HER Expert Panel
Summer Roundtable

HER Health Collective  roundtables provide an opportunity for us to bring our panel of experts together to discuss important issues that are relevant to mothers in our community. The topics discussed in this session include: Diet Trends, How Food Affects Us, Supplementation, Fasting, and Dietary Restriction.

With HER Expert Panel

HER Health Collective is working to improve the lives of moms with a dynamic social community
supported by local women’s health experts.


Our expert team is a collaborative effort between local women’s health experts from a variety of
different industries, all working together to better serve the women in our community. Through
these efforts, we aim to improve postpartum care so that women are receiving the care they
need and deserve.


HER Health Collective’s Core Values include:

  • A Holistic approach to health and wellness, recognizing the importance of balancing physical,
    mental, emotional, and spiritual health.
  • We believe in empowering women to make informed decisions by giving them access to
    trustworthy knowledge and a supportive community.
  • We Respect each mother unique story and where she is at in her journey. Every woman is unique and we believe our approach to health and wellness should reflect that.

 

Our roundtables provide an opportunity for us to bring our panel of experts together to discuss

important issues that are relevant to mothers in our community.

Diet Trends

Crissy Fishbane:

Alright we are excited to go ahead and dive in. We have roughly 3 questions. We’re
going to spend approximately 15 minutes on each of those conversations and we’re just going to let our
panelists dive in and just have that conversation going. So our first question:

 

In what ways do weight changes across the lifespan, body image and diet culture impact mothers today? What do you see being the long term effects of these trends if we don’t see a shift in societal norms?

 

Anna Lutz:

I’ll jump in. You know, the thing that comes to my mind first is just the pressure on women
to return to pre-pregnancy weight immediately after the baby is born. And that somehow our society
decided that that’s how things are supposed to happen.

 

Instead if we could be sending messages to women that they need to nurture their body, take care of
their body, have a strong body so that they can take care of this wonderful baby that is here.

 

That might mean that their body is different, and it probably does mean their body is different. That’s
not a bad thing.

 

It’s actually something that as a society I hope we can move toward celebrating rather than this pressure that plays out with many detrimental mental health outcomes if the only focus is that a woman is supposed to get back to their pre-pregnancy body.

 

Jessica Altemara:

I agree with that focus being something that is prevalent across the board. One of the places like social media has the ability, especially right now when people are physically isolating, that social media has the ability to provide a community where it might not otherwise be available. At the same time social media is a place where you see that pressure where people only put their best face forward. You see people posting about how their exercise routine that they return to when they’re two weeks postpartum.

 

Like my almost 13 year old I took a picture the other day he looked at it and he said “oh that’s insta-
worthy mom” and it made me think about how many freshly postpartum people are just trying to be
insta-worthy.

 

I read a study that was talking about how people feel, because of social media and reality tv, people
have this weird idea that there’s always somebody watching them and that they are in this constant
performance mindset. And I think that that’s a huge distractor for a lot of people in making the
connections that you are talking about that are healthier.

 

Katherine Andrews:

I’m gonna second everyone, and just agree that it’s not even just postpartum but also as we age. We’ve seen that additional weight is actually health protective in older age.

 

I find that I’m seeing more disordered eating among the 40-50 year old women I see than any other age population right now. In terms of the question of what happens long term, it leads to restrictive eating and over exercising which then leads to hormone problems and menopause being far worse than what it would have been had they just accepted and embraced some of that minor weight change.

 

So it feels like there’s so much negative gut problems, right, that come from this fear of weight that
drives so much of what we do as a culture.

 

Dr. Lindsay Mumma:

I really don’t think that you’re going to get any sort of contention in this question. I think we can all pretty much agree that the idea that having weight on your body is a problem is ridiculous and that the pressure that women place on themselves because people are placing this external pressure on them is just so huge and it impacts so many different things.

 

It impacts their relationship that they have with food. It impacts the relationship that they have with themselves and then with their family and with everyone that they come into contact with.

