>From:    "Linda Volkovitsch, Nursing Mothers Counselor" <[log in to unmask]>
Does anyone have information on the need (or lack thereof) for
>vitamins for a healthy 17 month old who is still primarily breastfeeding?
>Baby nurses about 8 times a day, some snacking of crackers when feels like
>it, but diet is still primarily breastmilk (95% or so).  Pediatrician is
>upset about nutritional deficiencies of vitamins/minerals.

This child is either consuming VAST quantities of breastmilk or is not
growing to potential : or this mother has super-enriched breastmilk, much
higher in protein and calories than usual. (Milk does vary.) It's
meaningless to give an age of a child without giving a full history of
growth data. Knowing nothing about growth, I wouldn't be worried about
vitamins and minerals alone as the paed is, so much as about simple
protein-calorie malnutrition. The usual protein levels of breastmilk are
not enough for optimal growth in the second year. Kids can sometimes
compensate by staying smaller and in proportion, or guzzling vast
quantities (and having lots of fluid waste) but often they get increasingly
inactive as a way of conserving energy. There are studies all the way back
to the 1920's saying the outcome of exclusive breastfeeding past 12 months
can be very poor, including intellectual deficits. Not something to fool
with: WHY doesn't this child eat? There's usually a reason. What's the
family history of food intolerance and allergy? I would always investigate
such cases fully before feeling comfortable with supporting an almost
exclusive breastfeeder at 17mos.

As for green milk: in resting breast fluid of non-lactating women, this was
associated with cholesterol epoxides in the only study I know of that
looked at colour of such fluid. In the case seen, was this lots of milk,all
green orjust  one nipple duct/pore that green could be expressed from? I'd
suspect different causes in the two cases: some natural or synthetic
dyestuff, possibly blue or green in the first. (For orange milk, both
carrots and artificial tanning creams can do the trick.) How much animal
meat and fat in the diet? Enough to have huge quantities of cholesterol
by-products? Grey-green or deep olive green is common/"normal" in cysts in
western women, but a lactating breast usually produces enough milk to
dilute such colours. I suppose one small cyst near to the nipple could be
out of communication with the rest of the ductal system if you're seeing
one green ductal product and the rest milk. After lactation all bets are
off, especially for smokers: horrid dark colours in resting breast fluid.
The breast is an excretory (as well as secretory) organ, after all.

TTFN    MM