Imagine this scenario – you’ve been getting symptoms such as vulval itching and redness so you treat it with an over-the-counter thrush cream. The symptoms go. Must have been thrush, right?

It happens again later, but this time the treatment doesn’t work. So you try something else – maybe a pessary or an oral antifungal. Still getting symptoms…

Eventually, you get a swab from your GP, but the results don’t show anything definitive.

So you do a bit of research and decide to go on a strict anti-Candida diet and take several strong natural products that wipe everything out.

But now your gut’s feeling off, you’re anxious about everything you’re eating, and somehow you’re no closer to answers.

You go back to your doctor, and this time you’re given an antidepressant.

How did you end up here!?

Now take this story, and swap out thrush for recurrent UTIs, or BV, or interstitial cystitis. It’s a common journey for so many people, and it can be incredibly frustrating when symptoms keep recurring and you’re left without clear answers. Sometimes things do get picked up early and treatment is straightforward – but often I hear variations of this story, where people don’t fully know what’s causing their symptoms, or they’re led to believe it’s just something they have to live with. Others are placed on long-term medications they don’t feel comfortable with or are never told there may be an underlying imbalance.

A different approach –

When looking into vaginal microbiome health it’s important to have a good idea what you’re working with.
Most people are familiar with the classic symptoms of Candida/thrush – itching, redness, discharge. But sometimes it can present in less typical ways – for example, with only skin irritation or splitting, and no discharge at all. And importantly, Candida is just one type of imbalance. There are many microbes that can disrupt vaginal health – including bacteria linked to BV or chronic UTIs, and others that can trigger inflammation or discomfort without a clear “infection.”

So how do you find out what the cause is?

First and foremost we look at signs and symptoms. The colour, texture, sensations and odour of vaginal discharge can be very informative. Then we can narrow down whether the environment is too acid or alkaline, something that has a big impact on determining what sort of microbes can grow.

After examining symptoms, we can look at vaginal pH – an easy thing you can do at home to monitor the fluctuates from day to day. Vaginal pH is a good indicator of whether the condition is bacterial or fungal, and can show changes before symptoms appear.

A typical swab performed by the GP can also provide a lot of insight. Things like the presence of clue cells, leucocytes, what can be cultured, and whether bacteria appears to be there regardless of whether we know what type it is or not. However, Candida and other microbes don’t always show up on the day of testing, especially in cases of RVVC (recurrent vulvovaginal candidiasis), which can wax and wane.

This can often be enough. But if we need to dig deeper a more in depth vaginal microbiome test can be helpful.

There are several versions of vaginal microbiome testing available, currently my preference is through Nutripath which I discuss in the below video.

What is a microbiome?

A community of microorganisms that exist within an area of our body contributing to that spaces function and wellbeing. In female reproductive health we commonly refer to the vaginal microbiome – that microbiome that exists within the vagina and also affects the vulval tissues, as well as the endometrial microbiome (impacting the uterus and surrounding fluids) which may be different depending on cervical competency, and the peritoneal fluid microbiome. In the case of RVVC and chronic BV the vaginal microbiome is the most relevant.

Unlike the gut microbiome, the vaginal microbiome is meant to be relatively low in diversity. In most people, it’s dominated by Lactobacillus species, which help keep the environment slightly acidic and defend against invaders. There are variations in the vaginal microbiome based on hormonal stage (e.g. puberty, pregnancy, menopause) and even across the menstrual cycle. The type of lactobacillus that is dominant may vary based on your genetics, referred to community subtype (CST).

Signs of vaginal microbiome imbalance

• Itching in the vulval or vaginal tissues
• Redness or irritation
• Discomfort or soreness of the vulva or vagina that’s not related to
• Discharge that does not fit the typical ovulation discharge pattern
• Discharge that has a fishy, yeast, acidic, or “rotten/off” smell
• Recurrent UTIs
• Splitting in the creases
• Gushing or watery discharge (a clue depending on the microbe involved)
• Symptoms that flare or change during different phases of your menstrual cycle

Underlying Drivers of Vaginal Microbiome Imbalance

There’s no single cause for microbial imbalance. Often, several systems in the body interact and contribute. Here’s a breakdown:

• Gut health: Our gut is integral in almost all facets of our health and wellbeing. The impact of gut health on vaginal health may be different to what you may think. While older theories linked gut Candida to vaginal thrush, newer research shows this is unlikely due to the gut’s low-oxygen environment. RVVC is not typically caused by reinfection from the gut. Our gut health has an impact because of it’s influence on things like our immune system, hormonal balance, nutritional status and inflammation levels such as histamine tolerance. While gut candida is uncommon, and if present does not typically cause RVVC it is still important that we support gut microbiome in chronic dysbiotic cases.

• Oral health: Poor gum and oral health can drive systemic inflammation, which in turn can affect microbial balance elsewhere in the body.

• Immune health: An immune system that’s either overactive or suppressed can make it harder for the vaginal microbiome to stay balanced. Histamine excess can perpetuate chronic vaginal/vulval symptoms and can cause a heightened reaction when candida is present. There is a relationship between hormonal imbalance and mast cell activation issues that can feed RVVC.

• Hormonal balance: Both high and low oestrogen can create imbalances. In cycling women, this may lead to fluctuating symptoms throughout the month. In menopause, reduced oestrogen means less glycogen in vaginal tissues – a critical food source for Lactobacilli – leading to lower populations of these protective microbes. PCOS can be associated with a unique discharge pattern, and hormonal contraceptives like the OCP can alter both microbiome composition and typical discharge characteristics. Supporting hormonal balance is often a key goal in treating vaginal dysbiosis.

