Re: Subpar Breast Milk (was Chicken Choices, insurances and more)

[Guest guest]

Desh,

> I am particularly tired of comments about

> subpar breastmilk, without any science thrown up for discussion. I am a

> battering ram about the formula issue and about birth issues I admit, but

> I will follow etiquette here and post science about it;

I didn't get to read all the posts in the chicken thread so I'm not

sure exactly what was said on the subject. But, surely one must admit

the general principle that, since breat milk depends on the mother's

nutritional status for many nutrients, mothers with subpar nutritional

status will have subpar breast milk.

I'm not aware of any direct evidence that average breast milk is

subpar, except that certain supplements during the neonatal period are

beneficial. So, for example, the fact that vitamin K supplementation

after birth is useful indicates that average breast milk is deficient

in vitamin K. The fact that vitamin D supplementation is useful in

this period indicates that average breast milk is deficient in vitamin

D. And so on.

It is very difficult to provide direct evidence that average milk is

suboptimal, especially when there is little to compare it to besides

formula, which is often worse (especially with DHA and AA content, for

example). But the fact that its vitamin content varies according to

diet and maternal nutritional status suggests that there would be such

thing as subpar milk and the fact that at least some nutrients,

perhaps not all, can be increased and favor increased health,

indicates that there is such a thing and it is fairly common in our

society.

That's not to say that this justifis formula, which I think should be

a last resort.

Chris

[Guest guest]

Actually, I think there is debate about Vitamin D supplementation for breastfed

infants. Yes, breastmilk, as compared to formula, has less vitamin D. However,

I believe that Vitamin D in breastmilk has been shown to be more readily

bioavailable than that which is in formula. Additionally, making sure that your

infant gets ample sun exposure, particularly if he or she is light skinned (and

making sure that you also get proper sun exposure) can pretty much handle the

Vitamin D issue.

At least, I know we will not be supplementing.

From: chrismasterjohn@...

Date: Wed, 26 Mar 2008 01:18:30 -0400

Subject: Re: Subpar Breast Milk (was Chicken Choices, insurances and more)

Desh,

> I am particularly tired of comments about

> subpar breastmilk, without any science thrown up for discussion. I am a

> battering ram about the formula issue and about birth issues I admit, but

> I will follow etiquette here and post science about it;

I didn't get to read all the posts in the chicken thread so I'm not

sure exactly what was said on the subject. But, surely one must admit

the general principle that, since breat milk depends on the mother's

nutritional status for many nutrients, mothers with subpar nutritional

status will have subpar breast milk.

I'm not aware of any direct evidence that average breast milk is

subpar, except that certain supplements during the neonatal period are

beneficial. So, for example, the fact that vitamin K supplementation

after birth is useful indicates that average breast milk is deficient

in vitamin K. The fact that vitamin D supplementation is useful in

this period indicates that average breast milk is deficient in vitamin

D. And so on.

It is very difficult to provide direct evidence that average milk is

suboptimal, especially when there is little to compare it to besides

formula, which is often worse (especially with DHA and AA content, for

example). But the fact that its vitamin content varies according to

diet and maternal nutritional status suggests that there would be such

thing as subpar milk and the fact that at least some nutrients,

perhaps not all, can be increased and favor increased health,

indicates that there is such a thing and it is fairly common in our

society.

That's not to say that this justifis formula, which I think should be

a last resort.

Chris

_________________________________________________________________

Test your Star IQ

http://club.live.com/red_carpet_reveal.aspx?icid=redcarpet_HMTAGMAR

[Guest guest]

Chris-

> That's not to say that this justifis formula, which I think should be

> a last resort.

Are you referring to storebought formula (obviously bad) or an NT-

style breast milk replacement?

-

[Guest guest]

,

> > That's not to say that this justifis formula, which I think should be

> > a last resort.

> Are you referring to storebought formula (obviously bad) or an NT-

> style breast milk replacement?

Any formula. I'm not saying it shouldn't be used, but it should be

used when attempts to increase breast milk and correct the mother's

diet fail.

