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From:
michelle i scott <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Wed, 26 Mar 1997 12:00:57 -0500
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I've been reading the comments of decreased dairy for mothers and the questionable need for large amounts of dairy in children's diets.  As an RD, I would like to offer the following:  Calcium's importance for bone mineralization and maintenence is widely appreciated but the impact of other nutrients on bone health need to be considered as well.
Dietary sodium, and caffeine increase urinary calcium losses, so when a mother goes off dairy products, it is equally important to do a dietary assessment to see if there's >2000mg Na, and what level of caffeine is consumed.   Since the ratio of CA to Phosphorus in the body is important (it should be about 1:1), the diet should be assessed to see what levels of Phos
she is getting.  Of note is that meat eaters, soda drinkers, and users of prepared mixes or foods often have a high level of Phos.   When dietary Ca is
inadequate, the condition is aggravated by low potassium intake. (Fruits and vegetables provide adequate potassium when eaten as recommended 5-9 X/d)
There are many other factors to consider, and other nutrients and minerals which are influential, but the bottom line is, dietary analysis would help rather than simply prescribing Ca, and using "dairy substitutes".  Incidently, when TUMS are used to excess this can cause constipation, and neutralizes stomach acids which play an important part in normal digestion and absorption of nutrients.
        For toddlers who are eating table foods and still nursing, whole milk can provide some of their protein and calcium needs, but needs only be a part of a healthy diet.  Soy milks, creative cooking with high Ca greens, use of canned fish with the bones, getting plenty of K from veg/fruits, and avoiding excess Na, phosphates, and caffeine make good sense whether you are nondairy or not.
        And for the inferred question about the mother's FE pills causing the baby's lack of BM, it is not likely at all.  Iron levels in the mother's blood do not automatically appear in the breast milk, the breast milk production is more discriminating than that.  Just as iron fortified formula does not cause constipation in infants, the mother's FE supplement is very unlikely to have any effect on baby.
 Supplements of FE for women are often l0 or more times the daily requirement--the more is better mentality, which is not backed up by research.   A recent study showed that when mothers skipped days of taking FE, there was a greater absorption response when she did take it.   The IOM guidelines do not suggest FE for every pregnant woman, tho prenatal pills have at least 2-3 X the MDR. 
Excellent article on "Dietary Phosphorus, Calcium Metabolism and Bone" by Mona Schiess Calvo publ. l993 Am. Institute of Nutrition
M. Scott, MA, RD, IBCLC    [log in to unmask]

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