After I moved to California I quickly realized how easy it was to become mildly dehydrated in the hot summer months if I didn’t pay attention to getting enough water and other fluids to drink. However, it’s also all too easy for breastfeeding mothers to get dehydrated in the cold months with the dry indoor air from furnace heating. Mothers of newborns in particular need to watch out for early signs of dehydration simply because new mothers can get so busy caring for a newborn that they neglect their own needs.

Recommendations for Fluid Intake for Breastfeeding Mothers

When it comes to fluid intake for breastfeeding mothers, the mantra is “drink to thirst.” That means that a woman should drink enough water to stave off thirst, and not drink in excess of thirst in the mistaken belief that she needs the extra water or that more water will boost her milk supply. How do you know whether you are getting enough? If your urine is pale yellow, then you are getting enough fluids. If your urine is a dark, concentrated yellow, then up your fluid intake. In addition to water, fluids such as milk and juice also count, but keep in mind that fluids with caffeine (tea, coffee, certain colas) can actually have a dehydrating effect. So make sure to balance the types of fluids and get enough water to keep yourself adequately hydrated.

How and When Dehydration Might Affect Breastfeeding

The good news is that dehydration would have to reach severe levels before it would even affect milk supply at all. The Breastfeeding Mother’s Guide to Making More Milk says:

A pervasive myth in many cultures is that not drinking enough water causes low milk supply. While it’s true that life-threatening, severe dehydration may cause you body to cut back on milk production, the mild dehydration that most of us operate under does not. An old but still valid study from 1939 reported that nursing mothers who were given one liter less of water a day than was recommended continue to produce plenty of milk.

So what’s the danger in becoming mildly dehydrated? If the nursing mother (any mother!) gets dehydrated, it can affect her energy level, mood, and ability to care for her nursling. If you find yourself becoming particularly run-down and overwhelmed, it’s a good idea to sit down and have a glass of water and a snack. You might be surprised how that simple step boosts your mood! It can help to keep a glass of water by your bed and your other usual nursing locations. Have easy snacks at the ready too — carrot sticks, raisins, apple slices.

The Danger in Over-Hydrating

One study showed that consuming 25 percent more fluids than the “drink to thirst” recommendation led to a decrease in milk supply. I also learned from lactation consultant Linda Wieser at the LLL area conference that drinking more than 80 ounces of water per day can reduce a woman’s potassium levels and have a negative impact on milk supply. The Breastfeeding Mother’s Guide to Making More Milk explains:

The body’s reaction to excessive water intake (well beyond thirst) is to dump the excess fluid through the urine in order to maintain the proper electrolyte balance. Water is diverted away from the breast, and lower milk volume can result.

Your Experience

Have you noticed that your fluid intake affects your energy level and mood? Do you have any tips to share to help breastfeeding mothers get enough fluids?

Other Carnival Entries

Cave Mother: A Mother’s Christmas
Mama Knows Breast: A Breastfeeding Poem: Twas the Breastfeeder’s Nighttime
Chronicles of a Nursing Mom: Don’t Forget the Pump!
Accidental Pharmacist: Motherhood Statement
Hobo Mama: Breastfeeding and the holidays: How to take care of yourself
Mommy News & Views: The Holidays And Being A Breastfeeding Mom
The Adventures of Lactating Girl: Breastfeeding and Holidays
Happy Bambinos: How to Take Care of Ourselves during the Holidays
Breastfeeding Moms Unite!: Caring for a High-Needs Baby during the Holidays
Breastfeeding Mums: Looking After Yourself During the Holidays: 7 Tips for Breastfeeding Mothers
Motherwear Breastfeeding Blog: Taking Care of Yourself and Your Baby during the Holidays

Post from: Breastfeeding 1-2-3

AIDS Awareness ribbons; Photo by Subhadip Mukherjee

WHO now recommends that breastfeeding continue until the infant is 12 months of age, provided the HIV-positive mother or baby is taking ARVs during that period. This will reduce the risk of HIV transmission and improve the infant’s chance of survival.

2. CNN reports on the on-going story of the group of women who stepped in to breastfeed an infant when his mother passed away after giving birth. It’s been 11 months that baby Moses has been nursed by over 20 women. The baby’s father, Robbie Goodrich, said, “It’s been such an incredible outpouring of community love for this child of mine.”