Chris

[Guest guest]

Amy,

> Actually, I think there is debate about Vitamin D supplementation for

> breastfed infants. Yes, breastmilk, as compared to formula, has less

> vitamin D. However, I believe that Vitamin D in breastmilk has been shown

> to be more readily bioavailable than that which is in formula.

> Additionally, making sure that your infant gets ample sun exposure,

> particularly if he or she is light skinned (and making sure that you also

> get proper sun exposure) can pretty much handle the Vitamin D issue.

> At least, I know we will not be supplementing.

There is no need to supplement the infant if the mother's vitamin D

status is good. However, the vitamin D status of most mother's is not

good, and thus their breastmilk is " subpar " in vitamin D.

You are correct that the vitamin D in breast milk is more

bioavailable. However, it has already been quantified that an

infant's vitamin D status is supported by breast milk equivalently to

the recommended 400 IU direct infant supplement when the mother is

receiving 2,000 IU. If the climate is sunny and during a time of year

when UV-B is available, exposure of the mother and infant can solve

the problem; if it is not, then the only two solutions are to

supplement the infatn directly to compensate for the mother's subpar

breast milk, or to bring the mother's breast milk up to par by

increasing her vitamin D intake or supplementation.

Also, the 400 IU mark is not sufficient to guarantee freedom from type

1 diabetes. Supplementation with 2,000 IU or higher in the first year

of life directly nearly eradicates the risk of type 1 diabetes.

Perhaps 4,000 IU for the mother from all inputs including sun, food

and supplements, and moderate exposure of the infant to sun, would

guarantee this protection without supplementation.

I have an article that covers all of this:

http://www.westonaprice.org/children/infant-vitamin-d-safety.html

Chris

[Guest guest]

On Mar 26, 2008, at 6:59 AM, Amy Sikes-Dorman wrote:

>

> Actually, I think there is debate about Vitamin D supplementation

> for breastfed infants. Yes, breastmilk, as compared to formula, has

> less vitamin D. However, I believe that Vitamin D in breastmilk has

> been shown to be more readily bioavailable than that which is in

> formula. Additionally, making sure that your infant gets ample sun

> exposure, particularly if he or she is light skinned (and making

> sure that you also get proper sun exposure) can pretty much handle

> the Vitamin D issue.

I spoke to a Russian, Finnish, and a Turkish person -- all told me

that it is common practice in their countries to bundle the baby up

and let him or her sleep outdoors during the day -- for sunlight and

fresh air. They also all give cod liver oil.

> At least, I know we will not be supplementing.

That is what I planned too. :-)

I had to begin supplementing with the raw milk formula at 4 months. I

continued to breast feed for 9 months, supplementing with the raw milk

formula. I didn't find out about WAPF until my baby was 4 months old

-- which is when I worked very hard to improve my diet and increase my

supply. I did the best I could.

I have discovered recently that I am probably hypothyroid (I have many

of the symptoms, failed the iodine patch test, and am now going to do

the iodine loading and spot test). I'm sure this is due to my extended

(unknowing) consumption of soy (restaurant foods and processed foods).

I have read that there is a correlation between low milk supply and

hypothyroidism.

" Untreated low thyroid levels in mom may result in a decrease in milk

supply and sometimes poor weight gain in baby (due to low milk

supply). Per Breastfeeding and Human Lactation (Riordan & Auerbach

1999, p. 543-544), " If replacement therapy of thyroid extract... is

adequate, the relief of the symptoms and an increase in the milk

supply can be quite dramatic. " "

http://www.kellymom.com/health/thyroid/thyroid-faq.html

I only wish I had known this 6 months ago! I had no idea I had an

issue with my thyroid -- and I had no idea there was a connection to

my milk supply.

We do the best we can with the knowledge we have at the time.

