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Ask the Expert: What Foods and Drinks Should I Avoid When Breast-Feeding?

When women begin breast-feeding, many consider how their diets will affect the health of the baby. Advance practice registered nurse of Lactation Services of Connecticut, Lorna C. Aliperti, has been a lactation consultant for more than 10 years and shares answers to the most common diet questions for women who are breast-feeding.

How careful do you have to be about your diet to protect the health of your breastfed baby? The answer is—less than you might think. The quality of your diet has little influence on the milk you produce. Nonetheless, if you’re like most moms, you still worry about how what you eat affects your milk and your baby, and here are answers to some of the questions I hear most.    

Do some moms make milk that isn’t rich enough for their baby?
Breastmilk averages approximately 22 calories per ounce, and this is not influenced by diet. A baby’s weight gain is only dependent on the amount of breastmilk she drinks—not anything about mom’s diet or the quality of her milk.

What about vitamins?
Vitamin supplements are not necessary for breast-feeding mothers, although many women continue to take their prenatal vitamin while nursing. This is more for the mom’s health than the baby’s, as levels of most nutrients are maintained in mom’s milk at expense of her nutritional status if needed.

Some oil soluble vitamins can concentrate in mom’s milk and adversely affect her baby, so mega supplementation is not safe. Strict vegans, who eat no animal products, need to be sure they get adequate amounts of vitamin B12 from supplements or fortified foods. 

What foods help me make more milk?
Many cultures have foods to help milk supply that are traditionally given to new moms.  There is almost no research in this area, and one mom’s (maybe yours?) opinion is as good as the next. In the U.S., oatmeal is a popular recommendation. There is a recipe for lactation cookies which have oatmeal, brewer’s yeast and flaxseed as ingredients.   They certainly taste good and can’t hurt.

Will breast-feeding help me burn calories?
Breastfeeding does help moms lose weight — you use approximately 500 extra calories a day producing milk. Experts suggest waiting two months after giving birth to start dieting, to aim for weight loss of not more than a pound or two a week and not to go below 1500 to 1800 calories a day. Before the two-month mark, there’s never any harm in sticking to healthy foods — fruit instead of pastry, etc., which will lower your calorie intake.

What about alcohol and coffee?
Occasionally having wine, beer, or other alcoholic beverage is considered safe while you’re breast-feeding. Try to allow 2 to 3 hours for each drink to clear from your milk.  Nursing before you have a drink works out well. One to two cups of coffee a day are generally tolerated by most babies.

How much water should I drink?
Even though it is commonly believed that water intake influences milk production, research has failed to demonstrate this effect. Drink when you’re thirsty. Have a glass or bottle of water when you feed your baby. Many moms find they get thirsty once they’ve started nursing, so having it ready can help. Your urine is a good indicator of whether you’re getting enough fluid—it should be light colored.  If it’s dark or concentrated, you’re not drinking enough water.

My baby is so gassy. Is there something in my diet that could be causing her problems?
In general, there is no one food that causes problems for babies. And some gassiness is a fact of life in infancy. If your baby is gassier on some days more than others, it may help to know that it takes on average 4 to 6 hours for a food to show up in your milk, although there are individual variations of from 1 to 24 hours. Often it’s food you’ve eaten for dinner, since many of us tend to have a similar breakfast and lunch every day.

What about allergies and food sensitivities?
Food sensitivities do occur in breast-fed babies, particularly in families with a history of allergies. If a baby is sensitive to a food in the mother’s diet, there will usually be other symptoms other than gassiness—rash, congestion, red itchy eyes, sore bottom, reflux, or crying and discomfort after feeds. If it is a food that mom eats frequently, the symptoms will be ongoing.

Cow’s milk protein is the most researched and common food sensitivity in babies.  Complete elimination for 2 weeks or more may be needed to see improvement.  Other possibilities are soy, wheat (gluten), eggs and peanuts. A milk protein sensitivity is generally outgrown, and mom can usually reintroduce it later. Although babies do react to foods in their mother’s diets, it is less so than if they ingest it themselves—a baby may turn out to be allergic to milk when they are given formula even though their mom has been having it all along.

Smoking? Nobody suggests you smoke, but it is better to smoke and breast-feed than to smoke and formula feed. Breast-feeding is protective. It can help minimize the ill effects of some not so optimal health habits.

So, it is of course great if you eat a clean, whole foods, organic diet and drink nothing but pure filtered spring water—but if you slip and slide on your road to diet perfection, you’re still doing a wonderful thing for your baby by breast-feeding. Be proud of yourself.

Lorna C. Aliperti is a nurse practitioner and board certified lactation consultant who provides home visits to new mothers and babies with breast-feeding problems.
Prior to establishing her private practice, Lactation Services of Connecticut, LLC, she worked as a hospital perinatal nurse and as a nurse practitioner in the office of Dr. Christina Smillie, a pediatrician who specializes in breastfeeding medicine.
She has been a clinical instructor in the Columbia University Women’s Health Nurse Practitioner Program, and taught obstetrics and infant assessment there and at Fairfield University. She is the author of an ARCO test preparation book for practical nurses taking their NCLEX certification exam (in press since 2001), and published research on hospital breastfeeding management in the Journal of Perinatal Educcation. She has also written articles for several parenting publications. Lorna has four children and two grandchildren.

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