We were elated to welcome our first child into the world last month. After a long journey to become pregnant, which I have documented on this blog, it was wonderful to finally meet our baby and transition into the next phase of our lives as a family. Of course, the transition itself wasn’t without issue (seems to be the way of things in my family – rarely do things go smoothly or to plan). I could not have had a more opposite birth experience than what I wanted. We fell victim to the “your baby must be out at 42 weeks” dogma that rules in our state and I had to be induced. This led to every intervention under the sun and in the end I had a pretty harrowing and traumatic birth experience. I include the hospital setting in this. Hospitals are such toxic places, full of both material and psychological stressors. Aside from the constant interruptions, one can expect garbage food and noxious supplies at every turn. I’ll need a year just to detox from the vinyl blood pressure cuffs and IV tubes. I left exhausted and feeling like a pin cushion. Thankfully our baby is healthy and we are both recovering well.

baby feet

If there is a silver lining from the experience, it’s that I learned a lot and can now share with all of you, particularly how childbirth and breastfeeding can affect or be affected by MTHFR mutations. In particular I want to discuss two major areas where your MTHFR mutations can come into play and affect your childbirth and breastfeeding experience, both of which are interrelated.

The first issue is toxins. While I wanted a completely drug-free, natural childbirth, this was not possible for me with what I had to have for an induction. I received Pitocin, which led to an epidural. Prepared as I was for dealing with labor pain, Pitocin contractions are not “natural” and I struggled with them, especially after the 36 hours I had gone through with Cervidil prior to starting the Pitocin. I had little sleep and no food. It wasn’t happening. So here are several drugs you may encounter should you end up in the hospital for your birth. I would never choose an induction but as I have learned sometimes these things are inevitable despite our best intentions. I have often felt sorry for us in our postpartum days, thinking how did I of all people end up with all this? But I’m not special. And I also realize that many women choose these interventions every day. For those who have this choice, I want to be sure to point out some things to consider, especially if you have MTHFR mutations.

All drugs have to be detoxed by the body. As we know, MTHFR mutations make it more difficult for the body to process substances and eliminate them from the body. This includes not only any pain medications received for labor or C-section, but also the Pitocin. Pitocin is now routinely used in hospitals for preventing hemorrhage as the placenta is removed, so you can expect to receive some even if you weren’t induced. This synthetic form of the “cuddle hormone” oxytocin tends to hang around in your system for a while. For those of us with MTHFR mutations, that’s a problem as it’s even harder to detox. C-sections often require postpartum pain medications, like hydrocodone, which contains Tylenol (another MTHFR no-no because it depletes glutathione). Aside from putting extra stress on your system, these drugs (or having a C-section) can also cause problems with breastfeeding.

As aware as I was about the problems I would have with the interventions discussed so far, I had no idea what a challenge my experience would present to breastfeeding. Despite having a labor that progressed beautifully once it got going, I still ended up with a C-section after two hours of pushing. That’s another story. A C-section is what I most wanted to avoid but I had no idea that one of my reasons should have been the challenges it presents to breastfeeding. Women who have C-sections can experience delays in milk production. Having a lot of Pitocin in your system can also delay your milk coming in. We did not learn about this until the day we were discharged from the hospital when we finally were seen by a good lactation consultant (LC). Luckily this LC was also versed in MTHFR and I ended up learning quite a lot from her.

For milk supply, the first two weeks are crucial. If you have interventions such as Pitocin and/or a C-section, you’ll want to get additional support from a LC and may need to start pumping very soon after the birth. C-section moms can have a delay in their milk coming in of 10 days or more. This happened to me and I needed a lot of help to get back on track. We had to supplement with donor milk the first weekend home and had I not gotten immediate help from my doula and a LC, I don’t know where we would be right now. I think having MTHFR mutations may exacerbate this problem because you have a harder time detoxing substances like Pitocin. And if you had a stressful birth as I did, this can further impair milk production.

The LC at the hospital also talked to us about teas and supplements containing fenugreek that are commonly used to increase milk supply. She mentioned that using fenugreek while breastfeeding can potentially cause peanut allergies in babies when there is a history of food allergy in the family. I had never heard of this before so I want to mention it here for your further research and exploration.

