The Microbiome is a buzz topic for a reason. The trillions of microbes that live in and on us impact our health and function on many levels.
The microbiome is usually discussed in context of the GUT (as that’s where the greatest concentration of microbes live), but MOST body sites have their own microbiome – including breast tissue & breast MILK – and it’s super important for breastfeeding outcomes!
Let me explain; Third Trimester Microbiomes
In third trimester the microbiome across the different body sites change in preparation for birth and breastfeeding;
• The vagina microbiome increases its levels of lactobacilli (the good bugs) for the ‘exposure’ during a vaginal birth
• The gut microbiome changes to increase fat and sugar uptake and storage (to increase energy stores for birth and breastfeeding)
• Even the oral microbiome changes
• And breast tissue begins to build up microbes in preparation for breastfeeding
The body uses the lymphatic system to ‘transport’ microbes (from the other major reservoirs around the body) into breast tissue. This not only looks after the health and function of the breast tissue and breastmilk, but it is also one of the main ‘colonisation’ pathways of microbes from mum to baby.
Breastmilk is one of the major contributors to baby’s microbiome.
Breast milk not only contains the ‘live bacteria PRObiotics’ that help to support & develop the babies immature digestive & immune system but also ‘PREbiotics – Human Milk Oligosaccharides (HMOs)’ that feed a specific type of microbiome in a developing infant’s gut.
HMOs are pretty amazing, they’re probably my FAVORITE part of human physiology!
Not only do they govern the ‘type’ of bacteria that grows in bubs gut, they’re incredibly individual (to the needs of each baby), anti-inflammatory AND they can act as ‘decoys’ to pathogens (bad bugs) so they can protect a bubs little delicate tummy while it’s getting used to the world outside mum…
How amazing is that!
Formula companies have tried to ‘mimic’ the functions of the HMOs, but they can’t make them do what human milk does – especially the way breastmilk changes in response to the baby’s needs via the ‘backwash reflex’. It’s not just the HMO profile that changes either, it’s also the other components of breastmilk that are crucial to optimal growth & development – immune cells, antibodies, growth factors, stem cells and hormones etc. Again – how amazing is that!!
The Microbiome & Breastfeeding Outcomes;
Dysbiosis is the term that describes the ‘imbalance’ in our microbiome, this can happen in any body site and commonly occurs in breastmilk. Typically, it looks like a loss of ‘good bugs’ and/or overgrowth of the ‘bad bugs’.
Unfortunately, it’s very common to have dysbiosis as many of our daily activities & components of our ‘modern lives’ impact our microbes;
• Diet – high sugar & processed foods, low nutrients & fibre content
• Environmental toxins, Herbicides, Pesticides, Chlorine etc
• Common Medications – acid reflux meds, steroids, anti-inflammatories, antidepressants, – even paracetamol!
If you have dysbiosis at any point from pre-conception to birth (in any body site), chances are you will bring this into breastfeeding. And if you end up with a UTI, GBS positive, or having a C-section delivery, that means more antibiotics, and more dysbiosis!
Very commonly we come into this stage with a compromised microbiome and this can GREATLY IMPACT our breastfeeding outcomes.
Research shows dybiosis can contribute to increased risk of breastfeeding complications such as;
• Breast pain
• Nipple pain, nipple thrush, oral thrush (baby)
• Inflammation and/or Infection – mastitis
• Blocked ducts
• Colic / ‘Refluxy’ / Unsettled babies
How do I ensure my microbiome will support better breastfeeding outcomes?
As mentioned, the breastmilk microbiome is contributed to by other body sites – so it’s best to begin looking after your microbiome as early as possible (even from pre-conception) and across all body sites – but this definitely begins in the GUT.
Diet is the single most effective intervention we have over our microbiome so it’s crucial to get this right;
• Lots of plant-based, colourful, polyphenol rich (plant chemicals) whole foods – we should be aiming for a predominantly PLANT-BASED diet with good diversity & variety. Aim for 30 serves of DIFFERENT plants foods per week.