Ann Marie

[Guest guest]

Ann Marie-

Dr. Jack Newman, author of The Ultimate Breastfeeding Book of Answers

would disagree with you. He says that overwhelmingly, breastfeeding

failure is cultural. Women come to his clinic all the time believing

that there is something biologically wrong, when usually, somewhere in

the chain of events they have been taught bad breastfeeding practice

(usually by the hospital lactation consultant). Their latch is shallow,

or they gave the baby a pacifier, or they didn't nurse frequently enough

or long enough etc. or etc. He is quite clear on this point. He is also

quite clear that supplementing will always reduce supply.

I myself have type 2 hypo- I had a significantly enlarged node on my

thyroid during my second pregnancy- not quite a goiter but almost. I am

cold to the point of having Raynaud's, failed the patch test, plus the

entire list of symptoms. I made plenty of milk. The link you cited also

has conflicting evidence that hypo mothers can breastfeed from Dr. Hale,

who is of much more reknown in the field than the other authors kellymom

sited.

Desh

[Guest guest]

My son had good latch until he was given a pacifier by my mother when I

wasn't looking. I instinctually felt that was why he stopped trying or even

allowing me to try and nurse him. I was having problems getitng the latch

right but just the night before he nursed for a long time and we both even

fell asleep in the hospital bed and I woke up when my nipple was so sore

from him nursing so long. It was the last good experience I had trying to

breast feed =(.

Since that day he wouldn't latch anymore and would scream and get stiff as a

board if I tried to nurse him. I had to go to pumping and bottle feed him

and I lost my breast milk with my c-section complicatoins etc. It has been

explained to me that my low supply could be thyroid related (I have

autoimmune thyroiditis) and also because pumping doesn't stimulate milk as

well as nursing.

I was taking herbs, teas etc to try and increase my flow too. But I was on

some pretty strong pain medications because of the severe pain I was in with

the wound vacuum in my stomach.

Dawn

From:

[mailto: ] On Behalf Of De Bell-Frantz

Sent: Thursday, March 27, 2008 10:09 PM

Subject: Re: Subpar Breast Milk (was Chicken Choices, insurances and

more)

Ann Marie-

Dr. Jack Newman, author of The Ultimate Breastfeeding Book of Answers

would disagree with you. He says that overwhelmingly, breastfeeding

failure is cultural. Women come to his clinic all the time believing

that there is something biologically wrong, when usually, somewhere in

the chain of events they have been taught bad breastfeeding practice

(usually by the hospital lactation consultant). Their latch is shallow,

or they gave the baby a pacifier, or they didn't nurse frequently enough

or long enough etc. or etc. He is quite clear on this point. He is also

quite clear that supplementing will always reduce supply.

I myself have type 2 hypo- I had a significantly enlarged node on my

thyroid during my second pregnancy- not quite a goiter but almost. I am

cold to the point of having Raynaud's, failed the patch test, plus the

entire list of symptoms. I made plenty of milk. The link you cited also

has conflicting evidence that hypo mothers can breastfeed from Dr. Hale,

who is of much more reknown in the field than the other authors kellymom

sited.

Desh

[Guest guest]

Hi, Desh,

> Dr. Jack Newman, author of The Ultimate Breastfeeding Book of Answers

> would disagree with you. He says that overwhelmingly, breastfeeding

> failure is cultural. Women come to his clinic all the time believing

> that there is something biologically wrong, when usually, somewhere in

> the chain of events they have been taught bad breastfeeding practice

> (usually by the hospital lactation consultant). Their latch is

> shallow,

> or they gave the baby a pacifier, or they didn't nurse frequently

> enough

> or long enough etc. or etc. He is quite clear on this point. He is

> also

> quite clear that supplementing will always reduce supply.

I'm sure the cultural reasons are a large part of it. Maybe even the

main cause.

Unfortunately we live in a culture where most women work and need to

go back to work to support their families. So even if thyroid

dysfunction is not an issue, there are still the cultural issues which

make it tough for most women to do extended (3-5 yr -- heck, even past

1 yr) breast feeding.

Like it or not, most women are not able or willing (for whatever

reason) to do extended breast feeding in this day and age. They are

resorting to commercial formula. Yes, educating them on the importance

of breast feeding is absolutely critical. However, many of them will

not do it.

