~ Get some exercise (Breastfeeding123.com)
~ Plan ahead for quality family and couple time (BreastfeedingMums Blog)
~ Work on manageable goals (drink more water, volunteer, not overextend) (The Lactivist)
~ Get organized (Mama Knows Breast)
~ Do at least three things to support breastfeeding (Motherwear Breastfeeding Blog)
~ Consider what’s best for your child first (Momma’s Angel)
~ Work on how you speak to your child(ren) (Natural Moms)

Post from: Breastfeeding 1-2-3

If you are like me, you may be wondering what the scoop is on exercise for nursing mothers. (If your New Year’s Resolution is to quit smoking, see my Fast Facts about Cigarette Smoking and Breastfeeding).

Brand-new Mothers
New mothers, particularly those who have had a cesarean section, should get clearance from their doctors before beginning or resuming an exercise program. Once you’ve gotten that okay, start slowly and let your body be your guide.

In The Womanly Art of Breastfeeding, La Leche League advises that mothers do nothing to consciously bring about weight loss during the first two months postpartum. (p. 219). Personally I exercise as much for my mental health as my physical health, and not so much for weight loss (particularly in those early months after giving birth). It can do wonders for both mother and baby to get out for a walk with the baby in the sling or stroller. In cold weather, even a baby who is properly bundled can enjoy some fresh air.

Of course if conditions simply don’t permit outdoor exercise, there are plenty of other options. Take a stroll around an indoor mall or try any one of the workout videos for moms and babies (these are especially helpful for moms who want to nap when the baby naps and save exercise for later, or those moms whose babies don’t want to be out of mom’s arms while she exercises!)

With each of my children I made a too-early attempt to get them to stay in the gym daycare. I was not successful because I couldn’t stand for them to cry–that’s not a relaxing break for me, knowing that my child is crying for me. We were both happier when we waited until the child was ready to separate from me for half an hour at a time. I’m happy to report that my toddler now loves the gym and squeals “There it is! Gym!” when we pull in to the parking lot!

Exercise for Nursing Mothers in General
At one time it was thought that mothers should not breastfeed immediately after exercising due to changes in the mothers’ milk, but now we know that exercise does not change the composition of breast milk.

As long as you replace fluids lost during moderate exercise, your milk supply will not be affected. In fact one study suggests that mothers who exercise generally have a greater milk supply than those who do not exercise.

While mothers who exercise at 100% intensity (exhaustive exercise anyone? Anyone? Not me!) show an increase in lactic acid in their milk, there are no known harmful effects on the baby. Kellymom.com explains that there was one study that implied that babies rejected milk with the increased lactic acid content, but the researchers had tested their theory by feeding the babies by dropper. I think my baby would reject a dropper too if she had never been fed that way before–what baby wouldn’t prefer the breast, lactic acid or no lactic acid? Fortunately, a later study confirmed that babies do not refuse to nurse even when there is a slight increase in lactic acid in the milk.

Exercising for Weight Loss
If your goal is to lose weight after those first eight weeks postpartum have passed, then there are a few things you can do. The number one thing to do, though, is to continue breastfeeding! The Womanly Art of Breastfeeding reports that studies have shown that breastfeeding mothers generally lose more weight three to six months postpartum than mothers who take in fewer calories but are not breastfeeding! (p. 219).

If you slowly increase your exercise level with activities like aerobics and swimming, avoid foods with excess fat and sugar while not restricting calories too much, you can safely lose weight while breastfeeding.

One of my favorite exercise activities is swimming or playing in the pool with my baby. Babies generally are not bothered by the chlorine on a mother’s breast, but if a mother is concerned she can rinse off the breast with plain water before nursing (using soap is not usually recommended as it washes away the breast’s natural lubricants).

Vote in the exercise poll in the sidebar to the right or through this link! Feel free to leave a comment about whether your New Year’s resolution involves exercise. How do you manage to incorporate exercise into your day?

To go back to the Carnival of Breastfeeding on New Year’s Resolutions, click here.

Post from: Breastfeeding 1-2-3

With that in mind, I’ve started a new poll:

To view all prior poll results, click here.

Post from: Breastfeeding 1-2-3

First, some fast facts about breastfeeding and cigarette smoke:

~ It is far from ideal to smoke and breastfeed–but it is worse to smoke and not breastfeed. (1)

~ The half-life of nicotine is two hours, meaning that two hours after smoking a cigarette, half of the nicotine released into the body remains in the body. (2)

~ Nicotine decreases production of prolactin, the hormone that stimulates milk production. (3), (4)

~ Maternal smoking cuts breast milk production at two weeks postpartum from 514 milliliters per day to 406 milliliters per day. (5) (Breastfeeding counselors may wish to ask mothers with low supply whether they are smokers).

~ Mothers who smoked before, during, and after pregnancy were 2.18 times more likely not to breastfeed at 10 weeks. Women who smoked 10 or more cigarettes per day postpartum were 2.3-2.4 times more likely to wean their infants before 10 weeks than were nonsmokers. (6) (Remember, exclusive breastfeeding is recommended for 24 weeks and breastfeeding is recommended for at least 52 weeks total).

~ Women who quit smoking during pregnancy were more likely to breastfeed for six months or longer. (7)

~ The breast milk of mothers who smoked during pregnancy contained less of the healthy fats (total lipids and fatty acids) than milk produced by non-smokers. (8)

Second, if you want to see the voting results of the companion poll “Cigarette Smoking and Breastfeeding,” click here.

