Short Duration of Breast Feeding 

What Is Short Duration Of Breast Feeding?

[dropcap]S[/dropcap]hort duration of breast feeding, or lactation, is characterized by inadequate milk production by a mother who has just given birth.

Normally, lactation begins with the production and release of colostrum from the mammary glands during the first few days after birth until the milk comes in. Colostrum is a yellow colored, nutrient rich fluid, high in calories and containing immunoglobulins to protect the baby from infection.

Lactation depends on adequate secretion of prolactin hormone by the pituitary gland which begins after the rapid decrease of estrogen and progesterone from the ovaries that occurs with childbirth. Prolactin secretion is afterward stimulated by sucking of the infant and continues as long as the infant nurses.

Milk production to meet the needs of the infant depends on adequate nutrition on the part of the mother.

What Is Short Duration Of Breast Feeding In Celiac Disease and/or Gluten Sensitivity?

• Relationship between short duration of breast feeding and celiac disease. Short duration of breast feeding is a maternal complication of celiac disease and may be an uncommon presenting feature of untreated celiac disease.
• Relationship between short duration of breast feeding and risk. It is widely accepted that untreated celiac disease represents a risk for short-breast feeding period which can be corrected by a gluten free diet.¹
• Relationship between short duration of breast feeding and occurrence. 96% of infants of celiac mothers are fed 2 months or less.
• Relationship between short duration of breast feeding and malnutrition. Nutritional deficiencies are common before treatment with gluten free diet. In 2013, a study evaluating the nutritional status of 80 Dutch patients with newly diagnosed celiac disease showed 87% to have at least one nutrient deficit.²
• Relationship between milk composition and celiac disease. Milk produced by mothers with celiac disease have reduced levels of important substances necessary for immune protection and normal gut microbe populations in comparison to mothers without celiac disease.³

How Prevalent Is Short Duration Of Breast Feeding In Celiac Disease and/or Gluten Sensitivity?

Mothers with celiac disease are at higher risk of short duration of breast feeding.⁴

Importantly, duration of breast feeding was 2.54 times shorter in untreated mothers with celiac disease than mothers with treated celiac disease.⁵

What Are The Symptoms Of Short Duration Of Breast Feeding?

• Short duration of breast feeding is marked by inability to produce sufficient milk to satisfy the infant’s needs.

How Does Short Duration Of Breast Feeding Develop In Celiac Disease and/or Gluten Sensitivity?

• Short duration of breast feeding results from nutritional deficiencies in celiac disease including protein, calcium, phosphorus, and fat.

Does Short Duration Of Breast Feeding Respond To Gluten-Free Diet?

Yes. Milk production responds to a gluten free diet. The possible prevention or treatment of reproductive effects can only be achieved through a life-long maintenance of a gluten free diet.⁴

Study results comparing untreated mothers with celiac disease with treated mothers with celiac disease indicated that the gluten-free diet increased duration of breast feeding 2.38 times.⁵

Mothers should consume yogurt with active cultures containing bifidobacteria and talk to their doctor about taking supplements with bifidobacteria to improve their own gut population (microbiota) and help their baby develop a better microbiota.

6 Steps To Improve Duration Of Breast Feeding In Celiac Disease and/or Gluten Sensitivity:

• [dropcap]1[/dropcap]Remove the Trigger. Maintain a Strict, Nutritious Gluten Free Diet:

[box type=”shadow” ]Treatment. This condition responds to the complete elimination of gluten, which is the required treatment that improves both duration of breast feeding and gut health.

• Gut health is the foundation to restore ALL health. Restored health will enable you to maintain a strict gluten free diet, just as other life tasks will be easier.
• A strict gluten free diet means removing 100% of wheat, barley, rye and oats from the diet.
• Cutting out bread and other obvious sources of gluten is not good enough for recovery. Even 1/8th teaspoon of flour or bread crumb is enough to sustain the inflammation that is damaging your small intestine, causing increased permeability (leaky gut) and allowing undigested gluten to enter your body where it can damage structures and function, and instigate immune inflammatory responses.

Correct Your Individual Nutritional Needs.

• Eat foods that can replenish missing nutrients. Find them under NUTRIENT DEFICIENCIES.
• Take nutritional supplements as needed. Find them under NUTRIENT DEFICIENCIES.

Recovery. You should begin to feel better within a week and notice more energy as inflammation subsides and the  absorbing cells that make up the surface lining of your small intestine are better able to function.