I think raw milk formula is a good option for those who cannot or are

for some reason unable to breast feed. A much better option than

commercial formula.

You really do not need to defend breast feeding to me. I get it. I

agree. I'm with you. I'm guessing most (all?) of this group agrees

with you. I think you're right.

At the same time, I don't think it's so easy to change society. 50%

of the population is not suddenly going to be able to quit their jobs.

And those employers are not suddenly going to start paying for those

moms to stay home with their babies.

I think we should do our best to support mothers with options that are

do-able for them. For example, if they are unable to stay home and

breast feed due for financial reasons, or if they are simply unable to

produce enough milk for whatever reason, I think they should have the

option of raw milk formula. Breast feeding is the first choice,

always. Second choice would be the raw milk formula. At least that is

better than the commercial formula.

> I myself have type 2 hypo- I had a significantly enlarged node on my

> thyroid during my second pregnancy- not quite a goiter but almost.

> I am

> cold to the point of having Raynaud's, failed the patch test, plus the

> entire list of symptoms. I made plenty of milk. The link you cited

> also

I think it's great that you were able to make plenty of milk. However,

that statistic is not meaningful in that you are just one person. The

fact that you could produce plenty of milk with a dysfunctional

thyroid is not representative of anything due to the fact that it

could be an aberration. As you know, for data to be meaningful, we

have to look at a larger group.

Do you have any studies that actually disproves the hypothyroid

connection to diminished supply? From what I am reading, it seems very

plausible that there is a connection.

" Iodine is put into the mother's milk by the lactating breast to

levels that are 30 times the levels in the mother's blood.... There is

an increased need for thyroid hormone and iodine during pregnancy.

Thus each pregnancy is a load on the thyroid function which not every

women's thyroid gland carries out adequately. "

(http://thyroid.about.com/library/derry/bl12.htm

)

It makes sense to me. I never had issues with my thyroid before my

pregnancy (well, I'm sure I did but they were not serious enough to

cause symptoms). Even after the birth, I was still OK. My symptoms

didn't really start showing up until a few months after the birth. I

have read that depleted thyroid function is very common for mothers

after giving birth because pregnancy uses a lot of your nutritional

stores. But it makes sense to me that you are also depleting it when

breast feeding. And if you didn't have enough, I just wonder if that

could affect your milk supply.

I am just beginning to research this. Does anyone else have

information about the connection between iodine deficiency, low

thyroid function, and low breast milk supply?

Ann Marie

[Guest guest]

> Unfortunately we live in a culture where most women work and need to

> go back to work to support their families. So even if thyroid

> dysfunction is not an issue, there are still the cultural issues which

> make it tough for most women to do extended (3-5 yr -- heck, even past

> 1 yr) breast feeding.

I agree that most women have been handed a bad card by having to work and

pump, however that situation is to blame for their inability to nurse, not

the fact that they have low supply. These same women would likely be able

to have a full supply in a situation where their child could nurse while

they worked. Ann Marie, you very likely fall into that category, because

true supply issues related to thyroid would show up very early, not after

months of successful nursing. The amount of milk involved is set by

autocrine control at the 6-week mark, and thyroid fluctuations after that

point have little to do with it, in the absence of the development of things

like tumors or a severe blood loss episode. So your thyroid likely has

little to nothing to do with your inability to nurse at 10 months, it was

most likely the pumping.

Pumping makes it more difficult to keep up a good supply, which is why it is

even more critical to establish an ample supply in the early days by

frequent nursing AND starting a freezer stash- you actually need to force

yourself into having over-supply in order to have enough to ensure you're

not going to set your supply too low. Most women can not increase their

supply past what they are making at 6 weeks, as at that point it is

basically set by autocrine control.