• Stress and nervous system regulation: Chronic stress can shift immune function, disrupt hormonal signalling, and create conditions in which opportunistic microbes thrive.

• Medication use: Antibiotics, antihistamines, and even some hormonal treatments can alter microbial environments by reducing protective species.

• Diet and lifestyle: High sugar and low-fibre diets, synthetic underwear, scented products, improper use of soaps or douching and certain sexual practices can disrupt pH or microbial stability.

The Complexity of Candida and RVVC

Recurrent vulvovaginal candidiasis is notoriously difficult to manage. One major challenge is timing – it may not show up on a swab done at your GP’s office if you’re between flares. But days later, symptoms can spike again.

And while low Lactobacilli is often linked to chronic Candida, this isn’t always the case. Some women have recurring Candida issues despite normal pH and healthy levels of Lactobacilli. In these cases, the key lies in addressing deeper factors – not just treating the yeast, but looking at immune regulation, inflammation, and systemic triggers.

The Broader Impact on Fertility and Reproductive Health

A disrupted vaginal microbiome can affect far more than just comfort. Studies link dysbiosis with higher miscarriage rates, IVF failure, and unexplained infertility. It may also fuel systemic inflammation via LPS production, worsening conditions like endometriosis and adenomyosis.

Both male and female reproductive microbiomes play a role in conception. The quality of the vaginal environment can influence sperm survival and how the sperm and egg interact.

What Can Be Done About It?

Effective treatment requires more than just “killing off” whatever shows up in a test. This is where working with a practitioner can make all the difference.

I’ve completed extensive training in vaginal microbiome care and offer tailored support – including custom pessaries and individualised treatment plans that target your unique underlying drivers.

A treatment strategy will typically involve:

• Supporting and regulating hormone balance

• Calming inflammation

• Addressing metabolic health and blood sugar regulation

• Modifying lifestyle and sexual practices as needed

• Supporting local vaginal tissue repair and resilience

• Enhancing immune function

• Restoring nervous system regulation and reducing chronic stress load

• Optimising diet, nutrient intake, and specific nutritional markers

• Identifying and targeting key pathogens where necessary

• Using timing strategies to prevent symptoms before they begin

• Balancing vaginal pH

• Supplying prebiotic fuels to feed beneficial microbes

• Using specific probiotics

References

Bradfield Strydom, M., Nelson, T.M., Khan, S. et al. The impact of fluconazole use on the fungal and bacterial microbiomes in recurrent Vulvovaginal Candidiasis (RVVC): a pilot study of vaginal and gastrointestinal site interplay. Eur J Clin Microbiol Infect Dis 44, 285–301 (2025). https://doi.org/10.1007/s10096-024-04999-1

Ono, Y., Kobayashi, Y., Shimada, S., Fukushi, Y., Yoshino, O., Wada, S., & Yamada, H. (2024). Uterine Endometrium Microbiome in Women with Repeated Implantation Failure Complicated by Endometriosis. Journal of clinical medicine, 13(16), 4605. https://doi.org/10.3390/jcm13164605

The post What to do when Thrush and BV don’t go away appeared first on Alison Mitchell Naturopath.

Gut Health

All disease begins in the gut – Hippocrates.

Your digestive system is more important for your overall health than you probably realise. It’s so much more than whether you do your number two’s regularly: digestive health impacts on your immune system, inflammation, hormone balance, mood, energy, skin, brain health and more!

Naturopaths and other holistic health practitioners have long been banging on about the importance of ‘healing the gut’ for a wide range of digestive disorders and overall wellbeing. In the last few decades, research into the importance of a healthy digestive bacteria balance (our ‘microbiome’) and digestive lining have been booming.

Put simply, the digestive system is a hollow tube ranging from mouth to anus, and is actually a continuation of our skin (just in a different format). You can imagine it like you’re a donut! And think about this: everything inside your digestive tract is actually outside of your body. Along this tube the surface of the skin changes, e.g. in the stomach there is a thick coating of mucous which helps to protect against the strong acids that are created there, and in the intestines the surface changes, developing a lot of finger like folds and protrusions called villi. Villi are designed to increase the surface area for both absorption of nutrients and room for immune cells. Almost like in a factory chain, other glands and organs will come into play, depositing enzymes and acids at various points that help us break down our food more effectively.

The bugs that live in your gut

If I told you that your body contains 10 times more bacteria than human cells, would you be reaching for the soap? Well you don’t have to worry because the majority of these bugs are working to keep you healthy. They are actually so interconnected with us, that we are now considered to be a ‘super-organism’ (1) (2).

The majority of the bacteria exist in your digestive tract, and there they work to detoxify harmful chemicals, process nutrients (and in some cases they actually create nutrients!), control the unfriendly bacteria that live there (yes there are usually always some bad guys present, about 15%, but the state of your good bugs determines whether the baddies cause a problem), control the immune system, produce energy for the rest of the body and much, much more.

The Goodies

There are over 400 known types of bacteria within our digestive tract. In some people there are more, and in others who may be eating a processed diet or have had damage to their gut flora, the diversity of these bacteria are significantly reduced. Interestingly, the bacteria in our gut are different throughout the different stages of our life.

Our friendly bacteria can be damaged by certain medications and lifestyle habits. Antibiotics are one of the most well known causes of damage to our friendly bacteria, and recently it has been discovered that some of our good bacteria may never recover after a course of antibiotics* (3).

Antibiotics, while often over used can sometimes be necessary and in some cases are life savers. Limiting their use and ensuring that if taken they are used correctly can help to prevent the development of antibiotic resistance. Consider your options before taking antibiotics, and if you do have to take antibiotics then see a practitioner who can guide you on how best to mop up at the damage.