 

Talking about the far end of the spectrum, my mother in law is a wonderful, beautiful, incredible woman and she is 67 and she still talks about how she had a large incision when she birthed my husband. And so her abdomen has never looked the same. And it breaks my heart to hear her talk about how she wants to be smaller in her stomach. She has such a disordered eating relationship with food and it’s so sad because my niece sees that.

 

My sister-in-law and I have talked about how we want to model the behavior that we want to see in our
children because it’s been going on for quite a long time and we don’t want that to pass on to the next
generation because this is what they’re seeing.

 

I mean babies are so aware of what’s going on. Gabriella knows what Elizabeth is doing right now and
she senses it and she can sense if Elizabeth is like “ugh I’m eating the thing and it’s bad”, you know, and
just being able to appreciate that the postpartum time period is for, like Anna said, nourishing and to
allow healing to happen.

 

One of the things I tell all of the women that I work with is that, from the moment that you either conceive or decide to adopt, your brain will change and everything in you will change. Everything from the cellular level to the metaphysical level changes when you become a mother. And so to go back to your pre-baby body is just a nonsensical thing.

 

I joke that I don’t talk to a lot of butterflies but I’m pretty sure none of them are trying to be caterpillars.
Because once you go through a transformation, everything’s changed and you become this more
incredible version of yourself. Why would you want to go back? But you’re being told that being back
there in those same jeans is really going to change your life. Leggings are pants. We don’t need that.

Jessica:

Did you finally, did you bring up something that actually could be debated? If leggings are
pants? (laughing)

 

Lindsay:

The leggings thing? I mean we can debate it if we want. (laughing).

 

Jessica:

I think you might have found something that we can debate. I’m not actually disagreeing with you, I totally agree.

 

Lindsay:

I’m totally agreeing with you. Leggings are pants.

 

Jessica:

I’m just saying you might have found something that we could debate. (smiling)

 

Dr. Elizabeth Sierkowski:

I’ll jump in here. I think one of the things that I like to touch on is each of us can talk about this from being a woman, from some of us being a mother. But honestly from so many perspectives – being a sister, being a friend, being a daughter. We’ve all interacted with ourselves and with other women and we see the challenge that this brings up and now as a mother, and I’ll talk about it from the medical perspective, it starts right now with her.

 

We’re a bit obsessed with numbers as they say. I mean, we’re already, I’m tracking, I’m plotting her
growth on a chart. Ultimately the point of those growth charts is not to scrutinize her body habits, right, it’s to make sure that she’s generally tracking the way that she’s supposed to. But that’s not how they’re used.

 

Even myself, I find that “oh she was born in the 88th percentile but now she’s the 83rd percentile, am I
making enough breastmilk? Is my milk rich enough? Am I losing weight too fast? Am I losing weight fast enough? Do I feel guilty about one or the other?”

 

We can scrutinize to the ends of the earth and, ultimately, when people come into my office, I don’t
weigh them unless there’s a reason to weigh them, but that’s not conventional care. Conventional care
is get them in, get their vital signs, because weight is somehow whether you’re alive or not. And then
put them in a room and put that on a chart and we’re supposed to judge you by these numbers on this
piece of paper. It’s just so ingrained in everything that we do. No wonder people are obsessed about it.

 

You know if you’re getting it from the Instagram point and you’re getting it from your friend and you’re
getting it from your mom and you’re getting it from your doctor and it starts when you’re little about
whether you’re big enough or small enough. It’s all disordered. None of that is normal.

 

The dialogue that I’m using with my patients and friends and my mom which, to speak to Lindsay’s
point, when she eats cheese puffs and feels guilty I’m like “either don’t eat the cheese puffs or stop
feeling guilty about it.” Just eat them and be happy about it and enjoy every one of those little cheese
puffs. It’s just her favorite food.

 

Instead the dialogue is: Are you happy? Are you functional? Can you move? Does your breast feed or
not? What is really the point of your body? Because it’s not the number on the piece of paper.

 

I pull a lot of this from one of my favorite books of all time which is “Women Who Run With The Wolves” and if anybody hasn’t read it, or its been awhile, it’s a really good time for a reread.

 

Crissy Fishbane:

You are all posing these amazing points. What do we do to shift this? How do we make this the new norm?