The type of pump used is CRITICAL, as is the fit. I've met many working

women sabotaged by the use of a sub-par pump, a pump that wasn't right for

them, and wrong size flanges. Often times, just a change in flange size can

increase milk output by 25-50%. You need a qualified specialist to help you

get the right fit, and I'll give you a clue- the majority of women in the US

do not use the size flange supplied with the pumps. You also must

hand-express for a couple of minutes when you finish pumping to help keep

your supply up, a step which is critical. That alone can make a huge

difference in supply, and it's a step most women skip or don't know to do.

Most women who nurse longer that one year will tell you, the longer you go,

the easier it gets, because their need for milk decreases slowly and so you

pump less, then you quit pumping at work because it isn't needed and you

just nurse ad lib at home. I've known a number of women who pumped until

their baby was 15-18 months, then quit pumping and finished their freezer

stash and just nursed when they were at home.

> I think raw milk formula is a good option for those who cannot or are

> for some reason unable to breast feed. A much better option than

> commercial formula.

> Do you have any studies that actually disproves the hypothyroid

> connection to diminished supply? From what I am reading, it seems very

> plausible that there is a connection.

Yes, there is a connection for some, but not all. IIRC, it falls along

these lines- 40% make the right amount, 20-30% have oversupply, 30-40% don't

make enough. That's in the first few weeks after birth. So that means that

60-70% can nurse without low supply issues, even with thyroid problems.

I'll have to dig up that reference later when I'm not trying to bake my own

birthday cake and corral two very excited kids. LOL

KerryAnn

www.cookingTF.com - Traditional Foods Menu Mailer, Recipes and Cooking Helps

Homestyle TF meals your kids will LOVE

[Guest guest]

On Mar 28, 2008, at 6:30 AM, KerryAnn at CookingTF.com wrote:

>

> months of successful nursing. The amount of milk involved is set by

> autocrine control at the 6-week mark, and thyroid fluctuations after

> that

> point have little to do with it, in the absence of the development

> of things

> like tumors or a severe blood loss episode. So your thyroid likely

> has

> little to nothing to do with your inability to nurse at 10 months,

> it was

> most likely the pumping.

Hmm OK.

But you know, I do know other women who did not pump at all, left

their babies to go to work, and still have plenty of milk. For

example, one woman I know went back to work when her baby was 4 mos

old. She has never used a pump. Her daughter is now almost a year and

a half and most days she nurses her just twice a day morning and

night. Some days she is there and nurses more often but most days it's

twice a day. And yet she's had no supply issues.

I know, that's just one person. I'm just curious about it because I

was not *just* pumping. I was also nursing my daughter 2-4 times per

day. And my milk did dry up. And I was eating a very good diet, taking

cod liver oil, eating liver, etc.

I still think there had to be something going on with my health. I am

going to to research it further. Obviously can't do anything about it

now as it is in t he past -- but am curious.

Ann Marie

[Guest guest]

> But you know, I do know other women who did not pump at all, left

> their babies to go to work, and still have plenty of milk. For

> example, one woman I know went back to work when her baby was 4 mos

> old. She has never used a pump. Her daughter is now almost a year and

> a half and most days she nurses her just twice a day morning and

> night. Some days she is there and nurses more often but most days it's

> twice a day. And yet she's had no supply issues.

Yes- you nurse directly twice a day, the demand is twice a day, your body

downregulates to that level and keeps it there since there's constant demand

for those two nursings. That's basic lactation science, and a gradual

downregulation is actually how natural weaning happens.

> I know, that's just one person. I'm just curious about it because I

> was not *just* pumping. I was also nursing my daughter 2-4 times per

> day. And my milk did dry up. And I was eating a very good diet, taking

> cod liver oil, eating liver, etc.

How do you know your milk dried up? Was it physically impossible to remove

any milk from your breasts at all, even the baby wasn't getting a drop? How

long did you keep trying after you saw that literally not one drop was

coming out? Is it possible you had a supply dip due to hormonal

fluctuations from your period starting, the baby had a growth spurt (common

around 10 months), was being given too much in the way of solids, or the

like? Or more than one thing at the same time? But what most women assume

is their milk drying up really isn't, because we've lost the cultural

knowledge about how to nurse and the normal progression of nursing.