Finally we got onto the subject of tongue and lip ties, which is now an issue I have personal experience with.

Tongue-Tie and Lip-Tie

As a MTHFR-aware person, of course I had heard of tongue-tie. What I didn’t realize is how much they affect my family. I was surprised to learn that I have one, though it is quite flexible and I am able to touch the roof of my mouth with my tongue. I was also breastfed as a baby and didn’t have any issues with that. My husband, on the other hand, has a more significant tie that doesn’t allow him to touch the roof of his mouth, and he did have breastfeeding problems as a baby. During our meeting with the hospital LC, she identified a posterior tongue-tie in our baby as well as a lip-tie. We later met with another LC who referred us to a pediatric dentist to further evaluate the ties.

tongue tie

My very elastic tongue tie

Tongue-tie, also known as ankyloglossia, is a midline defect that seems to be associated with MTHFR mutations. The tongue-tie is actually a short frenulum that restricts tongue movement. There are four types depending on placement in the mouth. Tongue tie can cause a variety of problems with breastfeeding, including nipple and breast pain, low milk supply, plugged ducts, mastitis, poor latch and suck, poor milk transfer, falling asleep at the breast and early weaning.

Although I thought I was well-supplemented with the right forms of folate and vitamin B12 during pregnancy, our child still had this defect. Knowing exactly how much to supplement is, of course, a common dilemma for those of us with MTHFR. Tongue-tie is also hereditary, which we have noticed within our family. Of course, breastfeeding is a priority for us, so we were anxious to correct this problem as soon as possible – the earlier you address tongue and lip ties the better because the first two weeks are really critical to breastfeeding progress. So we went ahead with water laser surgery, which was a success.

Of course, nothing is a quick fix. In fact, going ahead with the surgery sent us down a bit of a rabbit hole. We had to do some exercises to massage the open cuts created by the laser. This kept the frenum from reattaching but also caused some distress to the baby. Our major issues were gas and baby falling asleep after a very short time on the breast and failing to transfer much milk. These didn’t resolve right away for us, though apparently some people do experience instant dramatic improvements after the frenotomy procedure. We were told that it would likely be four weeks before our child’s sucking improved. Because the baby has been motility impaired since being in the womb, there is muscle memory and a need to relearn how to use the facial muscles to create an optimal suck. Muscles beyond the tongue and lips would have been involved in helping compensate for the prior movement restrictions. It’s like trying to throw a ball when your arm has been in a cast your entire life. The entire fascia must be relaxed and regrouped.

We read about CranioSacral Therapy (CST) as an effective complementary treatment to the frenotomy and began those sessions last week. So far we have noticed quite a bit of improvement as a result but we are still not completely on track with our feedings. I do a lot of pumping and supplementing breast milk by bottle. Of course this is not at all what I thought our breastfeeding experience would be like but we are doing the best we can and I feel fortunate that we received so much fast help with all of these challenges from the local holistic birth and breastfeeding community. My milk supply is ample.

Unfortunately sometimes our plans just don’t work out. That was certainly my experience with birth. But mentally I have been working hard to accept what happened and move on – the health of our child going forward is the top priority. I look forward to sharing our experiences as a family with MTHFR, particularly as these related issues arise.

If you have a comment that is related to your own health or have questions that require an answer, please leave these in the community discussion forums and not in the comments below. Thanks! =)

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48 thoughts on “MTHFR, Childbirth and Breastfeeding

  1. Rachel Dugas

    Hi there! I’m compound hetero as well. Just had my 2nd child- no drug interventions and I did not take methyfolate or any prenatals as I could not tolerate even the slightest bit. My question is do you know of any benefit or downside to taking Placental encapsulation pills for post pregnancy recovery. I was wondering what effects MTFHR has on placenta – should I take them for a metabolism boost? My mood has actually been quite great – I’ve felt better than I have in years, taking a low dose sari nothing else. I’ve tried methylfolate but did not tolerate it. I try to eat a wholefood diet to get the nutrients I need but am sure I’m depleted in some way or another. I’ve researched the placenta pills and the results are mixed. Has anyone with MTFHR taken placenta pills? What was the result?

