¿Qué tiene la leche materna?

Traducción: Laura Nafissi, Vanina Schoeijett, Verónica Garea, IBCLC.
Revisión: Delfina Medeot
babybluependleton.jpgPuede ser que hayas escuchado a las mujeres de tu comunidad, quizá tu madre o tu abuela, hablando de amamantar a sus bebés. Mucha gente dice que amamantar es la “mejor” opción para todas las madres y que todas las madres deberían amamantar a sus bebés. ¿Te preguntaste alguna vez qué tiene la leche humana que la hace tan diferente de la fórmula? A diferencia de la fórmula tu leche es específica de la especie (hecha para los humanos) y brinda todos los nutrientes necesarios para que tu bebé crezca sana y fuerte.
La leche está compuesta de muchas partes. Están los elementos no-nutritivos, algunos tan pequeños que ni el mejor laboratorio los puede replicar. Estos componentes bioactivos ofrecen más que alimento: se ocupan de proteger el tracto urinario de tu bebé de infecciones y de mantener el intestino libre de bacterias nocivas y virus. Se especula que la razón por la que la leche de las madres tiene tantos anticuerpos y componente inmunológicos es que al nacer el sistema de defensa del bebé está muy inmaduro. El sistema inmunológico de tu hijo no madurará por completo hasta aproximadamente los cuatro años de edad, así que tu bebé nace relativamente indefenso y muy vulnerable a la enfermedad. Cuando amamantas proteges a tu bebé recubriendo sus intestinos y otras partes de su sistema digestivo inmaduro con proteínas protectoras, especializadas, y los factores inmunológicos de la leche materna hacen su trabajo también en el torrente sanguíneo. Tu leche es una barrera sólida contra gérmenes indeseables.
De acuerdo con el trabajo esclarecedor de la Dra Ann  Prentice en 1996, la lista de factores no-nutritivos incluye los siguientes elementos:
“Factores antimicrobiales: IgA  secretora, IgM, IgG, lactoferrina, lisozima, componente C#, leucócitos, factor Bifidus, lípidos y ácidos grasos, mucinas antivirales, GAGs, oligosacáridos.”
• La lactoferrina funciona como un transporte de hierro que también actúa como antimicrobiano, en particular contra la bacteria E.coli.
• La lisozima es bactericida (mata bacterias) y anti inflamatoria, y a medida que sigues amamantando, sus niveles aumentan paulatinamente y alcanzan su máximo  aproximadamente a los 6 meses. Amamanta a tu bebé durante el tiempo que quieras, tu leche lo protegerá de enfermedades mientras dure la lactancia
• sIgA, IgG e IgM trabajan brindando una extensión del sistema inmunológico de la madre hacia el bebé. Los anticuerpos de la madre se expresan en la leche para dar inmunidad (protección) a enfermedades específicas (antígenos) en el ambiente. Mantener a la madre y la bebé juntos después del nacimiento le da a la madre más oportunidades de desarrollar anticuerpos a cualquier bacteria en su entorno común. Si este tema te interesa especialmente, aquí tienen otro artículo sobre el sistema inmune entero-mamario (N de T: en inglés)
• Los ácidos grasos poliinsaturados de cadena larga, en particular DHA y AA, están asociados a la visión y al proceso cognitivo (pensamiento). El contenido de estos dos factores en la leche materna está vinculado con la dieta de la madre.
Otros ejemplos de componentes no-nutricionales de la leche materna en el artículo de Ann Prentice:
