Breastfeeding: Your Nutritional Needs (cont.)

Alcohol and Caffeine: Nutrients to Avoid or Limit While Breastfeeding

As you probably already know, alcohol and pregnancy are a dangerous mix. Surprisingly, however, the evidence is far less clear when it comes to alcohol's effects during breastfeeding. With studies on both sides of the fence -- some showing it may increase the risk of problems, others failing to prove it -- it's not surprising that experts are divided on the subject. As a result, breastfeeding moms should err on the side of caution. Limit alcohol to one or two drinks occasionally, says Huotari. "Until we know more, it's better to drink less," she says. Her advice is also endorsed by the American Academy of Pediatrics.

If you do decide to have a drink now and again, have it right after you finish nursing, at least two hours before it's time to nurse again. Two hours is the least amount of time it takes to eliminate alcohol from the body. If you do try nursing while alcohol is active in your system, don't be surprised if you have difficulty "letting down" (getting the milk to flow easily). One now-classic study published in 1992 reported that alcohol inhibits the production of oxytocin, a hormone that encourages the flow of breast milk. Nursing with alcohol in your body might also cause your newborn to shy away from feeding. Huotari sites studies showing the scent of alcohol can be detected in breast milk and might turn baby away from your body. When it comes to caffeine and breastfeeding, many doctors advise caution. The American Academy of Pediatrics points out that a caffeine overload can cause the same symptoms in your baby as it does in you -- nervousness, edginess, irritability, and insomnia, as well as poor feeding habits. Indeed, because babies can't process caffeine as quickly as moms, an overload can occur much faster in their systems than you think. To reduce risks, pediatricians recommend you drink fewer caffeinated beverages while nursing. Limit coffee, tea, colas, and chocolate. If you notice your baby appears nervous or edgy after feeding, consider cutting all caffeine from your diet.

Smoking and Breastfeeding: What You Should Know

Although you may have quit smoking while pregnant, you could be eager to start again after baby is born. Experts say this is not a good idea for a number of reasons. First, whether you are breastfeeding or not, studies show smoking around a newborn dramatically increases their risk of sudden infant death syndrome (SIDS). What's more, depending on how much you smoke, nicotine and other harmful chemicals in cigarettes can head straight for your milk supply, leaving your baby with a variety of ills. "Essentially, anything that gets into your body, gets into your breast milk. So whatever chemicals are in a cigarette are going to end up in your baby's body," says Hanna. Indeed, if you smoke more than 20 cigarettes a day, La Leche League experts say your baby may have nausea, vomiting, abdominal cramps, and diarrhea. At the same time you may have problems with milk "let down" and reduced milk production, making it harder for baby to feed. If you're thinking of using a nicotine patch to tame your cravings, the news is good: According to the textbook Medications and Mother's Milk by Thomas W. Hale, PhD, RPh, the average daily dose of nicotine in a patch is only about 17 mg, less than half of what you would get in 20 cigarettes.

Originally published Sept. 29, 2003.
Medically updated May 2005.

SOURCES: Linda M. Hanna, BSN, RNC, IBCLC, program coordinator, Lactation and Prenatal Education Services, Cedars-Sinai Medical Center, Los Angeles. Carol Huotari, IBCLC, manager, Center for Breastfeeding Information, La Leche League International, Schaumburg, Ill. A Woman's Guide to Breastfeeding, American Academy of Pediatrics. Pediatrics, December 1997; vol 100: pp 1035-1039. ACTA Endocrinology, 1992; vol 126, pp 3-16. The New England Journal of Medicine 1991, vol 325: pp 981-985. The American Academy of Pediatrics.

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