Thanks Heather. I couldn't agree more. Blog posts, comments and personal experiences are not scientific research. Just because someone perceives their milk as increasing or decreasing at a pumping or feeding does not mean that it actually has, or that it is in any way related to what they ate. I think we can all understand that moms frequently feel their supply is low when it isn't. Also, there are many factors that play into milk removal during pumping, such as time of day, stress, pain, how frequently the baby nursed the day before, etc. Things are things that moms may not be aware of or understand and can affect output, and I think they often erroneously feel it is due to what they ate. There are absolutely no studies to show that a particular food or food group could increase or decrease output. When we tell women this, I think it contributes to their confusion about milk production. There is not enough emphasis, in my opinion, on making sure that the milk is being removed from the breast and far too much worry about foods that mom is eating or how much water she is drinking even among some IBCLCs. I think that some IBCLC's are unfortunately contributing to this confusion among other HCP's and parents. Here's an example. I had a friend recently that delivered at a large teaching hospital in Chicago. She was breastfeeding and the IBCLC came to see her. She told her that the main things she need to know about milk production was never to eat spearmint or peppermint, and that's all she was told. What? Really? Where is the science behind statements like this? I also think it's those kind of pseudo-scientific statements that are going to keep us from being taken seriously in the medical community. Milk production is supply and demand (largely in the absence of other underlying physiological problems such as breast surgery or hormonal problems). It's under autocrine control. The more milk you remove, the more milk you will make. I tell the parents, it's not about eating special foods or drinking lots of water - this is supply and demand, if you want to make more milk, you need to take it out more frequently by feeding the baby, hand expressing or pumping. That's it. If you want to make more milk - put the baby on the breast! I think that sometimes we over complicate the very simple when it comes to breastfeeding. The mother would have to be profoundly dehydrated or starving before milk output is affected because our bodies burn fat store and pull fluids from interstitial tissues and blood. And then I remind them that doesn't mean they shouldn't drink water - drink water if you are thirsty, but it doesn't directly make milk and neither does eating any particular food.  For goodness sakes, I really hate the idea that drinking more water is going to make more milk. It seems like parents think they are going to pour water down their throat and it's going to come shooting out their breasts like it's a spigot or something. So they drink a gallon of water and then supplement with a bottle of formula and wonder why they aren't making enough milk. Oh boy. Let's be sure that we are being crystal clear with parents about this one.  Tricia Shamblin, RN, IBCLC   Thanks, Lynn.

The blog post and the attendant comments are interesting but far from 
convincing. We'd need a good study, backed up with a physiological 
explanation, to be confident that there is a link. However, I don't 
mind at all a tentative 'keep it in mind and be  watchful' approach 
to this.

My main issue is the blanket instructions to mothers that they must 
eat healthily, or must eat/must not eat certain foods....especially 
to the mothers who have concerns about their baby's well-being or 
growth, and whose breastfeeding frequency and effectiveness are not 
even explored.

Heather Welford Neil, NCT bfc and tutor,
UK


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