3. Sinead at BreastfeedingMums covers the tragic story of a mother who fell asleep sitting up while breastfeeding her baby and accidentally smothered the child. As Sinead says, it’s important to pay attention to the guidelines for safe co-sleeping.

Post from: Breastfeeding 1-2-3

Photo courtesy of Nicolas Raymond

1. Heart health for breastfeeding mothers. A study of 140,000 post-menopausal women revealed several heart health benefits of breastfeeding. Women who breastfed their babies had lower incidence of diabetes, high blood pressure and high cholesterol. Women who breastfed for seven months or more were significantly less likely to develop heart disease. Women who breastfed for a cumulative 12 months or more in their lifetimes had a 10% lower incidence of heart attack, stroke, or heart disease later in life.

2. Lower risk of breast cancer for women with family history. The New York Times reported on a new study that found that “for women with an immediate relative, like a mother or a sister, who had breast cancer, those who breast-fed had a 59 percent lower risk of premenopausal breast cancer. That is closer in line with the risk for women who had no disease in the family.” The discovery was made by Dr. Alison M. Stuebe of University of North Carolina. The Motherwear Breastfeeding Blog features a podcast with Dr. Stuebe on the problem with formula company diaper bags.

3. Stem cells in breast milk. Scientists have discovered three different types of stem cells in breast milk. Researcher Dr. Mark Cregan believes the stems cells help each child “fulfill its genetic destiny” as the mother’s breasts take over from the placenta in guiding the infant’s development. This discovery not only highlights the fact that artificial milk is a poor substitute for breast milk, but also opens the door to research on causes of low milk production and drugs that could improve milk supply.

4. Breastfeeding helps prevent multiple sclerosis relapse. A study showed that women who breastfed exclusively for at least two months after giving birth were far less likely to experience a relapse of multiple sclerosis than women who did not breastfeed or started supplemental feedings with artificial milk.

5. Breastfeeding benefits for both baby and mother. In November the American Dietetic Association released an updated position paper promoting and supporting breastfeeding. The paper listed the breastfeeding benefits for babies as:

* Enhanced immune system
* Reduced risk for nonspecific gastroenteritis, severe lower respiratory tract infections and asthma
* Protection against allergies and intolerances
* Promotion of correct development of jaw and teeth
* Association with higher intelligence quotient and school performance through adolescence
* Reduced risk for chronic disease such as obesity, type 1 and 2 diabetes, heart disease, hypertension, hypercholesterolemia and childhood leukemia
* Reduced risk for sudden infant death syndrome.

The paper also listed the breastfeeding benefits for mothers:

* Strong bonding with infant
* Increased calorie expenditure, which may lead to faster return to pre-pregnancy weight
* Faster shrinking of the uterus
* Reduced postpartum bleeding and delays in the menstrual cycle
* Decreased risk for chronic diseases such as type 2 diabetes, breast cancer and ovarian cancer
* Improved bone density and decreased risk for hip fracture
* Decreased risk for postpartum depression
* Enhanced self-esteem in the maternal role
* Time saved from preparing and mixing formula
* Money saved from not buying formula and increased medical expenses associated with formula feeding.

Post from: Breastfeeding 1-2-3

The symbolic red flag that says: Slow down or else! (Photo by Jay Simmons)

* I make no medical claims about whether Graprefuit Seed Extract or cranberry supplements work or are in any way appropriate — I am not a doctor, just a breastfeeding mother sharing her attempted home remedies for a plugged duct!

Your Experience with Plugged Ducts

Have you ever gotten a plugged duct (or many over the years like me?) What do you do when you get one? Do you consider it a warning to take better care of yourself? Do you alter your diet, or ditch that underwire bra?

