Supporting a mother to breastfeed is a beautiful way to nourish infant health, although some mothers may experience challenges when it comes to their breastfeeding journey. As naturopaths, we can assist this journey from a multifactorial approach.
The positive impacts of breastfeeding span beyond child health and intellectual development, with emerging evidence suggesting protective factors for the mother’s health in both the postpartum period and the long-term. Breastfeeding shortly after childbirth reduces haemorrhaging, increases uterine contractions, is protective against postpartum depression and strengthens mother-infant bonding. Long-term maternal benefits include reduced risk of metabolic disorders, cardiovascular disease and reproductive cancers. 1,2
The protective factors breastfeeding affords the infant microbiome and subsequently their immune system, is significant. Human breastmilk is rich in pre and probiotics that encourage growth of beneficial bacteria in the infant microbiome. A resilient microbiome is conducive to strong intestinal integrity, while additionally modulating the inflammatory response by competitively inhibiting the binding of harmful bacteria in the gut. 1 The high levels of secretory IgA and IgM in human breastmilk are essential for mediating adaptive mucosal immunity, working to inhibit pathogenic growth and build resistance to infection. 3
Hydration
Almost 87% of breastmilk is composed of water, therefore, adequate hydration is vital for ensuring consistent milk supply and avoiding maternal dehydration. 2 The New Zealand recommendation for breastfeeding women is 3.5L per day. 4 Breastfeeding-safe herbal teas such as fennel, nettle and lemon balm, or infusing water with fruit and cucumber, are some techniques that can be used to support breastfeeding mothers to reach this goal. 5
Nutrient rich diet/lactogenic foods
Lactation is a period of high-energy demand and increased mitochondrial function. Therefore, a well-balanced and nutrient rich diet supports the health of both mother and baby. 6 Focusing their dietary intake to include a wide variety of fruits, vegetables, legumes, nuts, seeds, plant and animal proteins, and wholegrains, will ensure they are meeting their nutritional requirements. Lactogenic foods such as oats, brewer’s yeast, flaxseeds and almonds have proven useful for increasing milk production. 7
Galactagogue herbs
Naturopaths can address insufficient milk production with herbs such as Fenugreek (Trigonella foenum-graceum), Fennel (Foeniculum vulgare) and Milk thistle (Silybum marianum). Fenugreek works to increase milk production by stimulating prolactin and oxytocin release. 8 Recent evidence suggests consuming Fenugreek during the early lactation stage proves more efficacious in supporting milk supply, than consuming in the later stages. 6 Both Fennel and Milk thistle have been used traditionally to increase milk production, with additional clinical evidence to support their use during lactation. 9
Mastitis management and prevention
Mastitis is painful inflammation of the breast tissue secondary to blocked milk ducts. Symptoms include local inflammation, pain, redness, swelling and breast tenderness, and often coincides with a fever and flu-like symptoms. Improper latching, infrequent feedings, immune dysfunction and high stress levels are risk factors for mastitis development. 10 Fortunately, there are several breastfeeding-friendly herbal supports we can employ to ease discomfort and prevent recurrent episodes.
- Echinacea (Echinacea purpurea) is a powerful immune-stimulating herb. Indicated for mastitis by supporting the body to fight infection and reduce inflammation. 6
- Calendula (Calendula officinalis) is anti-inflammatory, assists lymphatic clearance and helps to reduce a fever. 6
- Garlic (Allium sativum) is a potent antimicrobial, aiding the body to fight infection. 11
Emerging evidence suggests an association between the maternal microbiome and the pathogenesis of mastitis. While we await more human studies, animal studies are revealing interesting insights. Dysbiosis of the gastrointestinal microbiome has been increasingly recognised as a contributing factor in the development and progression of mastitis in dairy cows. Research has demonstrated that disruptions in the gut microbial community can lead to systemic inflammation, which may exacerbate the severity of mastitis or trigger its onset. 12 Conversely, experimental studies involving faecal microbiota transplantation (FMT) have shown promising results. When faecal material from healthy mice was transplanted into mice with mastitis, researchers observed a significant reduction in inflammation and a reversal in the severity of the disease. These findings suggest a strong gut-mammary axis and highlight the potential of microbiome-targeted therapies as a novel approach for managing mastitis. 12 Applying this evidence to naturopathic practice can be done by addressing dysbiosis induced mastitis with targeted probiotic strains such as Lactobacillus fermentum and Lactobacillus salivarius, encouraging dietary intake of prebiotic rich foods to feed advantageous gut bacteria and administering gut-loving herbal medicine. 13
In addition to being safe for breastfeeding, the antimicrobial actions of Echinacea (Echinacea purpurea), Calendula (Calendula officinalis), and Wild Indigo root (Baptisia tinctoria) support the management of dysbiosis by targeting pathogenic bacteria and helping to rebalance gut flora. 6
Stress management
Maternal psychological distress has been shown to negatively impact milk production in breastfeeding mothers. This is theorised due to the adverse effect stress has on prolactin and oxytocin release. Conversely, positive maternal emotions are associated with increased milk volume and frequency of infant feeding. 14 Stress management plays a critical role in successful lactation, with breastfeeding-safe herbs helping to stabilise mood and support hormonal balance.