“Citokinas/antiinflamatorios: factor de necrosis tumoral, interleukinas, interferón-gama, prostaglandinas, antioxidantes, antitripsina α-1, antiquimotripsina α-1.
Hormonas: Inhibidor por realimentación (FIL), insulina, cortisol, prolactina, hormona tiroidea, corticoesteroides, ACTH, ocitocina, calcitonina, PHrP, eritropoyetina.
Enzimas digestivas/otros: esterasa BSS, lipasa BSS, amilasa, lipasa-lipoporteína, casomorfina, péptidos β, nucleótidos, ADN, ARN.”
Notarás que algunos de los componentes que hemos listado en este artículo están repetidos en más de una categoría: éstos sirven para más de un propósito. De hecho, algunos de estos factores tienen propósitos nutricionales luego de que han cumplido su trabajo antimicrobiano y han sido digeridos y absorbidos. Se relacionan unos con otros y con el cuerpo del bebé. En tanto la leche es digerida, más factores bioactivos son producidos y van teniendo nuevos efectos en el bebé. Puedes verlo como un círculo conectado entre la madre, el bebé y la leche.
Aquí van algunos detalles más sobre los principales componentes de la leche:
• La amilasa es una enzima necesaria para que el cuerpo descomponga los almidones que contienen los alimentos. Hace la digestión de la leche materna mucho más fácil para tu bebé.
• La lipasa es una enzima que el cuerpo necesita para descomponer las grasas y es también beneficiosa para tu bebé.
• El factor activador de plaquetas ayuda a acelerar cualquier necesidad de curar los pezones de la madre y también los intestinos del infante.
• La caseína dificulta que los microbios se peguen a las paredes mucosas del cuerpo de tu bebé. Esas paredes recubren la parte interna de los pulmones, del tracto digestivo, de la nariz. Todas las puertas de entrada están cubiertas por mucosa.
• Los oligosacáridos trabajan como los principales protectores contra los gérmenes. Poseen partes llamadas “ligadores” que engañan a las bacterias y virus haciéndoles creer que son partes del bebé; las bacterias y virus se adhieren a los oligosacáridos en su lugar y luego son eliminados del cuerpo del bebé.
Existen ciertas proteínas en la leche que ofrecen funciones de protección:
• -caseína
• Proteínas del suero: -lactoalbúmina: Alfa-lactoalbúmina Humana Hecha Letal para las Células Tumorales (HAMLET por sus siglas en Inglés), lactoferrina, inmunoglobulinas, lisozima y seroalbúmina.
Existen carbohidratos que proveen las calorías necesarias para el crecimiento de tu bebé:
• Lactosa
• Lacto-N-tetraosa
Existen grasas que sostienen el almacenamiento de calorías  para los picos de crecimiento y son esenciales para el desarrollo del cerebro y de la visión:
• Triglicéridos (la grasa primaria en la leche materna)
• Ácido oleico
• Ácido palmítico
• Ácido araquidónico (AA)
• Ácido docosahexaenoicoExisten células que hacen un trabajo especial manteniendo a tu bebé sano:
• Leucocitos (glóbulos blancos): fagocitos, basófilos, neutrófilos, eosinófilos y macrófagos
• Linfocitos: células T y B
• Células  madre
Hay  factores de crecimiento:
 Cortisol
 Insulínico
 Tiroxina
 Colecistoquinina
 Epidérmico
 Nervioso
 Transformante
 Taurina
 Poliaminas
* Las siguientes secciones de hormonas (vitaminas, minerales, transportadores, y citoquinas) estarían incompletas si no fuera por el trabajo de Cecily Hedberg, Sherri Hedberg, y Haley Rumble. Nos basamos en gran medida en su trabajo, y el crédito de esta sección es de ellas con adiciones nuestras de poca importancia.
