain loses neurotransmitter regulation robustness - Deficiencies in B6, folate, DHA, and magnesium increase vulnerability to neurotransmitter disruption and HPA axis dysregulation.
Your thyroid is affected - Iodine, selenium, and iron deficiency impair T4-to-T3 conversion and increase risk of postpartum thyroiditis.
Milk supply declines - Zinc, B2, and B12 deficiency impair prolactin response and epithelial cell metabolism, leading to supply issues misattributed to “hydration.”
You get persistent fatigue and burnout - Mitochondrial cofactors (iron, B2, B3, B6, CoQ10, magnesium) depleted faster than in pregnancy; energy collapse is common without repletion.
The Post-Pregnancy Weight Loss Paradox
Despite needing all this extra material, mothers are routinely recommended to actually lose around one pound of bodyweight per week during breastfeeding to compensate for pregnancy weight gain, in the hopes of getting them to near-pre-pregnancy weight and body composition.
This is a tall order (and a very harsh way to treat mothers who just got through the epic struggle that is pregnancy!!), but it emphatically does not have to be as difficult as it appears. It absolutely ispossible to simultaneously:
Lose overall weight,
increase muscle mass,
and produce excellent breast milk…
all at once during breastfeeding. But please note that this is not a call for mothers to learn to “do it all.” I for one believe that this sort of messaging is entirely harmful, to say the least.
Rather, mothers need to be allowed to do what is natural and genuinely conducive to their essential wellbeing rather than being forced into chasing after phantom standards.
The rest of the breastfeeding roadmap goes into all of this in very great detail with precise targets for different nutrients, supplements, and things to test. But let me go ahead and share two small points from the roadmap that would be generically useful for everyone:
FIRSTLY: If you can only test one genetic marker when breastfeeding then:
PEMT and BHMT are in my view arguably the most important genes to test for in a breastfeeding mother.
The PEMT gene encodes an enzyme that’s involved in producing phosphatidylcholine, a MAJOR component of breastmilk involved in ensuring the baby’s brain health (and your own). Estrogen goes down in breastfeeding, reducing PEMT function. If you have a loss-of-function variant of PEMT, this is a double-hit on an already sensitive nutrient pathway, virtually REQUIRING that the mother consume more choline.
The most impactful SNP for PEMT seems to be rs7946.
SECONDLY:
If you can only test one blood biomarker (as opposed to genetics as above), then probably make it an omega-3 Index or erythrocyte DHA percentage.
This reflects how much DHA mother has available for herself and for milk production. Omega-3 Index over 6.5% is ideal. You can get this test very easily from Quest Diagnostics.
Feel free to check out the whole Breastfeeding Optimization Roadmap, part of my Roadmaps to Health subscription, which teaches you how to test the most important things to optimize the quality of breastmilk for your baby’s health AND for your own health. HERE:
Breastfeeding Optimization Roadmap
I personally consider this one of my most important roadmaps. The subscription also includes a private Facebook group where you can ask questions and get direct answers. Thanks! Also check out:
EVERYTHING in this article is purely educational and informational in nature. None of this is medical advice. Make no health changes based on this article. I am not your doctor. Discuss any and all implementations with your own doctor.
READ MORE:
4th question I received: