A New Mother's Guide to Breastfeeding/What role does my nutrition, lifestyle preferences, and medications have on breastfeeding?

= Breastfeeding - Health And Other Factors =

Breastfeeding is often an enjoyable and rewarding experience for mothers. A breastfeeding mother must continue to take care of her baby and herself, as she did during her pregnancy.

Mom's Nutrition
In general, lactating women should get nutrients from a well-balanced, varied diet, rather than from vitamin and mineral supplements. Eat generous amounts of fruits and vegetables, whole grain breads and cereals, calcium-rich dairy products, and protein-rich foods (meats, fish, and legumes). Make sure you are getting enough calories.

Mom's Foods
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.

Don't limit your diet excessively. Make sure you are getting enough 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. In these cultures, the mothers nurse their infants without problems.

It is possible that some highly allergenic foods (strawberries, peanuts) may be passed into breast milk, increasing the risk of a later food allergy in the baby. If there is a strong history of food allergies in your family, discuss this with your pediatrician.

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 and Pasta - Eat about 6 to 11 servings Fats, Oils, and Sweets - Go Easy!

This is just a general guideline, and you may need to eat more than this based on your size and activity level.

Drink Fluids
Nursing mothers need enough fluids to stay hydrated -- most experts recommend drinking enough fluids to satisfy thirst. Eight 8-ounce servings (64 ounces total) of fluid such as water, milk, juice, or soup is a good goal.

= Caffeine, Alcohol, and Smoking =

A nursing mother can safely consume caffeine in moderation, usually around 1 to 2 cups of coffee per day, without causing harm to her baby. Any more caffeine than that 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, it’s better not to drink alcohol and nurse your baby at the same time. It takes about 3 hours to clear the alcohol from a single drink (1 oz of liquor, 12 oz of beer or 5 oz of wine) from your system. So if you have a glass of wine with dinner, you can give your baby pumped milk for the next feeding and then you can resume breastfeeding safely. You don’t need to pump and dump your milk to get rid of the alcohol – it naturally clears from your breast milk as it’s cleared from your bloodstream.

If you smoke this is a great opportunity to stop for yourself and for your baby. Nicotine and other chemicals found in cigarettes are found in the breast milk of mothers that smoke. If you are unable to quit, try to limit the number of cigarettes as much as possible, change to a brand with low nicotine, and visit your doctor regularly. If you can’t quit, it’s worth knowing that one large study suggests moms who smoke and breastfeed have healthier babies than moms who pump and bottle feed.

= Lactation Amenorrhea =

Most women who breastfeed do not have normal menstrual periods in the first few months after their baby is born. This is called lactation amenorrhea. Although the risk of pregnancy is decreased for a woman who is breastfeeding and hasn’t had her period, pregnancy can occur during this time and should not be used for contraception as pregnancy is possible.

= Getting Pregnant =

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.

= Birth Control =

Birth control choice should be discussed with your health care provider. Barrier methods (condom, diaphragm), progesterone contraceptives (oral or injectable), and IUDs have all been shown to be safe and effective. Progesterone contraception is generally not started until the milk supply is established, usually at 4 weeks postpartum.

NOTE: It is recommended that a breastfeeding mother should not use any estrogen-containing birth control methods they can affect milk supply.

= Drugs In Human Milk =

Many medications (prescription and over-the-counter medications) will pass into the mother's milk. Most of them are safe, but check with your pediatrician before taking any medications. Do NOT stop taking any prescribed medication without speaking first to your doctor.

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.

= Other Factors =

Uncontrollable circumstances can alter your plans to breastfeed your new baby. How and what your baby eats may ultimately depend on the both your baby's physical condition and your health after birth. However, with help from a lactation consultant, most babies can breastfeed.

References

Davidson, M., London, M., &amp; Ladewig, P. (2008). Newborn Nutrition. In Maura Conner (Ed.), Olds' maternal-newborn nursing &amp; women's health across the lifespan (8th ed., Rev., pp. 890-927). Upper Saddle River, New Jersey: Pearson Education, Inc..

U.S. Department Of Agriculture Center for Nutrition Policy and Promotion (2008). What should I eat? Retrieved November 1, 2010, from http://www.mypyramid.gov/downloads/resource/pregnancyposter.pdf

U.S. Department Of Health And Human Services Office On Women's Health (2006, September). An easy guide to breastfeeding. Retrieved November 1, 2010, from http://purl.access.gpo.gov/GPO/LPS60089