> I still think there had to be something going on with my health. I am

> going to to research it further. Obviously can't do anything about it

> now as it is in t he past -- but am curious.

Yes, if you think you have a thyroid problem, by all means pursue it,

because it could affect your next pregnancy and not just your ability to

nurse.

KerryAnn

www.cookingTF.com - Traditional Foods Menu Mailer, Recipes and Cooking Helps

Homestyle TF meals your kids will LOVE

[Guest guest]

On Mar 28, 2008, at 8:09 AM, KerryAnn at CookingTF.com wrote:

>>

>

> How do you know your milk dried up? Was it physically impossible to

> remove;

I don't know... I was only producing about 4 oz per day. When I would

nurse, the baby would get very frustrated and cry because it was not

coming out -- she would drain the breast very fast and still be

hungry. It was very frustrating for both of us.

It's a vicious cycle. They get used to the bottle and then they get

mad at the breast -- but you have to give the bottle, otherwise

they'll starve. One thing I wish I had done was use the Lact-Aid

device. I think that may have enabled me to keep going.

That said, I also wish I also would have known about the iodine issue.

Just starting to read about it, but I am finding evidence that there

is a correlation. I am not sure if low iodine causes low supply -- but

I do know that the baby needs a lot of iodine, and if I don't have it,

the baby is not getting it. And yet how many women know about this? I

read a lot of books while pregnant, consulted with a lot of people,

but nobody ever talked about this.

" In Japan seaweed, a concentrated source of iodine, has a legendary

history for protecting women’s health. In Korea new mothers are

traditionally fed seaweed soup. We are beginning to understand what

these cultures have known for a long time. Lactating women actively

take up the iodide ion by the same symporter protein that is in the

thyroid. " -- son, PhD

" High amounts of iodine are excreted in breast milk to help develop a

baby's growing brain and nervous system. Some evolutionary biologists

believe iodine and eating seafood played an important role in human

brain development and evolution. " --

http://www.laurapower.com/iodinedeficiency.htm

Interesting... so many women are advised to avoid seafood when

pregnant and nursing -- due to mercury. This is the time when they

most need to be eating seafood!

Oh well! Live and learn. I will work on correcting my nutritional

deficiencies and when the next baby comes I am sure I will be able to

breast feed longer.

Ann Marie

[Guest guest]

> It's a vicious cycle. They get used to the bottle and then they get

> mad at the breast -- but you have to give the bottle, otherwise

> they'll starve. One thing I wish I had done was use the Lact-Aid

> device. I think that may have enabled me to keep going.

There are options other than the bottle. There are cup and finger feeding

devices that don't interfere with nursing and keep the 'mad baby' problem

from happening. It won't take any longer once the care-giver knows how to

use them. And of course, depending on the baby's age, a sippy cup can be

used instead of the bottle.

KerryAnn

www.cookingTF.com - Traditional Foods Menu Mailer, Recipes and Cooking Helps

Homestyle TF meals your kids will LOVE

[Guest guest]

On Mar 28, 2008, at 1:09 AM, inasnit@... wrote:

>

> I'm sure the cultural reasons are a large part of it. Maybe even the

> main cause.

>

> Unfortunately we live in a culture where most women work and need to

> go back to work to support their families. So even if thyroid

> dysfunction is not an issue, there are still the cultural issues which

> make it tough for most women to do extended (3-5 yr -- heck, even past

> 1 yr) breast feeding.

>

> Like it or not, most women are not able or willing (for whatever

> reason) to do extended breast feeding in this day and age. They are

> resorting to commercial formula. Yes, educating them on the importance

> of breast feeding is absolutely critical. However, many of them will

> not do it.

>

Oy. This is near and dear to my heart. I get no end of grief from my

generally well-meaning mother for my continued efforts in nursing my

preschooler. He is in daycare full-time and has been there since he

was 4 months old. He is a reverse cycler, and has been since starting

daycare. The only way I have been able to nurse him (at night, no

less) for so long is because I was prepared to do whatever it took to

accommodate his needs. He sleeps with us - now on his own mattress on

the floor beside our futon, also on the floor. You will never find

our room (let alone our house) in an issue of " Better Homes and

Gardens. " And I still get grief from my mom about our sleeping

arrangements, in so much as it affects her when we visit them.

