The Secret Link Between Liver Health and Milk Supply

Published: Jan 25, 2025

Author: Robin Kaplan, M.Ed, IBCLC, FNC

When we think about lactation, we often focus on the chest/breasts themselves, but did you know that the liver plays a central role in your body’s ability to produce milk? This powerhouse organ helps regulate hormones such as estrogen, androgens, and insulin—all of which play an important role in milk production. It also manages inflammation, ensuring that your body’s systems work in harmony. But disruptions in liver function—often linked to conditions like insulin resistance, PCOS, or leaky gut—can impact milk supply and make chest/breastfeeding more challenging.

Let’s explore the liver’s role in lactation, how insulin helps prepare your body during pregnancy and postpartum, and practical ways to support your liver and overall health for the most robust milk supply possible!

ABOUT SDBFC

The San Diego Breastfeeding Center was established in 2009 by Robin Kaplan, International Board Certified Lactation Consultant, Functional Nutritionist, and parent.  Her vision was to create a judgment-free, inclusive support system for families navigating infant feeding challenges.  SDBFC offers a wide range of one-on-one breastfeeding, infant feeding, and nutrition consultations - as well as classes, support groups, online articles, and social media - making it your one-stop-shop for all things infant feeding!

Why Insulin is Important During Pregnancy and Postpartum

Insulin does more than regulate blood sugar; it’s also a critical hormone for lactation. During pregnancy, insulin helps build mammary gland tissue, laying the foundation for milk production. This is especially important in late pregnancy when your body prepares for making milk.

After birth, insulin sensitivity helps regulate prolactin, the hormone responsible for milk production. If your insulin sensitivity is low—a common issue with conditions like PCOS or gestational diabetes—it can delay lactogenesis (the onset of milk production) or result in a lower milk supply. Ensuring optimal insulin function during pregnancy and postpartum is essential for a robust milk supply and positive chest/breastfeeding outcomes.

How PCOS and Insulin Resistance Impact Lactation

Polycystic ovary syndrome (PCOS) and insulin resistance are common conditions that can significantly impact insulin sensitivity, liver function, and ultimately lactation. In PCOS, hormonal imbalances often lead to higher levels of androgens, which can interfere with ovulation and milk production. Additionally, insulin resistance—a hallmark of PCOS—can impair the liver’s ability to use insulin efficiently. This creates a feedback loop of heightened inflammation, poor blood sugar regulation, and disrupted hormone balance.

For chest/breastfeeding parents, these issues can delay or reduce milk supply. The liver’s role in processing insulin and hormones becomes even more critical in mitigating these effects. Supporting liver health can help break this cycle, improve hormonal regulation, and promote an easier lactation experience.

How to Support Liver and Gut Health for Lactation

The good news is that there are evidence-based strategies you can implement to support your liver’s function and improve insulin sensitivity. By making small, manageable changes to your diet and lifestyle, you can create a healthier foundation for lactation and overall well-being. If you’re unsure how to make these accommodations, working with a functional nutrition counselor, like Robin, can be a helpful step.

1.  Prioritize a Low-Carb, High-Fiber Diet

Your liver and gut are closely connected through the gut-liver axis, meaning that improving one often supports the other. Here are practical ways to nurture both:

• Focus on low-starch vegetables to support liver health and reduce blood sugar spikes.  These tend to be the veggies that grow above ground, like leafy greens, zucchini, and asparagus.

• Incorporate fiber-rich foods such as berries, flaxseeds, chia seeds, and non-starchy vegetables to promote gut health and improve insulin sensitivity.

• Minimize refined sugars and highly processed carbs that can contribute to insulin resistance.

• Include healthy fats like avocado, olive oil, and fatty fish to reduce inflammation and support hormone production.

2. Engage in Regular Physical Activity

• Activities like walking, yoga, or strength training improve insulin sensitivity, reduce systemic inflammation, and support the liver’s ability to metabolize fat and hormones.

• Aim for 20-30 minutes of moderate exercise most days, adjusting intensity based on how far along you are in your pregnancy and postpartum recovery stage.

• Focus on physical activities that you enjoy and look forward to, so it doesn’t feel like a chore.

• Incorporate your baby into physical activity, such as stroller walks, babywearing yoga, parent-and-me fitness classes, or hanging out on a playmat while you do a quick YouTube workout, so you don’t have to find childcare.

3. Consider Liver- and Gut-Supportive Herbs and Supplements

If you're currently using an herbal blend to support your milk supply, you may already be consuming some of these ingredients, as many herbs recommended for boosting milk supply also support liver function. (WOW, right?)

*** Before starting any new supplements, it's important to consult with someone who is knowledgeable about herbs and supplements—someone who can guide you on how they might interact with anything you're already taking, and help determine which ones are most suitable for your body.

• Milk thistle: Known for enhancing liver detoxification and repair.

• Turmeric: Contains curcumin, which has anti-inflammatory and liver-protective effects.

• Artichoke extract: Promotes bile production and overall liver function.