Hay hormonas:
 Oxitocina
 Prolactina
 Factor inhibidor (FIL)
 Insulina
 Cortisol
 Corticoesteroides
 Hormona adrenocorticotrópica (ACTH)
 Calcitonina
 Hormona Paratiroidea (PHrP)
 Eritropoyetina
 Triyodotironina (T3)
 Hormona tiroidea estimulante (TSH)
 Hormona liberadora de tirotropina (TRH)
 Trombopoyetina
 Hormona liberadora de gonadotropina (GnRH)
 Hormona liberadora de la hormona de crecimiento (GRH)
 Leptina
 Grelina
Hay vitaminas:
 Vitamina A
 Vitamina C
 Vitamina B1
 Vitamina B2
 Vitamina D
 Vitamina E
 Vitamina K
 Betacarotenos
 Tocoferoles
 Tiamina
 Riboflavina
 Niacina
 Ácido Fólico
 Ácido pantoténico
 Biotina
Los minerales:
 Calcio
 Fósforo
 Sodio
 Potasio
 Cloro
 Zinc
 Magnesio
 Hierro
 Selenio
 Colina
 Azufre
 Cromo
 Cobalto
 Flúor
Hay citocinas / elementos antiinflamatorios
 Antioxidantes
 α -1 antitripsina
 α -1 antiquimotripsina
 Interleukina-1β (IL-1β)
 IL-2
 IL-4
 IL-6
 IL-8
 IL-10
 Factor estimulante de colonias de granulocitos (G-CSF)
 Factor estimulante de colonias de macrófagos (M-CSF)
 Factor de crecimiento derivado de las plaquetas (PDGF)
 Factor de crecimiento endotelial vascular (VEGF)
 Factor de crecimiento de los hepatocitos -α (HGF-α)
 HGF-β
 Factor de necrosis tumoral-α
 Interferón-γ
 Factor de crecimiento epitelial (EGF)
 Factor de crecimiento transformante-α (TGF-α)
 TGF β1
 TGF-β2
 Factor de crecimiento insulínico-I (IGF-I)
 Factor de crecimiento insulínico- II
 Factor de crecimiento nervioso (NGF)
 Eritropoyetina
También hay transportadores:
 Lactoferrina
 Aglutinante de folato
 Aglutinante de cobalamina
 Aglutinante de IGF
 Aglutinante de tiroxina
 Aglutinante de corticosteroide
Hay muchas cosas buenas en la leche materna que aún se desconocen, y el tema sigue siendo explorado. Los efectos de la lactancia materna en tu bebé durarán hasta su vida adulta, y pueden influir en la salud de sus hijos, nietos y las generaciones posteriores. Incluso si estás fumando o bebes de vez en cuando, tu bebé todavía necesita tu leche. La próxima vez que alguien te diga que la fórmula es más fácil, puedes mostrarles este artículo, y podrán comparar los ingredientes en la parte posterior de una lata fórmula con esta lista. La lactancia materna es la opción natural, y amamantar a tu bebé resulta mejor para la salud de ambos.Referencias:
Prentice, A. (1996) Constituents of human milk,. Food and Nutrition Bulletin, (The United Nations University Press), 17(4)
Heslett, c., Hedberg, S. & Rumble, H. Breastmilk poster. Douglas College, new Westminster, BC, Canada
Riordan, J. & Wombach, K. (2010), Breastfeeding and Human Lactation, 4th edition. Jones and Barlett Publishers
Lucas, A., Gibbs, J. & Baum, J.D. (1977), What´s in breastmilk. Lancet, 8019:1011-2
Garofalo, R. (2010), Cytokines in human milk. Journal of Pediatrics. 152 (2 suppl): s36-40
Walker, a. (2010) Breastmilk as the gold standard of protective nutrients. Journal of Pediatrics, 152 (2 suppl): s3-7
Cregan, M.D. et al. (2007), Identification of nestin- positive putative mammary stem cells in human breastmilk. Cell Tissue Res. 329 (1): 129- 36
Lehti, K.K. (1989), Iron, folic acid and zinc intakes and status of low socio- economic pregnant and lactation amazonian women. Europian Journal of clinical Nutrition. 43 (8); 505 -13.
(c) 2011. Serena Meyer, IBCLC
Actualizado 16/07/2012

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We’re still here!

april-2011-238We apologize for our lack of posts these last few months. Our writing team is busy, busy, busy with family, school, and work. There never seem to be enough hours in the day to do all we would like and writing has unfortunately hit the bottom of the collective “to do” pile. Expect more posts from us near the holiday season (aka winter break). We have many exciting posts in the works, including some just for moms who need to express their milk. There will be guest posts, too!

In the meanwhile, please tell us what topics YOU would like to read about. We welcome your ideas (and perhaps even your guest post). Don’t forget to check us out on Twitter and Facebook. Use the quick navigation buttons on the right hand side of the page to take you there.

Thank you for your continued support of Native Mothering. We couldn’t do it without you!

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10 Ways Families Can Support Breastfeeding

You are welcoming a new baby to the family. Congratulations! Breastfeeding is one of the healthiest, most rewarding things a mom can do for her baby. It is only natural that you want to support the new mother in breastfeeding and to make it as easy as possible for her to succeed. Here are a few tips that you may find helpful along the way.

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1. Learn more about breastfeeding before the baby arrives. Reading books and articles from respected, evidence-based resources can help you gain a better understanding of how breastfeeding works and what to expect. Talking to other mothers about their breastfeeding experiences can also be a valuable way to learn.
2. Support her choice to breastfeed. Let her know you’ll do what you can to help her breastfeed as long as she desires. Don’t try to persuade her to offer bottles of breastmilk or formula when not medically indicated. Remember that there are many ways for family members to bond with the baby besides feeding.
3. Bring her water or her favorite beverage and a snack. Breastfeeding can make moms feel thirsty and hungry. New moms tend to care for their babies before themselves, and their own needs may go temporarily unmet without a little help. A refreshing drink of water in the middle of a marathon feeding can really make a new mom’s day!
4. Give her a break. After she breastfeeds her baby, offer to hold, rock, or carry the baby in a sling or front carrier while she rests (or showers, or goes for a walk around the block, or…). Assure Mom you will let her know when baby shows early signs of hunger.
5. Help her with baby care. Offer to change the baby’s diaper or bathe the baby while she takes care of her own personal needs.
6. Help with the chores. Ask Mom what she needs you to do or ask her to leave a list on the refrigerator. Laundry, vacuuming, sweeping, cooking, dishes, and grocery shopping are chores that most often top the “to do” list.
7. If there are older children, read to them, play with them, or take them out for the afternoon. The one-on-one time will be special for them, and Mom will appreciate the time to bond with her new baby.
8. Entertain house guests and enable Mom to have a quiet space alone with the new baby. During the early weeks it is common for babies to spend a lot of time breastfeeding. Mom will still be healing after birth, and entertaining for long periods of time may be tiresome. She may even feel uncomfortable breastfeeding in front of certain people. Entertaining guests can help take the pressure off of Mom to be sociable and allow her time and space to rest and bond with her baby.
9. Help her deal with criticism about breastfeeding. Remind her of all things she is doing right. Provide her with unbiased, evidence-based information that will help her overcome the criticism (for example, if she is being criticized for not supplementing remind her of how to tell her baby is getting enough milk). If necessary, step in and speak for Mom in a good way.
10. Tell her you’re proud of her for breastfeeding. Your encouragement and support could be the difference between her continuing with breastfeeding as long as she plans to or stopping before she is ready. You are an important part of her success!

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Emily and Zora

Emily and Zora_breastfeeding

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10 Tips for Breastfeeding in Public–With Confidence!

New mothers need to be out and about with their babies and often have lots of questions about breastfeeding away from home. Here are some easy tips to help you breastfeed fearlessly anywhere.

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image used with permission–do not copy

1. Attend a breastfeeding support group or meet-up and see how other moms are breastfeeding confidently in public. Confidence is contagious!

2. Practice makes perfect! Practice your breastfeeding technique at home in front of a mirror or with a trusted friend or family member who can tell you what they see from angles that you can’t see. Maintaining the level of modesty that you desire gets easier with trial and experience.

3. Wear a bra that allows easy access with one hand. Being able to hold your baby and access your breast with one hand makes latching on a virtually seamless move.

4. Is latching on the most awkward part for you? Try leaving the room or turning your back while your baby latches on. When baby is nursing comfortably, return to what you were doing as if nothing happened. Smooth.

5. In a restaurant, sit with your back to the crowd. No one is likely to notice your quietly breastfeeding baby from behind. A roomy booth provides the most comfort and privacy.

6. A baby cradled close in mom’s arms looks like a sleeping baby. Most bystanders won’t even notice you’re breastfeeding. See someone looking your direction? Make eye contact and smile!

7. Pull your shirt up from the bottom rather than pulling your breast out over the top of your shirt. Wearing a shirt that it is a little loose will give you the most coverage all around.

8. Looking for more coverage? Wear clothes or undergarments (such as nursing camisoles) that are designed for breastfeeding moms. They offer strategically-placed access holes that allow you to breastfeed while remaining comfortably covered whether you want complete modesty or just to cover your post-pregnancy tummy. For an inexpensive alternative, cut slits into a regular tank top or camisole and wear it under any shirt you already own.

9. Breastfeed while carrying your baby in a sling, wrap, or other soft carrier. The fabric of the carrier will help keep you covered. Bonus: You can walk, do chores, or a million and one other things while you are wearing your baby.

10. Still feeling shy about breastfeeding in public?  A nursing cover or blanket thrown across your shoulder and your baby offers full coverage and can provide for complete modesty.


Remember: Anything that helps you feel comfortable and confident while breastfeeding in public is right for you. There are no rules! Do what works best for you and your baby and makes breastfeeding an enjoyable part of your everyday life.

 

 

 

 

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Frequently Asked Questions About Breastfeeding and Diet

Many mothers wonder how their diets may affect the quantity and quality of their breastmilk. With so much emphasis in both the popular media and the medical literature on the effects of processed foods, sugar, and artificial ingredients on health, women who have difficulty eating a more natural diet may worry that breastfeeding might not always be the safest or most nutritious choice. Maybe you have heard that you should change your diet while you are breastfeeding, or perhaps you have been told that it’s fine to eat “whatever you want.” Here are some answers to these questions. Please contact us via the website or Facebook page if your question does not appear here.

31st Annual Thunderbird Mid-summer Native American Festival

I have heard that the way we eat today puts us at higher risk for illnesses like diabetes and heart disease. What about my baby’s health? Is my milk still best for him?

Yes! Even if your diet contains more processed and convenience foods than is best for your health, your milk will still be the best available food for your baby.

It is clear from the research that breastfeeding is the single best way for a mother to safeguard her infant’s health: babies not breastfed have higher risk of diabetes, diarrhea, ear infections, rashes, allergies, childhood cancer, respiratory illnesses, asthma, and SIDS, (Bartick & Reinhold, 2010; Stuebe, 2009), and the protection offered by breastfeeding does not depend on the mother’s diet.

Formula, whether milk-based or soy-based, factory-produced or homemade, can never provide your baby with all the specific nutrients and immune factors essential for his health. Your milk changes composition in order to best meet your baby’s needs as he grows. Also, breastmilk contains immune factors to protect him against illness–no formula offers immune protection. While most infants can survive and grow on formula, some ingredients are associated with health problems. The proteins in formula are different from the proteins in your milk and are associated with increased risk for certain diseases like juvenile diabetes (Virtanen et al., 1994; Kolb & Wassmuth, 2000) and colitis (Host, 1994; Savilahti et al., 2010). The iron in formula is less available and harder to absorb than the iron in your milk, and it may cause undesirable changes in your baby’s gut bacteria (Balmer & Wharton, 1989; Mevissen-Verhage et al., 1985). When considering how to feed your baby, remember that milk from your breast is always fresh. Formulas, whether homemade or store-bought, carry the additional risk of contamination with disease-causing bacteria from processing facilities (Power et al., 2013) or farm animals.

Research has found little significant variation between the milks of mothers with different diets. For example the amounts and types of fats may vary (Cruz-Hernandez et al., 2013; Innis & Kuhnlein, 1988), but no diet has been found to result in breastmilk that is inferior to formula or inadequate to meet an infant’s needs. Humans are “omnivores” and have the ability to both stay healthy and produce high-quality breastmilk on diets that vary widely in both composition and quantity of foods. When your body makes milk, it produces the nutrients, non-nutritive elements, and immune factors your baby needs in the proper quantities (Hassiotou et al., 2013).

Even if a formula were just as nutritious as breastmilk, breastfeeding is about so much more than the milk. It is a special relationship that is uniquely yours–something only you can do for your baby. Breastfeeding keeps your baby safe and warm, promotes normal sleep patterns, allows normal brain development, and develops his immune system (including his thymus gland). The breastfeeding relationship cannot be bottled, and breastfeeding is best for your health, too.