Feeding the Good Guys

Whereas Probiotics are the organisms, Prebiotics are their food.  The use of prebiotics is often neglected, but it’s an important part of recolonising your gut. You can get various isolated prebiotics in supplement form, or you can consume a variety of foods which contain these compounds, particularly those high in soluble fibre.

Fermented foods are another key tool in keeping your digestive system happy. The act of fermentation allows beneficial bacteria that naturally live on the food to grow, and it also makes a whole host of nutrients within the food more bioavailable (meaning we can get more out of it). You can buy fermented food, or grow it yourself.

You should aim to have a variety of fermented foods~ and prebiotic foods consistently.

Regularly chow down on these to keep your good bugs thriving*:

• Almonds
• Apricots
• Asparagus
• Avocado
• Banana (especially green)
• Beetroot
• Garlic
• Jerusalem artichokes
• Kefir~
• Kimchi~
• Kombucha~
• Lentils
• Plantain
• Pumpkin
• Sauerkraut~
• Sweet Potato
• Witlof and Wombok
• Yoghurt (free from added sugar and chemicals)~
• Zucchini

* If you have Fructose Malabsorption, some of these foods may cause digestive discomfort. Seek advice from your health practitioner if you are unsure.

The Baddies

There are a huge range of unfriendly pathogens that if allowed to get out of control can cause all sorts of havoc in your digestive system.  Some can even cause trouble with your mood. Chronic infections can result in a wide variety of symptoms that are often unexplained such as aches and pains, fatigue, brain fog, unexplained inflammation and recurrent infections –fibromyalgia and chronic fatigue syndrome are just a couple of conditions that can have a chronic infection as an underlying driver (4) (5).

There are a huge range of organisms that lie dormant in our digestion: many, many forms of bacteria, viruses, protozoa (e.g. malaria and giardia), fungi, yeasts and parasites can exist in our gut.  Some of them can be deadly killers, and others may not be lethal but can result in a variety of nasty symptoms.  Our immune system, digestive juices and the presence of our good bugs are what keep it all in check.

The Gut and Your Immune System

“The immune system present in the gut makes more immunological decisions in a day than the rest of the immune system does in a lifetime”.  (6)

If your immune system isn’t behaving itself properly, you might want to consider that your digestive system is the culprit.

Your digestive system has a special mucosal lining over the surface of your intestines, and the health of your gut flora (the complex, extremely important colony of bacteria within your digestive system, also known as the microbiome) has a huge amount of immune decisions to make on a daily basis – it has to deal with bacteria, viruses and food, and decide each time whether it is a friend or foe. It is via this mechanism that your gut health can contribute towards skin conditions such as eczema and psoriasis as well as autoimmune conditions such as SLE (Lupus), Rheumatoid arthritis, Graves disease and more.

The gut reports to the immune system

There is a special type of cell within the digestive system called a dendritic cell.  This cell is responsible for determining whether our immune system should be on high alert or not.  Occasionally this cell will extend a little feeler (almost like a tentacle) and take a handful of whatever is in your digestive system to examine, to then report back to the rest of the immune system whether everything is okay or not.  This can explain why your diet can have an effect on allergic conditions such as hayfever and eczema, as well as autoimmune conditions (7).

Immune cells in the gut

There are also a lot of other players involved in the gut, such as the immune cells Immunoglobulin A (sIgA) and certain T lymphocytes.  sIgA helps to protect the epithelial layer from being inhabited by bacteria and viruses.  This helpful immunoglobin is actually produced by lymphocytes (a type of white blood cell) which are actually created by Bifidobacteria (a good bacteria that exists mostly in the colon).  Unfortunately, Bifidobacteria are easily damaged, especially by antibiotics.

Enzymes do more than digest food

When you think about digestive enzymes, you’ll probably be thinking that they’re there to break down your food so it’s primed for absorbing.  They also have another important role to play, and that’s in breaking down substances that might be harmful to your immune system.  Due to poor eating habits, the secretion of enzymes is compromised in a large proportion of people.  Implementing habits such as chewing each mouthful more and taking time to enjoy and concentrate on your meal are helpful for stimulating the cephalic phase of digestion – where your brain tells the rest of the digestive system to get ready for food, and consequently more enzymes and acids are produced.

The Gut and Your Mood

The state of our intestinal lining and the balance of bacteria within our digestive system have a major role to play in the production of our neurotransmitters: chemical transmitters that tell our brain whether we should be feeling such ways as happy, sad, agitated, or calm.

When the balance of our gut bacteria (collectively referred to as the microbiome) is affected, this can affect your mood.  Studies have found that the microbiome can have a major impact on stress levels and anxiety (8).  In fact, by treating imbalances in our microbiota, it is possible to support a wide range of mental health disorders (9), (10), (11), (12), (13).

The second brain

The nerves in your digestive system are constantly speaking to your central nervous system.  If your gut is irritated for some reason – say you’ve eaten something that you’re intolerant to (like gluten, for example), you’ve generally got a bad diet, there’s an imbalance in your microbiome (that’s your collective gut bacteria, remember) or you’ve got an infection – this can create an inflammatory reaction and will certainly make you irritated as well.

We know that depression is both associated with, and worsened by inflammation.  This inflammation in the brain can be driven by inflammation in the gut, which can be caused by intestinal permeability (leaky gut) and bacterial imbalances (dysbiosis).  Treating leaky gut can help reduce the severity of depression (10), (14), (15), (16), (17).