- Lemon balm (Melissa officinalis) alleviates states of tension and irritability, while encouraging restful sleep. 6
- Chamomile (Matricaria recutita) is a gentle nervous system herb that is efficacious for lifting anxiety and associated restlessness. 6
- Passionflower (Passiflora incarnata) is a mildly sedating herb, beneficial for reducing anxiety and nervous tension, and supporting restful sleep. 6
- Withania (Withania somnifera) is supportive during times of stress, providing immediate relief while increasing resistance to stress overtime. 6
- Skullcap (Scutellaria lateriflora) is beneficial for relieving anxiety and nervous depletion, providing feelings of relaxation and calm. 6
Conclusion
Breastfeeding is a deeply nourishing and protective act that supports both infant and maternal health across physical, emotional, and immunological dimensions. From encouraging hydration and a nutrient-rich diet to recommending lactogenic foods and using herbal supports, there are many tools available to assist mothers in maintaining a healthy breastfeeding relationship. Ultimately, empowering mothers through education and holistic support enhances their well-being and lays the foundation for strong, resilient infants.
References
- Dieterich, C. M., Felice, J. P., O’Sullivan, E., & Rasmussen, K. M. (2023). Breastfeeding and health outcomes for the mother-infant dyad. Pediatric Clinics of North America, 60(1), 31–48. https://doi.org/10.1016/j.pcl.2012.09.010
- Mazur, D., Rekowska, A. K., Grunwald, A., Bień, K., Kimber-Trojnar, Ż., & Leszczyńska-Gorzelak, B. (2024). Impact of maternal body composition, hydration, and metabolic health on breastfeeding success: A comprehensive review. Medical Science Monitor, 30. https://doi.org/10.12659/msm.945591
- Brandtzaeg, P. (2003). Mucosal immunity: Integration between mother and the breast-fed infant. Vaccine, 21(24), 3382–3388. https://doi.org/10.1016/s0264-410x(03)00338-4
- Ministry of Health. (2020). Eating and Activity Guidelines for New Zealand Adults. https://www.tewhatuora.govt.nz/assets/For-the-health-sector/Health-sector-guidance/Active-Families/eating-activity-guidelines-new-zealand-adults-updated-2020-oct22.pdf
- Bone, K. (2003). Clinical guide to blending liquid herbs: herbal formulations for the individual patient. Churchill Livingstone.
- Kelleher, S. L., Burkinshaw, S., & Seun Elizabeth Kuyooro. (2024). Polyphenols and lactation: Molecular evidence to support the use of botanical galactagogues. Molecular Nutrition & Food Research. https://doi.org/10.1002/mnfr.202300703
- Ryan, R. A., Hepworth, A. D., Lyndon, A., & Bihuniak, J. D. (2023). Use of galactagogues to increase milk production among breastfeeding mothers in the United States: A descriptive study. Journal of the Academy of Nutrition and Dietetics, 123(9), 1329–1339. https://doi.org/10.1016/j.jand.2023.05.019
- Ravi, R., & Joseph, J. (2020). Effect of fenugreek on breast milk production and weight gain among Infants in the first week of life. Clinical Epidemiology and Global Health, 8(3), 656–660. https://doi.org/10.1016/j.cegh.2019.12.021
- Soon Hong Kwan, & Puteri Shafinaz Abdul-Rahman. (2021). Clinical study on plant galactagogue worldwide in promoting women’s lactation: A scoping review. Plant Foods for Human Nutrition, 76(3), 257–269. https://doi.org/10.1007/s11130-021-00901-y
- Wilson, E., Woodd, S. L., & Benova, L. (2020). Incidence of and risk factors for lactational mastitis: A systematic review. Journal of Human Lactation, 36(4), 089033442090789. https://doi.org/10.1177/0890334420907898
- Marciano, M., & Vizniak, N. A. (2020). Evidence informed botanical medicine. Professional Health Systems Inc.
- Wang, Y., Zhao, Y., Tang, X., Nan, X., Jiang, L., Wang, H., Liu, J., Yang, L., Yao, J., & Xiong, B. (2024). Nutrition, gastrointestinal microorganisms and metabolites in mastitis occurrence and control. Animal Nutrition, 17, 220–231. https://doi.org/10.1016/j.aninu.2024.01.010
- Yu, Q., Xu, C., Wang, M., Zhu, J., Yu, L., Yang, Z., Liu, S., & Gao, X. (2022). The preventive and therapeutic effects of probiotics on mastitis: A systematic review and meta-analysis. PLOS ONE, 17(9), e0274467. https://doi.org/10.1371/journal.pone.0274467
- Nagel, E. M., Howland, M. A., Pando, C., Stang, J., Mason, S. M., Fields, D. A., & Demerath, E. W. (2022). Maternal psychological distress and lactation and breastfeeding outcomes: A narrative review. Clinical Therapeutics, 44(2), 215–227. https://doi.org/10.1016/j.clinthera.2021.11.007