A recent poster asked about breastfeeding while on a very low fat diet. The mom about whom the counselor is concerned is s/p cholecystectomy (gall bladder removal). I have two concerns. One, the mom on a very low fat diet will not get or absorb fat-soluble vitamins in her diet. In her favor, fat-soluble vitamins are stored and therefore available to the body for awhile.
The more immediate concern is: isn't fat composition in breastmilk affected by mom's diet? The mom could consider lipase and bile salts supplements, sort of like some of us take Beano to help digest one of the carbohydrates in beans. I read one suggestion that the lipase supplement should be enteric-coated, to protect it from stomach acids (it is usually deposited directly into the small intestine). Bile salts should not be affected by the stomach acids. Low concentration of bile salts after meals is part of the difficulty dealing with dietary fats because the gall bladder usually "doses" the eater with a bigger bolus of bile (that's poetic, somehow) after the meal, while the person with no gall bladder gets small "doses" of bile delivered to the small intestine periodically throughout the day. The bile salts emulsify the fats so they are more easily digested by the enzymes. Is there a dietician affiliated with the mom's HCP? Is there a naturopathic
 doctor nearby? I fear that such a severe low-to-no fat diet will be harmful to both mom and baby. Just my two cents.
Rowena

Rowena Tucker BS, MA, PA, IBCLC, LLLL
Bryan, Texas


      

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