Lifestyle
and Breast Milk
The following information
is written for women who are breastfeeding, or are pregnant and considering
breastfeeding their baby.
A woman's lifestyle,
including diet and other behaviors, can have an affect on her breast milk, and
therefore on her baby. It's important for all nursing mothers to take care of
themselves so they can provide the best care to their babies. This includes
getting enough rest and proper nutrition so you have enough energy to take care of your baby and avoid
illness. Some women think that when they are sick, they should not breastfeed.
But, most common illnesses, such as colds, flu, or diarrhea, can't be passed
through breast milk. In fact, if a mother is sick, her breast milk will have
antibodies in it. These antibodies will help protect her baby from getting the
same sickness. Here are some other lifestyle issues that affect breast milk:
Viruses
A few viruses can pass through breast milk. HIV, the virus that causes AIDS, is one of them.
Women who are HIV positive should not breastfeed. Also, women with Hepatitis C
may be able to transmit the virus through breast milk, but it is not certain.
However, bleeding or cracked nipples on the breast of a woman withHepatitis
C puts a breastfeeding infant at higher risk for getting the virus.
Diet
Nutrition
Breastfeeding mothers who have generally good
diets produce healthy breast milk for their babies, even when they don't eat
well at times. But, chronically undernourished women who have had diets very
low in vitamins
and minerals, and low
stores in their bodies may produce milk that is lower than normal in some
vitamins, especially vitamins A, D, B6, or B12. These breastfeeding mothers can
help the vitamin levels in their milk return to normal by improving their diets
or by taking vitamin supplements. It is recommended that nursing mothers take
in about 2700 calories every day (about 500 calories more than a non-pregnant,
non-nursing woman).
Fluids
Many women think they have to drink a lot of fluids to have a good
milk supply. This is actually untrue. A nursing woman does, however, need to
drink enough fluids to stay well hydrated for her own health and strength to
give her baby the best care she can. Always drink when you are thirsty, which
is your body's signal that you need fluid. You can make it easy to remember to
get enough fluid, if you drink a glass of water or a nutritious beverage (milk
or juice) every time you feed your baby.
Caffeine
Many breastfeeding women wonder about how caffeine will affect their baby.
Results from studies show that, while excessive caffeine intake (more than five
5 ounce cups of coffee per day) can cause the baby to be fussy and not able to sleep well, moderate caffeine intake
(fewer than five 5 ounce cups) usually doesn't cause a problem for most breastfeeding
babies.
Allergies
Sometimes a baby may have a reaction to something the mother eats (like spicy
foods, foods that can cause gas, or dairy products). Symptoms of anallergy to something in the mother's
diet include diarrhea, rash,
fussiness, gas, dry skin, green stools with mucus, or the baby pulling up
his/her knees and screaming. This doesn't mean the baby is allergic to the
mother's milk. If the mother stops eating whatever is bothering her baby, the
problem usually goes away on its own.
Here's how to tell if something you are eating is upsetting your
baby:
Remember: It
takes about two to six hours for your body to digest and absorb the food you
eat and pass it into your breast milk.
·
So, if you eat dinner at 5:00 P.M., and
your baby shows the symptoms listed above around 9:00 P.M., think about what
you ate for dinner. To be sure if those foods are causing the problem, you will
have to eat them again and see if he/she has the same reaction.
·
If your baby seems very fussy, try keeping
a record of what you eat and drink.
·
Bring the record to your health care
provider to talk about a possible link between certain foods and your baby's
symptoms.
·
If you think a particular food is causing a
problem, stop eating it for a while and see if your baby reacts better. You can
always try later to introduce that food again into your diet in small amounts.
If your baby doesn't seem to react to it anymore, you could add more the next
time.
Sometimes
a baby can be born with a condition called primary lactase deficiency or with
galactosemia, in which they can't tolerate breast milk. This is because their
bodies can't break down lactose, a sugar found in the milk of humans and
animals. Symptoms include diarrhea and vomiting. Babies with severe
galactosemia may have liver problems, malnutrition, or mental retardation. Babies
with these conditions must be fed formula that comes from plants, such as soy
milk or a special galactose-free formula.
Nutrient by Nutrient Why Breast is Best
Milk is milk, right? Mammals make it
(humans are mammals) and babies drink it. There's more to the story than that.
