Hi! and thanks for asking more about what I believe is the myth that bf moms
need a perfect or near perfect diet, including continuing to take their
prenatal vitamins.
First, please call me "Laurie." :)
In NAACOG's (now AWHONN) CLINICAL issues in perinatal and womens health
nursing, breastfeeding special edition, 1992: "there is a wide variation in
nutritional status, energy expenditure, metabolic efficiency, so no
universal statement about maternal nutritional requirements can be made." A
range can be suggested instead. p. 695. Routine vit-mineral suppl. is not
necessary. Women should also be counseled to drink to thirst. "there is no
data to support the belief that increasing fluid intake increases milk
supply." (so here is another myth). p. 696. Nutrition During Pg and
Lactation, Institute of Medicine, 1992, see indications for nutrient suppl,
which indicates if pt is anemic, low calcium intake in diet, or low energy
(calorie)
intake, then suppl are indicated. In BF and Human Lactation by riordan and
auerbach, see the chapter on maternal health or see nutrition in index.
"these worldwide studies, taken together, support the theory that maternal
nutrition has only a modest effect on milk production and on milk
composition in the face of malnutrition." p. 349 There may be more recent
editions, but to my knowledge none of these statements have changed. So all
this means that women can eat a less than perfect diet and still make great
milk. My counseling is this:
If the OB prescribes a supplement FOR THE MOM, i.e. she is anemic
postpartum, then she should take it FOR HER. If the mom is very
undernourished or truly has VERY POOR nutrition then she can
take a daily multivitamin/min suppl. It does not have to be the prenatal
prescription one, which is often very costly. it can be a generic "one a
day" variety. If the mom does not consume dairy
and cannot get her calcium from other dietary sources then she can take a
ca. suppl. But for the most part, women can be counseled re a generally
healthy diet and do not need the vit suppls. The main thing that I am
against is making women think they have to take their special prenatal vit
or there milk will be poor. I do let them know that if thier diet is very
poor and they lack vits there milk will lack some too, esp. the water
soluble ones. Many women choose to take a generic vit. every day "just in
case" and so do I, which I think is ok, but not mandatory. I do not think
the babies need the supps either, I agree w/ you. Again I would assess the
moms general diet and then rec. suppl only if deficient. Most USA moms are
overnourished, altho admittedly some may be not eating lots of fruits and
veggies and they do need the vits. I think you would agree that it is best
to get the nutrients and vits from the foods and not the supplements.
Thanks for asking. Of course, I am open to discuss this further - I do have
an open mind. Live and learn is my motto.
Laurie Wheeler RN MN IBCLC
Violet Louisiana, s.e. USA
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