• Intestinal lining cells are replaced every 5 days. The healing process is like sunburn where the damaged surface layer of skin sloughs off and is replaced with new normal cells.
• Leaky gut normally resolves in two month after starting a gluten free diet and brings about a big improvement in health. Improvement in intestinal permeability precedes morphometric recovery (cell appearance and structure) of the small intestine in celiac disease.⁶
• The intestinal lining may take up to a year to heal.[/box]

• [dropcap]2[/dropcap] Reduce Inflammation. Foods to Eat and Foods Not to Eat:

Because gluten is inflammatory, eliminate OTHER inflammatory foods from your diet to reduce an additive effect to gluten. At the same time, try to eat foods that reduce inflammation (anti-inflammatory).

[box type=”shadow” ]Here Are Major Inflammatory Food Types That Reduce Healing:

• Damaging Foods. In susceptible persons, includes corn, dairy (cow), and soy. Lactose, the sugar in any animal milk disrupts intestinal permeability causing leaky gut.⁷
• Allergenic Foods. Includes foods that trigger the immune sytem to produce IgE antibodies. Allergy testing is the usual way to discover these offending foods.
• Shelf Stable Processed Foods. Includes any that contain additives and preservatives. Look for them on the nutrition label of the box or package. Additives and preservatives also disrupt intestinal permeability causing leaky gut.⁷
• Fats. Limit deep fried foods, trans-fats, saturated fats (animal fat/butter), and EXCESSIVE omega-6 fatty acid oils like corn oil. Rancid fats, sodium caprate (a medium chain fat), and sucrose monester fatty acid (a food grade surfactant) induce significant disruption of the intestinal barrier that causes leaky gut.⁷.
• Excessive Refined White Flours (bran layer removed). Includes products made from them such as cookies, bread, cakes, pies. Bran contains the vitamins and minerals that metabolize grains and slows the otherwise rapid entry of sugar from their digestion into the bloodstream. Also disrupt intestinal permeability causing leaky gut.⁷
• Refined Sugars.  Includes white sugar, corn fructose and high fructose corn syrup.
• Certain Spices. Includes paprika and cayenne pepper which disrupt intestinal permeability causing leaky gut.⁷
• Alcohol and Caffeine. Disrupt intestinal permeability causing leaky gut.⁷
• Cocoa and Black Tea increase blood sugar.
• Rosemary. Increases blood sugar levels and should not be used by persons with insulin resistance or diabetes. [/box]

[box type=”shadow” ]Here Are Important Anti-Inflammatory Food Types to Promote Health:

• Fruits. Contain ample amounts of vitamins, minerals and phytochemicals which are naturally occuring components in plants that detoxify toxins, carcinogens (reducing the risk by 50%) and mutagens.
• Non-Starchy Vegetables. Support intestinal integrity and provide ample amounts of vitamins, minerals and phytochemicals. Includes green leafy vegetables such as lettuce and kale, also onion, broccoli, garlic, and others.
• High Quality Complex Carbohydrates. Provide vitamins, minerals, and fiber while boosting serotonin levels to help you relax and feel calm. Includes whole grains, legumes, and root vegetables such as carrots, parsnips, sweet potatoes, turnips, red beets, and others.
• Antioxidants. Protect the body from inflammatory oxidant molecules that continually occur and help us handle stress and reduce irritability. Includes vitamin C-containing foods such as lemon, grapefruit, apricot, Brussels sprouts and strawberries, and others. Also, includes vitamin E-containing foods such as nuts, seeds, avocado, olive oil, and others. Cocoa is good, too.
• Omega-3 Fatty Acids. Balance opposing omega-6 fatty acids and bad fats. Fish sources includes tuna, salmon, cod, and others. Plants sources include flax, chia seeds, canola oil, and others.
• Probiotics. Supply normal microbes needed for colon health and health of the body such as these fermented foods: yogurt, kefir, and unpasteurized apple cider vinegar.
• Prebiotics/ High Fiber Foods.  Food with fiber keeps our population of colonic microbes healthy.
• Protective Herbs and Spices.  See below #6 below for examples.[/box]

• [dropcap]3[/dropcap] Information Sheet You Can Take to Your Doctor or Other Health Professional:

Click here.

• [dropcap]4[/dropcap] Manage Your Medications Safely:

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Certain medications deplete protein, calcium, phosphorus, and fat that impair milk production in a new mother. Ask your doctor or pharmacist about this possible adverse effect if you are taking any of the drugs listed below. Do not stop prescribed medications without supervision.

This is not a complete listing.

ANTACIDS / ULCER MEDICATIONS

• Pepcid®, Tagamet®, Zantac® deplete Calcium.
• Magnesium and Aluminum Antacid preparations (Gaviscon®, Maalox®, Mylanta®) deplete Calcium, Phosphorus.
• Alka Seltzer®, Baking Soda deplete Proteins.

ANTIBIOTICS disrupt intestinal permeability which complicates celiac disease.

•  Tetracyclines deplete Calcium.

ANTI-INFLAMMATORIES disrupt intestinal permeability which complicates celiac disease.

