Internet: Separating Facts from Myths
I am developing a love-hate relationship with the internet. It can be both a wonderful source of information and a terrible source of information. The challenge for internet users is separating facts from myths.
One popular resource that I use for accessing the latest news on a specific topic is Google Alerts. Among the listings on a recent alert was an article on foods to avoid while breastfeeding by Apuva Shree.
The article begins with the statement, “There are no hard and fast rules regarding foods to avoid while breastfeeding.” The author then proceeds to give readers a series of hard and fast rules.
“Nursing mothers should stay away from chocolate, cabbage, chili, garlic, curry, and all such foods that can cause flatulence in the baby.” MYTH
“If you want a good night’s sleep, the safest thing to do is to just drink some milk and feed your baby before going to sleep. On the other hand, if you have consumed some food with a strong flavor, it’s likely that the baby might not like some breast milk flavors and it could wake up howling in the middle of the might.” MYTH
“Caffeine, present in coffee, tea, soda, and over-the-counter medicines should be avoided at all cost.” MYTH
“Basically the foods that have sharp, strong tastes should be avoided while breastfeeding. In fact, the nursing mother should steer clear of any such foods till the breastfeeding period is over.” MYTH
There is no indication as to Ms. Shree’s academic background. But it appears that the site is actually a referral point for those seeking debt consolidation.
The take home lesson – before you accept what’s written as fact, do your homework.
In the meantime, if you’re a breastfeeding mother, eat, drink, and enjoy! The name of the game is MODERATION and the one EXCEPTION is alcohol which should be limited to a single serving (serving size = 12 ounces of beer or 6 ounces of wine or one ounce of liquor) a week.
On RARE occasions, a particular food in a mother’s diet can cause a reaction in her baby. If you think this may be happening, discontinue the food and see if your baby’s symptoms improve. If there is no improvement and the symptoms continue, call your baby’s doctor.
The following comment was provided by Ms. Shree.
“Ms. Spangler has pointed out that the breastfeeding mother does not require any additional calories and states that breastfeeding may make it easier to lose weight after pregnancy. I would like to draw your attention to some authority websites and information.
Please refer to a special report published on the WHO website: http://www.who.int/child-adolescent-health/New_Publications/NUTRITION/ Breastfeeding/Trainers_Guide_Part4.pdf
We would like to draw your attention to page 6 of this report, which clearly mentions that, “A breastfeeding mother should eat enough food to provide nutrients to make breast milk, and to prevent her own body tissues from being used up. She needs enough food to help her to feel well and strong enough to care for her family. This is an example from one country of the extra food that a breastfeeding mother is advised to eat, in addition to her usual food. She needs to eat food, which provides about 500 Calories extra. If this is from a variety of foods, then the extra protein and vitamins and minerals will automatically be provided.
More authority websites support this information including:
http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=Retrieve&db=PubMed&list_u ids=1200699&dopt=Abstract
None of the mothers were aware of the extra caloric requirements of the body during nursing although the Department of Health and Social Security and the United Nations Food and Agriculture Organization recommend increases of 500 and 1000 kcal/day. This information comes from an authority website quoting an international organization – United Nations Food and Agriculture Organization.
http://life.familyeducation.com/nursing/postpartum/36048.html
The last paragraph of this page clearly supports intake of additional calories. It states, “While your body is producing breast milk, it requires more calories than usual. Most lactating women will need to consume about 500 additional calories above their normal pre-pregnancy food intake. An individual mother’s calorie requirements can vary widely depending upon her basic metabolism and level of activity. Nutrition experts recommend that breastfeeding women consume 2,700 calories per day.
http://www.fda.gov/fdac/features/895_brstfeed.html
This report published on USFDA sites states,Eat right, get rest: To produce plenty of good milk, the nursing mother needs a balanced diet that includes 500 extra calories a day and six to eight glasses of fluid. She should also rest as much as possible to prevent breast infections, which are aggravated by fatigue “
http://www.kellymom.com/nutrition/mom/mom-calories-fluids.html
In her article Kelly Bonyata, who is an IBCLC states,An exclusively breastfeeding mother, on average, needs to take in 300-500 calories per day above what was needed to maintain pre-pregnancy weight.
