A woman needs to
decide whether to breastfeed before her infant is born. Almost all women can
breastfeed; breast size is no barrier. Lactation, the pro-duction and
secretion of breast milk for the purpose of nourishing an infant, is
facilitated by an interplay of various hormones after delivery of the infant.
Oxytocin and prolactin instigate the lactation process. Prolactin is
responsible for milk production, and oxytocin is involved in milk ejection from
the breast. The infant’s sucking initiates the release of oxytocin, which
causes the ejec-tion of milk into the infant’s mouth. This is called the
let-down reflex. It is a supply-and-demand mechanism. The more an infant
nurses, the more milk the mother produces.
It will take 2 to 3
weeks to fully establish a feeding routine; therefore, it is recommended that no
supplemental feedings be given during this time. Human milk is formulated to
meet the nutrient needs of infants for the first 6 months of life. Iron content
in breast milk is very low, but it is very well absorbed; there-fore, no iron
supplement is needed for breastfed babies.
A lactation specialist is an expert on
breastfeeding and helps new mothers who may be having problems such as the baby
not latching on properly. This could cause the breast to become sore and could
be discouraging to first-timemothers. Since the best first food for babies is
breast milk, a lactation specialist can teach the proper techniques for
There are many
positive reasons to breastfeed. The primary benefit of breast milk is
nutritional. Breast milk contains just the right amount of lactose; water;
essential fatty acids; and amino acids for brain development, growth, and
di-gestion. No babies are allergic to their mother’s milk, although they may
have reactions to something their mother eats. Human milk contains at least 100
ingredients not found in formula.
Breastfed babies have
a lower incidence of ear infections, diarrhea, aller-gies, and hospital
admissions. Breastfed babies receive immunities from their mothers for the
diseases that the mother has had or has been exposed to. When a baby becomes
ill, the bacteria causing the illness is transmitted to the mother while the
baby is breastfeeding; the mother’s immune system will start making antibodies
for the baby.
Sucking at the breast
promotes good jaw development because it is harder work to get milk out of a
breast than a bottle, and the exercise strengthens the jaws and encourages the
growth of straight, healthy teeth. Breastfeeding facili-tates bonding between
mother and child. The skin-to-skin contact helps a baby feel safe, secure, and
loved. Pediatricians encourage mothers of premature ba-bies to hold their
babies on their chests—skin to skin. This is called “kangaroo care,” which has
been shown to soothe and calm a baby and help maintain the baby’s temperature.
Fathers too can participate in kangaroo care by placing their infants against
their bare chests.
Benefits for mother
include help in losing the pounds gained during pregnancy and stimulating the
uterus to contract to its original size. Resting is important for a new mother,
and breastfeeding gives her that opportunity. Breastfeeding is economical,
always the right temperature, and readily available—especially in the middle of
There is no need to
stop breastfeeding when returning to work; a breast pump can be used to express
milk for feedings when the mother is not available. Breast milk will keep 8 to
10 hours at room temperature (66°–72°F), 8 days in the refrigerator, 3 to 4 months
in the refrigerator freezer, and 12 months in a deep freezer. Previously frozen
milk must be used within 24 hours after defrosting in the refrigerator. Breast
milk should not be heated in the micro-wave or directly on the stove. Those
methods of heating breast milk will kill its immune-enhancing ability.
The mother’s calorie
requirement increases during lactation. The caloric requirement depends on the
amount of milk produced. Approximately 85 calories are required to produce 100
ml (31⁄3 ounces) of milk. During the first 6 months, average daily
milk production is 750 ml (25 ounces), and for this the mother requires
approximately an extra 640 calories a day. During the second 6 months, when the
baby begins to eat food in addition to breast milk, averagedaily milk
production slows to 600 ml (20 ounces), and the caloric requirement is reduced
to approximately 510 extra calories a day.
The Food and Nutrition
Board suggests an increase of 500 calories a day during lactation. This is less
than the actual need because it is assumed that some fat has been stored during
pregnancy and can be used for milk produc-tion. The precise number of calories
the mother needs depends on the size of the infant and its appetite and on the
size and activities of the mother. Each ounce of human milk contains 20
If the mother’s diet
contains insufficient calories the quantity of milk can be reduced, as seen in
many third world countries. Thus, lactation is not a good time to go on a
strict weight loss diet. There will be some natural weight loss caused by the
burning of the stored fat for milk production.
In general, most
nutrient requirements are increased during lactation. The amounts depend on the
age of the mother (see Table 11-2). Protein is of par-ticular importance
because it is estimated that 10 grams of protein are secreted in the milk each
MyPyramid will be
helpful in meal planning for the lactating mother. She should be sure to
include sufficient fruits and vegetables, especially those rich in vitamin C.
Extra fat-free milk will provide many of the additional nutrients and calories
required during lactation. Chips, sodas, candies, and desserts provide little
more than calories.
Vegetarians will need
to be especially careful to be sure they have suf-ficient calories, iron, zinc,
copper, protein, calcium, and vitamin D. A vitamin B12 supplement
can be prescribed for them.
It is important that
the nursing mother have sufficient fluids to replace those lost in the infant’s
milk. Water and real fruit juice are the best choices.
The mother should be
made aware that she must reduce her caloric in-take at the end of the nursing
period to avoid adding unwanted weight.
chemicals enter the mother’s milk, so it is essential that the mother check
with her obstetrician before using any medicines or nutritional supplements.
Caffeine can cause the infant to be irritable. Alcohol in excess, tobacco, and
illegal drugs can be very harmful. Both illegal drugs, such as marijuana or
heroin, and prescription medication, such as methadone and oxycodone, can cause
the baby to be excessively drowsy and to feed poorly. Stimulant drugs can cause
the baby to be irritable. The biggest concern is addiction of the mother and