• Collagen or bone broth: Helps repair the gut lining and supports gut health.

• L-glutamine: An amino acid that supports intestinal integrity and reduces gut inflammation.

4. Keep On Lactating

• Producing milk for at least six months significantly improves blood sugar levels and reduces the risk of insulin resistance long term. 

• Chest/breastfeeding not only benefits your baby but also promotes lasting metabolic health and supports your body’s hormonal balance during the postpartum period. 

• Additionally, lactating for longer than six months may help you build a more robust milk supply with each consecutive baby, setting the stage for smoother chest/breastfeeding experiences in the future.

Supporting Your Liver, Gut, and Hormones for a Robust Milk Supply

Taking care of your liver and gut health can be a gentle way to support your body in balancing hormones and managing inflammation—both of which play important roles in lactation. Small adjustments to your diet, movement, and supplements can have a meaningful impact on your milk supply and chest/breastfeeding experience.

If you're facing challenges with low milk production, please know that you're not alone. Every chest/breastfeeding journey is unique, and it’s okay to feel uncertain or frustrated at times. If you suspect underlying health concerns like PCOS, insulin resistance, or gut issues, making a functional nutrition appointment can be a helpful step toward understanding what’s going on and finding the support you need. Your body is doing its best, and with the right care and guidance, you can make progress toward the breastfeeding experience you hope for.

Ready to Support Your Milk Supply?

Whether you're pregnant and looking to become more insulin sensitive or postpartum and facing challenges with milk production, Robin Kaplan, Functional Nutrition Counselor, is here to help. Robin can guide you through personalized nutrition plans and gentle lifestyle adjustments to support your liver, gut, and hormones, optimizing your body's ability to produce milk and manage inflammation.

Reach out today to schedule your one-on-one appointment with Robin (consider a virtual appointment, if you don’t live in San Diego!) and take the next step toward a more nourishing and confident chest/breastfeeding experience. Your body’s potential is greater than you may think, and Robin’s compassionate, individualized care can help you unlock it.

SDBFC is committed to providing high-quality lactation and functional nutrition consultations to parents in San Diego and beyond. Explore our postpartum, prenatal, and functional nutrition consultations, take a breastfeeding class or attend a workshop.

About the Author

Robin Kaplan has been an IBCLC since 2009, the same year that she opened up the San Diego Breastfeeding Center.  Robin was the founding host of the Boob Group podcast and published her first book, Latch: a Handbook for Breastfeeding with Confidence at Every Stage in 2018.  Melding her passions for supporting lactating parents and holistic health, Robin finished her Functional Nutrition Certification in 2023. In her free time, she enjoys hanging out with her two teenage boys, hiking, traveling, weaving, cooking, and searching for the best chai latte.

Breastfeeding My Type 1 Diabetic Daughter

Almost 2 years ago, a dear friend of mine found out that her 19 month old daughter had type 1 diabetes and was fighting for her life.  Here's Theresa's triumphant story of how she was able to preserve her breastfeeding relationship while healing her daughter.  

_____

About a month ago a friend alerted me to a Facebook post that brought a wave of memories flooding over me from a day that changed my life forever as a parent.  A day that I will never forget, even though I wish I could.  It was literally the worst day of my life, but one that I will always be grateful for because it was the day my daughter’s life was saved.  

The Facebook post was from a worried mom whose child was hospitalized after being diagnosed with type 1, “juvenile,” diabetes that very day.  The mama was breastfeeding and was terrified not only for her child's life, but that she would lose the best way she knew to feed and comfort her baby.  A little over a year and a half ago I was in her shoes.  At 19 months old, we were told that our daughter had type 1 diabetes, was in diabetic shock, and needed to be rushed to the emergency room.  She came very close to losing her life and was in critical care for a week at a children’s hospital. 

While she was at her sickest (almost admitted to the ICU), she was not allowed to nurse.  For as comforting as breastfeeding can be, not being able to do it during a time of crisis was torture.  My daughter was barely conscious, was in pain and terrified while she was awake, and I could not even hold her because she wanted to nurse.  I hope no other mama has to experience the excruciating helplessness you feel in a situation like that.  Our children's hospital has no lactation consultants and, by the time they could find a pump for me, we had already skipped about 7 or 8 feedings.  I was scared to death and in physical pain myself.

When we were finally given the okay for her to eat, I had to fight tooth and nail to be able to breastfeed her.  The doctors finally consented to her having breast milk, but because she was not a tiny baby, the doctors did not think it was important.  They told me that she absolutely had to drink from a cup or bottle.  (I had a manual pump at home and did not respond well to it at all.  I could not imagine how difficult it would be to have to exclusively pump.)  I begged them to let me nurse her.  It was my milk after all, whether it came from a pump and was poured directly into a cup or came straight from my breast.  No mother should ever have to beg to be able to feed their baby.  It took hearing our daughter scream and sob hysterically for the doctor to finally take pity on us and let me breast feed her.  As I held my tiny girl in my arms, it was the first time I began to feel like there was a possibility that she would be okay. Still, we were encouraged to not let her nurse after that.