 

Dr. Lindsay Mumma:

For me, personally, I take it on myself to just always be honest and to deal in facts.

 

The facts are I don’t really care what my relationship with gravity is. I will talk to my patients and the women in classes and my friends and have honest and open conversations.

 

I also choose to share more than a highlight reel on my Instagram and I don’t think that that’s the biggest change in the world to make. But you can expect that you’re going to get honesty.

 

Today I found out that a friend of mine overdosed and it’s obviously still hard. I worked out and in the
middle of my workout I just started crying. I was making a video of working out. But I posted that video because I wanted people to see me work through challenges.

 

I get so many messages because I always have minimal clothes on because I just really like the sun and I like to get as much vitamin D as I can. I get so many messages from women who are like “the fact that you’re wearing a bathing suit right now makes me want to put a bathing suit on and I wasn’t going to.”

 

I don’t take it, like, some people get offended by that “well because your body’s not perfect, I feel ok in
my imperfect body.”

 

My body is imperfect and I love it that way. And so just showing my own self and then within my circle
of friends and my community, what it looks like to love myself at any size, in any shape, in any situation and through any hard challenge. I just want to let people see how I do it. Because I have tools and I like to use them.

 

So I think that what we do is, us professionals who are dealing with women who are frequently having issues surrounding this, we don’t put it on the back burner. We ask them questions about how it’s going. How do you feel in your body?

 

Like Elizabeth was saying, asking the questions that matter instead of “well how much weight have you
lost since you had your baby.”

 

Being mindful of the things that we say to new moms like, “oh you don’t even look like you had a kid.” I worked for that kid, I better look like I had one. There’s a lot of things in here that have changed. I would like for you to notice those. Look how big my boobs are. I don’t want to look like I don’t have a kid. And just being honest is how, that’s the approach that I take to specifically answer your question in a very long and emotional way.

 

Katherine Andrew:

Real quick – I think as practitioners, we can continue to emphasize and do our own research, if you will, around other tools of measurement.

 

People want ways, I mean especially even in quarantine, schedules help and tools of measurement help. To Lindsay’s point, how do we pose those questions, the better questions, so that it doesn’t come back to traditional medicine’s evaluation of what Dr. Sierkowski said in terms of numbers and weight being the baseline for everything.

 

Am I pooping daily? Do I have a sex drive? What are the better things that, as a female, I could be
evaluating for my own health? Because right now a lot of people don’t know that. All we know is blood
pressure and weight and when you ask people about “what is health” they come up with this very dry
list of numbers that you have to get from a physician. So what does it look like for me: Am I sleeping? Do I wake up rested? That would describe my healthy versus someone else’s.

 

Jessica Altemara:

I think that motivation is one key factor.

 

How do we help people feel motivated to change the way they approach things? That’s hard. Especially
for someone in the process of a transition, just becoming a parent or adding a family member, that
when you’ve just had a baby self-care is hard. Talking about what that looks like can mean a lot of
different things.

 

Finding something that motivates us to change the way that we think and approach this is important. Years ago a friend of mine was talking about how her whole life her mother was always saying disparaging things about her body. “Oh my butt is so big” and they would go clothing shopping and she would make remarks, and that she really wanted to be more thoughtful. She had just had a daughter and she wanted to think about what she was modeling because she realized that her own internal dialogue about her body was mirroring, was an echo of her mother.

 

She said that she was going to try to do it but she just felt dishonest. I said just fake it fake it till you
make it” and try to think about what you’re modeling.

 

A lot of times people think, “ I want to model good nutrition. I want to model a healthy weight.” But also
we have to model how we feel about all of that. What is actually healthy?

 

I love the question, what are our bodies for?

 

They’re not really for looking great in a bathing suit or a dress. One thing we can use to motivate
ourselves and to help motivate other moms is to consider what you’re practicing and what you’re
portraying to your children.

 

Say good things about your body. Notice what’s good, what’s healthy.

 

Talk about “ I want to eat this food because I feel better when I eat this food.” And not “I want to eat
this food so I can be beach worthy.”