My diet is limited to my budget, and I don’t always have access to fresh fruits and vegetables–is my milk still nutritious?

Absolutely! Your milk is always the most nutritious food for your baby, even if your diet is not as varied and nutritious as recommended by health experts. Information about nutrition during pregnancy and breastfeeding may not take into account the limitations that many mothers face: lack of food, limited access to fresh foods, and limited or no access to common food-preparation needs such as running water, stove, refrigerator, or microwave. That said, eating as wisely as possible is best for your health and that of your children. Cutting back on fast and convenience foods and increasing your intake of fruits and vegetables and other whole foods will be better for your health, especially for reducing the risk of diabetes and heart disease. If you are in a situation that limits the food you have available, here are some ideas:

  • Buy fresh fruits and vegetables from a local fruit stand, farmers’ market, or Community Supported Agriculture (CSA) organization. They are usually cheaper than your local grocery store (especially if you live where convenience stores are your main shopping centers or where fruits and vegetables are usually trucked or flown in). Many accept SNAP benefits or WIC cash value checks. You may even be able to barter for fresh food this way simply by asking.
  • Keep dry ingredients like beans, rice, and pasta on hand: they make inexpensive bases for healthy meals.

  • Pre-packaged “health foods” like granola bars and cereals are costly and often have unnecessary added sugar. Making your own snacks from bulk ingredients like nuts, oatmeal, cornmeal, and whole-grain flour costs less than buying commercial snacks and are healthier because you control the ingredients.

  • Build your weekly or daily menu around what is on sale at your local grocery store. Shop for markdowns in the meat, produce, dairy, and bakery sections. These sales may save you 30-50% of the cost.

  • If you do most of your shopping at convenience stores, choose more healthful options like mixed nuts instead of potato chips.

  • If you use a food bank, don’t be afraid to ask specifically for healthy foods.

  • Remember that WIC and SNAP both allow produce purchases and make special allowances for families who have limited resources for cooking and food storage (for example, SNAP would allow you to purchase hot foods from a grocery store). Both agencies provide nutritional counseling, as well as food-preparation classes.

  • Your tribal or community wellness agency may provide nutritional counseling and special assistance in buying wholesome foods.

Here is one tribe’s answer to the problem of where to find fresh, affordable, local food: Oneida Community Integrated Food Systems

Some families find getting enough food to feed a family especially difficult. If you need assistance in finding food, please contact these helpful agencies:

 WIC (Women, Infants, and Children)

USA Federal food programs

Community food programs

Do I need to take a multivitamin to breastfeed?

Your body will use your stores of vitamins and minerals to ensure that your milk has exactly what your baby needs. Finishing the prescribed prenatal vitamin is usually enough to meet your own health requirements (Nutrition During Lactation, 1991). However, if your diet is high in processed foods, you eat fewer than 2700 calories per day, you avoid or limit certain food groups, or you have any health conditions that may limit how well your body absorbs nutrients or vitamins, nutrition counseling is recommended. Increasing your intake of certain foods and food groups is likely to provide a greater benefit than a supplement (Lawrence & Lawrence, 2011).

Even though you are able to produce high-quality breastmilk on a diet deficient in some nutrients, when you take in more vitamins and minerals through supplements and dietary changes, some of them also increase in your milk. If you take in more of vitamins A, D, B1, B2, B3, B6, or B12, your milk will have more of these vitamins as well. Fatty acid and iodine supplements may also influence quantities in your milk. (Valentine & Wagner, 2012).

If you are concerned that you or your baby may not be getting enough of all the vitamins you need, talk to your health-care provider. She may recommend simple testing or vitamin supplements. Breastfeeding is still best in these situations.

Do I have to eat certain foods or take supplements in order to produce enough milk?