Post from: Breastfeeding 1-2-3

Posing with Dr. Bob Sears after his lecture

La Leche League conferences are great because children are welcome at the lectures. As I chased my 10-month-old around the back of the room (until she finally fell asleep in the sling as you can see above), I managed to take in a lot of valuable information from the lecture. Dr. Sears discussed the occurrence and severity of various childhood illnesses, how vaccinations have affected the prevalence of those illnesses, toxins in vaccines, delayed and alternative vaccination schedules, the debate about vaccines and autism, and how the “same” vaccines vary by manufacturer and brand. I like that he offers an opinion on particular vaccines but does not push vaccination or not vaccinating; it’s all about the parents making an informed decision. If you get an opportunity to hear him speak, it’s well worth it! He stayed long after the lecture ended to answer individual questions, and I took the opportunity to ask him some questions I had about my daughter’s potential reaction to the rotavirus vaccine.

One tip that’s not in The Vaccine Book: Making the Right Decision for Your Child: be wary of any future swine flu vaccination developed for humans. I plan to stay tuned to Dr. Bob’s blog for The Vaccine Book for the latest information on that and other vaccines.

Post from: Breastfeeding 1-2-3

Photo courtesy of Furya

Thus, the CDC urges new mothers to initiate breastfeeding early and to feed frequently. Mothers already breastfeeding should continue to do so, even if they become ill. Formula feeding should be avoided or minimized and breastfeeding maximized. In the Health News Digest, USBC Chair Joan Younger Meek, MD, MS, RD, FAAP, FABM, IBCLC, recommends breastfeedng in emergency situations such as a swine flu outbreak:

Research clearly shows that breastfeeding provides a safe, reliable food source, full of disease-fighting cells and antibodies that help protect infants from germs and illnesses. Mothers exposed to influenza produce specific protection for their infants and transmit this through their breast milk. Infant formula does not provide these specific infection fighting properties. Unnecessary formula supplementation should be eliminated so the infant can receive as much benefit as possible from maternal protective antibodies and other immune protective factors.

Key points from the CDC swine flu guidance include:

1. If a mother is ill with swine flu, she should continue breastfeeding and feed the baby more often. If she is too ill to feed at the breast but can pump, expressed breast milk should be fed to the baby. The risk of transmission of the H1N1 virus through breast milk is unknown, but reports of transmission of the regular, seasonal flu through breast milk are rare.

2. If the baby becomes too ill to feed at the breast, he should receive the mother’s expressed breast milk or donated human milk from a non-profit milk bank.

3. Antiviral medication treatment and prophylaxis are compatible with breastfeeding.

4. All usual precautions against virus transmission should be taken, including hand washing and covering coughs and sneezes.

Post from: Breastfeeding 1-2-3

Photo courtesy of Karen Barefoot

Nearly 140,000 post-menopausal women were studied in the Women’s Health Initiative. According to the Vancouver Sun (via One Small Step for Breastfeeding…), the study revealed breastfeeding’s heart health benefits on three levels:

1. Risk Factors. Women who breastfed their babies had lower incidence of the following three risk factors for heart disease: diabetes, high blood pressure and high cholesterol.

2. Cardiovascular Disease. Women who had never breastfed were significantly more likely to develop heart disease than women who breastfed for seven months or more.

3. Heart Attack and Stroke. Women who breastfed for a cumulative 12 months or more in their lifetimes had a 10% lower incidence of heart attack, stroke, or heart disease later in life.

Researcher Eleanor Bimla Schwarz, MD told WebMD:

The longer women nursed babies, the less likely they were to develop diabetes, heart disease, or stroke. Any breastfeeding was good, but more was better.

The complete study appears in the May 2009 issue of Obstetrics and Gynecology.

Post from: Breastfeeding 1-2-3

A little birth control humor by Treyevan

Post from: Breastfeeding 1-2-3

Photo by Steve Woods

1. Nursing after 1 or 2 drinks (including beer) causes the infant to:
a) increase milk intake.
b) decrease milk intake.
c) Milk intake remains unaffected.

2. Nursing or pumping within one hour before ingesting alcohol:
a) does not affect the level of alcohol in the milk.
b) increases the level of alcohol in the milk.
c) decreases the level of alcohol in the milk.

3. Breastmilk alcohol levels are:
a) the same as blood alcohol levels.
b) higher than blood alcohol levels.
c) lower than blood alcohol levels.