 

I think for me, I’m not good at remembering self-care. But I’m really good at thinking about what I’m
doing to pass on healthy things to my kids. If we frame the concept of changing our language and
changing our approach as something we’re doing for our kids, we’ll benefit but I do think that it could
motivate people. It’s a good motivator that might work more potently than self-care.

 

Eva Miller:

I think we’re talking about self-compassion and self-acceptance too.

 

I’m curious what you all think, as I’m talking to you, and I’m looking at your faces, I’m also looking at my
face and my body. That’s a real shift in the time of this pandemic when we’re doing zoom calls. As I’m
seeing my clients I also have myself looking at me. I’m looking at myself too.

 

I’m curious what you all are noticing about that. I’m sure for new moms, but also for anybody. I know some clients in treatment for eating disorders are really uncomfortable with looking at their image. We’re finding ways to work around that, whether it’s covering their image with a sticky note or
an affirmation.

 

I know even personally I feel like my relationship with my sense of self has shifted in the last couple of months because I’m seeing myself. I’m thinking “oh that’s what I look like when I’m talking to you? Oh that’s hilarious.”

 

Some of it is just compassion and humor. Self-acceptance can go such a long way. Well that’s overall during this pandemic, but in general.

 

Dr. Lindsay Mumma:

I’m actually really glad that you brought that up Eva, because that was not
something that I thought about at all when we moved all our classes to be online.

 

Then my sweet wonderful mother-in-law is not participating in the church group that she loves because
she says that she hates to see herself on camera. I was like, “for all that is holy. Okay, let’s get you a
great headshot and you can just put your picture up. Then you can still connect with the people that you
love. You can have your fancy little face up there if you want to.” But I had not thought of that at all.

 

I think it’s a really good point for where we are right now. A lot of people are looking for some amount
of connection but aren’t really feeling that accepting of themselves as they are. The place that they are
right now they don’t necessarily want to see.

 

Then there is, on the other side of it, if you’re teaching a class or working with people and they don’t have their camera up, it is much harder to feel a sense of connection.

 

I mean even when in person and they have a mask on and you can’t see their reaction. I happen to have
very expressive eyebrows so most people know what I’m doing at any point in time with whatever amount of face you can see, but not everybody does and it’s hard to read.

 

I think that there are some aspects of how we’re connecting right now that are actually going to be
impacting us for a long time. That’s a good point Eva.

 

Jessica Altemara:

After the last roundtable discussion, I sent out an article to everybody that was about why virtual consultations are exhausting.

 

Usually when I work with a client I feel energized afterwards, but I have found that after a virtual
consultation I’m starving, I’m exhausted, my nervous system just feels raw.

 

It was so interesting and the article was very informative. One of the reasons why was that you’re watching yourself. It’s not just an engagement in some kind of therapeutic practice, it is a performance.

 

Instead of just being a conversation that we’re having with each other, it feels like a performance.

 

What happens to us energetically, psychologically, physiologically when we’re performing is very
different from what happens to us when we’re engaging socially.

I am really working very hard now to avoid categorical restriction if I can avoid it. Orthorexia is rampant when we’re talking about being insta-worthy and there are many ways now to validly have a food sensitivity but use it as a sense of control to continue to restrict, to continue trying to get a bikini body instead of necessarily focusing on, “Am I healing? Do I feel good? Is this nourishing?

- Dr. Elizabeth Sierakowski

How Food Affects Us

Cindi Michaelson – Thank you so much for everyone that has jumped in and answered that question.
We’re going to move on for the sake of respecting time to the second question:

 

There is no question that food affects us. From food sensitivities to gut health,
constipation to GI dysfunction, and food’s undeniable impact on mood, what key things
should mothers know about the food they put on their plate?

 

Dr. Elizabeth Sierakowski:

 

Before we get started, I’m going to jump in on this one because I just had a really poignant conversation with a patient yesterday.

 

I’m a functional integrative primary care doc, food is everything.

 

I do a lot of food sensitivity testing, I deal with constipation, so many things. I won’t go down that rabbit hole, but I’m very careful at the beginning to always remind patients and myself before we get started – what is the point of food change?

