Yael Wyshogrod wrote:
>My understanding is that there is an increased need for calories, but the
>500 calorie number was way too high and it is more like 200 calories; and
>that this number, whatever it is, doesn't change for the mother of a one
>month old or five month old baby who is exclusively breastfeeding..
>Somehow this doesn't make sense. Isn't a 5 month old baby consuming more
>milk than a one month old?
Actually, no, the amount a baby is taking is constant at least from
one to six months. This was demonstrated as a side observation in
Peter Hartmann's study when they were looking at the correlation of
prolactin levels and milk supply. There was no relationship as such -
the prolactin levels steadily fell to just above pre-pregnancy levels
while the milk supply remained *constant* over the period of the
study (normal, thriving babies, one to six months).
Ref: Cox D, Owens RA & Hartmann PE, 1996, Blood and milk prolactin
and the rate of milk synthesis in women, Exper Physiol 81: 1007-1020
Oh, and that leads me onto something else I wanted to comment on -
the mum with the low supply at about 8 months. Taking Reglan may
boost her prolactin levels but at that stage of lactation the normal
level of prolactin is not elevated anyway, so *theoretically* it may
not be expected to work to increase milk supply.
Has anyone had experience in using metoclopramide in 'later'
lactation like this? Did it work like you would expect at an earlier
stage?
>
>And how does this relate to the idea that breastfeeding (all other things
>being equal) can help a mother lose pregnancy weight? Does it? Are any of
>you still telling mothers this?
There have been studies on this. Dr Jill Sherriff, here in Perth,
Australia, studied this. I have an article she wrote in the Child and
Antenatal Nutrition Bulletin (produced by the Health Dept of Western
Australia), from 1995, that summarises the other studies that have
been done on this and what she found in her study. She quotes Dewey,
Heinig & Nommsen (Am J Clin Nutr 1993, 58:162-6) who found that the
weight loss was only apparent after 3 months of lactation, and Ohlin
& Rossner (Int J Obesity 1990, 14:159-73) in Sweden, who found the
greatest impact of breastfeeding on weight loss occurred between 3
and 6 months postpartum. This was similar to what she found. (Her
article is quoted as Hartmann, Sherriff & Kent, Proc Nutr Soc 1995 in
press, so I can't give the exact citation - yes, it's Peter's
department again!). I also remember from a talk Jill gave that the
weight loss pattern from different mothers did vary a great deal.
One of the recommendations that she makes is to promote breastfeeding
for at least 6 months so the opportunity to lose the extra fat stored
during pregnancy is not lost. I know we know there are *lots* of
other reasons to breastfeed, but it can't hurt to add this one,
particularly for the mother who wants to know 'what's in for them' as
opposed to benefits for the baby.
******************************************************************
Joy Anderson B.Sc. Dip.Ed. Grad.Dip.Med.Tech. IBCLC
Nursing Mothers' Association of Australia Breastfeeding Counsellor
Perth, Western Australia. mailto:[log in to unmask]
******************************************************************
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