• Corticosteroids (Prednisone, Medrol®, Aristocort®, Decadron) deplete Calcium, Phosphorus.
• Aspirin and Salicylates deplete Calcium.

ANTICONVULSANTS

• Phenobarbital and Barbituates; and Dilantin®, Tegretol®, Mysoline®, Depakane/Depacon® deplete Calcium.

ANTIVIRAL AGENTS

• Foscanet depletes Calcium. 

BRONCHODILATORS

• Inhaled corticosteroid inhalers (Flovent, Pulmicort and others) that are breathed in on a daily basis as a long term therapy to reduce inflammation in airways deplete Calcium.
• Albuterol inhalers that are breathed in on a daily basis as a long term therapy and also for quick relief as rescue inhalers to open airways depletes Calcium.

CHOLESTEROL DRUGS

• Lipitor®, Crestor®, Zocor®, and others deplete Phosphorus.

DIURETICS

• Thiazide Diuretics (Hydrochlorothiazide, Enduron®, Diuril®, Lozol®, Zaroxolyn®, Hygroton® and others) deplete Phosphorus.
• Loop Diuretics (Lasix®, Bumex®, Edecrin®) deplete Calcium, Phosphorus.
• Potassium Sparing Diuretics (Midamor®, Aldactone®, Dyrenium® and others) deplete Calcium.

LAXATIVES

• Metamucil, FiberCon, Citrucel, Colace, Glycolax, Milk of magnesia, Dulcolax deplete: Calcium.

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• [dropcap]5[/dropcap]Nutritional Supplements To Help Correct Deficiencies:

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The type and quantity of nutritional supplements that may be needed depend on which nutrients are deficient. Review all supplements with your doctor to make good choices.

• Multivitamin/mineral combination that provides 100% once a day is useful to improve overall nutrient levels. This is a safe dose, but always check with your doctor to avoid interactions with medications.
• Calcium citrate is the best absorbed of calcium supplements. Calcium carbonate is a poor choice.
• Probiotics with bifidobacteria as directed.

Storage Note: Store container tightly sealed, away from heat, moisture and direct light to avoid loss of potency. That is, in a safe kitchen cabinet – not in the bathroom or on the kitchen table.[/box]

• [dropcap]6[/dropcap]Manage Natural Remedies: 

[box type=”shadow” ]Hydration:

• Eight glasses of water are recommended per day unless there is a contraindication such as kidney or heart disease. The Institute of Medicine recommends approximately 2.7 liters (91 ounces) of total water, from all beverages and foods, each day for women and 3.7 liters (125 ounces) daily of total water for men.
• If you are thirsty, drink water. Add fresh, squeezed lemon to water. Lemon is anti-inflammatory, alkalizing and provides vitamin C.
• Hydration Test: Urine should be pale yellow. Fingertips should be plump, without pruning but this may not be reliable when fingers are swollen with edema. Lips should be plump, without puckering. The feeling of thirst can be unreliable.
• What is wrong with soda, coffee, tea, and alcohol? These drinks are dehydrating, increase acid, and deplete nutrients.[/box]

[box type=”shadow” ]Carminatives. The following  anti-inflammatory plant sources called carminitives help heal the digestive tract. They also tone the digestive muscles which improves peristalsis, thus aiding in the expulsion of gas from the stomach and intestine to relieve digestive colic and gastric discomfort.

Carminative Food Remedies:

• Raspberry.
• Carrot is also a cleansing digestive tonic.
• Grape is also bile stimulating and a cleansing remedy for sluggish digestion and laxative.
• Redbeets also stimulate and improve digestion and are easily digested.
• Cabbage also stimulates and improves digestion and is also a liver decongestant.
• Lettuce also stimulates and improves digestion and is also an alterative, meaning it improves the function of organs involved with the digestion and excretion of waste products to bring about a gradual change.
• Potatoes are antispasmodic (due to atropine like properties) and a liver remedy.

Carminative Herb Remedies:

• Sage is also a digestive, astringent, bile stimulant and energy tonic that heals the mucosa.  Drink as tea or use in cooking.
• Chamomile, lemon balm, and fennel, (as a tea) also help relieve nervous tension.
• Parsley also relieves indigestion.
• Rosemary as a tea and in cooking also is a nervous system tonic for stress and fatigue, bile stimulant, and can relieve headaches and indigestion. However, because it increases blood sugar levels, it should not be used by persons with insulin resistance or diabete.
• Thyme is also soothing remedy useful for stimulating digestion of rich, fatty foods.

Carminative Spice Remedies:

• Cloves are also antispasmodic.
• Nutmeg is also useful for indigestion.
• Ginger.[/box]

[box type=”shadow” ]Exercise Helps:

Exercise improves circulation and rids the body of toxins.