Neurotransmitters in our gut

Serotonin is produced in large amounts in our digestive system.  In people with Irritable Bowel Syndrome (IBS) there is too much serotonin in their digestive system.  This is why antidepressants known as SSRIs (selective serotonin reuptake inhibitors) can improve the symptoms of IBS: these act by reducing the amount of serotonin taken into cells in the rest of our body which allows more to get into the brain.  However in some instances anti-depressants can affect the gut negatively, because if you weren’t making enough serotonin in the gut in the first place, you can end up with even lower levels in the digestive tract and so it can become irritated, affectively you’ll get a depressed gut (18), (19).

A vicious cycle

When your gut is upset, you feel upset.  But stress can affect your digestive system just as much as it affects your mood.  It can impair the secretion of digestive acids, slow down the motility of the gut, allows the unfriendly bacteria to grow, reduces your friendly bacteria and exacerbates intestinal permeability (leaky gut) (20), (14).  This is a recipe for an unhappy digestive system, and as you know this can then go on to send more messages to your brain: so you can see how the cycle continues.

People with gut problems are more likely to experience anxiety and depression.  Some studies have found a high proportion of anxiety in those with gut conditions such as Irritable Bowel Syndrome(IBS), Crohn’s disease and coeliac disease (21), (22), (23).

Look after your gut and it will look after you

The body has an amazing ability to heal, if given the right means to do so. If you eat a predominately plant based diet that is free from processed food, get your microbiome happy by feeding the good bugs with prebiotics and occasionally adding in some good bugs with fermented foods and probiotics, you’ll be on the right track to start healing your gut.

Works Cited

The post The Importance of Gut Health appeared first on Alison Mitchell Naturopath.

As I move on to breastfeed my second child my love and admiration of breast milk continues to grow. I am always in awe of the amazing benefits that breastfeeding provides, both for mother and baby.

In the same breath I also think of the challenges it can face, how hard some mothers have to fight to be able to breastfeed and how devastating it can be for mothers who want to, but for one reason or another cannot breastfeed their child. I also acknowledge that formula feeding can be challenging as well (such as sterilising bottles and the cost of formula), and that while I will dedicate this article to the benefits of breastfeeding, I want you to know that if you weren’t breastfed or you can’t breastfeed your babe, it will still be okay.

I want to share some of the benefits of breastfeeding with you, as well as some information about your nutritional requirements during breastfeeding, and things which your diet can and cannot change about your breastmilk.

In fairness, I also discuss some of the less awesome things about breastfeeding (mostly from personal experience) and share some breastfeeding resources.

Some awesome benefits of breastfeeding.

Better bone health for Mum

While your calcium stores might drop down in the first few months of breastfeeding, as you continue to breastfeed your bone density is actually strengthened.

Prebiotics

I know I’m repeating myself but I can’t help it, I just love the amazing prebiotic goodness of breastmilk for babies tummy. There are a vast amount of prebiotic sugars and fibres in breastmilk which encourages the growth of the good bacteria in the digestive system, and thus improves their immune system, skin health, digestion, behaviour, sleep and more. Having had to have a c-section for my first son I felt very reassured that I was doing wonders for his tummy by breastfeeding (which I have continued to do so).

Improves babies iron stores

There is a protein called lactoferrin in breastmilk which improves iron absorption, but also inhibits the growth of harmful micro-organisms which can steal iron for their own growth (such as E. coli, Candida spp. and Staphylococcus spp.). As young babies receive minimal iron from breastmilk this is a very handy feature, and it also means that when they do start receiving solids in addition to breastmilk it is better absorbed and utilised.

Protects against cancer in mothers

A study published in The Lancet in 2016 found that breastfeeding mothers had greater protection against breast cancer, as well as possibly ovarian cancer and type 2 diabetes. The authors estimated that is breastfeeding was more universally established it could 20 000 annual deaths from breast cancer.

Individualised immune support

Whenever the mother is exposed to a pathogen of some form, she will start making protective antibodies which she will then transfer to the baby via her breastmilk. And what if the baby was exposed to these pathogens before mum? Baby will send some of these into the breast via a backwash mechanism, which then allows the mother to start making antibodies against. So baby gets the benefit of an experienced adult immune system to help them fight against infections, via breastmilk.

The same study mentioned above predicted that universally established breastfeeding could prevent 823 000 annual deaths in children younger than 5 years.

Better development of sleep-wake cycles.

Babies don’t have a natural day-night hormonal until a few months of age, but breastmilk actually delivers different hormones in the day and night that teaches baby when it’s time to be awake, or to sleep.

Better reaction to vaccinations for babies

Babies who are exclusively breastfed, and to a certain degree partially breastfed, have been shown to have less of a negative reaction to vaccinations. They are less likely to get a high fever or discomfort after the vaccinations, and breastfeeding during or immediately after the vaccination can also reduce the discomfort of the process.

The immune response to the vaccination is also better for a breastfed baby, making the vaccination more effective.

There is also a better metabolism of the less positive components of vaccines, in particular ethylmercury. Because of the prebiotic effect of breastfeeding, better gut flora can also protect against other negative effects of vaccinations and improves the immune response.

Breastfeeding burns calories.

Exclusive breastfeeding burns approximately 500 additional calories for the mother per day. It is thought that the fat stores from the thighs are what are used for this source first, however not all mothers notice a dramatic difference in their body shape or weight from breastfeeding.

Your nutritional requirements while breastfeeding.

Just as you did while you were pregnant, it’s important to make sure that you’re eating well so that you look after both yourself and baby. Even women (and men) who are formula feeding their baby need to look after themselves, as it’s very important for parents to take care of their health.