 

I am really working very hard now to avoid categorical restriction if I can avoid it. Orthorexia is rampant when we’re talking about being insta-worthy and there are many ways now to validly have a food sensitivity but use it as a sense of control to continue to restrict, to continue trying to get a bikini body instead of necessarily focusing on, “Am I healing? Do I feel good? Is this nourishing?”

 

Just as a place to start, the point is healing and self-love, not self-restriction and making food devoid of
pleasure.

Jessica Altemara:

There is nothing that everybody needs to eat or everybody should avoid, food-wise, to make enough milk or to have healthy milk for their baby. I just want to say that.

 

I understand that might be actually a contentious thing to say, but you can make enough milk eating a
regular diet and there’s not anything that everybody needs to avoid or needs to eat to make enough
milk. If you’re capable of making enough milk, and I will recognize that some people legitimately have
milk supply problems that are going to play into it, but I just, that would be my big assertion.

 

Katherine Andrew:

I’m going to be quick too because, again I love what Dr. Sierkowski said,and I would add when you said pleasure at the end — so satisfaction and pleasure I think are two biggies when it
comes to health for me.

 

I think the question was phrased a little differently at one point when I read it and I think that’s probably one of the most important things for people to figure out. What foods bring me joy? What foods are satisfying? And how do I include those on a regular basis?

 

That doesn’t discount food sensitivities, healthy eating ,or vegetables and all the things we know are
healthy. Too often we chase those rabbits and forget just about the simple value of pleasure and joy and satisfaction that we need to find in food.

 

Anna Lutz:

I’m looking at the last part of the question which is what do mothers need to know about the food they put on their plate?

 

The key things that come to my mind is the importance of adequacy. Having enough food to make milk if they’re nursing or to heal after pregnancy for gut health.

 

If we’re not eating enough food, so many of my clients who don’t eat enough food, their gut health is so
impacted, so adequacy is so important. Take the time to feed yourself just like you will your children. This is hard for moms, you know we’re conditioned to meet everyone else’s needs.

 

If you’re making a snack for your child, sit down and decide if you’re hungry and put some food on your
plate if you are. To really think. To do all the things that are demanded of me that I need to make sure
that I’m taking the time to feed myself just like I am feeding all the people in my family.

 

Dr. Lindsay Mumma:

I have a friend and colleague who’s been trained with Mark David at the Institute for the Psychology of Eating and she shared this with me a couple of years ago — and the reframe of it has been really helpful for me and also for all of my patients — that food is, because it’s a source of nourishment, either effective or ineffective.

 

In order to determine that you just need to know what your intention is. Usually we talk about food in moral terms. This is good and this is bad. But really the only bad food is rancid food that would make you get ill if you ate it. Other than that, there’s not bad food. There’s food that’s effective and there’s food that is ineffective. It just depends what your intention is.

 

If your intention is to eat as quickly as possible then McDonald’s is very effective. If your intention is to
get as much green leafy vegetables as possible then McDonald’s is ineffective.

 

Recognizing that can oftentimes help women adapt to what their surroundings are so that they can then choose what is effective for them or for their children or for the scenario they’re in.

 

For me personally, when I eat (previously cause I haven’t tried recently) but when I have eaten gluten
and dairy, things do not go well in my body, those are not effective foods for me in order to feel good in my body. But I still would prefer to have celebratory-ish foods, so even if a bucket of broccoli could give me lots of nutrients, it’s not going to be effective at a birthday party. I’m going to have a gluten-free, dairy-free cupcake, and I’m going to feel really good about that because I feel good with the food that comes in and I don’t have any sort of label on “this is good food or bad food” cause it’s just food.

 

Is this effective for what I’m doing? Is a bucket of broccoli effective for getting lots of nutrients? Yes. Is it effective for celebrating a birthday? Not really, that sounds terrible.

 

Having that reframe has been really helpful. Another thing that she taught me that I pass on to all of the moms that I work with is to take ten deep breaths before you eat, because then that allows you to down-regulate your autonomic nervous system as well as make the determination of what your
intention is. Then find out what your level of satiety is and how hungry you are. Do you need more food
than what’s on your plate? It also lets your eyes begin the digestive process of creating nutrients out of the food that’s on your plate.