    Reply

    1. Andrea Post author

      Hi Rachel – I took placenta pills. My doula did the encapsulation and she said that my placenta was incredibly healthy with little signs of deterioration that she would normally see for such a late term birth. Apparently it had an extra lobe! I chalk it up to all the excellent nutrition I had during pregnancy (I took the Seeking Health prenatals every day). It’s hard to say how much of a difference the pills made after birth – that time was so crazy and I don’t remember, but they certainly didn’t harm me. In fact I think I kept up incredible stamina for such a difficult time. That’s just my experience – others may have others to share. Good luck!

      Reply

  2. Jenny

    Do you have any posts or information or links on MTHFR supplements while breastfeeding? I stayed on all my supplements while pregnant but now that I’m breastfeeding I’m feeling a little nervous about how to approach it. I’ve found very little information online in my searches and my prior provider is no longer available to me. Thank you!!!

    Reply

    1. Andrea Post author

      Hi Jenny – I just kept taking my Seeking Health prenatals – whatever prenatal you used during pregnancy should be just fine for breastfeeding too!

      Reply

      1. Jeannie

        Hello

        Was there a specific seeking health prenatal that you were taking? I’m on their website and notice that they have protein powder to make prenatal shakes

        Reply

  3. Shelly

    Hi Andrea,
    I am pretty new to the MTHFR and diagnosed 2 months ago so far heterozygous for C677T. I just ordered the 23 and Me test yesterday. I miscarried at 2 months this April and am sure it was due to my absorption issues and this mutation. I had been spotting for 2 weeks when I miscarried. I am sure my mom had this problem too as she had preclamspia and I had to be induced 6 weeks early. After reading on all the associated risks with this mutation, I now wonder if her cancer was connected to this defect also. Probably so…I have been on 5mg of MTHFR for 3 months (before my test as my naturopath saw the potential diagnosis in my blood work). I do not feel any better yet on the pure folate, low adrenals, low mood and increasingly difficult to exercise. My question is how to best prepare for my next pregnancy. I am pretty concerned about trying again as this is all new to me. I am feeling pretty overwhelmed by what I read and the lack of doctors who are familiar with this. I live in NYC and am struggling to feel better and a good support team. Any feedback is greatly appreciated! Thanks!

    Reply

  4. Shannon Riley

    I was diagnosed with MTHFR after an emergency c-section d/t preeclampsia. I was dead set on breastfeeding, thinking I was doing the very best for my baby. He was born at 36 weeks and had difficulty breastfeeding,so we decided to strictly pump. I was mentally/physically exhausted. My goal was to breast feed up to 6 months. When we reached that point I switched him to formula and he seemed to eat more and seem to be more satisfied. I wondered if he wasn’t getting the nutrients that he needed from my milk; half the time I don’t even know if i am getting what I need. And with my future children would breastfeeding be ideal or would they be better off being fed formula…

    Reply

  5. Bernadette

    I suspect I have some form of the mutation and will be going to my doctor to get a test done. Both my babies were tongue and lip tied! (That’s not the reason I’m being tested) It is so hard! I too have breastfed, but dealt with pain as we only identified it (still too late) with our recent addition. My question is (providing I test and have mutation) how do you detox while breastfeeding? Or can you? My little one will not take a bottle so weaning is out of the question, and she’s just six months. I’m miserable with the bloating and pain, migraines, and FEEL like I need a detox even if I’m mutation free but how can I accomplish that?

    Reply

  6. Jenny

    Hi. I want to start by thanking you for sharing your knowledge of mthfr. After 5 miscarriages I was finally diagnosed with 2 copies of c677t mutation. Once treated with heparin and meta folate I was able to have a healthy baby boy. You mention that your baby had gas and trouble staying awake for breastfeeding. Mine has these issues as well but he is not tongue tied. His gas and discomfort seems to be getting worse…do you think this could be related in some way to my mthfr? He is 9 weeks old and supplements 8oz of formula. He just started nutrimigen formula but I wonder if the problem is my breast milk. Any info or suggestions would be appreciated.

