Say 'cholesterol' and most people immediately think of blockages in arteries and heart disease, but like most things, it's not quite so simple as that, particularly when you're pregnant or breastfeeding.
Why some cholesterol is good
Cholesterol is one of the body's fats - or lipids - produced by the liver, and to make matters confusing there are two kinds; a 'good' and a 'bad' kind of cholesterol. The 'good' cholesterol is known as HDL and the 'bad' as LDL. LDL is what's responsible for cardiovascular disease by clogging up the arteries, whereas the HDL can actually help protect against cardiovascular disease by reducing cholesterol in the body's tissues and directing it back to the liver for processing.
After initially falling during the first trimester of pregnancy, your cholesterol levels are naturally higher than usual during the second two trimesters when general fat levels rise as hormones prompt the liver to increase production. As the level of fats rise, the ratio of HDL to LDL increases. Doctors believe that this is all as it should be as cholesterol helps to make cell membranes, some hormones, and vitamin D and so is needed for healthy fetal development. In fact, some studies have shown a link between low levels of maternal cholesterol in early pregnancy with serious malformation of the fetus' brain, limbs and central nervous system.
The raised HDL cholesterol level continues for breastfeeding mums and again, is thought to be beneficial to both mother and baby. While breastfed babies do, on average, have higher cholesterol levels of both HDL and LDL than formula fed babies, this cholesterol is important to a baby's healthy development and the ability to regulate cholesterol levels in later life: Studies have shown that breastfed babies have lower LDL levels than formula fed babies, and consequently a lower risk of heart disease.
Because of the role of cholesterol in healthy development and vitamin D absorption, cholesterol-blocking products aren't recommended for pregnant or breasfeeding mums. There are a variety of these cholesterol-blockers on the market, usually in dairy products like margarine or yoghurt, of which Benecol is probably the best known. All these products should contain warnings in small print for pregnant and lactating women.
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But still watch your dietary sources of cholesterol
However, the importance of cholesterol to general health and fetal development is not a green card to indulge your pregnant or breastfeeding self with a feast of fatty treats. Your liver naturally provides for your body's cholesterol needs, so there's no need to take in significant extra from meats and whole milk dairy products. Standard nutritional advice stands: make sure your dietary intake of cholesterol is moderate, and if you're upping your dairy or red meat intake to ensure you get the vitamins and minerals they provide, then opt for low-fat or lean versions of these foods.
What if I have already been diagnosed with a cholesterol problem?
If you have been told by your doctor that you have a cholesterol problem, with too low levels of the 'good' cholesterol and too high levels of the 'bad', then the only safe way to treat it through pregnancy and breastfeeding is through diet and exercise. This is because available anti-cholesterol drugs, known as statins, are not yet considered safe for use during pregnancy and could be transferred to the infant during feeding with damaging consequences.
Treatment through diet and exercise works in two ways. Through reducing your dietary intake of cholesterol you can lower your LDL, bad cholesterol, levels. Meanwhile exercise prompts the production of HDL to improve the ratio in your blood.