Each species of mammal makes a unique kind of milk, which meets all the
nutritional requirements of its offspring at the beginning of life. Each
species' milk has specific qualities that insure the survival of the young in a
particular environment. This principle is known as the biological specificity
of milk. Mother seals, for example, make a high-fat milk because baby seals
need lots of body fat to survive in cold water. Since brain development is
crucial to the survival of humans, human milk provides nutrients for rapid
brain growth.
No matter what animal it comes from,
milk contains the basic nutritional elements of fats, proteins, carbohydrates,
vitamins, and minerals. Let's look at each one of these nutrients in human
milk, comparing them to the same nutrients in formula or cow milk, so you can
further appreciate how your milk is custom-made to meet the needs of your baby.
Unique nutrition for unique humans. As hormones levels change in the days
after birth, the mother's body starts to make more plentiful amounts of milk.
Colostrum gradually changes into mature milk--the stuff babies have been
thriving on for thousands of years. Milk's basic ingredients are fat, proteins,
lactose, vitamins, minerals, and water. This is true of milk from all kinds of
mammals. Yet, the proportions of these ingredients differ, as do the kinds of
protein and fat. This is what makes each species' milk uniquely suited to its
young. It's also why cow's milk and cow's milk-based formulas are not the ideal
food for human infants.
HIGH
QUALITY PROTEIN
Protein is a prime example of how
human milk is unique nutrition for human babies. Human milk is low in protein,
at least when compared with the milk of other species, especially cow's milk.
This isn't a nutritional deficiency; there are good reasons for this. Human
infants are designed to grow slowly. While it's important for humans to develop
strong bodies, even more important is brain development and the learning of
social skills. The experiences that shape the brain come from close contact
between mother and baby when baby is held and carried. If human infants doubled
their birthweight in less than 50 days the way baby calves do, and then
continued growing, how could their mothers carry them and talk to them and keep
them close? Baby cows need to learn where to find the best grass in the meadow;
baby humans need to learn how to work with others so that everyone's needs get
met.
Though the protein content of human
milk is generally low, the types of amino acids that make up these proteins are
important. One particular amino
acid, taurine, is found in large amounts in human milk. Studies show that
taurine has an important role in the development of the brain and the eyes. The
body can't convert other kinds of amino acids into taurine, so its presence in
human milk is significant--so significant that some formula manufacturers have
begun adding it to artificial baby milks.
If you let milk stand out of the
refrigerator and sour, you will see that milk proteins fall into two
categories, curds and whey. (Remember Miss Muffet?) The curd portion, the
casein proteins, are the white clots; the liquid is the whey. Cow's milk is
mostly casein protein, which forms a rubbery, hard-to-digest curd in babies'
tummies. Human milk has more whey than curd, and the curds that are formed are
softer and more quickly digested. Breastfed babies get hungry sooner than
babies who are formula-fed because human milk proteins are digested so
efficiently. It doesn't take as much energy to digest human milk as it does to
digest formula. Frequent feedings also ensure that human babies get lots of
attention from their mothers.
SELF-DIGESTING
FATS
There's another reason why babies
digest human milk so quickly: the fat in human milk comes with an enzyme,
lipase, that breaks the fat down into smaller globules so this important
nutrient can be better absorbed into the bloodstream. Fat is a valuable source
of energy for babies, so the presence of lipase makes the fat in human milk
more available. This is one of the reasons human milk is so good for premature
babies, who need lots of energy to grow but whose digestive systems are very
immature.
A changing nutrient for changing
needs. The fat content of human
milk changes constantly. Typically, fat levels are low at the beginning of a
feeding and high at the end. Babies nurse eagerly to get the low-fat,
thirst-quenching foremilk, then slow down and linger over the high-fat dessert
at the end of their meal. Babies who nurse again soon after the end of the last
feeding get more high-fat milk, so babies who breastfeed more frequently during
a growth spurt get more calories. Longer intervals between feedings bring down
the fat content of the milk stored in the breast. This nutritional fact of
human milk is one of the many reasons why the rigid 3 to 4 hour scheduled style
of feeding is biologically incorrect.
Smarter fats. The special kind of fat in human milk
is important to brain development. As newborn babies grow, the nerves are
covered with a substance called myelin which helps the nerves transmit messages
to other nerves throughout the brain and body. To develop high-quality myelin,
the body needs certain types of fatty acids--linoleic and linolenic--which are
found in large amounts in human milk.