    Reply

  7. Rachel

    Congratulations on your new baby, it is such a life change when they come along. I too have little one, 2months and I have the MTHFR gene mutation. Today I got my baby’s lip tie and tongue clipped. I hope it will help me due to the engorgement I have been feeling. Just found out too that our gene mutation causes over-abundant milk supply but I cannot find any research on that. Perhaps you know about that? I did take the prenatals you suggested for now 8 months but I do have a family history of lip ties.

    Reply

    1. Andrea Post author

      Thank you, Rachel – congrats on your baby as well! I had not heard of the over-abundant milk supply…I wouldn’t say that I’ve noticed that – I only have three baggies of frozen milk for my efforts so far. Interesting! I am not convinced that MTHFR mutations alone cause the lip and tongue tie… I hope your bub’s lip and tongue tie surgery is a success!

      Reply

    2. Allison

      I had major over production problems. My milk came in within 2 days and I was engorged within a week.

      Reply

      1. Rachel

        Hello! I am newly diagnosed MTHFR, and I had a lot of postpartum issues including over production of breastmilk which led to 4 rounds of mastitis in 2 months. I eventually had to stop breastfeeding because of it. My daughter has a sacral dimple, and is also tongue-tied. The new discovery of my MTHFR mutation has us shelving our thoughts of a second child until I undergo treatment to improve methylation. Everything is starting to make sense with this new diagnosis!

        Reply

        1. Anastasia

          Hi! My son also has a sacral dimple, and a upper lip tie, I am thinking of getting him tested on MTHFR, But he is only 4 month. Did you get your child tested and when, if so? Did you gave her any supplement? I live in Russia and there is very little information available

          Reply

    3. Rachel R.

      I had an overabundance of milk early on, but dried up way too easily. I don’t know if it’s related to MTHFR or not. (I haven’t been fully tested, but know I have at least some of the “lesser” mutations.) The overabundance of milk seems to cause a foremilk-hindmilk imbalance, which the babies compensate for with a weaker such or incorrect latch, and it’s just a nasty downward spiral.

      Reply

  8. Erin

    Congrats on your new baby! I had to comment after reading your story because I had a c/s with my first (plus pitocin, epidural, and an induction). It took two weeks for my milk to come in (one week for any colostrum). I’ve never heard of anyone else having that experience before, but now I have a possible explanation. (Even my ibclcs had not encountered it before.) Thank you! My kids and I are very newly diagnosed and learning more and more each day. Btw, they both had tongue ties but we were able to breastfeed successfully; I hope it gets easier for you. CST has been wonderful with my second son, too. My first nursed until he weaned himself just past age two; my second is still going strong at 9 months. I just found your blog and will definitely be back.

    Reply

  9. Jessica

    For what it’s worth, I think you made the right decision to induce. I would also encourage you to, as best as possible, focus on your healthy baby and not the hospital experience. Easier said than done. 🙂 But it sounds like you did wonderful given the circumstances.

    Reply

    1. Andrea Post author

      Thank you, Jessica! I feel pretty much past the hospital but still trying to get my health back – postpartum has been tough! Thanks for your encouraging words.

      Reply

  10. Valerie

    Thanks for this information! I mentioned in another post that I struggled with infertility due to MTHFR (I have one copy and my spouse has two copies). After treatment with blood thinners, we conceived and delivered a baby girl. I struggled for 3 months to nurse and sought LC support. We had her frenulum clipped twice. My milk supply suffered, and we endured physical therapy twice a week for 10 weeks to work on my daughter’s latch. Finally, after my own research, I stumbled upon posterior tongue tie. I flew my daughter to LA (4 flights in one day) for a 90-second laser treatment. She had a posterior tongue tie and a lip tie that the medical staff, the LC’s and the PT’s missed.

    Reply

    1. Andrea Post author

      Thanks for sharing, Valerie. The posterior ties do seem to get missed more often. That is what our baby had and the first couple of LCs didn’t notice it at all.