Breastfeeding mothers who aren’t able to access quality food can still provide excellent breastmilk to their babies, however it is often depleting their own nutritional reserves, which can result in fatigue, mood swings, hormonal imbalances, and also reduces the nutrient stores for future babes (which can be built back up, but may be an issue if the mother conceives again quickly).

The nutritional composition of breastmilk

Breastmilk is largely made up of carbohydrates in the form of lactose. It also contains a significant amount of fats and protein. It is the carbohydrates within the breastmilk that provide some of it’s wonderful benefits in boosting babies immune system, these are the prebiotic, the fuel which feeds the good bacteria in babies digestive tract. The growth of this bacteria is vital for their immune health in particular, but has a big role in almost every other facet of health including digestion, metabolism and impacts on future mental and hormonal health.

When infant formula was first created in the early 19^th century scientists worked hard to make it as close as possible to the composition of breast milk, however babies were not thriving on it. Over time it was discovered that the key to this different was the prebiotics, in particular the oligo-saccharides (of which breast milk contains >200 different forms), and various forms of prebiotics are now often added to many brands of infant formulas in the attempt to provide this benefit. Unfortunately the ability to replicate this diversity of prebiotics is still lacking and so there is still a discrepancy between the gut flora of breast fed and infant fed formulas (but much less so than in the past before the addition of prebiotics to formula).

There is a small amount of protein in breast milk, and a substantial amount of fat, which makes it very energy dense. The protein content increases as the child ages, and is often made up of more specific immune boosting proteins.

Our breasts cleverly change the composition of breast milk over various stages of babies life.

Initially we produce colostrum, which is much lower in the carbohydrates but richer in the protein and fat to boost immune health.

After the placenta is passed our progesterone levels decrease dramatically, causing our milk to ‘come in’. As part of this, levels of lactose increase. (This is why things such as a retained placenta or use of progesterone medications i.e. the mini pill, can impact on the milk supply as progesterone essentially ‘holds the milk at bay’.)

Eventually the hormones have less of a role and our breasts will respond to ‘supply and demand’ – the more they are emptied they more they will fill. (Many women worry that their breasts feel softer during this time and that this means their supply is dropping – don’t worry, for most women it means your breasts are actually getting smarter at feeding).

If you are still breastfeeding your child into their second year there is an increase of protein (specially the immunoglobulins), which means that while your toddler is getting less milk quantity they are getting just as much of the immune boosting properties.

The milk will often change in composition during a feed as well, and the more the breast is drained the higher the fat content.

Your Diet and Breastmilk

As a general rule your breasts will keep the composition of breastmilk the same regardless of diet, for as long as possible (the repercussions of a bad diet fall onto the mother more so than the baby). But there are ways that your diet can impact on breast milk.

I see many mothers who cause themselves a great deal of stress about the potential of their diet harming baby, and I feel that it is important to remember that even with a sub-par diet, you are providing a wondrous array of benefits with breast milk. But if possible, eating well will provide many additional benefits to mother and baby.

Things that your diet CANNOT change

Lactose content

Your breasts will carefully regulate the amount of lactose in the milk and if you have been told that your baby many be lactose intolerant (an unfortunately common and incorrect piece of advice) your breasts will maintain lactose levels regardless. Lactose overload is more commonly the issue, rather than lactose overload, and this is likely due to insufficient drainage of the breast.

Things that your diet CAN change

The quality of the fat.

The omega fatty acid balance of your diet will have an impact on the milk, with women who consume more DHA have higher levels in the breastmilk. Women who have more DHA in the third trimester of pregnancy have higher fat levels in their breastmilk later on. For women who are vegan or do not consume omega fatty acids it may be worth considering to take a DHA supplement, as this is an important nutrient for brain and nervous system health, however dietary sources are better utilised than supplements.

Trans fats, which are predominately from junk food can also pass into breastmilk, so avoiding junk food is advisable.

To ensure you’ve got plenty of good fat, try to consume 2-3 serves of low mercury seafood per week, such as small fish like sardines. Vegan mothers may choose to supplement with algal DHA, (they may also benefit from supplementing with zinc, vitamin B12 and choline).

These micronutrients

Vitamin A, C and E, and B vitamins (except folate), Iodine, Selenium, B12, Vitamin D and Choline

Nutrients not in this list are still important for you, but your breast will closely regulate levels of regardless of intake.

Intolerance reactions

Some foods may potentially cause a reaction to baby. The protein within dairy, wheat and soy, chilli, and some cruciferous vegetables are common examples. I have provided a list of these foods here.

If you suspect that baby is intolerant to a food you are eating try eliminating one food at a time and then rechallenging. It is important to do this as thoroughly as possible tog et the best results. I don’t recommend taking a lot of foods out of your diet at once while breastfeeding as it is a time of increased energy requirements and you are often struggling to prepare good food at the best of times, so do it slowly and gradually. Speak to a health care practitioner for guidance if you’re struggling.

Medications and breastfeeding

Have you ever been told that you need to stop breastfeeding due to medication use?

There is a large difference in what medications are safe during pregnancy and breastfeeding, and some people are unfortunately told to stop breastfeeding when this might not be necessary, or decide by themselves to “pump and dump”. Doing this unnecessarily can reduce the amount of amazing breastmilk that your baby gets, and is also very stressful, and hard work, for the mother.

There can also be natural medicines that may be safe and effective as an alternative whilst breastfeeding, talk to your natural therapist about this if this is something you might consider.

Some things which aren’t so great about breastfeeding

Of course there are some downsides. I don’t believe they outweigh out the benefits, however I feel that in fairness I should mention them, mostly just so that other mother’s don’t feel like they’re alone if they experience these things too.

