Is there any known link between cholecystitis (gall bladder inflammation) and breastfeeding?

Question

I have helped new mothers with breastfeeding for over a decade now. I am often surprised how many end up with their gall bladder removed within the year following birth, many in the first few months. Many will say they had some irritation during pregnancy, while many also had no indications at all.

I am well educated on the mechanics of breastfeeding and it's biological components within the mother. It is well known that while breastfeeding, you release a linear peptide called CCk (cholecystekinin) that aids in digestion, and it floods your systems and is excreted in the milk. Among the actions CCK is triggering, a major one is the gall bladder to release bile.

In most cases I am seeing, the woman is under 30, in otherwise relatively good health, no history of being overweight, etc. I cannot seem to understand why so frequently I am seeing such young women with no major risk factors have this issue and am trying to understand it it's preventable.

I became interested when it happened to me. I had a doctor willing to help me look at life changes to support my gall bladder through diet to see if it could heal. I cannot say I will never need it out, I am at higher risk that I will, eventually. My current enzymes have been stable and fine for years and that I kept my gall bladder and had another baby without any flares. I had to follow a pretty strict diet for a year and then I was able to slowly add foods back in and my inflammation seemed to subside. I went back to a stricter diet after birth, due to my prior experience, but that was merely a precaution. I do not think that is possible in all cases, this was only after thorough exams and talks with my doctor that he felt it might be worth trying to heal it versus removal.

My thought is if we could know what puts a specific mother at risk, perhaps we could preemptively help her take measures to avoid the issue. It's considered a minor surgery generally, but no mother wants surgery when recovering from birth and trying to take care of a young baby, etc. I would love if I could find any link there as I have poked around trying to understand a potential link for at least 8 years now since I went through it. I have no anecdotal statistics on this, but I can tell you that in helping about 50 mothers a month, I am getting 4-5 in there asking me about the effects of this surgery on breastfeeding, every month. That seems very high to me for healthy women in this age range.

Answer 1

PREVENTATIVE AND RISK FACTORS FOR GALLSTONES

1. BREASTFEEDING:

Childbearing, breastfeeding, other reproductive factors and the subsequent risk of hospitalization for gallbladder disease (PubMed) (A prospective cohort study on 1.3 million women in England and Scotland from 1996-2001)

Hospitalization for gallbladder disease is common in middle-aged women. The risk increases the more children a woman has had, but decreases the longer she breastfeeds.

2. OBESITY:

The known risk factors for gallstones (and hence cholecystitis) are (PubMed Central):

• Obesity
• Rapid weight loss (>3.5 lbs/week; 0.5-2 lbs/week is considered low risk) due to a very low calorie diet (<800 Cal/day)

(Some women who have more children go through repeated cycles of obesity and rapid weight loss.)

3. GENETICS:

   • Genetic predisposition
   • Ethnicity (Hopkins Medicine):

The Pima Indians of Arizona have the highest prevalence of gallstones worldwide. Ninety percent of Pima women over the age of 65 have gallstone disease. Micmac Indians of Canada, Hispanics, and Mexican American women also have a higher prevalence of gallstone disease, as do both men and women in Norway and Chile.

4. DIET:

There is INSUFFICIENT EVIDENCE about high fat, high saturated fat or high cholesterol intake as risk factors, and fiber, vitamin C or unsaturated fat intake as preventative factors for gallstones (PubMed Central).