Of course, there are potential challenges. Nutritional deficiencies can occur after weight loss surgery, and they can affect milk production. This can happen with any type of weight loss surgery — while malabsorptive surgeries restrict the amount of nutrients that can be absorbed out of food that is taken in, restrictive procedures can also limit absorption simply by limiting the amount of food a woman can eat.
"Vitamin B12 always comes to mind as a possible issue," says Phyllis Kombol, RNC, MSN, IBCLC, RLC, and Lactation Consultant at Carolinas Medical Center-NorthEast in Concord, N.C. "If a baby is having low weight gain, and we think volume of milk intake is adequate — which is always the first question — then low B12 could be an explanation for baby’s slow growth." Other possible areas of concern are protein, vitamins D and A, folate, calcium, and water soluble vitamins like thiamine.
Waiting until your weight loss is stable (for most women, 12 to 18 months after the surgery) before becoming pregnant can help. "Right after you have surgery, [your food] intake is so low, it can be difficult to take in enough calories for adequate milk production, even if you were able to take in enough calories to sustain a pregnancy," says Blankenship.
In addition, Blankenship reports that iron deficiency is a very common problem for new moms who have had weight loss surgery. "The challenge with iron deficiency with regard to lactation is that, if you have low iron levels and you become anemic, you're really fatigued. It's not so much that it's going to affect the quality of your milk and your milk production, but you're just going to feel exhausted. And one of the biggest challenges with maintaining lactation is that moms have to be able to have that energy to do evening feeds, and to meet the demands of their newborns."
Breast-feeding provides considerable health benefits for both babies and moms. According to the US Surgeon General's "Call to Action to Support Breastfeeding," released in January 2011, breastfed babies are less likely to suffer from illnesses that include ear infections, diarrhea and pneumonia, and are less likely to develop asthma. There is a decreased risk of breast and ovarian cancers in women who breastfeed, and breastfeeding also reduces the risk of sudden infant death syndrome (or SIDS).
Breastfeeding for at least six months also lowers a child's risk for becoming obese. "We know that women who have had weight loss surgery were or are obese, and they have the genetic tendency to be obese, so their infants are at risk for obesity," says Blankenship. "Breastfeeding is one of the first things parents can do to help their infants with the genes that have already been handed to them. It's one thing a mom can do very early on that can have a protective effect for the infant and for the child, throughout the rest of his or her life."
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To learn more about breastfeeding and pregnancy, check out these resources from Amazon.com:
The Womanly Art of Breastfeeding (La Leche League International Book), by Diane Wiessinger, Diana West, and Teresa Pitman
Your Plus-Size Pregnancy: The Ultimate Guide for the Full-Figured Expectant Mom, by Brette McWhorter Sember, Dr. Bruce D. Rodgers