• It can hurt. Breastfeeding in the early days can be painful while your nipples get used to the process. If baby has a poor latch (perhaps due to tongue tie or an incorrect technique) this can also cause pain, contributing to nipple damage, which lengthens the duration of pain. If baby does not take enough nipple into their mouth it can rub against the hard palette, and this can really hurt. It is important to establish good technique from the start to reduce this, and getting consistent advice from a lactation consultant is a great way to do this.
• Breasts can leak. Oh boy, can they. The amount of breast pads I went through was ridiculous, and I still don’t understand why there aren’t more pattern breastfeeding friendly shirts available (because solid colours show the stains so much more). Thankfully the leakage situation does settle down – for me it took about 8 months.
• You can get ‘over-touched’, where you feel like all you want to do is sit by yourself and have no-one touch you for a while. Newborns like to nurse a lot. And the more you feed them, the better your supply, and the more a baby is held and carried the more settled they are, so of course we indulge them. And as baby ages, they can get a bit handsy. Mothers who have continued to feed their toddlers are likely well aware of the ‘twiddling’ that toddlers love to do, which for many mothers can drive them a little crazy.
• Many mothers notice a significant lack of libido whilst breastfeeding, at least until their period returns. This can be combined with vaginal dryness due to the hormone changes involved, meaning that even if you do want to have sex it can potentially be painful.
• It can be stressful. There are so many doubts that breastfeeding mothers can experience – ‘is my baby receiving enough milk’, ‘is my milk good enough’, ‘did something I eat/drink affect my baby’ and this can cause a mother significant stress and worry. There are so many benefits to breastfeeding that it would be a real shame if a mother were to stop feeding unnecessarily, without getting quality advice from a lactation consultant first.
• It can be embarrassing. A newborn baby will have no concept of when or where is an appropriate place to feed, and so mothers often will feed their baby is situations that might be a little awkward. I remember the feeling of ‘everyone is looking at me’ from the early days of feeding that can be very off-putting for some Mums. I have realised in retrospect that nah, most people are just looking at your cute baby and anyone else that is looking at you with judgement can bugger off.
• Mastitis. This is an infection of a milk duct in the breast. It doesn’t happen to all mothers but for those who do experience it, it’s pretty damn awful. A blocked duct can lead to infection, resulting in fever, chills, pain and lethargy. The whole thing can be incredibly painful and unpleasant. Thankfully there are natural methods to prevent and/or treat it, so if you are prone to this, see a naturopath for support.
• Juggling work and breastfeeding can be difficult. While women are within their rights to ask for allowances in the workplace to express, this can be easier said than done. It is also not always easy to express enough milk to maintain supply and provide a good feed for baby. Many mothers can produce bountiful amounts of milk when their baby is feeding, but expressing produces little to none. Even if they do manage to express, the storage and handling of the expressed milk can be a nuisance.

Breastfeeding resources

Australian Breastfeeding Association

ABA provides a free 24 hour hotline to answer questions about breastfeeding issues or provide support. This service doesn’t require you to be a member.

There are regular talks held on various topics by local groups. You can attend 3 without joining as a member. They also hold playgroups and catchups occasionally.

I attended ABA meetings for the first year of feeding Ash until work commitments stopped me from going, and they were an enjoyable and valuable experience. You can find local groups by contacting ABA directly or searching on facebook.
1800 686 2 686 / 1800 mum 2 mum
http://www.breastfeeding.asn.au/

La Leche

Facebook: https://www.facebook.com/LLLSydney
Email: sydneylll@outlook.com
Website: http://www.llli.org

Find a lactation consultant

https://www.lcanz.org

www.ilca.org

Information on attachment:

Watch this video before baby is born:       

How to increase milk supply:

More links on breastfeeding attachment:

ABA – Attachment to the Breast

Biological Nurturing

Baby Led Attachment – How to Awaken your Babys Breastfeeding Instincts

Baby Led Attachment – Renee Kam

Some great resources to check medications:

LactMed: http://toxnet.nlm.nih.gov

Medications and Mothers Milk Online: http://www.medsmilk.com

The post The amazing benefits of breastfeeding appeared first on Alison Mitchell Naturopath.

Thrush – it’s something that most women have experienced at least once in their lives. Vaginal thrush is a fungal infection caused by an overgrowth of Candida, a type of yeast. Candida albicans is the most common species of the Candida family, and when it becomes overgrown this can be referred to as a Candida infection, a yeast infection, thrush, or Candidiasis.

Normally, Candida lives harmlessly within our digestive system, however if our immune system or gut flora is disrupted an overgrowth of the yeast can occur. For most people who experience an overgrowth it is only a temporary, albeit unpleasant occurrence. Genital thrush is more common in women than men, and oral thrush can occur in the sick, the very young and the very old. Systemic candida can occur in those with a very weak immune system.

Symptoms

The symptoms of a vaginal thrush infection can include:

• Inflammation (swelling and redness) of the affected skin
• A creamy or cottage cheese like discharge that may be white or slightly yellow, and can have no smell or a slightly yeasty smell.
• Itching and/or pain

Types of Candida

Candida albicans is the most common species that causes thrush, however there are some less common forms of Candida which are becoming more prevalent, most likely due to resistance to the commonly used forms of antifungal treatment. These types include Candida glabrata and Candida rugosa.

Why does it happen?

While it’s fairly common to get thrush after a course of antibiotics, if thrush sticks around for a long time or is recurrent, then there may be some other causes.

This article is not exhaustive, so if you’re dealing with a difficult to shift thrush issue then consult a practitioner who can help you get to the bottom of the problem.