It takes a deep connection to one's motherly intuition to do things

that feel right, but that aren't sanctioned by mainstream societal

pressures. I don't think most women have that deep connection. I

also think it takes a lot of courage to believe that one's intuition

is right (for oneself), and to tell mainstream care providers and

other well-meaning loved ones to stuff their " guidance " elsewhere. It

takes a lot of ... guts?.. for me to tell my own mother to stuff it -

'coz we otherwise have a very good relationship and most of her other

advice is actually quite useful.

-jennifer

[Guest guest]

On Mar 28, 2008, at 8:50 AM, KerryAnn at CookingTF.com wrote:

>

> There are options other than the bottle. There are cup and finger

> feeding

> devices that don't interfere with nursing and keep the 'mad baby'

> problem

> from happening. It won't take any longer once the care-giver knows

> how to

> use them. And of course, depending on the baby's age, a sippy cup

> can be

> used instead of the bottle.

Hmm -- interesting -- I never heard of those.

[Guest guest]

back to the vitamin content of breast milk and whether supplements are

necessary, my nutrition professor told us today that when a mother's

nutrient status is compromised, it effects the quantity, but not the

quality of breast milk she produces.

she said that the composition of breast milk is rarely anything other

than ideal, except that in very recent years pesticides (yikes!!) have

started showing up in the milk in certain cases.

also, in regards to vitamin D and infants, healthy babies are born

with a six month supply of it, as well as iron.

katie

[Guest guest]

-

This is plainly and simply incorrect.

-

> back to the vitamin content of breast milk and whether supplements are

> necessary, my nutrition professor told us today that when a mother's

> nutrient status is compromised, it effects the quantity, but not the

> quality of breast milk she produces.

>

> she said that the composition of breast milk is rarely anything other

> than ideal

[Guest guest]

,

> back to the vitamin content of breast milk and whether supplements are

> necessary, my nutrition professor told us today that when a mother's

> nutrient status is compromised, it effects the quantity, but not the

> quality of breast milk she produces.

> she said that the composition of breast milk is rarely anything other

> than ideal, except that in very recent years pesticides (yikes!!) have

> started showing up in the milk in certain cases.

>

> also, in regards to vitamin D and infants, healthy babies are born

> with a six month supply of it, as well as iron.

I am think of a way to put this that doesn't sound arrogant and

insulting to your teacher. Let me just say that all of the

fat-soluble vitamins vary in concentration directly by maternal

status, certain B vitamins do, that vitamin D stores accumulated

during pregnancy appear to last 2 months, not six, and in one study,

32% of infants born to white mothers in the spring in the UK had no

detectable vitamin D in their blood at all.

If you look in a vitamin A textbook, for example, they talk about

whether they should use breast milk vitamin A instead of serum vitamin

A to judge the dietary status of a population because it correlates so

well.

And of course healthy babies are born with plenty of vitamin D -- they

are born to mothers with good vitamin D status. Those are the same

mothers that have plenty of vitamin D in their milk.

Chris

[Guest guest]

Here are some exerpts from the paper I cited before:

http://www.unu.edu/unupress/food/8F174e/8F174E04.htm

Breastmilk composition can vary during the day and from the beginning to

the end of a feeding. This is most pronounced for fat and fat-soluble

components such as vitamin A and zinc [5, 42]. The fat content of

breastmilk can change by as much as fivefold during the course of a

feeding [42]. The fat concentration is influenced by the breastfeeding

routine of the mother, and short-term variations are related to the

volume of milk produced per feeding and the time interval between

feedings [42]. . . .