VITAMINS
AND MINERALS
The vitamins and minerals listed on
the formula can are no match for those in the milk made by mom, even if
milligram by milligram comparisions suggest otherwise. When formula researchers
want to know how much of a particular vitamin or mineral babies need each day,
they look first at how much of that nutrient is present in human milk and how
much milk a baby of a given age takes in a day. But just doing the math doesn't
tell the whole story. More important than the amounts of nutrients in the milk
is the amount that is available for the infant to use, a nutrient principle
called bioavailability. The
bioavailability of a nutrient is influenced by many factors, including its
chemical form and the presence of other substances.
The three important minerals calcium,
phosphorus, and iron are present in breastmilk at lower levels than in formula,
but in breastmilk these minerals are present in forms that have high
bioavailability. For example, 50 to 75 percent of the iron in breastmilk is absorbed by the baby. With formula,
as little as four percent of the iron is absorbed into baby's bloodstream. To
make up for the low bioavailability of factory-added vitamins and minerals,
formula manufactures raise the concentrations. Sounds reasonable, right? If
only half gets absorbed by the body, put twice as much into the can. Yet, this
nutrient manipulation may have a metabolic price.
Baby's immature intestines are
required to dispose of the excess. Meanwhile, the excess unabsorbed minerals
(especially iron) can upset the "ecology of the gut," interfering
with the growth of healthful bacteria and allowing harmful bacteria to flourish.
This is another reason formula-fed infants have harder, more unpleasant
smelling stools.
To enhance the bioavailability of
nutrients, breastmilk contains facilitators - substances that enhance the
absorption of other nutrients. For example, vitamin C in human milk increases
the absorption of iron. Zinc absorption is also enhanced by other factors in
human milk. In an interesting experiment, researchers added equal amounts of
iron and zinc to samples of human milk, formula, and cow'd milk, and fed them to
adult volunteers. More of the nutrients in the human-milk sample got into the
bloodstream compared to the formula and cow's milk. In essence, breastmilk puts
nutrients where they belong - in baby's blood, not in baby's bowels.
HORMONES
AND ENZYMES
Every year medical journal articles
describe more valuable substances discovered in human milk. Scientists are only
beginning to write the story on other factors in human milk that may be
important to baby's growth and development. For example, other enzymes besides
lipase are available to aid infant digestion. Epidermal
growth factor, present in human milk in significant amounts, may promote the
development of tissues in the digestive tract and elsewhere. Other hormones in
milk may influence a baby's metabolism, growth, and physiology. The effects may
be subtle, but they may also have far-reaching implications. Being breastfed
has advantages that reach into adulthood. Science is only beginning to learn
what these benefits are.
What's in Breast Milk
The American Academy of
Pediatrics (AAP) strongly recommends exclusive breastfeeding for the first six
months of life and that breastfeeding continue for at least 12 months.
It is optimal for both babies and mothers. For babies it can protect
against infections and reduce the rates of later health problems including
diabetes, obesity, and asthma.
For mothers breastfeeding helps the uterus to contract and
bleeding to cease more quickly after delivery. Breastfeeding can reduce
the risk of breast and ovarian cancer and also provides a great way for mothers
to bond with their babies.
The advantages of breastfeeding are numerous. Breast milk
is ultimately the best source of nutrition for a new baby. Many
components in breast milk help protect your baby against infection and disease.
The proteins in breast milk are more easily digested than in formula or cow’s
milk. The calcium and iron in breast milk are also more easily
absorbed.
The following is a brief
overview of the components of breast milk and the nutrients they provide for
your baby.
Proteins
Human
milk contains two types of proteins: whey and casein.
Approximately 60% is whey, while 40% is casein. This balance of the
proteins allows for quick and easy digestion. If artificial milk, also
called formula, has a greater percentage of casein, it will be more difficult
for the baby to digest. Approximately 60-80% of all protein in human milk
is whey protein. These proteins have great infection-protection
properties.
Listed below are specific proteins that are found in breast milk and their
benefits:
·
Lactoferrin inhibits the growth of iron-dependent
bacteria in the gastrointestinal tract. This inhibits certain organisms,
such as coliforms and yeast, that require iron.
·
Secretory IgA also works to protect the infant from
viruses and bacteria, specifically those that the baby, mom, and family are
exposed to. It also helps to protect against E. Coli and possibly
allergies. Other immunoglobulins, including IgG and IgM, in breast milk
also help protect against bacterial and viral infections. Eating fish can
help increase the amount of these proteins in your breast milk.
