It is impossible to predict whether your particular baby will be as healthy as he would have been if he could have your milk. Research has shown over and over that breastfed infants suffer fewer illnesses, such as diarrhea, ear infections, respiratory infections, etc., and they are less likely to have allergic-type symptoms than formula-fed infants.

Human milk has anti-infective properties that decrease the likelihood of illnesses caused by many bacteria, viruses, parasites, etc. When breastfed infants do become ill, most illnesses tend to be milder. Infant formulas do not contain such anti-infective properties. Because human milk was designed by nature for human infants, it is extremely unlikely to trigger allergic symptoms.

Research has shown that “breast is best,” bottle-feeding pumped breast milk is second best, bottle-feeding human milk from an accredited milk bank is third (but banked human milk is in short supply), and infant formulas are the fourth diet of choice for newborns and infants less than a year.

You are wise to use an infant formula if breastfeeding or providing your baby with your pumped breast milk is absolutely not possible. Most pediatricians recommend that babies receive formula, rather than cow’s milk, for at least a year – even after they begin to take solid foods well. You will also want to hold your baby for all feedings in a slight semi-sitting position, as a flat position is associated with an increased risk of ear infections.

During feedings, hold your baby so that your faces are about 8-12 inches apart. This helps a baby learn to interact and helps both of you get to know and bond with each other. The stimulation of holding helps with brain development, too. Using a sling or baby carrier also helps give baby’s brain this kind of stimulation. Other skin contact, such as infant massage, also has physical and emotional health benefits for a baby. There are classes and illustrated books available that show parents massage techniques that are appropriate for babies.

I am sorry you are unable to breastfeed. It must be difficult if the decision was not yours to make. Fortunately, there are only a handful of health conditions and treatments that restrict a woman from breastfeeding. There are even fewer baby-related reasons that interfere with breastfeeding.

1. Will feeding my baby breast milk affect his IQ?
2. I have read in many books that breastfeeding contributes to losing some of the weight that was gained during pregnancy. How is this so?
3. If I eat a high fiber diet, will this fiber benefit my baby through the breast milk?
4. How long does it take for the food I eat to reach my breast milk?
5. What affect does drinking coffee have on a nursing baby?
6. Is it okay to drink diet soda that contains NutraSweet while breastfeeding?
7. Is it okay to breastfeed after taking Benadryl and Sudafed for my allergies?
8. If I drink heavily one night a week, am I better off feeding formula to my infant daughter?
9. Is it safe for a mother who is breast feeding to take supplements with Ephedra or Ma huang in them?
10. Is smoking while I am breastfeeding harmful?
11. Can I take birth control pills while breastfeeding?
12. If a breastfeeding mother uses cocaine, how will that affect her infant?
13. Can radiation affect breast milk?

Will feeding my baby breast milk affect his IQ?

The literature regarding breastfeeding and IQ has conflicting results. In studies, breast-fed children score higher on tests of cognitive function, but the cause for these higher scores is unknown. Cognitive development is complex and is affected by multiple factors including genetics and environment, and the interaction between these factors at a specific point in time. In addition, some of the literature states that the differences are significant while others do not. The best advice is breastfeed your infant for his health; don’t do it just to try to have a smarter baby.

I have read in many books that breastfeeding contributes to losing some of the weight that was gained during pregnancy. How is this so?

During pregnancy, the woman with a typical weight gain of 25-35 pounds will add 5 to 10 pounds of weight as maternal stores. During breastfeeding, the body uses approximately 2700 calories per day, or 500 calories more than a non-pregnant, non-breastfeeding woman uses. The average woman will consume between 2200 and 2600 calories. The difference between the calories taken in and those needed by the body will result in a slow and very gradual weight loss.

If I eat a high fiber diet, will this fiber benefit my baby through the breast milk?

Just as it is not necessary to drink milk in order to make milk, it is not necessary to eat a high fiber diet to provide the benefits of fiber to a baby. Human milk is made from the products of a mother’s blood, so it is made after the mother has already digested her own food. If one looks at healthy mothers eating adequate amounts of food, the nutritional components of breast milk vary little in milk from mother to mother, in spite of mothers’ somewhat different diets. About the only thing to change, based on mothers’ diets, is the proportion of saturated vs. unsaturated fats, but the overall amount of fat in breast milk still is similar. Also, vitamin B6 in breast milk may be affected when a mother’s intake is low due to of a very restrictive vegetarian diet, such as a macrobiotic diet.

