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Date: | Sun, 8 Jun 2008 13:00:12 -0400 |
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While I agree that the baby's growth should be proof enough of the adequacy
of its mother's milk, I don't think the doc who was treating the mother with
the kidney disease was off base. Normally our kidneys do not allow protein to
enter our urine. They filter out waste but conserve protein. Protein in urine is
not normal. Pregnant women with proteinuria have lower serum albumin levels
than pregnant women with normal kidney function. Low serum albumin
predisposes to edema, also postpartum, and many of us have seen what an
obstacle that can be to the normal establishment of breastfeeding. Someone
with low serum albumin will have great difficulty mobilizing edema fluid because
they lack osmotic pressure to draw extracellular fluid into circulation.
In the case of the woman mentioned here on Lactnet, her kidney condition
made her less able to tolerate a high protein diet, putting her doubly at risk for
reduced serum protein. She is losing protein because of her kidneys' inability
to conserve it, and is less able to replenish her stores because of her
compromised renal function. She is also giving protein to her child via her
milk. Since blood is the substrate from which milk is synthesized, the level of
protein in her milk could be a reasonable thing to wonder about. Also, it may
be that as long as she is lactating, she could tolerate a diet higher in protein
since her breasts are actively removing protein from her blood with every
feed.
In any case, if her consumption (use) of protein is greater than her intake, her
muscle mass could start to waste, OR she could become immune compromised
herself due to lack of basic ingredients from which to synthesize her own
immunoglobulins. It sounds like a challenging case nutritionally. I say we
should be relieved that her doctor is concerned enough to want to know more
about it.
Rachel Myr
Kristiansand, Norway
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