 No. However, in some cultures it is customary to eat certain foods after the baby is born in order to promote milk production. Interestingly, many of these customary “mother foods” are packed with B vitamins, iron, calcium, protein, antioxidants, and anti-inflammatory properties, which may help support lactation nutritionally. If your traditions recommend eating (or avoiding) certain foods after birth, you should feel encouraged to do so.

Sometimes mothers are told they need to take a certain herb, drink a commercial herbal tea, drink cow’s milk, eat oatmeal or oatmeal-based “lactation cookies”, or even drink one dark beer each night in order to produce enough milk. While most of the recommendations aren’t harmful, and some may even be beneficial from a nutritional standpoint, they aren’t likely to make or break your breastfeeding relationship. Milk production is controlled inside the breast, by the frequency and thoroughness of milk-removal. The best way to encourage your body to make all the milk your baby needs is to feed on demand.

 Please keep in mind that alcohol consumption should be limited while you are breastfeeding. Always talk to your health-care provider or traditional healer before taking any herbs or over the counter medications. If you are concerned about your milk production, talk to an IBCLC or other breastfeeding support specialist.

 Can I diet while breastfeeding?

 Reducing the number of calories you eat daily and avoiding desserts, sodas, chips, and other foods with “empty calories” will not cause your milk to lose nutritional value. Many mothers find that breastfeeding alone helps them lose the extra weight they gained during pregnancy. It is possible to lose additional weight through restricting calories while you are breastfeeding, but the current recommendation is that the diet not include fewer than 1800 calories per day (Lauwers & Swisher, 2011).

 Are there foods I should avoid while breastfeeding?

 The short answer is that there are no foods all mothers should avoid. Diets vary around the world, and so do the traditions of foods to eat or avoid while breastfeeding. Many experts recommend avoiding fish that are known to have high levels of mercury (tuna, swordfish, and others), foods like margarine that are high in trans fats, and foods that are common allergens like peanuts. However, the research on these topics is incomplete. Discuss any dietary restrictions you would like to make with your health care provider or IBCLC. It should be noted that milk-based formulas, including homemade formulas, contain trans fats (Mozaffarian et al., 2006; Satchithadandam et al., 2002; Ratnayake et al., 1997), and most formulas contain common allergens such as animal milk or soy proteins.

 I have heard that certain diets will make my milk much healthier for my baby. Should I still breastfeed if I don’t eat a traditional or natural-food diet?

 Definitely. While a diet rich in fresh fruits and vegetables and low in processed foods is an ideal choice for your and your family’s health, breastfeeding always provides the best possible nutrition for your baby, even if your diet is not as wholesome as it should be. A mother eating a typical American diet and a mother eating a whole-food diet may have some different types of fat and slight differences in the levels of some vitamins in breast milk, but this variation is not as great as the nutritional difference between broccoli and candy. Your milk is still best, even if your diet is not.

I have heard that what I eat and drink goes into my milk–so if I eat french fries or drink soda, my baby gets the same fat and sugar through my milk?

 The old adage “you are what you eat” sounds catchy, but it is not helpful to breastfeeding mothers wondering if their milk is nutritious enough for their babies. Most of the nutrients found in your milk do not pass directly from your food to your blood to your milk–the process your body uses to produce breastmilk is much more complex. Many substances in the foods you eat are never found in your milk, while others can pass through. However, no matter how much junk food you eat, there is no evidence to support the idea that your milk is not the best available food for your baby.

 If my milk is still the best choice for my baby, why should I bother to try to make healthier food choices for myself?

 Your health is important, too! Breastfeeding helps protect you from diseases like breast cancer (Bartick & Reinhold, 2010; Stuebe, 2009), but your diet is also crucial in maintaining your health. Also, your baby will not be breastfeeding forever–he will soon learn to eat table foods, and he will want the same foods he sees on your plate. Now is the perfect time to begin making those changes in your diet which will help your baby learn to eat healthily, and the foods you eat will flavor your milk so he will grow accustomed to their tastes. Some first table foods for your baby are also great for you: sweet potatoes, avocados, bananas, beans, lean meats, and oatmeal are simple to prepare, easily mashed with a fork, and very nutritious. Fresh ingredients cost less than prepared baby foods and cereals, and they are free of added sugar and other unnecessary ingredients.