 

Jessica Altemara: 

Lindsay, I love the idea of framing things as effective or ineffective. I love that idea.

 

You’re right, putting moral terms on food is a terrible idea. One of the things that I see coming up a lot is debates about the food pyramid, portion size, the healthy plate, that kind of stuff.

 

I’m curious to see what Eva has to say about framing that. I mean, I know if you’ve worked with people
with eating disorders or disordered eating a lot that’s probably something that comes up — hyper
analyzing what’s on the plate. I’m curious how you frame all that?

 

Eva Miller:

Well, I don’t know that I have any secret answers but, and maybe some of the dieticians have a better idea, but the mindfulness part, and challenging the good and bad.

 

People are really afraid of this idea of comfort food. It scares the hell out of them. But what’s wrong with being comfortable? I love Lindsay’s point, maybe what you’re needing is comfort. That’s alright. That’s beautiful. Maybe you’re needing celebration. Maybe you’re needing certain nutrition. Maybe you’re needing energy.

 

Dr. Elizabeth Sierakowski:

I do want to touch on the food sensitivity thing.

 

There are many many many GI dysfunctions out in the world, some of them are disease processes with
labels, some are not. They’re just your body or your GI tract isn’t functioning optimally so you’re not
digesting to your fullest or you’re having some bloating or gas or your stools are abnormal.

 

The benefit to the internet and this more transparent world is that people are starting to understand
that common does not mean normal. That’s a good thing. But going into the internet or to friends for advice is many times leading to conflicting plans.

 

What should I do? Or people will try to do all of them. So another conversation with a patient I had today was, she has SIBO, small intestinal bacteria overgrowth, and that’s something that I deal with a lot. It’s really common in up to 80% of people who meet criteria for irritable bowel syndrome which is just, you know, irregular stools, on the loose end or constipated end for a period of time with pain or
discomfort relieved by having a bowel movement. That describes a lot of people. If 80% of those have a bacterial overgrowth in the wrong part of their intestine that isn’t being dealt with, that’s a big deal.

 

The problem is they go and decide they have SIBO. Then they’re restricting themself to lettuce, bell
peppers and meat because they have no idea what to eat. This person says avocados are bad, this one
says mushrooms are bad, and that one says brussels sprouts are bad and they don’t know what to do or
what feels good or bad because they’ve lost that self-intuition.

 

I highly recommend:

  1. Be open with somebody that you trust with what’s going on and start to
    acknowledge when something doesn’t feel right, it’s probably not right.
  2. I would encourage you to find help by somebody who knows what they’re doing. A trained practitioner who can help guide you to align what you’re doing with your ultimate goals instead of you sort of getting stuck in this spiral of “well maybe I think these nine things should go. Or, I shouldn’t eat anything. Or, I’m going to try to be AIP paleo vegan and not eat nuts.”

 

That’s just a terrible idea, don’t do that. Having guidance is good.

Supplementation, Fasting, & Dietary Restriction

Crissy Fishbane:

Our final question really kind of spins off of this. …

 

There is some controversy around the effectiveness and need for supplementation and trends such as intermittent fasting and dietary restriction. Should supplementation play a role in a mother’s life? If so, what key areas do you think women should focus on with supplementation? What do you wish women knew about fasting and dietary restriction? Are there any lessons to be learned in looking at intermittent fasting from a historical perspective?

 

Katherine Andrew:

I could speak to all of these and of course have lots of opinions, but in terms of supplementation, the biggest thing that I want mothers to know is that there’s just so much out there.

 

Just like Dr. Sierkoski said, please please work with a practitioner before you go choosing random supplements to treat your SIBO that you’ve self-diagnosed by looking at the internet and now are under eating and have all kinds of other gut issues.

 

There’s no verification in the industry of supplements, so anyone can produce a supplement, put it on
the shelves at Whole Foods and until there’s been enough deaths, they don’t have to look into it. Working with a practitioner allows you to rely on higher quality supplements, know if you need them at all, and not end up in a rabbit hole of using a ton of supplements because you’ve heard this is great from your friend who went to a functional doctor and this was good.