4. While food consumption can delay the peak of breastmilk alcohol levels, the peak generally occurs:
a) one hour after ingestion of alcohol.
b) two hours after ingestion of alcohol.
c) three hours after ingestion of alcohol.

5. When a baby nurses after a mother consumes alcohol, the baby sleeps:
a) better.
b) worse.
c) the same.

6. True or false: The American Academy of Pediatrics rates alcohol as “usually compatible with breastfeeding.”
a) True.
b) False.

7. What minimum level of alcohol consumption affects infants negatively and is associated with shortened duration of breastfeeding?
a) Any alcohol consumption.
b) Casual alcohol consumption (1 drink per day).
c) Daily heavy use (more than 2 drinks daily).

8. One study estimated that a breastfed infant received a certain percentage of the mother’s weight-adjusted dosage of alcohol when she consumed 1.5 drinks. That percentage was:
a) between 0.5 to 3.3% of the mother’s weight-adjusted dosage.
b) between 3.3% to 5.0% of the mother’s weight-adjusted dosage.
c) between 5.0% to 8.3% of the mother’s weight-adjusted dosage.

The Answers

1. b. Nursing after 1 or 2 drinks can decrease the infant’s milk intake by 20 to 23% in the 3-4 hours after ingestion of alcohol. However, the infants increase the number of feedings over the next several hours and total milk consumption over 20 hours is the same. Smart babies!
2. c. Nursing or pumping within one hour before drinking alcohol may slightly decrease the amount of alcohol in the milk.
3. a. Breastmilk alcohol levels closely parallel blood alcohol levels.
4. a. Breastmilk alcohol levels peak approximately one hour after ingestion of alcohol, although food consumption can delay the peak.
5. b. Babies slept more frequently for shorter periods of time during the 3.5 to 4 hours after alcohol intake.
6. a. True, the AAP category is “usually compatible with breastfeeding.”
7. c. Heavy drinking is dangerous. Casual drinking is unlikely to cause short- or long-term effects particularly if the mother waits 2 to 2.5 hours per drink before nursing.
8. a. The study showed the breastfed infant received between 0.5 to 3.3% of the adjusted dose.

How did you do? What surprised you the most?

Post from: Breastfeeding 1-2-3

Photo by Jyn Meyer

Symptoms of Postpartum Thyroiditis

Symptoms of hyperthyroidism include anxiety, insomnia, weight loss, increased heart rate, fatigue, and weakness. Hypothryoidism causes fatigue, unexplained weight gain or inability to lose weight, coarse and dry skin and hair, constipation, and depression. Lots of new mothers are tired and might attribute any of the other symptoms to the demands of caring for a baby! Fortunately simple blood tests can determine whether there is indeed an underlying thyroid condition, and mothers experiencing any unusual and ongoing symptoms should contact their doctors.

How Postpartum Thyroiditis Affects Breastfeeding Women

Nursing mothers should work to protect the breastfeeding relationship with three key considerations throughout the process: (1) compatible diagnostic testing, (2) compatible treatment and medications, and (3) management of milk supply, both oversupply and low supply.

Lucky me, I have hit the statistical jackpot and had both postpartum Graves’ Disease and now postpartum thyroiditis. The first doctor I saw wanted me to pump and dump my milk for an uptake scan and encouraged me to wean altogether. Needless to say I sought a second opinion. As MyThyroid.com explains:

The diagnosis is often made clinically, and as many women are still breastfeeding at the time of presentation, it is not generally desirable or necessary to stop breastfeeding for an uptake or scan as the diagnosis can usually be made on clinical grounds alone. Obviously, breastfeeding women should not have tests with radioactive isotopes as small amounts of the isotopes can be passed along in the breast milk, which is to be avoided.

Thyroid medications (both antithyroid medications used to suppress thyroid function and thyroid supplements used to boost thyroid levels) at appropriate doses are compatible with breastfeeding. Thyroid function can affect the milk ejection reflex and hence it can cause low milk supply. My experience has been the opposite — I had significant oversupply when I had undiagnosed Graves’ Disease. This time with the low thyroid function I have not experienced low milk supply.

Your Experience

Have you dealt with postpartum thyroid issues? What was your experience? How did it affect breastfeeding, if at all?

Post from: Breastfeeding 1-2-3