Sue

You haven't missed anything.  And by the way, 
there's a typo on the notice too -  it's 
"hydrated"!   It's really counter-productive for 
mothers to be told to drink plenty of fluids, ie 
to force the fluids, without - as you say - 
looking for other reasons for reduced milk 
supply.  The breastfeeding mother should drink to 
thirst, no more, no less.  If she is not drinking 
enough her urine will become dark, and breastmilk 
output may, in fact, temporarily increase.  If 
she drinks too much, the result may be a slight 
suppression of lactation, as the kidneys go into overdrive.

If you search the archives from early Feb 2002, 
you'll see that information was sent in by Ruth 
Scudieri citing Lawrence and Riordan & Auerbach, 
p 517, "excess fluid intake may result in reduced 
milk production".  The refs given were:

Dusdieker LB, et al:  Effects of supplemental fluids on milk production. J
Pediatr 106:207-11, 1985

Dusdieker LB, et al: Prolonged maternal fluid supplementation in breast
feeding.  Pediatrics 86: 737-40, 1990.

Hope this helps.

Pamela Morrison IBCLC
Rustington, England

-----------------------
Sue Jacoby writes:

In a handout for physician's offices, I read the following:
(if breastfeeding is not going well)

"Remind mother to stay hyderated whenever breastfeeding the baby."

The above instruction is one of only four bullet points.
See it in context, below:

If there are signs breastfeeding is not going well, intervene
as necessary, (e.g., provide telephone and in-office support,
refer mother to a lactation specialist and/or support group).
In addition:
• Reinforce on-demand feeds ­ and no supplementation
n
­ will increase milk supply.
• Remindmothers not to take formula samples, if offered.
• Remind mother to stay hydrated whenever
breastfeeding the baby.
• Discuss benefits of exclusive breastfeeding for the
first 6 months of life, and the benefits of continued
breastfeeding through 12 months. Explore barriers,
work through solutions, and provide resources, support
and community referrals.

Question: Is this an evidence based suggestion? 
Is it an actual concern, so much so that it would 
be highlighted as the one bullet point in a list 
of four suggestions for when breastfeeding is not going well?

I hear this a lot- "Be sure you are drinking a 
lot of water." But I don't believe this is a 
particularily pertinent help in troubleshooting a 
breastfeeding problem. Remember to stay hyderated 
-sure- always a good idea- but it has always 
seemed to me to be a rather vapid and meaningless 
suggestion, along the lines of: "Wear a sweater or you might catch cold!"

Then you get mothers forcing excessive fluids. 
And the breastfeeding problem never really gets 
addressed. Or have I missed something?

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