Maternal diet and nutritional status

In the past it was commonly believed that poorly nourished mothers had

reduced lactational performance, in both the amount and the quality of

breastmilk produced. This view has now been shown to be largely incorrect

[4]. A recent examination of the world literature could not demonstrate

any convincing relationships between maternal nutritional status, as

indicated by body mass index (BMI), defined as weight/height2, and either

breastmilk output or energy content [52], even in very thin mothers (BMI

< 18.5 kg/m2).

Direct dietary supplementation studies mostly support this view. In a

Gambian study, where poorly nourished lactating mothers were given a

high-energy, nutritionally balanced supplement that provided a net energy

gain of 3 MJ/day, there was no impact on breastmilk volume [4, 37].

Breastmilk fat and protein concentrations were increased slightly by the

supplement, but lactose levels fell, resulting in only a marginal effect

on total breastmilk energy. A review of other intervention studies

concluded that there was no persuasive evidence for the positive effects

of diet on breastmilk energy output [53]. Although breastmilk fat

concentration has been correlated with various aspects of maternal

fatness in a number of studies [4, 36], including those in the Gambia

[45], this observation is not universal; in some populations negative

relationships have been reported [4].

Lactation, therefore, appears to be relatively robust in the face of poor

nutrition. Maternal diet can, however, affect the breastmilk

concentrations of many minor constituents, particularly long-chain

polyunsaturated fatty acids, some vitamins, zinc, selenium, iodine, and

fluorine [51]. The profile of fatty acids in the mother's diet and

adipose tissue stores is reflected in the fatty acids of breastmilk [5,

47]. The concentrations of two water-soluble vitamins, riboflavin

(vitamin B2) and ascorbic acid (vitamin C), show rapid, dose-related

responses to maternal supplementation [4, 50]. The fat-soluble vitamins

A, D, E, and K are less responsive to diet because of the buffering

action of maternal stores and carrier proteins, but large supplements can

result in increased breastmilk concentrations, occasionally to

potentially toxic levels [51]. Maternal zinc supplementation may slow the

decline in breastmilk zinc concentration during lactation, although the

magnitude of this effect and its significance for the breastfed child are

still uncertain [41, 54].

Here are the citations for those footnotes :

http://www.unu.edu/unupress/food/8F174e/8F174E05.htm

Sorry if those quotes are too long, it's late here. . .

Desh

[Guest guest]

Desh,

> Lactation, therefore, appears to be relatively robust in the face of poor

> nutrition.

Right. The caloric value is robust in the face of poor energy intake.

That is not the kind of " nutrition " I am talking about, if this is a

response to me.

> Maternal diet can, however, affect the breastmilk

> concentrations of many minor constituents, particularly long-chain

> polyunsaturated fatty acids, some vitamins, zinc, selenium, iodine, and

> fluorine [51].

Right. " Minor " in total concentration, not in importance.

> The profile of fatty acids in the mother's diet and

> adipose tissue stores is reflected in the fatty acids of breastmilk [5,

> 47]. The concentrations of two water-soluble vitamins, riboflavin

> (vitamin B2) and ascorbic acid (vitamin C), show rapid, dose-related

> responses to maternal supplementation [4, 50].

So AA, DHA, vitamins A, D, E, K, zinc, riboflavin and vitamin C are

responsive to maternal nutritional status.

> The fat-soluble vitamins

> A, D, E, and K are less responsive to diet because of the buffering

> action of maternal stores and carrier proteins, but large supplements can

> result in increased breastmilk concentrations, occasionally to

> potentially toxic levels [51].

This would make them less responsive to day-to-day intake, but not to

nutritional status. All this means is that maternal stores and

carrier proteins buffer the maternal nutritional status against

day-to-day fluctuations. It doesn't change the fact that their

concentrations in breast milk are just as dependent on maternal

nutritional status.

> Maternal zinc supplementation may slow the

> decline in breastmilk zinc concentration during lactation, although the

> magnitude of this effect and its significance for the breastfed child are

> still uncertain [41, 54].

Better to be safe than sorry, no?

> Here are the citations for those footnotes :

> http://www.unu.edu/unupress/food/8F174e/8F174E05.htm

> Sorry if those quotes are too long, it's late here. . .

No problem.

Chris