Veg, fruit, nuts, seeds, herbs, spices, legumes, pulses, wholegrains – lots of options!
• Low / no sugar or processed foods (these feed the bad bugs)
• PREbiotic foods – the undigestible fibres in plant food that FEED the live bugs
• PRObiotic foods – foods that actually contain LIVE bugs – yoghurt, kefir, kombucha, kimchi, sauerkraut etc
Lifestyle is also important – reduce stress, reduce environmental toxin exposure, sleep well, be active, minimal medications, practice mindfulness etc.
Pre & Probiotic Supplements;
Even when you are eating well, living well & avoiding medications – it’s still REALLY hard to avoid things that cause dysbiosis.
I take an ‘optimise & protect’ approach with my client’s breastmilk microbiome care. Along with diet & lifestyle interventions, I employ the help of good quality prebiotic & polyphenol supplements and specific probiotic strains that have direct positive impacts on the microbiome during breastfeeding.
The most difficult bit here for mums is choosing the right supplements, so I ALWAYS recommend getting the advice of a qualified health professional.
Unfortunately in Australia labelling is ‘not great’ when it comes to probiotics. TGA (Therapeutic Goods Administration) doesn’t even require manufacturers to put the strain on the product, which is crazy because it’s the STRAIN that determines a probiotics function. Go figure!?
Great news though – there is a well-researched probiotic strain that has strong clinical evidence for restoring the breastmilk microbiome, treating & preventing mastitis & improving breastfeeding outcomes (1-4).
Lactobacillus Fermentum CECT5716 is a probiotic strain that was originally isolated from healthy human breast milk (as opposed to food or bowel flora as in other probiotics), so not only does it have scientific research & proven clinical efficacy, but it also ‘makes sense’ for supporting breastfeeding, and that’s something we can relate to as mums!
To better understand what happens when we take a probiotic, let me explain Clinical Efficacy;
The probiotic strain has shown proven ‘mechanisms’ (effects) that ‘have a beneficial impact on the host’ (that’s us!). Some of these effects are;
• Ability to kill pathogens like Staph (most common mastitis bacteria), Strep, E.Coli & Candida while protecting the good flora – works like a ‘selective antibiotic’
• Helps restore mums indigenous good flora in gut & breastmilk
• Maternal transfer – actually gets into breastmilk when taken orally
*this is crucial we need it to get to the breast if it’s going to do the jobs there, right? It does this because it’s a BREASTMILK STRAIN. Makes sense again, yes?!
• Reduces inflammation (in gut & breast tissue)
• Strengthens immune system
• Improves gut lining integrity
So thinking about those mechanisms you can see why this strain can be so beneficial for ALL breastfeeding outcomes; from Mastitis treatment and prevention to thrush, to blocked ducts, to pain, to supply issues.
Breastmilk microbiome is an essential thing to consider when supporting better breastfeeding outcomes, not just for the health of the breast & breastmilk – but also for the optimal colonisation, growth & development of the infant and their microbiome.
By Emma Park
Functional Medicine Nutritionist
Health Professional Educator
- Oral Administration to Nursing Women of Lactobacillus fermentum CECT5716 Prevents Lactational Mastitis Development: A Randomized Controlled Trial. José A. Hurtado et al https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5444431/
- Treatment of Infectious Mastitis during Lactation: Antibiotics versus Oral Administration of Lactobacilli Isolated from Breast Milk. Arroyo et al https://academic.oup.com/cid/article/50/12/1551/303815
- Lactobacillus fermentum CECT 5716 Reduces Staphylococcus Load in the Breastmilk of Lactating Mothers Suffering Breast Pain: A Randomized Controlled Trial. Maldonado et al https://www.liebertpub.com/doi/pdf/10.1089/bfm.2015.0070
- Lactobacilli and bifidobacteria in human breast milk: influence of antibiotherapy and other host and clinical factors. Soto et al https://www.ncbi.nlm.nih.gov/pubmed/24590211