 

It’s very individualized. That’s my biggest recommendation — not to self-diagnose and self-treat when it comes to supplements.

 

Jessica Altemara:

I will add that, on Facebook a couple days ago, somebody posted on a mom group. They said “Hey I’m about to have my first baby. Breastfeeding is really important to me. What do I need to do? How should I prepare?”

 

People were posting, “order this supplement”, “get these cookies”, “order that supplement”, “oh you got to make sure you take this”, “oh but don’t take it until this point.” “Have your placenta encapsulated”, which, I don’t know if you consider that a supplement, might be a conversation in and of itself. But everybody had an answer and nobody said to her “have your baby, nurse your baby, see what
happens”, because this is a biologically normal behavior that shouldn’t require 12 herbs and, if it does, then maybe you want to get down.

 

The other thing that’s important is, I often work with people who say “I was having milk supply problems, I started this supplement and it helped, but it didn’t help all the way so what should I do?” I say, “well you should see somebody and get some labs done and look at what you need and look at where things are”, because it’s kind of crazy what often ends up helping isn’t necessarily something that will say “for breastfeeding” on it. Sometimes it’s not a pill or supplement at all.

 

There almost seems to be an assumption right now that somebody who is breastfeeding needs supplements to make enough milk, to have good quality milk, or to be healthy while they’re doing so. There’s this crazy demand that somehow our bodies are failing without a lot of pills. I don’t think that is.

 

I don’t think there’s any way to know what your body’s going to need to feel good and make enough milk to feed your baby, to meet your own breastfeeding goals, whatever those are, until you’re in it and you’re doing it. There’s too much focus on what you can have in a bottle and not enough focus on how you can connect with your body and your baby and just flow with that.

 

Dr. Louise Metz:

I would agree with a lot of that and would also add that I think it’s helpful to kind of
shift away from this idea that we should be able to control our health with what we’re eating or not eating and what supplements we take, and really start to really trust our own bodies.

 

That our bodies know what they need and that we can typically, with an adequate and varied diet, we
can get most of what we need and usually don’t need supplements. You know there are certainly some
medical indications for certain supplements when individuals have vitamin deficiencies, and we know
folic acid is crucial during pregnancy. But, for the most part, we can get a lot of what we need through a varied diet. So I agree, it’s helpful to kind of trust that our bodies know what they need and to talk to practitioners to find out if there are any deficiencies or are there any specific indications for any
particular supplements.

 

Brit Guerin:

And to piggyback off of the trust piece, speaking to the intermittent fasting, when we manipulate when we’re allowed to eat and when we’re not allowed to eat, that takes us away from
trusting our bodies.

 

If you all know Kate Sutton, Counselor Kate, she wrote a really great blog post on intermittent fasting in a lot of ways looking like disordered eating behaviors. I would never recommend intermittent fasting. If it works for you and you don’t feel like you’re out of control, and you’re not overdoing it and feel like you’re starving yourself, go for it. But I would not recommend intermittent fasting due to the restrict-binge and feeling like you’re not allowed to trust your body.

 

Dr. Lindsay Mumma:

I actually, just because I was like “intermittent fasting seems like it’s probably a
bad idea”, I tried it, cause that’s sort of what I do.

 

So I did it for a little while just to see what does this do? What do I feel? How do I feel? How hungry am
I? When am I hungry? You know, there are some really beautiful fasting practices that have nothing to do with food and have a lot more to do with spirituality. Those, historically, again have had nothing to do with food. And so I think that there’s potential for there to be benefit from fasting in that way and biologically speaking, you know, as hunter gatherers we never had three square meals. So I get that.

 

But I think that in a time, especially during pregnancy, which is a state of growth, the idea of only eating between a certain window does not seem biologically appropriate, given our current availability of food and in the postpartum time period, especially with breastfeeding, your caloric needs will change every single day. If you only have a certain window within which to consume food, then that is likely to lead to more issues than not.

