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Inflammatory Bowel Disease Resource

Inflammatory Bowel Disease and Breastfeeding

laura lomax

To say I was one of those moms who was set on exclusively breastfeeding was an understatement. There were many adventures surrounding being a new mom I tried to prepare myself for, but it never crossed my mind breastfeeding would be more complicated than choosing to breastfeed.

I was diagnosed with ulcerative colitis shortly after giving birth to my first child. I experienced worsening symptoms throughout my pregnancy, but postpartum my symptoms quickly spiraled out of control. Less than a month postpartum I could barely care for my newborn. I was constantly running to the restroom (often interrupting feeds), eating and drinking minimally, drastically losing weight, and sleeping minimally.   As a result of my inadequate nutrition and hydration I was not making significant milk. My son was putting out as many hints as possible for a baby including wanting to continuously feed, sleeping minimally, and was extremely fussy.  My husband and family were very supportive and wanted to take the burden off of me by feeding bottles of formula, but I refused. While the lack of milk was a problem, the even bigger problem was my refusal to except my illness and the fact that no matter how hard I tried or wanted to breastfeed it did not change the fact I was not making adequate milk.  As a dietitian I helped many moms navigate through difficult breastfeeding scenarios, encouraged friends to breastfeed, and advocated breastfeeding benefits to everyone. How was it going to look when I didn’t even breastfeed my own baby??? I felt like I couldn’t just give up…  Honesty I felt if I stopped breastfeeding I would be failing as a mom, failing my son, and even failing as a dietitian.  Beside all the pressures I put on myself I also LOVED breastfeeding and the unique bond created.

A few weeks later I was finally able to be seen by a gastroenterologist and get scheduled for a colonoscopy. Knowing during the prep I would not be able to breastfeed, I began trying to pump milk. Trying being the key word. I was not able to pump more than an ounce over multiple days before the colonoscopy and reluctantly agreed to give my son formula. At this point I had no choice and honestly agreed because I felt it would just be temporary.

Before I knew it I was abruptly awaken from the colonoscopy and given the diagnosis of ulcerative colitis, told I required lifelong medications, and had to stop breastfeeding completely.  The next day my son had a pediatrician visit and he was now falling off the growth curve. So there it was solid evidence I could no longer ignore. In that moment as we all do as parents I quickly realized that what I “wanted” was no longer the priority. I had to start thinking as a parent and prioritizing what was best for my son. He started formula and almost immediately his fussiness and desire to feed improved and he started gaining weight appropriately.  While exclusively breastfeeding was out of the picture for me, along with my son’s pediatrician I worked with an AMAZING lactation consultant.  My lactation consultant helped me feel confident in formula feeding, as well as provided guidance to me on how to incorporate breastfeeding into my feeding plan. Together with my lactation consultant, my son’s pediatrician, and my husband we developed a plan to help incorporate breast feeding as my health allowed and based on the medications prescribed for my ulcerative colitis.

Whether you choose to breastfeed, choose not to breastfeed, or are unable to breastfeed for whatever reason I hope my story reminds you that your feeding choice makes you no less caring or loving of a mother. My struggles with breastfeeding opened my eyes to the unique experiences we all face as mothers and how important it is that we support each other.  

While my first experience with breastfeeding was far from what I ever expected with my second child my ulcerative colitis was well controlled and was able to breastfeed almost exclusively. My daughter loved breastfeeding and we got to share so many of those experiences I longed for with my first child. Below I have summarized my top 5 tips for breastfeeding and Inflammatory bowel disease.  

Tips:

  1. Stay Hydrated- Breastfeeding women have increased fluid needs to help maintain adequate supply. For women with IBD especially during times of flares or increased diarrhea fluid needs will be greater. Keep a water bottle with you throughout the day. To help encourage intake try a simple fruit infused water. Simply add fresh berries, oranges, watermelon to a pitcher then fill with water and allow to refrigerate for several hours.

  2. Consume Adequate Calories and Protein. To help achieve this goal eat small frequent meals. While calorie needs vary for each individual breastfeeding mothers can require an additional 300-500 calories per day. To help ensure calorie needs are met set a goal to eat a small snack while breastfeeding or pumping. Choose a nutrient rich snack such as a banana and string cheese, yogurt, an avocado, a boiled egg and fruit, or whole grain crackers with peanut butter.

  3. Speak with a lactation consultant- Lactation consultants are the breastfeeding specialist. Lactation consults help parents navigate feeding a new baby including feeding schedules, latching, adequate intake, and so much more. Specific to IBD they are also a great resource for medication and breast feeding safety, different positions to breastfeed that might be more comfortable with IBD, tips to increase milk supply, and provide support and reassurance.

  4. Have a supportive Team – Along with a lactation consultant be sure to discuss your feeding plans with your child’s pediatrician, your gastroenterologist, and spouse/partner. Choose a medical providers that will sit down and discuss the safety of drugs prescribed for IBD while breastfeeding, their potential transfer to breast milk, and examine the overall risk vs benefit of breastfeeding in your individual situation.  Being surrounded by a supportive team and being informed will help you make the best decisions regarding breastfeeding.

  5. Prioritize your health. As a new mom if you are not healthy you will not be able to care for your baby. One of the most important tips for all new moms and especially a mom with IBD is to rest when your baby is resting. Infants particularly having very demanding feeding schedules making adequate rest difficult. It is tempting to want to accomplish task around the house when the baby is sleeping, but it is imperative to use this time to rest.  

*Disclaimer: Thoughts shared are based on my personal experience. Always speak to your physician and healthcare team when making decisions regarding your health or the health of your baby. *