How what you drink and eat affects your breast milk

BreastfeedingBy Allison Eatough

When Kristen Williams was pregnant, she occasionally thought about if and how her diet would change when she began breastfeeding.

But within days of her daughter Cassie's arrival, her breastfeeding diet became a constant thought.

"When I brought (Cassie) back from the hospital, I realized everything I was consuming was nourishing her," says Williams, a Columbia resident.

Williams, like many moms, heard tales about how eating broccoli could cause a breastfeeding baby to have gas and how moms must pump and dump their breast milk if they drink a glass of wine. Figuring out what is safe or unsafe to eat and drink can be confusing when breastfeeding, she says.

"There's a lot of dos and don'ts you can really get hung up on," Williams says.

Luckily for moms and their babies, most of those "don'ts" are myths. Almost everything is safe to eat and drink while breastfeeding, as long as it is in moderation, breastfeeding experts say.

"There isn't a need to place unnecessary restrictions," says Jen Doyle, a lactation consultant at Anne Arundel Medical Center.

Breastfeeding — still eating for two

To understand just how much of a mother's diet gets into her breast milk, it's important to first look at how breast milk is made. According to the American Academy of Pediatrics, breast milk is produced from a woman's mammary glands, not from the substances she ingests. The glands draw nutrients from a mother's diet, as well as the nutrients stored in her body.

To provide nutritious breast milk, the woman's mammary glands get the "first shot" at nutrients, the AAP says.
"If a mom is deficient or has a poor diet lacking in vitamins, the baby will still get the full benefit," says Ann Faust, a lactation consultant in Columbia. "But the mothers will suffer big time."

Moms may feel more run down or even get sick more often if they are not eating a healthy, well-balanced diet while breastfeeding, she says.

Breastfeeding mothers need an extra 400 to 500 calories a day to produce sufficient milk for their babies. Snacks like almonds, oats and yogurt and protein like eggs or non-processed chicken can boost a woman's own defense system, Faust says.

"Ideally, mom's eating a healthy diet so she can have more energy and take care of her baby," Doyle says.

Breastfeeding and Caffeine

Before Kristin Stuppy of Highland had her first child, her mother told her about a friend who didn't breastfeed because she didn't want to give up chocolate.

"If I had to give up chocolate I certainly would," Stuppy says. "But chocolate has never affected my children."
Chocolate, as well as coffee, tea and soda, can contain the stimulant caffeine. Some mothers worry if they drink a cup of coffee or eat a chocolate bar, the caffeine will come through the breast milk and potentially make their babies more alert or even fussy.

Studies have shown breastfeeding mothers can safely have up to 570 milligrams of caffeine a day, says Renee Neuens, a lactation resource nurse at Baltimore Washington Medical Center. The average cup of coffee has 130 milligrams.
"Mom can have a cup of coffee in the morning or tea or an iced tea with lunch and she can feel completely fine with it," Neuens says. "Actually, she can have all three and be fine."

Still, some babies — especially younger ones — are more sensitive to caffeine than others. To be safe, Faust recommends avoiding coffee in the evening.

Moms should also drink plenty of water, juice or milk to ensure they are getting the fluids they need while nursing, Neuens says.

Breastfeeding and Alcohol

Faust says her heart melts every time she hears about a mom pumping her breast milk and then dumping it because she had a glass of wine.

"If you're legal to drive, you can nurse your baby with no problem," she says.

A mom's blood alcohol level is similar to the breast milk alcohol level, Faust says. For example, if a mom drinks a glass of wine, her blood alcohol and breast milk levels should be next to nothing three to four hours later.

Ideally, mom should nurse her baby before she plans to have a drink, Doyle says. After that, having a 5-ounce glass of wine, a 12-ounce beer or a 1.5 ounce, 80-proof alcoholic drink should be fine, she says. If mom drinks more than that and is neurologically still affected by the alcohol at the next feeding time, she should pump her milk and then discard it, Doyle says.

After talking with Faust, Williams says she felt comfortable drinking an occasional glass of wine while nursing.

"I gave up coffee when I was pregnant and I never looked back," she says. "But I never pumped and dumped."

While having a drink may be safe in terms of alcohol reaching the baby, alcohol consumption can affect some women's milk production. Prolactin and oxytocin are two hormones needed to produce milk. When a mom drinks alcohol, it increases her prolactin levels. That increase can delay the milk letdown reflex, Neuens says.

Breastfeeding and Food Allergies

Stuppy's first child, Zane, never had trouble digesting breast milk or food. But her 4-month-old daughter, Maya, does.
"She has spit up a lot since birth," Stuppy says. "I'm trying to figure out why."

To see if Maya could keep more down, Stuppy cut dairy out of her diet for several weeks. The amount of spit up didn't change, Stuppy says.

Then in November, she noticed Maya spit up more than usual and acted uncomfortable after Stuppy ate popcorn. It's difficult to say if popcorn was the reason for the change, but it's something Stuppy says she will monitor.

Professional opinions differ when it comes to eating or avoiding foods like dairy products or peanuts that are common food allergies.

Doyle says moms should be aware if they have a family history of food allergies, but they don't need to eliminate specific foods from their diet. Instead, watch baby for signs and symptoms of food sensitivity, including eczema, rash, hives, wheezing, stools with blood or mucous in them or colic or fussiness that lasts all day.

Faust says she has never heard of a baby going into anaphylactic shock after drinking breast milk from a mom who eats peanuts. Still, if a family member has a known food allergy, she says to check with the child's pediatrician — and to err on the side of safety.

"Why risk it?" she says.

More breastfeeding information

Want more information about how foods and drinks can affect breastfeeding? Check out the following resources:
Book – Real Food for Mother and Baby by Nina Planck
App - Breast Milk Alcohol Content Calculator for iPhone and iPad by Darren Gates
Support – La Leche League International, Anne Arundel Medical Center's breastfeeding support group (443-481-6977)