Have you ever wondered why you get thrush more if you’re on the oral contraceptive pill? Or why pregnant women commonly experience thrush? Oestrogen levels have a lot to do with it – when oestrogen is consistently high and doesn’t fluctuate as it normally would in a monthly cycle it sets up an environment that Candida can grow in easily.

Pregnancy and being on the Pill aren’t the only instances where oestrogen levels are high – some women with hormonal imbalances, thyroid disorders, poor detoxification of oestrogen and exposure to xeno-oestrogens (chemicals which interact with oestrogen receptors) will also be more susceptible to thrush.

If the vaginal environment is disrupted, such as change in the normal vaginal pH (3.5-4.5) or the normal flora (mostly lactobacilli) this also sets up an environment where Candida can grow. Some things you may not know that affect this environment are spermicides, semen, douching, regular use of diaphragms, as well as getting your period (blood has a pH of 7.35-7.45).

If your immune system isn’t up to scratch this can also allow Candida to grow more readily. This can happen during periods of stress, as a result of poor diet and/or nutritional deficiencies such as vitamin c and zinc, use of steroid or immunosuppressant medications, after chronic infections (including glandular fever but most notably HIV), as well as during pregnancy (the immune system changes during pregnancy to allow a foreign body to exist within you – isn’t the body amazing?). People with diabetes are also more susceptible to yeast infections.

Does your diet affect thrush?

The “Anti-Candida” diet is well known method to keep thrush at bay. It involves strictly avoiding all sugar, refined carbohydrates and in some instances the recommendation is also to avoid yeast containing foods (such as breads and beer), and fermented foods.

When patients who have been following this diet seek my help, I observe that the diet often causes a lot of stress as any lapses in the condition can cause the person to blame themselves, attributing it to a ‘slip up’ in their diet.

I recommend keeping sugar and refined carbohydrates to a minimum for the majority of people, and you have most likely heard me prattle on about the importance of a whole food diet in the past as well, so it should come as no surprise that I would suggest to someone who is experiencing thrush to avoid sugar and refined carbohydrates (as much as possible), but in no instance would I recommend doing it to such a degree that it causes stress.

While I think the dietary component is important in dealing with thrush, it’s not the only factor. It is common for fluctuations of chronic Candida infections to occur (as it can be with most health conditions) so blaming yourself for poor adherence to a diet isn’t good for your happiness.

There have recently been challenges to the view that ingestion of yeast containing foods increases the incidence and severity of Candida. Theoretically, it may be that foods which contain yeast are often sources of simple and refined carbohydrates, which if over consumed can negatively affect the immune system and the balance of good and bad bacteria in the digestive system, which act to keep our normal levels of Candida in check.

Crowd Control

Most people are aware of the importance of ‘replacing’ the good bugs after a course of antibiotics to prevent thrush, but what you may not know is that just using a general probiotic may always not do the trick.

After taking a course of antibiotics, a lot of the friendly bacteria that exist in your digestive system are also killed and this can make room for opportunistic organisms such as Candida to grow. In other instances, bacteria such as Clostridium difficile can grow, the culprit for antibiotic associated diarrhea.

Taking probiotics during a course of antibiotics can help to keep the unfriendly bacteria from taking up too much space, but if Candida is a regular occurrence and needs to be treated directly there are some specific strains of probiotics which can be used.

The probiotic strains that have the best research behind their use in supporting vaginal health and reducing Candida are Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14. Probiotic capsules containing these species can be taken orally as well as occasionally inserted vaginally for best effect. For an over the counter option, I like Blackmores Women’s Flora Balance.

The therapeutic yeast Saccharomyces boulardii, commonly referred to as SB, can also be beneficial in the treatment of thrush.

Yoghurt, in particular Vaalia (because it contains the strain Lactobacillus rhamnosus LGG) when consumed regularly can help reduce the frequency of Candida infections.

Prebiotics are an important tool in keeping your gut flora happy – prebiotics are food for the good bacteria. I’ve written more detail about prebiotics here. Eating a diet rich in prebiotic foods will help with the crowd control, but if needed there are some prebiotic supplements which can be beneficial, such as lactulose. Taken in small doses this syrup can help to feed your good bacteria. Large doses can produce a laxative effect, so start small.

Are you sure it’s Candida?

I have had several patients seek my help for treatment of Candida, only to find that the reason they’re having such a hard time with it is because it’s not actually a Candida albicans infection. It’s definitely worthwhile getting a test from your doctor to confirm what is actually happening – it could be a more stubborn form of Candida such as Candida glabrata, or it could be a different condition which is causing similar symptoms such as lichen sclerosis, bacterial vaginosis, vulvodynia or genital herpes.

Related post: What to do when Thrush and BV don’t go away

Other treatments

If after tweaking your diet and using probiotics, chronic thrush is still a problem, then it may be worthwhile looking at some of the other treatment options available.

Boric acid has been shown to be a highly effective treatment for Candida, including the more stubborn form, Candida glabrata. It is something that can be prescribed by your doctor in the form of a vaginal suppository. Depending on how stubborn the Candida is, it may need to be used anywhere from 3 days to 4 months. The use of boric acid can disrupt the vaginal flora, so probiotic and prebiotic use alongside is a good idea.

Some more natural forms of topical treatment include the use of garlic or tea tree oil which have anti-microbial properties, however while they can be effective at killing Candida they are potentially irritating to the delicate vaginal and vulval tissues.

Herbs which producing soothing, healing effects such as Calendula can be used as a topical wash to help irritated and inflamed tissues. Herbs can be taken internally to support the immune system, and there are some herbs which can also be helpful in killing Candida.

Coconut oil can have a soothing effect topically and also has some anti-candida activity.