• Walking is aerobic exercise that reconditions the whole body to improve stamina. Read more about Exercise and Fitness.
• Weight training builds muscle. Read more about Exercise and Fitness.
• Stretching improves flexibilty. Read more about Exercise and Fitness.

Note: Exercise is important, but the amount and type of exercise undertaken depends on your health. Your first priority is to heal. [/box]

What Do Medical Research Studies Tell About Short Duration Of Breast Feeding In Celiac Disease and/or Gluten Sensitivity?

RESEARCH STUDY SUMMARIES

“Human milk composition differs in healthy mothers and mothers with celiac disease.” This study investigating whether breast-milk composition and microbiota differ in healthy mothers and mothers with celiac disease found that celiac disease mothers’ breast milk is characterized by a reduced abundance of immunoprotective compounds and bifidobacteria, an essential gut bacteria.

Breast-milk samples from 12 healthy mothers and 12 mothers with celiac disease (CD) were collected. Cytokines and secretory immunoglobulin A (sIgA) were analyzed by bead-arrays and flow cytometry and human milk oligosaccharides (HMOs) were assessed by capillary electrophoresis with laser-induced fluorescence detection. Breast-milk microbiota composition was analyzed by conventional and quantitative real-time PCR.

Breast milk from CD mothers showed significantly lower levels of interleukin (IL) 12p70, transforming growth factor (TGF)-β1) and sIgA and almost significantly lower levels of interferon (IFN)-γ. Six mothers in each group belonged to the secretor Le(a-b+) type, one to the secretor Le(a-b-) type and five to the non-secretor Le(a+b-) type. CD mothers of non-secretor Le(a+b-) type showed increased Lacto-N-tetraose content compared with healthy mothers. CD mothers’ milk showed reduced gene copy numbers of Bifidobacterium spp. and B. fragilis group of gut microbes. The reduction in these components could theoretically diminish the protective effects of breast-feeding on the child’s future risk of developing celiac disease.³

“Celiac disease and pregnancy outcome.” This study designed as a case-control study and a before-after study investigated the effect of gluten-free diet on pregnancy outcome and lactation in 125 women affected with celiac disease. It found the high incidence of abortion, of low birth weight babies, and of short breast-feeding periods is effectively corrected by gluten-free diet in women with celiac disease.

In this case-control study, comparison of 94 untreated with 31 treated celiac women indicated that the relative risk of  short duration of breast feeding was 2.54 times shorter in untreated mothers. Duration of breast feeding did not significantly relate to the severity of celiac disease among untreated women. In the before-after study, 12 pregnant celiac women in either treated or untreated condition were compared. Results indicated that the gluten-free diet increased duration of breast feeding 2.38 times.⁸

Sources:

1. Pellicano R, Astegiano M, Bruno M, Fagoonee S, Rizzetto M. Women and celiac disease: association with unexplained infertility. Minerva Med. 2007 Jun;98(3):217-9. [↩]
2. Wierdsma NJ, van Bokhorst-de van der Schueren MA, Berkenpas M, Mulder CJ, van Bodegraven AA. Vitamin and mineral deficiencies are highly prevalent in newly diagnosed celiac disease patients. Nutrients. 2013 Sep 30;5(10):3975-92. doi: 10.3390/nu5103975. [↩]
3. Olivares M, Albrecht S, De Palma G, Ferrer MD, Castillejo G, Schols HA, Sanz Y. Human milk composition differs in healthy mothers and mothers with celiac disease. Eur J Nutr. 2014 Apr 4. [↩] [↩]
4. Stazi AV, Mantovani A. A risk factor for female fertility and pregnancy: celiac disease. Gynecologica endocrinology: the Official Journal of the International Society of Gynecological Endocrinology. Dec 2000;14(6):454-63. [↩] [↩]
5. Ciacci C, Cirillo M, Auriemma G, Di Dato G, Sabbatini F, Mazzacca G. Celiac disease and pregnancy outcome. Am J Gastroenterol. 1996 Apr;91(4):718-22. [↩] [↩]
6. Cummins AG, Thompson FM, Butler RN, et al. Improvement in intestinal permeability precedes morphometric recovery of the small intestine in coeliac disease. Clinical Science. Apr 2001;100(4):379-86. [↩]
7. Farhadi A, Banan A, Fields J, Keshavarzian A. Intestinal barrier: an interface between health and disease. Journal of Gastroenterology and Hepatology. 2003;18:479-91. [↩] [↩] [↩] [↩] [↩] [↩]
8. Ciacci C, Cirillo M, Auriemma G, Di Dato G, Sabbatini F, Mazzacca G. Celiac disease and pregnancy outcome. Am J Gastroenterol. 1996 Apr;91(4):718-22. [↩]