Third, in this article I’ll answer the questions: Should a smoker breastfeed? What are the effects of nicotine on the baby? How does secondhand smoke affect a baby? Can a nursing mother use smoking cessation medications and products? Where can I find resources on quitting smoking?

Should a smoker breastfeed?
The short answer is yes. The long answer is that a mother who smokes should continue to breastfeed and ideally should attempt to quit smoking. Some mothers may mistakenly believe that if they are smoking it’s better for their babies if they switch to formula. In reality, smoking and formula-feeding is the worst case scenario.

What are the effects of nicotine on the baby?
Breastfed babies of smokers are more likely to experience colic (excessive crying) compared to breastfed babies of nonsmokers. (4)

Also, the Australian Breastfeeding Association notes:

Nicotine is an appetite suppressant and can alter the taste of breastmilk. Babies may express their distaste for the milk by fussing and struggling at the breast or even refusing the breast. If the mother smokes more than 15 cigarettes a day, infants can exhibit symptoms of nicotine poisoning (Bisdom 1937). These symptoms may include vomiting after a feed, grey skin colour, loose stools, an increased heart rate and restlessness. Classically, the infant can be observed to wiggle and squirm, giving the appearance of trying to frantically ‘tread water’ and though they appear very tired they seem to find it hard to keep their eyes shut. Symptoms are slowly reversed when the mother decides to cut back or quit her previous smoking habit. However, infants may also suffer withdrawal symptoms such as sleep disturbances, headaches and irritability.

How does secondhand smoke affect a baby?
The Australian Breastfeeding Association says:

Babies who are “smoked over” are more likely to be hospitalised and to suffer from respiratory and gastrointestinal illnesses. Studies show that these infants are more likely to be colicky and irritable and to experience a wide range of problems from apnoea (short periods when the baby stops breathing), vomiting, poor growth, squint (strabismus, cast or lazy eye), hearing impairment and unexplained death. Smoking depresses the immune system, leaving both the mother and infant more vulnerable to infection, allergy and other immunodeficiency problems (Minchin 1991).

Can a nursing mother use smoking cessation medications and products?
Always consult with your doctor about the safety of any medication for you and your breastfed baby. The general answer is yes, the nicotine patch, nicotine gum and the nicotine inhaler are compatible with nursing. (These items are marketed under the trade names Habitrol, Nicoderm, Nicorette, Prostep, Nicabate, and Nicotinell TTS).

One of the foremost experts on medications and mothers’ milk states:

[T]he absolute infant dose of nicotine and its metabolite cotinine decreases by about 70% from when subjects were smoking or using the 21 mg patch to when they were using the 7 mg patch. In addition, use of the nicotine patch had no significant influence on the milk intake by the breastfed infant. Undertaking maternal smoking cessation with the nicotine patch is, therefore, a safer option than continued smoking.

(2), (9). Note that it’s dangerous to use the patch and continue to smoke–the combination of the two sources of nicotine results in extremely high levels of nicotine which can harm the baby.

While the patch provides a continual low-dose level of nicotine, the gum has a rapid effect on nicotine levels. Therefore, it’s best for women to breastfeed immediately before chewing the gum, then wait another two to three hours before breastfeeding again after chewing the gum.

Where can I find resources for quitting smoking?
There are several on-line resources for quitting smoking. I’ve also linked to one of many books on the subject (the American Lung Association’s book got a five star review from all its reviewers as of the writing of this article).

American Cancer Society’s Guide to Quitting Smoking

American Lung Association’s Resources on Quitting Smoking

Center for Disease Control’s Tobacco Information and Prevention Source

National Cancer Institute’s Quitting and Prevention Help and Information

Nicotine Anonymous (a 12-step fellowship program)

SmokeFree.gov

Smoking Cessation Leadership Center

Sources:
(1) Minchin M.K. “Smoking and breastfeeding: an overview.” J. Hum. Lact. 1991 Dec.;7(4):183-8.

(2) Hale, Thomas W. Ph.D., Medications and Mothers’ Milk, 12th edition, Texas: Hale Publishing (2006), p. 645.

(3) Benowitz N.L. “Nicotine replacement therapy during pregnancy.” JAMA 1991;266(22):3174-3177.

(4) Matheson I., Rivrud G.N. “The effect of smoking on lactation and infantile colic.” JAMA 1989; 261(1):42-43.

(5) Hopkinson J.M. et al. “Milk production by mothers of premature infants: influence of cigarette smoking.” Pediatrics 1992; 90(6):934-938.

(6) Liu J., Rosenberg J.D., Sandoval A.P. “Breastfeeding duration and perinatal cigarette smoking in a population-based cohort.” Am. J. Public Health. 2006 Feb. 96(2):309-14.

(7) Giglia R.C., Binns C.W., Alfonso H.S. “Which women stop smoking during pregnancy and the effect on breastfeeding duration.” BMC Public Health. 2006 Jul. 26;6:195.

(8) Agostoni C. et al. “Earlier smoking habits are associated with higher serum lipids and lower milk fat and polyunsaturated fatty acid content in the first 6 months of lactation.” Eur. J. Clin. Nutr. 2003 Nov. (57)11:1466-72.

(9) Ilett K.F. et al. “Use of nicotine patches in breast-feeding mothers: transfer of nicotine and cotinine into human milk.” Clin. Pharmacol Ther 2003; 74(6)516-524.

Post from: Breastfeeding 1-2-3