You need not be concerned about fiber in your breastfed baby’s diet. The stools of breastfed babies tend to be very loose to soft. It is very unusual for the completely breastfed baby to develop constipation or diarrhea. Also, some of the components in breast milk act as fiber, or roughage. Oligosaccharides, a simple sugar, occur in breast milk. They perform important functions in the baby’s system, including acting as fiber, or roughage, in the baby’s digestive tract.

How long does it take for the food I eat to reach my breast milk?

Although there is some evidence that flavor and odor molecules from certain foods may pass into milk, the foods you eat do not reach a baby in the same form as when you consumed them. The foods eaten by the breastfeeding mother are digested by her body and broken down into more basic molecules or “active” ingredients, such as amino acids, sugar molecules, fatty acids, alcohol, etc., which then circulate in the maternal blood stream. Some of those nutrients then are “pulled” into the milk-making cells (alveoli) in the breast, which continuously take what they need from the mother’s blood stream to make human milk. The time it takes for different foods to be digested by a mother and the resulting nutrients or byproducts used by the breast for, or passed into, milk may vary by several hours.

What affect does drinking coffee have on a nursing baby?

According to the La Leche League the amount of caffeine in five or fewer cups of coffee per day will usually not cause a problem with breastfeeding. However, it is important to remember that caffeine is found not only in coffee but also in teas, colas, many soft drinks, and other beverages along with many over-the-counter drugs.

Some babies are very sensitive to caffeine. Signs that your baby may be stimulated by the caffeine include: wide-eyed appearance, little sleeping and fussiness. If you notice these in your baby you should cut the caffeine out of your diet. However, it will often take several days to a week for the effects of the caffeine to leave your baby’s system.

Is it okay to drink diet soda that contains NutraSweet while breastfeeding?

NutraSweet, also known as Aspartame, is a sweetening agent used in foods and beverages. Aspartame is made up of two amino acids aspartic acid and phenylalanine. If your infant has PKU (phenylketonuria), no Aspartame (or any product with NutraSweet) should be ingested. Research has found that Aspartame levels in breast milk are generally too low to produce a significant side effect in a normal infant. However, some mothers complain that their infant’s fussiness and irritability increase. If you find this in your infant, you might want to remove Aspartame from your diet and see if the fussiness and irritability in your baby decrease. Also remember that Aspartame has only been on the commercial market since 1981, so long-term studies are not available. As with anything, moderation is probably the key.

Is it okay to breastfeed after taking Benadryl and Sudafed for my allergies?

Healthcare providers prescribing medication for lactating women must weigh the benefits of mother’s milk for her infant against any risks of the medication they prescribe. There are medications that are contraindicated when breastfeeding, but it is rare when there is not a “safe” alternative that may be used instead. Contacting your babies’ pediatric care provider may be beneficial when you have a medication question about use during breastfeeding that requires an immediate answer.

According to the available literature, there are no reported health concerns in infants whose mothers have taken Benadryl, and it is thought that the amount secreted in milk is minimal. However, infants should be observed for drowsiness for several hours after breastfeeding when taking it. Sudafed (Pseudoephedrine) is a medication that is also given to breastfeeding mothers, which has minimal problems. Studies indicate an infant probably receives less than 1% of the maternal dose via milk.

References:
Hale, T W (1999). Medications in mothers’ milk (8th ed). Amarillo, TX: Pharmasoft Medical Publishing. Lawrence, RA & Lawrence, RM (1999). Breastfeeding: A guide for the medical profession (5th ed.). St. Louis: Mosby.

If I drink heavily one night a week, am I better off feeding formula to my infant daughter?

Occasionally drinking one or two alcoholic beverages over a period of several hours is not a reason to stop breastfeeding. The American Academy of Pediatrics (AAP) considers limited maternal drinking (less than 1g/kg daily) to be compatible with breastfeeding. Alcohol readily passes in and out of breast milk in about the same amount, and at about the same rate, that it enters and leaves your blood stream (about 1 oz/hr). When a breastfeeding mother feels drunk, her milk often smells differently and it can cause irritability or sleepiness in babies. Once a mother is again sober, her milk is free of alcohol – just as her blood stream is – even if she did nothing to empty her breasts since having her last drink. Therefore, it is not necessary to “pump and dump” breast milk if enough time has elapsed, since alcohol is not “stored” in breast milk.