Some more examples to support this statement are as follows:
http://womenshealth.about.com/cs/breastfeeding/a/nursingdiet.htm
“A nursing mother produces 23 to 27 ounces of milk per day, containing 330 milligrams of calcium per quart. This requires an extra energy expenditure of at least 500 calories per day. Good nutrition is therefore just as important for you as it is for your baby.
Some more examples:
http://www.pregnancy.org/article.php?sid=1044
http://parenting.ivillage.com/newborn/nbreastfeed/0,,3×5f,00.html
http://pediatrics.about.com/cs/quizzes/l/bl_bf_results.htm?level=20&q0 =12&q1=13&q2=17&q3=2&q4=11&q5=15&q6=7&q7=14&q8=9&q9=19&q10=18&q11=10&q 12=5&q13=6&q14=3&q15=4&q16=8&q17=0&last=20&q18=16&q19=1
http://breastfeed.com/resources/articles/weightloss.htm
She indicated that my statement, “Caffeine, present in coffee, tea, soda and over-the-counter medicines and it should be avoided at all cost, is a myth.
She quoted part of the statement while the complete statement reads, “Caffeine, present in coffee, tea, soda and over-the-counter medicines and it should be avoided at all cost. While a moderate intake of caffeine or social drinks is not harmful, the baby’s sleep pattern may be disrupted and it could keep waking up at night due to poor feeding.
http://www.euro.who.int/document/e73182.pdf
WHO report states: The principles of healthy nutrition recommended for pregnancy apply also during breastfeeding. Page 17 number 3. Caffeine Tea, cocoa and cola -type drinks contain about the same amount of caffeine while coffee contains about twice as much caffeine. Try to limit your coffee intake to 3-4 cups a day.
Page 25 Remember:
Alcohol can pass into the breast milk, so do not drink or at least restrict alcohol intake during lactation; there is no evidence of any beneficial effect of alcohol on breast milk production;
smoking may decrease your ability to produce breast milk and thus affect the growth of your baby, smoking also decreases the vitamin C content in breast milk;
try not to harm the lungs of your newborn child – never smoke in baby’s room;
caffeine can pass into the breast milk and cause hyperactivity and sleeping problems in your baby – try not to drink too much coffee, tea and cola drinks (recommendations are the same as for pregnancy);
many medications can also pass into breast milk – check with your doctor before taking any (however, taking most medications is not a contraindication to a breastfeeding)
If something (caffeine), which has no proven benefits but could be a source of possible problems shouldn’t it be avoided for the benefit of the child?
More examples:
http://www.babycenter.com/expert/baby/postpartumnutrition/8906.html
Too much caffeine can interfere with your baby’s sleep or make him fussy. Remember that caffeine is also found in some sodas, teas, and over-the-counter medicines.
http://www.femail.com.au/foods_breastfeeding.htm
These sources also dispel Ms. Amy’s objections regarding use of spicy food, strong flavors, cauliflower, cabbage etc. Moreover, we should not forget that internet is a source of information for global audiences and different cultures have different opinions about foods to use and foods to avoid while breastfeeding.”
I appreciate Ms. Shree’s thoughtful response to my post.
I am grateful for the reminder that many cultures have different practices with regard to dietary recommendations and/or restrictions.
The point I was trying to make is that many sources recommend dietary restrictions and/or recommendations in the absence of evidence to show that the restrictions and/or recommendations are necessary.
More importantly, when too many rules and regulations are applied, breastfeeding mothers are more likely to choose not to breastfeed or to breastfeed only for a short time.
While many of the sources Ms. Shree refers to in her commentary are credible, some of the information dates back to 1975.
Dr. Ruth Lawrence, author of Breastfeeding, A guide for the medical profession and a highly respected expert in the lactation community, states in her most recent edition, copyright 2005, “Most writings for nursing mothers regarding maternal diet during lactation set up complicated “rules” about dietary intake and fail to consider the mother’s dietary stores and normal dietary preferences and cultural patterns. Thus one barrier to breastfeeding for some women is the “diet rules” they see as being too hard to follow to too restrictive. Therefore the physician and nutritionist must understand the simple requirements and widely acceptable variations so that dietary guidelines make minimal demands on a woman’s lifestyle. All over the world women produce adequate and even abundant milk on very inadequate diets.”
With so much information at our fingertips, parents and health professionals alike are challenged to separate what is credible from what is not.