Breastfeeding - Health And Other Factors
Breastfeeding can be an enjoyable though challenging experience for mothers. A breastfeeding mother must continue to take care of her baby and herself, much like during her pregnancy.
The Committee on Nutritional Status During Pregnancy and Lactation at the National Academy of Sciences recommends that lactating women should be encouraged to obtain their nutrients from a well-balanced, varied diet rather than from vitamin-mineral supplements, and to drink enough fluids to alleviate thirst. The committee recommends generous amounts of fruits and vegetables, whole-grain breads and cereals, calcium-rich dairy products, and protein-rich foods such as meats, fish, and legumes. A well-balanced intake adequate in calories is suggested.
Breastfeeding Daily Food Guide
- Milk, Yogurt and Cheese - Eat at least 4 servings
- Meat, Poultry, Fish, Dry Beans, Eggs and Nuts - Eat at least 3 servings
- Vegetables - Eat at least 3 to 5 servings
- Fruits - Eat 2 to 4 servings; Choose two foods high in Vitamin C and Folic Acid, and one food high in Vitamin A
- Bread, Cereal, Rice & Pasta - Eat about 6 to 11 servings
- Fats, Oils, and Sweets - Go Easy!
This is just a general guideline, you may need to eat more than this based on your size and activity level.
Drinking To Satisfy Thirst
Nursing mothers need adequate fluid intake to stay healthy and hydrated. Most experts recommend encouraging drinking enough fluids to satisfy thirst. Eight, 8 ounce servings (64 ounces) of fluid such as water, milk, juice or soup is a good goal.
Breastfeeding mothers can safely eat any foods they like. Some foods may flavor the breast milk but babies rarely react to this. If your baby is fussy after you eat a certain food, try avoiding that food for a while, then try it again later to see if it is a problem. There is no need to limit your diet excessively, and you should maintain adequate nutrition for yourself and your baby. If you become overly concerned about foods or spices causing problems try to remember that entire countries and cultures have diets that contain foods that are extremely spicy, belong to the cruciferous family or are otherwise suggested by folklore to cause problems with nursing. In these countries the mothers nurse their infants without problems.
Caffeine And Alcohol
A nursing mother can safely consume moderate amounts of caffeine (equal to one to two cups of coffee per day) without causing harm to her baby. Excessive caffeine intake may cause agitation and difficulty sleeping for your baby. Since alcohol has been found in human milk and can interfere with the milk ejection reflex, alcohol consumption should be avoided while breastfeeding. An occasional drink, not exceeding two ounces of alcohol, may be safe, but you should consult your health care provider about the associated risks. Amounts exceeding two ounces should definitely be avoided.
Drugs In Human Milk
Most medications (prescription and over-the-counter medications) will pass into the mother's milk. Breastfeeding mothers should check with their physicians before taking any medications. The American Academy of Pediatrics' Committee on Drugs releases a periodic statement with a list of drugs and their compatibility with breastfeeding. Your obstetrician and pediatrician are both likely to be familiar with this publication and can answer your concerns about breastfeeding while taking medications.
In addition, Dr. Ruth Lawrence, MD, a world-renowned expert based in New York State, offers information on taking medications while breastfeeding through a hot line: (716) 275-0088.
Most breastfeeding women do not have normal menstrual periods (lactation amenorrhea). Although the risk of pregnancy is less for a woman experiencing lactation amenorrhea, pregnancy CAN occur during this time. Breastfeeding should not be used for contraception since failure is likely.
Oral contraceptive pills are safe and effective during breastfeeding. Most breastfeeding women may be able to start the pills 2 weeks after delivery. Although the estrogen in the combination (estrogen and progesterone) oral contraceptive pills may theoretically alter the breast milk content and even reduce milk supply, progesterone only ("mini-pill") oral contraceptive pills do not affect breastfeeding at all. Discuss your birth control options with your health care provider.
Women can get pregnant while they breastfeed, although some women will find that their menstrual periods don't return while they are nursing. This is due to hormonal changes, which suppress ovulation. However, it is IMPOSSIBLE to predict when ovulation and menstruation will resume. In fact, some women ovulate and conceive again before their period resumes.
Working Outside The Home
Mothers face unique obstacles in maintaining adequate milk supply once they return to work. With planning, commitment, and skilled use of a breast pump, breastfeeding mothers can maintain their milk supply and continue breastfeeding even after returning to work outside the home. A maternity leave of at least 6 weeks is recommended to establish your milk supply and breastfeeding skills before returning to work. An ideal work place would provide a private room for breastfeeding moms, which can be locked, has a comfortable chair, and an electric breast pump for use by all nursing mothers. However, many moms have had success using a hand breast-pump and a bathroom stall for privacy. An electric breast-pump is much faster and easier to use and can be rented.
Maintaining Your Milk Supply
Here are some tips which have worked well with many breastfeeding mothers who work an 8-hour day outside the home:
- Before you return to work, have a helper introduce a bottle to your baby, keeping the special experience of breastfeeding for yourself. Your baby may be confused by a bottle you offer, but will adapt easily with another familiar adult.
- Two weeks before you return to work, rent an efficient and comfortable breast pump and start building up a supply of frozen milk. If the day you are to return to work arrives, and you don't have a freezer full of breast milk, one bottle of formula fed to your baby is not the end of the world.
- After returning to work, express milk 2 or 3 times a day, every 2 to 3 hours to continue exclusively breastfeeding. If you can only get one break a day and you are unable to pump a full day's allotment in one pumping, a supplemental bottle of formula may be needed. Be aware however, if bottles of formula are given regularly, your milk supply will decrease accordingly.
- Nurse your baby immediately before leaving in the morning and immediately upon return from work in late afternoon. Many mothers learn that their babies nurse more frequently in the evenings on days they work. Feed on demand when you are with your baby.
- If possible, arrange to nurse your baby at lunch time.
- Try to breastfeed exclusively when you are with your baby (evenings, nighttime, weekends).
- Delegate and share household responsibilities with other members of the family.
There are a number of breast pumps on the market, with varying degrees of comfort, efficiency and cost. Most require time to develop the skills to use them. Pumps may be hand-operated (manual), battery, or electrically operated. The most dependable, efficient, and comfortable pumps are electric, have intermittent action (creates and releases suction automatically), and require minimal training. Your local lactation consultant can help you make realistic plans and guide you to a supportive breast pump depot.
Review Date: June 29, 2001
Reviewed By: Peter Chen, M.D., Obstetrics and Gynecology, University of
Pennsylvania School of Medicine. Review provided by VeriMed Healthcare
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