If you plan to have an alcoholic beverage when breastfeeding, breastfeed your baby before having a drink and allow a couple of hours to pass after the drink (or second drink) before breastfeeding again. It will take longer for your body to rid itself of “heavy” amounts of alcohol, so if you become intoxicated, pump your milk every few hours to avoid uncomfortable engorgement, but don’t save that milk to give your daughter. (Interestingly, research indicates that many babies do not seem to like either the taste or the smell of alcohol in their mothers’ milk, as they tend to drink less at feedings when the milk contains alcohol although they “ask” to breastfeed more often.) You can resume breastfeeding once you are sober. Chronic, frequent consumption of even small amounts of alcohol may delay a baby’s motor development. This may contribute to weak sucking, so weight gain may be affected. In addition, it can slow rather than speed the milk let-down (milk-ejection reflex).

No matter how you choose to feed your baby, the most important point is that abusing alcohol by drinking heavily, whether once a month, once a week or daily, affects your ability to properly care for your daughter. Alcohol use can create all kinds of unsafe child-care situations. A sober adult needs to be available to care for your daughter at all times. Also, if you (and your partner) are out and become intoxicated, your daughter is depending on you when it comes to assuring there is a sober, designated driver to get you back home to her safely.

References:
Black RF, Jarman L & Simpson JB (1998). Lactation specialist self-study series: The science of breastfeeding (Module 3). Sudbury, MA: Jones & Bartlett.
Hale TW (2000). Medications and mothers’ milk (9th ed.). Amarillo, TX: Pharmasoft Medical Publishing.

Is it safe for a mother who is breast feeding to take supplements with Ephedra or Ma huang in them?

Ephedra or Ma huang is often called ‘natural ecstasy’ or ‘natural fen-phen’ and is a stimulant. The FDA warns against using it as a diet aid and has banned the stimulant version. This herbal product can cause:

Anxiety Confusion Constipation Dizziness Headache Insomnia Irregular heart beats

Heart attacks Nervousness Psychosis Restlessness Skin inflammation Urine retention Uterine contractions

As you can see, this herb has many potential side effects. In addition, it also interacts with commonly prescribed drugs:

• Drugs to relieve depression
• Beta-blockers
• Phenothiazines
• Sudafed
• Theo-Dur

Any dietary supplement should be used with caution. Dietary supplements are not regulated, and the strength, quality, and amounts your body receive vary among brands and batches within brands. There has also been no research on the passage into breast milk.

Having a baby is stressful, and breastfeeding takes a lot of energy, but taking an herbal supplement is not the way to relieve your fatigue. Try to look at all you are trying to do, and see if you can reduce the number of things you are doing, or can they be given to someone else to do. We tend to think that we are the only one who can do something, but, YOU are the only one who can breastfeed your baby – others can cook, clean, watch other children and do laundry.

Is smoking while I am breastfeeding harmful?

Breastfeeding is the best start that a new mother can give her newborn. However, smoking can affect the breastfeeding process. Smoking lowers your prolactin levels (a hormone that helps with milk production). Cigarette smoking also interferes with milk letdown, so you should not smoke immediately before breastfeeding or while breastfeeding. If you are a heavy smoker, you may have a decreased milk supply. Not surprisingly, weaning tends to occur earlier when mothers smoke. Smoking may decrease the amount of fat in breast milk. The combination of lowered milk production and less fat means that some babies do not gain weight well. In addition, nicotine is suspected as having a role in a baby’s fussiness and with sleep difficulties. Heavy smoking is occasionally associated with severe symptoms in a breastfed baby, such as nausea, vomiting, cramping, diarrhea, rapid pulse, and other “circulatory disturbances.” Smoking a cigarette or two a day when wearing a nicotine patch also has been associated with more severe symptoms.

Some nicotine does get into the milk after even one cigarette, but most of it is out of breast milk within 2-3 hours. If a mother chooses to smoke a cigarette, it is better for her to do so immediately after a breastfeeding. Since most babies breastfeed at about 2-3 hour intervals, most of the nicotine will be out of the milk by the next feeding. However, some babies would find it hard to wait this long between feedings. Also, less nicotine will be in the breast milk at 2-3 hours if the mother smoked a cigarette that is low in nicotine and if she puts the cigarette out without smoking the last 1/3 of it.

The real danger of smoking is that one cigarette often leads to two, then three, and so on. The more a mother smokes, the more the quantity and quality of her breast milk is affected. The more she smokes, the more likely her baby is going to be affected by nicotine and other substances in cigarettes that get into breast milk.

It would be ideal for you to quit smoking. If you don’t think this is possible, try to decrease the number of cigarettes you smoke each day, and try to smoke immediately after breast feeding. It is also a good idea to smoke in a different room from the baby. No matter how a baby is fed, if a parent smokes, that child is at much greater risk to suffer from respiratory illnesses, such as colds, bronchitis, pneumonia, SIDS, etc. Asthma also has been linked to parental smoking. As a baby grows, he/she learns how to behave by watching parents. When either parent smokes, the child is more likely to become a smoker too.