·
Lysozyme is an enzyme that protects the infant
against E. Coli and Salmonella. It also promotes the growth of healthy
intestinal flora and has anti-inflammatory functions.
·
Bifidus factor supports the growth of
lactobacillus. Lactobacillus is a beneficial bacteria that protects the
baby against harmful bacteria by creating an acidic environment where it cannot
survive
Fats
Human milk also contains
fats that are essential for the health of your baby. It is necessary for
brain development, absorption of fat-soluble vitamins, and is a primary calorie
source. Long chain fatty acids are needed for brain, retina, and nervous
system development. They are deposited in the brain during the last
trimester of pregnancy and are also found in breast milk.
Vitamins
The amount and types of
vitamins in breast milk is directly related to the mother’s vitamin
intake. This is why it is essential that she gets adequate nutrition,
including vitamins. Fat-soluble vitamins, including vitamins A, D, E, and
K, are all vital to the infant’s health. Water-soluble vitamins such as
vitamin C, riboflavin, niacin, and panthothenic acid are also essential.
Because of the need for these vitamins, many healthcare providers and
lactation consultants will have nursing mothers continue on prenatal vitamins.
Carbohydrates
Lactose is the primary
carbohydrate found in human milk. It accounts for approximately 40% of
the total calories provided by breast milk. Lactose helps to decrease the
amount of unhealthy bacteria in the stomach, which improves the absorption of
calcium, phosphorus, and magnesium. It helps to fight disease and
promotes the growth of healthy bacteria in the stomach.
Breast Milk is Best
Breast milk has the
perfect combination of proteins, fats, vitamins, and carbohydrates. There
is nothing better for the health of your baby. Leukocytes are living
cells that are only found in breast milk. They help fight infection.
It is the antibodies, living cells, enzymes, and hormones that make breast milk
ideal. These cannot be added to formula.
Though
some women ultimately are not able to breastfeed, many whothink they cannot actually are able to
breastfeed. Lactation consultants are able to provide support to women
learning to breastfeed. For those who are not able to breastfeed, milk
banks or donor milk may be an alternative.
What's in breast
milk?
What's in breast milk depends on
when it's being made and for whom. One of the wonderful characteristics of
human milk is the way it changes to meet your baby's needs as he grows. The
breast milk a mother produces for her premature baby differs from the milk she
would produce for a full-term newborn, and that differs from the milk she'll
have for her 6-month-old baby. All breast milk, however, contains exactly the
nutritional and protective components needed most by each baby at every age.
Colostrum is the
first pale yellow milk your breasts produce after giving birth. (You may have
noticed beads of colostrum on your nipples in the last weeks of pregnancy.)
It's so high in antibodies that some people call it a baby's first
immunization. It's higher in protein, minerals, salt, vitamin A, nitrogen,
white blood cells, and certain antibodies, and has less fat and sugar than
mature milk. Colostrum also has a slightly laxative effect and helps a newborn
rinse his gastrointestinal tract of meconium, the waste product accumulated
before birth, thereby reducing the risk of jaundice. A little colostrum goes a
long way. You may not feel as if you're producing much, but each drop is packed
with nutritional and protective components.
Mature milk comes
in approximately two to four days after your baby's born, depending on the
frequency of nursing in the first hours and days after birth. and is produced
in greater amounts than colostrum. (Moms often produce too much at first, until
their baby's appetite and nursing frequency match the amount produced to the
amount needed.) Mature milk contains water, fat, carbohydrates, protein,
vitamins and minerals, amino acids, enzymes, and white cells. Over the course
of a feeding, breast milk changes from foremilk, high in water and lactose, to
hindmilk, high in fat and calories. After the first few weeks of nursing, your
breast milk will contain fewer white cells and more of another antibacterial
enzyme, lysozyme, the level of which stays high as long as breastfeeding
continues. The quantity of milk you produce increases along with your baby's
weight and appetite until solid food becomes a daily part of his diet.
Breast milk contains more than 200 known beneficial elements, with more being
discovered all the time. For example, researchers believe that a recently
discovered fatty acid in breast milk promotes the growth of a baby's brain and
retina and may even enhance cognitive development. Many of these elements,
including infection-fighting white cells, can't be manufactured.