The New Zealand herb Horopito can also be helpful in killing Candida, both when taken internally and topically. Kolorex has a range of products containing Horopito but I especially like the Intimate Care cream as a way to reduce discomfort and irritation.

Prevention

These are a few tips to help keep thrush at bay.

• Wee after sex
• Wipe front to back
• Use condoms
• Don’t douche
• Don’t use soap down there
• Wear non synthetic underwear such as cotton or bamboo
• Keep blood sugar levels balanced with a low GI, wholefood diet
• Eat a probiotic rich diet
• Seek alternatives to antibiotics first, and limit use of antibiotics if possible (see a practitioner for help with this)

The post Thrush appeared first on Alison Mitchell Naturopath.

“The immune system present in the gut makes more immunological decisions in a day than the rest of the immune system does in a lifetime”.  (1)

If your immune system isn’t behaving itself properly, you might want to consider that your digestive system is the culprit.

Your digestive system has a special mucosal lining over the surface of your intestines, and the health of your gut flora (the complex, extremely important colony of bacteria within your digestive system, also known as the microbiome) has a huge amount of immune decisions to make on a daily basis – it has to deal with bacteria, viruses and food, and decide each time whether it is a friend or foe.

Setting up the gut bugs

The bacteria within your gut are established within the first 20 days of life.  If the bacterial colony does not set up adequately, babies can be immune compromised and can be more prone to immune imbalances later on in life, as well as increased inflammation which is largely controlled by our immune cells.

Frequent use of antibiotics can severely impact on the health of your digestive system.  In some cases, certain bacteria can never recover after they have been killed by antibiotics (2).

The gut reports to the immune system

There is a special type of cell within the digestive system called a dendritic cell.  This cell is responsible for determining whether our immune system should be on high alert or not.  Occasionally this cell will extend a little feeler (almost like a tentacle) and take a handful of whatever is in your digestive system to examine, to then report back to the rest of the immune system whether everything is okay or not.  This can explain why your diet can have an effect on allergic conditions such as hayfever and eczema, as well as autoimmune conditions (3).

Immune cells in the gut

There are also a lot of other players involved in the gut, such as Immunoglobulin A (sIgA) and certain T lymphocytes.  sIgA helps to protect the epithelial layer from being inhabited by bacteria and viruses.  This helpful immunoglobin is actually produced by lymphocytes (a type of white blood cell) which are actually created by Bifidobacteria (a good bacteria that exists mostly in the colon).  Unfortunately, Bifidobacteria are easily damaged, especially by antibiotics.

Enzymes do more than digest food

When you think about digestive enzymes, you’ll probably be thinking that they’re there to break down your food so it’s primed for absorbing.  They also have another important role to play, and that’s in breaking down substances that might be harmful to your immune system.  Due to poor eating habits, the secretion of enzymes is compromised in a large proportion of people.  Implementing habits such as chewing each mouthful more and taking time to enjoy and concentrate on your meal are helpful for stimulating the cephalic phase of digestion – where your brain tells the rest of the digestive system to get ready for food, and consequently more enzymes and acids are produced.

Fix your gut to improve your immunity

By now you are probably realizing that keeping your gut healthy is pretty dang important. In order to achieve this, there are a few strategies that can be implemented, all depending on how bad your gut and immune system is to begin with.

I highly recommend working with a practitioner in this, particularly if you are looking to assess and treat specific microbial imbalances, as it can be a complicated process that may require stool analysis, and some gut infections can take a long time to resolve so it’s helpful having the support of a practitioner.

Balance your gut flora: This process may need to start with a stool analysis to see if you’re lacking in certain beneficial bacteria, or whether you have a unfriendly bug that needs killing off. Depending on where your gut flora is at, you may need to look at using some herbal anti-microbial herbs or oils to kill off the unfriendly bugs, and also replacing the good guys with a probiotic supplement, as well as probiotic and prebiotic foods.

Repair the gut lining: There are plenty of options when it comes to gut healing. Things like slippery elm, the amino acid glutamine and glycine are my favorite tools for repairing the gut lining. Other options that can be helpful include Aloe Vera and Bone broths.

You also need ample supply of protein in your diet, as well as the mineral zinc.

Avoid irritating foods: This can be different for everyone, but some of the most common irritants for gut health include wheat, dairy and processed soy. As frustrating as it is, food intolerances can be developed to anything, so if you’re unsure what you’re intolerant or sensitive to it may be worthwhile completing an elimination diet or a food intolerance test.

Processed foods, sugar, alcohol and coffee can damage the gut lining as well so if gut healing is your goal it’s worthwhile keeping these foods out of the diet, or at least to a minimum.

Minimise stress: Interestingly the state of our gut and our mental health are interconnected (you can read more about this here) so it makes sense that if you are stressed, anxious or adrenally fatigued it is going to impair your gut healing journey.

Yep, stress affects everything in our body, and this includes stress of all forms. So even if your house isn’t on fire or something similarly dramatic, it doesn’t mean you’re not affected by stress. In this day and age there are a lot of pressures and expectations on people, everyone is usually in a rush and we’ve also got less support networks and rituals in place to help us deal with these stresses. On top of that, most people consume a diet that is less abundant in the nutrients that our bodies need to cope with stress, so it’s no wonder that stress has such as huge impact on our health and wellbeing.

Of course everyone deals with stress differently so the degree to which it affects your health will vary, but I recommend that everyone (regardless of whether you’re trying to heal your gut or not) incorporates stress management techniques into their day. This can include exercise, yoga, meditation, mental stillness, leisure time, time spent with friends or family, or journaling.

Works Cited

The post The gut and your immune system appeared first on Alison Mitchell Naturopath.