      Reply

  11. Anne

    I’m so EXCITED for you, Andrea! Congratulations! I’d been waiting for this post, and I’m just really, really happy for you and your new family, all of you. I wish you so much joy, joy, joy! I’m sorry you had a difficult experience, but every day it will get less and less prominent, and your baby will take over …in many ways, hah! Again, wishing you much happiness and joy and peace in this new chapter of your life.

    Reply

  12. Sarah Polk

    So how can we know how much folate and B12 to supplement with? I’m very soon trying for #2 (#1 had a tongue & lip tie….as did I, and my own mother too!) and I would love to prevent ties ***if possible.

    Reply

    1. Andrea Post author

      This I don’t know, Sarah. And I’m not completely sure that just getting enough folate and B12 is enough to prevent tongue tie. I was taking methylcobalamin injections throughout my pregnancy and what I thought was plenty of methylfolate and my child still had these. I was prescribed Bactrim during my first trimester and at the time I did not know that it’s a folate antagonist. I really don’t know that the drug did anything though because I was taking the active forms. I would love to hear from others with MTHFR mutations who felt adequately supplemented throughout pregnancy and still had tongue and lip ties. Another factor for me is that I haven’t explored other methylation gene defects in my DNA yet…perhaps I have other issues I have not addressed. I plan to do this in the future.

      Reply

      1. Tanya

        Andrea
        I recently found out that I am compound hetero. My daughter is 7 weeks old. During pregnancy I took citranatal assure. This has 1 mg of folic acid. I am now learning that synthetic folic acid is not good for us. Fortunetly my daughter seems to be in perfect health. I am concerned that she maybe didn’t get the appropriate nutrients from me during pregnancy because I am not breaking down folic acid and b’s. Until I am able to get an appointment with a genetic doctor and hematologist I have switched to mega food Baby and me prenatals which say folate not folic acid. Is the folate ok? Or should it be methylfolate. I am breastfeeding her and wondering if she is lacking folate and b because I can’t give to her in my milk? Or is she getting some from me. I also eat a very healthy diet rich in folate
        I would appreciate any insight or advice you can give me as I want to do what’s best for my child
        Thank you

        Reply

        1. Andrea Post author

          Congrats, Tanya! It is great that you switched prenatals and I recommend methylfolate if you tolerate it. As for vitamins in your breastmilk, I have no expertise on this but I would assume that she is getting plenty if your diet is adequate. Please see this article for further info.

          Reply

          1. Tanya

            Andrea
            Are you taking an aspirin or blood thinner while breast feeding ?
            What formula do you recommend if person can’t breastfeed and child may be carrier of mthfr

          2. Andrea Post author

            I’m not taking anything except fish oil postpartum. I checked my homocysteine in the last trimester and it was still quite low so I don’t feel like I’m at risk for clots at this point. What do you mean by “formula”?

          3. Tanya

            Thanks for the reply!! I was referring to baby formula for infant to drink in the event they were MTHFR carriers and mother couldn’t breast feed Was curious to see what you would recommend

            Thanks !!!

          4. Andrea

            I recommend making your own if possible – try the Weston A Price recipe (can be found online). I have to supplement with formula sometimes a little bit and I ordered Hipp from Europe. All of them have folic acid to my knowledge so none of them are ideal, even that one.

  13. Danielle Cooper

    While my birth experience was not necessarily complicated (just quick and back labor) I can sympathize with your breastfeeding experience. My son was also born with a lip and tongue tie which he inherited from me…my tongue tie was very severe and didn’t get resolved until I was in my 20’s. I credit my midwives sending me a lactation consultant with the only reason why we are able to breastfeed, however, I also mostly pump and give a bottle due to the set backs that came with the laser surgery causing discomfort. I look forward to seeing how things progress for you guys in the future.

    Reply

    1. Andrea Post author

      Lactation consultants are so valuable (the good ones – we had two in hospital that gave me bad advice). Thanks for sharing your experience, Danielle!

      Reply

  14. Becca

    Hi there!