Eventually, we were able to meet with the hospital's diabetes dietician who helped me calculate the average amount of milk I produced per feeding.  We looked at the amount of milk I was able to express with a pump then, by using the general amount of carbohydrates contained in breast milk, we were able to determine a rough estimate for carbohydrates per feeding.  Together we came up with a plan to space out her feedings as much as possible to keep her blood glucose stable (after each meal and to go to sleep).  The dietician was a lifesaver and a champion for us!  She spoke with our doctor on our behalf and convinced him that including breastfeeding as part of our daughter's nutrition was in her best interest.  The doctor has since become supportive.

Continuing breastfeeding brought my daughter so much comfort in the months of learning to live with daily multiple injections and painful finger prick blood tests.  It was something normal and peaceful for both of us during a stressful time of adjustment.  It supported her overall health.  It was a perfect source of nutrition for her combined with solids and was amazing for bringing her blood glucose back up to a safe level if she began to drop low at night (we do use a fast acting sugar, like juice, instead if she is below a safe threshold).  I am so thankful that we were able to continue our nursing relationship until she was 32 months old.

Type 1 diabetes (T1D) is a life-threatening, autoimmune disease in which a person’s body attacks their pancreas, causing it to stop producing insulin, a hormone needed to properly process carbohydrates in the food we eat.  People with type 1 diabetes check their blood glucose levels every few hours and must inject insulin several times every day or continuously infuse with insulin through a pump.  There is no known cause of type 1 diabetes and, at this time, no cure.  It will never go into remission and cannot be reversed.  As a mom, you can't help but wonder if you caused it somehow but, it just isn't possible that you did.  It is not connected to poor diet or lack of exercise.  Our daughter never has had a drop of formula, never had sugar other than that naturally occurring in fruit, never drank juice prior to needing it to treat hypoglycemia, and eats primarily homegrown, organic solid food.

Not many people think that a baby or toddler can develop type 1 diabetes, however it is definitely possible.  Not all doctors think of it either and it is commonly misdiagnosed as the flu, with deadly results.  It is very important to know the possible warning signs.  I would recommend all moms be aware of any major changes in nursing.  A sudden onset of increased nursing (past the length of time a growth spurt or teething would account for) along with much more frequent wet diapers can be a signal of diabetes.  Diaper rash (especially without a history of it) and yeast infections can be symptoms of high blood glucose.  Also, consider vitamin D supplements if a blood test returns low for vitamin D levels and investigate further if the test results are extremely low.  The researchers think there may be a link between low vitamin D and diabetes, however they don't know if it is a cause of diabetes or a symptom of it.  Our daughter had increased nursing and wet diapers, weight loss and developed labored breathing. Thankfully our pediatrician picked up on the problem and took action immediately.

Warning signs of type 1 diabetes can include:

 • Extreme thirst

 • Frequent urination

 • Drowsiness, lethargy

 • Sudden vision changes

 • Increased appetite

 • Sudden weight loss

 • Fruity, sweet, or wine-like odor on breath

 • Nausea or vomiting

 • Heavy, labored breathing

 • Stupor, unconsciousness

 • Sugar in urine

Most importantly, if you feel that something is wrong, go with your gut and keep asking until you find answers!  A quick finger prick test to check the blood glucose level can rule out diabetes.  For this test, a small drop of blood from the tip of the finger is sampled.  Results are often immediate.  A simple urine test can also check for abnormalities.  Undiagnosed and untreated T1D can become deadly very quickly.

If you have a little one diagnosed with diabetes, ask to speak to the nutritionist about continuing to incorporate breastfeeding into their nutritional plan.  By pumping once and measuring the amount expressed or by weighing the baby before and after feeding they can help you determine the general amount of milk and therefore carbohydrates they receive at the breast with each feed.  (Because it is an estimated number and not exact, they can often account for the difference in the allotted carbohydrate plan.)

Also, there are amazing support resources available for small children with T1D!  Facebook groups like “Diapers & Diabetes” and organizations like JDRF offer support for families, education, a place for children to feel encouraged and like any other child, and help navigate the uncertain and ever-changing waters that are type 1 diabetes.  Additionally, JDRF funds research and is constantly striving to improve life for type 1 diabetics.  Most importantly, they are fighting for a cure for type 1 diabetes.

*** Please note that these are just our experiences.  I'm not giving medical advice and don't claim to be an expert on diabetes--I'm just a breastfeeding mom doing everything she can to keep her daughter healthy!  Seeing her grow and thrive, and watching her play momma and nurse her baby dolls, I think I might be doing an okay job.

If you want to learn more about type 1 diabetes, www.jdrf.org is a wonderful resource.  For a glimpse into our life with it or to help fund a cure, please visit:

 http://www2.jdrf.org/site/TR/Walk-CA/Chapter-SanDiego4053?px=2922459&pg=personal&fr_id=2382

or watch our story at: https://www.youtube.com/watch?v=2Fc6r8HEnn0