December 2003

The five stages of pregnancy: Lactation

by Dr. Howard Loomis

The joyous day has arrived: the baby has been delivered, healthy and (mostly) happy. In this month's series installment, I'll be addressing the postpartum nutritional requirements for both the mother and the baby.

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The American Academy of Pediatrics has long advocated the use of breast milk as the primary food source for full‑term infants. In 1997, this advisory was extended to include premature infants. The Academy recommends that mothers breast‑feed their babies for at least one year. There are two reasons for this:

1. Breast‑feeding reduces infant illnesses. A recent study published in Pediatrics [1] has shown that breast‑feeding significantly reduces the occurrence of common infant illnesses such as respiratory tract infections, pneumonia, ear infections, and gastrointestinal disorders. In the two‑year study of 977 babies, a community program was implemented which urged women to breast‑feed their infants rather than use baby formula. The program resulted in a significant 38% increase in breast‑fed babies.

During this time, the number of babies who developed pneumonia in the first year of life declined by 33% and the cases of gastroenteritis decreased by 15%. Researchers suggest that "breast milk itself or the process of breast‑feeding provides protection against infant illnesses."

2. Breast milk is best for premature infants. Many experts believe breast milk contains a number of compounds that "jump‑start" an infant's immune system and help the infant fight off infections. Preterm infants fed breast milk developed significantly fewer infections. [2] In the study, 212 preterm, very low birth weight infants (under three pounds) were fed either breast milk or formula.

After adjusting for all other factors, they determined that infants fed breast milk dramatically decreased their odds of infection by 57%. Many of the immune system agents normally found in breast milk are found in higher concentrations in the breast milk of mothers who deliver prematurely.

Mother's fatty acid deficiencies

All three essential fatty acids (EFAs) are precursors for prostaglandins. EFAs promote conception, prevent spontaneous abortion, allow the mother to initiate labor, and commence lactation after delivery. An important point to remember is that many troubled pregnancies stem from fatty acid deficiencies.

Women, in general, have difficulty digesting and adsorbing protein and lipids. The nutritional cause is invariably a fatty acid deficiency if the new mother cannot begin lactating or cannot produce a sufficient quantity of breast milk. This deficiency may even manifest in soreness and cracking of the nipple region. An old yet successful remedy is to massage the area with cocoa butter.

It is interesting to note that essential fatty acid deficiencies are most commonly found in infants fed a nonfat formula.

Fat‑soluble vitamin deficiencies

Research has shown that vitamin A can reduce a child's risk of death from measles. [3,4] According to a study on Brazilian children, it can help treat severe diarrhea. [5]

Vitamin D deficiency is most common when the mother is a vegetarian and/or lacks adequate sun exposure. Mothers who breast‑feed should spend 15 minutes in the sunlight daily to increase their vitamin D levels.

Vitamin K deficiency may occur in some infants and neonates, including those with malabsorption disorders. This may lead to unexpected hemorrhagic disease. Babies are often given intramuscular vitamin K shots at birth to prevent this condition. Other nutritional factors

The B‑vitamins pass from the mother to the baby via breast milk. Deficiency is more common in mothers who are vegetarians. In these cases, supplementation is necessary for mother and child.

Iron deficiency, according to the American Academy of Pediatrics, may be related to feeding cow's milk to infants under the age of one year. Frequent ear infections are found in these children as well. Therefore, most baby formulas now contain iron to prevent such problems. Iron deficiency is often related to protein deficiency.

Zinc deficiencies are common in premature infants and children with malabsorption syndromes. Deficiencies are generally not found in breast‑fed infants, assuming the mother is not deficient. However, it is believed that the entire human race is border‑line zinc deficient.

Nutritional references list the signs of zinc deficiency as diarrhea, growth failure, alopecia, irritability, and anorexia. Zinc deficiency is also implicated in skin lesions such as diaper rash and candida manifestations. These are also signs of fatty acid deficiency and excessive sugar intake. Individuals who do not digest lipids consume excessive sugars and this will furnish the subject material to discuss postpartum depression next time.

References

1. Hylander, M.A., D.M. Strobino, et al. (1998). "Human milk feedings and infection among very low birth weight infants." Pediatrics 102(3): E38.

2. Wright, A.L., M. Bauer, et al. (1998). "Increasing breastfeeding rates to reduce infant illness at the community level." Pediatrics 101(5): 837‑44.

3. Hussey, G.D. and M. Klein (1990). "A randomized, controlled trial of vitamin A in children with severe measles." The New England Journal of Medicine 323(3): 160‑4.

4. D_Souza, R.M. and R. D_Souza (2002). "Vitamin A for treating measles in children." Cochrane Database of Systematic Reviews (Online : Update Software)(1): CD001479.

5. Barreto, M.L., L.M. Santos, et al. (1994). "Effect of vitamin A supplementation on diarrhoea and acute lower‑respiratory‑tract infections in young children in Brazil." Lancet 344(8917): 228‑31.

(Dr. Loomis welcomes input on the subjects covered in this column. To make a comment or ask a question, write to him at 6421 Enterprise Lane, Madison, WI 53719. Visit www.loomisenzymes.com online or call 800/662‑2630 for information on upcoming Loomis Institute seminars.)