From: Judy Hopkinson
RE: Maternal Cholesterol in lactation:
In 1991, (last summary I could find in my files) we knew that maternal
cholesterol was increased during gestation and in the postpartum period.
But, in spite of anecdotal reports, it was unclear whether there was a
difference between postpartum lactating and non-lactating women. Within a
few years reports surfaced indicating that HDL cholesterol, but not LDL
cholesterol remain elevated longer in lactating than non-lactating women.
The first five studies below established the elevation of cholesterol in
gestation and in the postpartum period. Because of this elevation, it is
generally recommended that women who had normal cholesterol prior to
pregnancy not be tested in the first 3-6 months postpartum.
Reference #6 concludes that two forms of cholesterol behave differently in
the postpartum period depending on lactation. In their study,
apolipoprotein A (which helps lower the risk of heart disease) returned to
pre-pregnant values more quickly in non-lactating women. At the same time,
apolipoprotein B (associated with increased risk of heart disease) returned
to pre-pregnant levels at the same rate independently of lactation status.
Reference #7 studied a very large cohort of women with gestational diabetes
and similarly concludes that HDL but not LDL cholesterol are elevated in
lactating women compared to non-lactating women. Reference #8, on the other
hand, reports that cholesterol decreased more rapidly in lactating women.
Here is a quote from the abstract of ref #7: "Nursing had no effect on
total cholesterol, LDL cholesterol, or triglyceride levels. However, the
mean serum HDL cholesterol was elevated in the lactating group after
adjusting for maternal age, BMI, and pregnancy insulin use compared with the
nonlactating group (48 +/- 11 versus 44 +/- 10 mg/dL; P < .01). CONCLUSIONS:
Lactation, even for a short duration, has a beneficial effect on glucose and
lipid metabolism in women with gestational diabetes."
1. R. Erkkola et al. Biological Research in Pregnancy 7(2):47-51, 1986.
2. R. Knopp et al. J of Clin Endo and Metab. 60(3):542-547, 1985.
3. R. Jensen et al. JAMA 262(15):2092-2093,, 1989.
4. M. Mellies et al. Am J Clin Nut 32:2383-2389, 1979.
5. G. Steiner, JJ Myher, A Kuksis. Am J Clin Nutr 41(1):121-128. 1985.
6. Steitz HO, Brockerhoff P, Holzer A, Schicketanz KH, Stinner B, Rathgen
GH. Klinik und Poliklinik fur Geburtshilfe und Frauenkrankheiten,
Johannes Gutenberg-Universitat Mainz. (article in German - information
above gleaned from abstract)
7. Kjos SL, Henry O, Lee RM, Buchanan TA, Mishell DR. The effect of l
actation on glucose and lipid metabolism in women with recent gestational
diabetes. Jr. Obstet Gynecol. 1993 Sep;82(3):451-5.
8. Qureshi IA, Xi XR, Limbu YR, Bin HY, Chen MI.
Hyperlipidaemia during normal pregnancy, parturition and lactation. Ann
Acad Med Singapore. 1999 Mar;28(2):217-21
Judy Hopkinson, PhD, IBCLC
Houston, Texas
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