    I’m compound heterozygous and have had two hospital births…both times I received pitocin and an epidural. I was, however, able to deliver both vaginally with no complications. I’m pregnant right now with #3 and am using a midwife to have a homebirth. Very excited about that!

    Can I ask what exactly led to the Cervidil and other interventions? Were you considered high risk with your OB?

    Thanks!

    Reply

    1. Andrea Post author

      It had nothing to do with MTHFR. I just had no signs of impending labor and was pushing 42 weeks. The baby was not engaged either. So this was concerning to the doctor. In the end for me it had to do with position of the baby – I had a doula and we tried everything to turn the baby. I did every exercise, Spinning Babies, etc. Stubborn bub. And an anterior placenta. Good luck with your homebirth – very exciting!!

      Reply

      1. Becca

        Was baby transverse or breech? I’m 32 weeks right now and our little buddy is transverse. Hopefully he’ll get his little body head down soon!

        Reply

        1. Andrea Post author

          Posterior. Have you seen a doula? I think you still have time but I admittedly don’t know much about it all! Good luck!!

          Reply

  15. MariaElena

    Thank you so much for sharing your very difficult and personal experience. The information you provided is extremely valuable.
    Congratulations! You did it!!!

    Reply

  16. Cassandra Kelton

    They forced you to induce? That is illegal. The doctor may have been able to drop you but every woman in every US state has the right to wait until labor happens and if you show up at the hospital in labor even though your doctor dropped you they cannot turn you away! And women give birth at home with midwives or unassisted gently and without complication all the time. I see a new complication-free beautiful unassisted birth every other day in my birth groups. I am so sorry that you had a traumatic birth experience because they made you think you HAD to induce. 🙁

    Reply

    1. Andrea Post author

      It wasn’t forced but yes, strongly recommended by my doctor and I didn’t want to just show up at the hospital and go with any doctor later on. After the way things transpired I suspect that the induction was a necessary thing but I will never know for sure. In the end for the complications I had I am happy that I stayed with my particular practitioner because of the expertise that was needed. I’d need to explain all the details of the birth for that to make sense but that wasn’t the point of my post. I just don’t know if I am someone who needed to gestate a longer time or if the baby never would have come naturally. So I am still holding onto negative feelings about it all, but part of me also thinks that maybe things had to happen the way they did. Thanks for sharing your thoughts on home birth – that is certainly the way I would have liked to go if things had worked out that way for me.

      Reply

  17. Nadia

    Wow, your experience, parts of the birth and post, sounds like mine. (I labored, but ended up having ‘the most difficult c-section extraction’ my doctor’s ever done.) Thanks for sharing. So many similarities. Except my milk didn’t come in very strong, and wasn’t able to get donor milk anywhere, so we had to go with formula. So amazing to have this baby in our arms After 8 long years of IF, and now so many challenges. I just finally got off the formula at 3 months pp. I wish I knew all this before. We just finished with a lip-tie revision, and second attempt at the tongue-tie a few days ago, at 3.5 mo postpartum. Our first tongue tie revision wasn’t laser, so wish we’d skipped that, but didn’t know any better. Latching is still a challenge today, as I’m pretty soar. But hoping this improves. We did some CST, and are doing ‘speech’ therapy for him. I took a TON of fenugreek… I’ll let you know if a peanut allergy ensues. I sure hope not, knock on wood. (Did you write about vaccines by chance?)

    Reply

    1. Andrea Post author

      Hi Nadia – so sorry to hear about your challenges! It can really take the shine off things. My latest one is mastitis – ugh! I did not write about vaccines yet and not sure if I will as it’s so polarizing. I really do not know what to do with regards to that topic and we are still feeling our way around ourselves. Good luck to you going forward!

      Reply

      1. Tammy

        Andrea
        I’m struggling with the vaccines right now as well. I have not decided when to start vaccinating my infant. Have you had your child tested yet for the MTHFR or anything else?

        Reply

          1. Valerie

            Not looking to start vaccine discussions, but, FYI, for those with MTHFR, there have been a couple of studies that indicate a higher risk of adverse events from vaccines in those with MTHFR SNP’s. Even Dr. Gregory Poland has mentioned these in one of his published papers.

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