References:
Hale T (1999). Medications and mothers’ milk 1999 (8th ed.). Amarillo, TX: Pharmasoft Medical Publishing.
Lawrence RA & Lawrence RM (1999). Breastfeeding: A guide for the medical profession (5th ed.). St. Louis: CV Mosby.

Can I take birth control pills while breastfeeding?

Medical experts recommend that mothers avoid contraceptive pills containing estrogen for at least the first 2 months postpartum, but it may be best to avoid them until your child is completely weaned. Estrogen-containing contraceptives have been found to reduce the amount of protein in mothers’ milk, and they have been associated with sudden, and sometimes severe, decreases in milk production. However, the longer a mother waits to use this type of hormonal contraception, the less effect it seems to have on breastfeeding and lactation.

The American Academy of Pediatrics (AAP) and The American College of Obstetricians and Gynecologist (ACOG) both state that Progestin-only contraceptives are approved for use in breast-feeding women, after six weeks. Progestin-only contraceptives seem to have little effect on breastfeeding and lactation, especially if begun after the first 6 to 8 weeks postpartum. Because there have been some reports of decreased milk production with progestin-only contraceptives, a “trial run” with a progestin-only pill may be a good idea before using a longer-acting progestin-only form of contraception, such as a Depo-Provera injection or Norplant. If there is any problem with milk production when taking a pill, it can be easily stopped so there is less chance of a long-term effect on milk supply. A woman taking progestin-only contraceptive pills should be aware that a missed pill is associated with a greater risk of pregnancy than with a contraceptive pill that also contains estrogen.

Reference:
Hale, TW (1999). Clinical therapy in breastfeeding patients. Amarillo, TX: Pharmasoft Medical Publishing.

If a breastfeeding mother uses cocaine, how will that affect her infant?

Cocaine in any dosage affects an adult’s ability to safely care for an infant or child, no matter what feeding method is used. It will affect the mother’s level of consciousness and related levels of awareness, reaction time, etc. Cocaine use during breastfeeding is NEVER safe in any amount. Women who use cocaine regularly should not breastfeed, as it would be almost impossible to avoid infant exposure. Cocaine readily passes into breast milk and is absorbed into an infant’s intestinal tract. Infant cocaine exposure is related to increased (dangerous) heart rate, increased blood pressure, extreme irritability, agitation, increased startle reflex, choking and vomiting. Cocaine is slowly metabolized and a breastfed infant’s urine can test positive for cocaine for days after exposure.

If a woman uses cocaine once during the time she is lactating, the recommendation for breastfeeding is to “pump and dump” the breast milk for 36-48 hours after cocaine use before resuming breastfeeding. In the interim, the baby could be fed either drug-free expressed breast milk (obtained and stored properly prior to cocaine use) or an artificial formula.

If you are aware of a breastfeeding mother who is using cocaine, you should take appropriate steps to change the situation. If parents are exposing, or allowing their baby to be exposed, to harmful substances, report your concerns to the Children’s Protective Agency in your area.

References:
Hale, T W (1999). Medications in mothers’ milk (8th ed.). Amarillo, TX: Pharmasoft Medical Publishing.
Lawrence, RA & Lawrence, RM (1999). Breastfeeding: A guide for the medical profession (5th ed.). St. Louis: Mosby.

Can radiation affect breast milk?

It depends on the level of radiation. For example, exposure to the ultraviolet rays of the sun or to X-ray does not affect breast milk or breast milk production, so there is no reason to interrupt breastfeeding for either type of exposure.

Exposure to the radioactive isotopes used for diagnosing or treating certain physical conditions usually requires an interruption of breastfeeding for hours to weeks, depending on the specific agent, the length of its use and its half-life. Many women express their milk by pumping their breasts and then dispose of this milk until it is again safe to breastfeed or give their pumped milk to their babies. This action often is referred to as “pumping and dumping” (the breast milk).

Exposure to the radiation used to treat certain cancers is not usually compatible with breastfeeding because related compounds/antimetabolites are excreted through the breast and are cumulative, posing a potential danger for an infant’s health. However, many women have breastfed infants born after the completion of radiation therapy. Some of these women experienced decreased milk production in a breast exposed directly to radiation. The radiation can destroy some of the milk-making tissue. The baby’s growth will then depend more on milk production in the unaffected breast. (One breast usually can provide enough to fully breastfeed one infant.)

Reference:
Lawrence, RA & Lawrence, RM (1999). Breastfeeding: A guide for the medical profession (5th ed.). St. Louis: Mosby.

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