Rachel wrote:
>I looked at the article at Health-e-learning and checked which references
>seemed to underlie the statement that a maternal diet high in refined sugars
>could lead to lactose overload and lack of fat in the breastmilk.  The only
>one I had at hand was Riordan and Auerbach, and what R and A say is that the
>proportion of fat in breastmilk is unaffected by maternal diet, though the
>composition of the fat component will reflect the composition of the fat in
>her diet.  To sum up: this reference does not support the claim that high
>carbohydrate and low fat intake by the mother leads to high carb, low fat
>breastmilk.
>I'm sceptical to such a claim at the outset; babies need milk of a certain
>nutritional composition.  We can give mothers vitamin D supplements to the
>point of toxicity without increasing the amount in their milk, likewise for
>iron.  Women in areas of famine continue to provide perfect milk for their
>babies, until they are in very advanced stages of starvation.  Most people
>in the western world following a special diet are doing so because they are
>carrying around their very own depots of fat.  I think the relative lactose
>overload sometimes seen as problematic in breastfed babies is from how the
>baby is feeding, not from some flaw in the milk synthesis.  Just my NSHO.
>Rachel Myr
>Kristiansand, Norway
>

Rachel, I agree with you. I have one of the other references here - 
the one by Abakada and Hartmann. This is from 1988, so quite old. I 
have heard Peter Hartmann say many a time that the fat content of 
milk is related to the degree of breast emptiness and *not* the 
maternal intake. Only the fatty acid profile changes with diet.

This article was a conference presentation and was about a 
'preliminary short term study' of just 7 well-nourished Western 
mothers. They found an inverse relationship between both dietary 
protein and energy, and concentration of lactose in the milk.

One of the graphs showed that lactose concentration was less when 
there were more feeds per day. Although all lactose levels were 
within normal limits, they found the highest lactose levels were in 
the women with lowest energy intake, and vice versa.

They quote another study from 1984 that found increased lactose when 
the mother changed from low-fat/high-carbohydrate diet to 
high-fat/low-carbohydrate diet.

They do admit that their sample size is small with no statistical power.

There is no mention that this change in lactose concentration could 
affect the baby in the case of lactose overload. This extrapolation 
from this small amount of data has been made by the authors of the 
Health-e-Learning article.

The third reference I do not have, but says it is case studies, so 
information about lactose concentration and diet may be considered 
anecdotal.

-- 
******************************************************************
Joy Anderson B.Sc. Dip.Ed. Grad.Dip.Med.Tech. IBCLC
Australian Breastfeeding Association counsellor, Nutrition student
Perth, Western Australia.   mailto:[log in to unmask]
******************************************************************

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