 

What I discovered when I did intermittent fasting was that some mornings I wasn’t hungry at all but I was eating breakfast because it was time for breakfast. And so I did learn things from doing it. In doing it, I didn’t recommend that anyone else did it. I really like to explore practices and see what they’re like and what we can glean from them. I kept it up for, I don’t know, two months maybe, just to see how I felt and what was going on. Ultimately I just stopped, because it didn’t seem to make sense to me that if I was hungry, I wouldn’t listen to that cue immediately. The idea of putting a timeframe around when it’s appropriate to eat doesn’t really make sense. I could see some aspects of fasting that could be very beneficial.

 

I don’t think that regular intermittent fasting is necessarily that.

 

Jessica Altemara:

And what happens if you’re in the baby phase of parenting and you’re up from 3am to 5am cause that’s how your baby’s cycling right now and you’re not allowed to eat? I mean, if you’re up from 3am to 5am and you’re hungry, you probably should eat.

 

I don’t think intermittent fasting looks at the fact that people might have broken sleep when they’re in the baby phase of parenting. I did want to add, just from the scheme of what I council, the moms I work with, to have good hormone regulation and to feel good, to have the energy they need is that anyone who’s not eating any animal products, probably should be taking a B12 supplement and it is
recommended that, unless you’re getting quite a bit of sunlight, and it’s in the right time of year, that vitamin D is taken and that’s pretty important for infant growth.

 

Those are the only things that I wanted to bring up that might be constructive. That somebody should
probably screen themselves because the two most common things that people need to take are B12 and vitamin D and there are better and worse ways to do that too.

 

Dr. Elizabeth Sierakowski:

Because this is a lot of the backbone of what I do, I’m going to jump in here.

 

I love what everyone’s talking about with intuition and paying attention to yourself. I want to bring up
here that this particular cohort of women, and a lot of people who we deal with and work with probably
have good intuition. There are a great many people who do not.

 

I’m trying to recommend that we, that everyone, just pay attention and just listen to their bodies is often not serving somebody because they really struggle with “what does that mean?”

 

If I’m craving a chocolate cookie, does that mean I need iron? Sometimes.

 

There’s some literature that talks about PICA, but probably not right? A lot of times this is again where I
recommend that someone work with a good practitioner who’s respecting them and their goals.

 

I have successfully used intermittent fasting for particular reasons, with an end goal in mind and,
Lindsay, like you said, it has a lot to do with learning austerity and sometimes that’s a helpful thing to do for a particular period of time.

 

It is not this blanket statement “eat every other day for the rest of your life cause there’s some studies
that say if we starve ourselves, those people live longer.” Not wise. Not the point of life, you know?

 

Supplementation, very similarly, has a lot of rhetoric out there that’s not really evidence based on either end. One, that functional medicine, “here take these 20 supplements every day.” Terrible idea.

 

Polypharmacy is very real for prescription medication as it is with supplements. And then on the other end, nobody needs any because our diets are good enough. A lot of times, probably not. You know even if somebody tries to eat perfectly and they’re getting nine cups of vegetables a day and they’re eating wild caught seafood, maybe they’re not absorbing it very well. Maybe they have GI dysfunction. Maybe they’ve just had a baby and breastfed and they have a family history of low iron. It’s difficult to say. It’s one of those things that again you can’t ask your friend about, you can’t google it.

 

Sometimes you can’t tell. We may not have symptoms and testing can be really helpful. But not across the board, it’s very individualized like everything else. I love what Jessica said about B12 and vitamin D being common ones that people need. There is no supplement that everyone needs, so I don’t blanket recommend anything. Calcium’s a big one for women, it’s difficult to get in a diet depending what you’re eating that’s fortified. Same with iodine, fish oil’s another one that’s really common. Probiotics would be considered a supplement that you don’t necessarily get from food. Some women really hate the idea of fermented stuff. So, you know, you work with someone to figure out what their goals are, what their needs are, where they are in their body, their life, their cycle. Lots of pieces, parts to that.

The HER Expert Panel consists of 12 local women’s health experts that have been nominated by local moms and vetted by the HER Health Collective team.  They are leaders in their respective industries and are committed to collaborating in an effort to change the conversation around postpartum care.  These experts participate in a quarterly roundtable discussion on a variety of women’s health issues and provide expert content for our virtual Resource Library.

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