Here is some general information about cholesterol, pregnancy, and breastfeeding that can assist you in making an informed decision.
Elevated cholesterol and triglyceride levels are common during pregnancy.1, 2 For this reason, most obstetricians do not recommend cholesterol testing during pregnancy.3 These changes in lipid profiles appear to be because of hormones. Women on birth control pills have changes in their lipid profiles, although not as much as women who are pregnant. There are even minor changes during the last part of the menstrual cycle.4
Cholesterol levels rise in the second trimester of pregnancy and peak during the third trimester. While cholesterol that is too high is a concern for many adults (and should be taken seriously!) cholesterol at its basic level is a necessary nutrient. It is important to your baby’s brain development. Because of this fact, as well as the fact that cholesterol levels return to normal levels somewhere around 4 weeks after delivery,5 hyperlipidemia is not treated during pregnancy. Expected levels usually do not exceed 337.6
Cholesterol levels usually drop somewhere around 4 weeks post partum. Most labs recommend waiting 6 weeks post partum to test cholesterol. As you discuss your risk factors with your physician, weigh the pros and cons of waiting 4-6 weeks after delivery to be retested before making a decision about medications.
Research indicates that cholesterol levels dropped most quickly in women who breastfeed their babies. Have you considered breastfeeding your baby? If your high cholesterol levels are related to your family history, your baby may also have high cholesterol later in life. We know that infants who were breastfed have lower cholesterol levels than infants who were not breastfed. Unless you and your doctor decide that your cholesterol levels are too high to wait to use medication, strongly consider breastfeeding; it could benefit both your and your baby’s cholesterol levels. 7, 8
Breast milk has been shown to be the BEST nutrition for babies. As far as “meal preparation” – Did you know that babies prefer their own mother’s milk to that of milk “prepared” by strangers? Ask any baby, its truly a gourmet meal!
About statins (cholesterol lowering medication) – Minimal amounts of most of these medications appear in mothers’ milk. However, because we know so little about their effect on a growing baby, the current recommendation is that breastfeeding women not take these medications.
It is easy to worry about your own health and that of your baby. However, stress can contribute to higher cholesterol. Look at the evidence, talk to your doctor, make decisions and then go with it! Now is a good time to consider things that help you reduce stress. (music, nature sounds, water, touch…) Practice these now but also make a list of “stress reducers” and give it to your partner or doula so they can suggest these in early labor. A relaxed mom can labor more efficiently.
Eat well. Extremely low cholesterol diets are not recommended during pregnancy, but you will want to be moderate about your cholesterol and saturated fat intake. Make sure you include lots of fresh fruits and vegetables. Increase those whole grains. Oatmeal is good. If you like it, include it. Stay away from the high fat meats. Include sea food. Consider low fat frozen yogurt instead of the ice cream. Add nuts to your diet if you don’t already eat them.
What about garlic? While the best research says that garlic has only moderate effect on cholesterol, it won’t hurt you. If you like it, include it in your diet. If you include large amounts of garlic in your diet, you may want to decrease the amount as you get close to delivery. Several researchers recommend stopping garlic (at medicinal levels) one week before surgery because it might increase your clotting time (make it more likely that you would bleed).9 Don’t worry about eating garlic while breastfeeding. Babies LIKE garlic in breast milk. 10
Exercise moderately. Staying active helps you stay healthy and can help with your cholesterol levels. Check with your doctor about the appropriate level of exercise for you. It can be as simple as a daily walk or as planned as a pregnancy exercise class.
One “old midwives tale” is that pregnant women who crave sweets are often not eating enough protein for their specific needs. Eating more protein often diminishes the craving for sweets. Making sure you have adequate protein is especially important for you, as animal studies have indicated that both too low of a protein intake and too high a cholesterol level could possibly lead to IUGR (intra-uterine growth retardation), a condition where your baby does not grow like he or she should during late pregnancy. 11
Remember that food nourishes the “self” as well as the body.
A tip for foods that you really enjoy but that need to be limited, such as ice cream. Go to the grocery store (or a specialty shop) and get the smallest amount of the best ice cream you can find. Bring it home. Put one scoop of this ice cream in a beautiful china dish and serve it to yourself with a cloth napkin. Sit at the table (not in front of the TV). Use a small spoon and savor every bite. Decide in advance how often you will have your “treat.” Some women immediately give the rest of the container to a friend so they won’t finish it. Others are fine waiting until the next “treat day.” Giving yourself the highest quality treats available fills the “pampering” need we all have and rewards you for all you are doing for yourself and your child.
1. 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
2. Kalllio MJ, Silmes MA, Perheentup J, Salmenpera L, Miettinen TA “Serum cholesterol and lipoprotein concentrations in mothers during and after prolonged exclusive lactation.” Metabolism 1992 Dec 42(12): 1327-30
3. “Cholesterol levels and the breastfeeding mom.” JAMA 262 #15 2092 Oct 20 1989
4. Erkkola R, Vilkari J, Irjala K, Solakivi-Jaakkola T “One-year follow-up of lipoprotein metabolism after pregnancy.” Biol Res Pregnancy Perinatol 1986 7(2):47-51
5. Qureshi IA, Xi XR, Limbu YR, Bin HY, Chen MI “Hyperlipidaemia during normal pregnancy, parturition and lactation.” Ann Acad Med Signapore 1999 Mar 28(2): 217-21
6. Baranan A “Pregnancy-induced hyperlipoproteinemia: review of the literature.” Reprod Sci. 2009 May;16(5):431-7
7. Christopher G Owen, Peter H Whincup, et. al American Journal of Clinical Nutrition, Vol. 88, No. 2, 305-314, August 2008
8. Christopher G. Owen, Peter H. Whincup, Katherine Odoki, Julie A. Gilg and Derek G. Cook. “Infant feeding and blood cholesterol: A study in adolescents and a systematic review.” Pediatrics 2002-9;110(3):597-608
9. Brinker R Herb Contraindications and Drug Interactions 3ed. Sandy (OR): Eclectic Medical Publications: 2001. p 99-101
10. Mennella JA and Beauchamp GK. 1991. “Maternal diet alters the sensory qualities of human milk and the nursling’s behavior.”
11. Bhasin KK, van Nas A, Martin LJ, Davis RC, Devaskar SU, Lusis AJ. “Maternal low-protein diet or hypercholesterolemia reduces circulating essential amino acids and leads to intrauterine growth restriction.” Diabetes. 2009 Mar;58(3):559-66
This section contains articles and guidance for healthy eating whether you are working on becoming pregnant, expecting or have a new baby. Articles cover information including what to eat, controlling nausea, breastfeeding and vitamins.