How do you proceed with a patient that is breastfeeding in terms of testing and treatment for gut issues? I would imagine running Cyrex Arrays 3, 4, and 10, if indicated, could be helpful because eliminating foods wouldn’t be contraindicated, but what about in the case of stool testing or SIBO? Is there a botanical protocol that’s safe while breastfeeding, and would it be more advantageous to run the test closer to when treatment can begin so you have a recent picture of what’s happening in the gut?

Dr. Amy Nett: If patients come to the clinic and they’re either pregnant or breastfeeding, I definitely have a conversation with them that I tend to be very conservative, and I really pretty much limit my treatment to diet and lifestyle modifications. There are not a lot of herbal supplements that I feel have been adequately tested in the setting of breastfeeding and nursing, and again, this is mostly because people don’t want to sign up for that sort of trial, of course. If there’s any question about whether or not something is either going to decrease your milk supply or potentially affect your baby, you just don’t even want to risk it, so we just don’t have the studies to know what’s safe and what’s not. In terms of treatment, I mostly limit it to diet and lifestyle.
Let’s say we’ve already done gut testing and then someone unexpectedly becomes pregnant, I might do something like probiotics and Lauricidin. Lauricidin is probably the one antimicrobial that we’re pretty comfortable using in pregnancy.