 All children benefit when their parents are healthy, and good health will allow you to have the energy and positive mood you need to meet the intense demands of motherhood.

 Is it true that you shouldn’t eat “gassy” foods like broccoli, onions, and beans while breastfeeding?

 Don’t worry! These vegetables are great choices for breastfeeding mothers. Even if they give you gas, the substances in them that can cause gas do not get into your milk.

 I am diabetic. If my blood sugar is high, will my milk have too much sugar?

 No–your body produces the main sugar in your milk, lactose, in the breast, and the amount of sugars in your milk remain fairly constant no matter how high the level of glucose in your blood may be (Dewey et al., 1991). Many mothers find that breastfeeding keeps their blood sugar lower than it was before they were breastfeeding, but if your blood sugar does get too high, do not worry about your milk–glucose only makes up a tiny percentage of all the sugars in breastmilk (Butte et al., 1987). However, if you have uncontrolled diabetes, you should seek treatment from your health-care provider as soon as possible for the sake of your own health.

 You may be happy to know that breastfeeding reduces the risk of your child’s developing both obesity and diabetes.

 I keep hearing conflicting advice about breastfeeding, and I am so confused! Where can I find the most accurate information?

 Breastfeeding is a hot topic in the media right now, and many people are eager to voice their opinions. Many mothers are unsure where to turn for answers. Fortunately, there are trained professionals who have access to high-quality research and can help. Find them here:

Guide to breastfeeding support professionals

Find a lactation consultant

References

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Bartick, M., & Reinhold, A. (2010). The Burden of Suboptimal Breastfeeding in the United States: A Pediatric Cost Analysis. Pediatrics, Published online April 5, 2010. (doi: 10.1542/peds.2009-1616)

Butte, N. F., Garza, C., Burr, R., Goldman, A. S., Kennedy, K., & Kitzmiller, J. L. (1987). Milk composition of insulin-dependent diabetic women. J Pediatr Gastroenterol Nutr., 6 (6), 936-41.

Cruz-Hernandez, C., Goeuriot, S., Guiffrida, F., Thakkar, S. K., & Destaillats, F. (2013). Direct quantification of fatty acids in human milk by gas chromatography. J Chromatogr A. 1284,174-9. (doi: 10.1016/j.chroma.2013.01.094).

Dewey, K. G., Heinig, M. J., Nommsen, L. M., & Lonnerdal, B. (1991). Maternal Versus Infant Factors Related to Breast Milk Intake and Residual Milk Volume: The DARLING Study. Pediatrics, 87(6), 829 -837.

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 Lauwers, J. & Swisher, A. (2011) Maternal health and nutrition. In Counseling the Nursing Mother (5th ed., p. 171). Mississauga, Ontario, Canada: Jones and Bartlett.

 Lawrence, R. A. & Lawrence, R. A. (2011). Breastfeeding: A Guide for the Medical Profession, 7th Edition. Elsevior. Maryland Heights, MO.

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Power, K. A., Yan, Q., Fox, E. M., Cooney, S., & Fanning, S. (2013). Genome Sequence of Cronobacter sakazakii SP291, a Persistent Thermotolerant Isolate Derived from a Factory Producing Powdered Infant Formula. Genome Announc 1(2), e0008213. doi:10.1128/genomeA.00082-13

Ratnayake, W. M., Chardigny, J. M., Wolff, R. L., Bayard, C. C., Sebedio, J. L., & Martine, L. (1997).  Essential fatty acids and their trans geometrical isomers in powdered and liquid infant formulas sold in Canada. J Pediatr Gadtroenterol Nutr., 25(4), 400-7.

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Whitney, E., Debruyne. L. K., Pinna, K. & Rolfes, S. R. (2011). The body’s energy budget. In Nutrition for Health and Health Care (4th ed., pp. 143-44). Belmont: Wadsworth, Cengage Learning.

© Adrienne Uphoff, IBCLC and Jolie Black Bear, IBCLC 2013–All Rights Reserved

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