Breast milk is very important to an infant's growth and development. There is no better source of complete nutrition that a mother can provide for her baby during the first year of life or longer. In fact, human milk is known to contain at least 100 ingredients not found in formula.

American Academy of Pediatrics Position on Breast Feeding²...

"Exclusive breastfeeding is ideal nutrition and sufficient to support optimal growth and development for approximately the first 6 months after birth. Infants weaned before 12 months of age should not receive cow's milk feedings but should receive iron-fortified infant formula. Gradual introduction of iron-enriched solid foods in the second half of the first year should complement the breast milk diet. It is recommended that breast feeding continue for at least 12 months, and thereafter for as long as mutually desired.

Breast Milk Facts

Healthier Babies: Breast-fed infants have lower rates of hospital admissions, ear infections, diarrhea, rashes, allergies and other medical problems than (formula) bottle-fed babies¹

Brain Development: Taurine, a sulfur-containing amino acid is found in relatively high concentrations in human milk. Taurine is known to become most concentrated in human brain cells during neonatal life³ In addition, formula fed babies, supplemented with taurine, are unable to maintain levels of taurine in their blood equivalent to breast-fed infants⁴

Gentle on Developing Organs: Other amino acids, such as phenylalanine and tyrosine are found in very low concentrations in human milk. These low levels are important since the infant's liver is slow to develop the enzymes that metabolize these amino acids. Therefore, higher levels may overburden the baby's delicate system.⁵

Immune System: Human milk contains a long list of proteins and protein antibodies that protect the [toddlers] immune system improving the baby's resistance to infections. Also included in human milk are small proteins that block viruses from attaching to cells. Simply stated, these protein enzymes disrupt the attacking bacteria's cell walls and prevent the bacteria from reproducing.⁶

References:
1. Williams, Rebecca D., FDA Consumer Magazine, October 1998.
2. American Academy of Pediatrics position on breast feeding, volume 100, no.6
3. Thurston, J.H. Hauhart, R.E. et al. Life Sci 26:1561-68,1980
4. Levin, Buck, Ph.D., R.D. Infant Nutrition, health & Nutrition Breakthroughs, March 1998, p40.
5. Levin, Buck, Ph.D., R.D. Infant Nutrition, health & Nutrition Breakthroughs, March 1998, p41.
6. Levin, Buck, Ph.D., R.D. Infant Nutrition, health & Nutrition Breakthroughs, March 1998, p40.

A mother that is able to acknowledge all of the hunger cues* an infant may display and to nurse their infant on demand should be easily able to meet their child's nutritional needs. Often times, a concerned mother believes that her milk supply is not adequate for her child, when, in reality, it is perfectly adequate; it is merely a "perceived" low milk supply. In order to help squelch any thoughts of inadequate milk supply, there are some physical signs an infant displays that help assess whether he/she is receiving adequate nutrients.

These include:

a) producing at least 6 wet diapers per day

b) urine that is pale and dilute (as opposed to dark yellow, strong-smelling urine)

c) frequent, seedy stooling (or if infrequent, large and soft stools)

d) eight or more nursings per day lasting 15-20 minutes (minimum) each

e) a slow and steady weight gain

f) he/she appears healthy, has good color, is alert, is active, and has good muscle tone

g) once a feeding is completed, he/she seems satisfied.

You've heard it said that a baby has different cries with different needs. Yet, crying is only one of the ways that a newborn communicates that it is hungry. One sign to look for is the rapid-eye-movement (or REM) during sleeping. This is actually a lighter sleep and a time when a newborn is beginning to feel the pangs and dissatisfaction that hunger brings. Especially for those infants that seem to sleep all the time and wake up ravenous, REM sleep may be a good signal that it is time to encourage the child to wake in order to initiate a feeding. Often times, if a feeding is delayed, the child becomes too hungry and is easily frustrated at the breast.

Another feeding cue to look for is the 'hand to mouth' movement. When an infant wants to nurse, the fist easily finds its way to the mouth of a hungry infant. The child may attempt to suck on the hand. Without milk to satisfy this infant, crying may ensue momentarily.

The 'rooting reflex' is another sign to look for. This is when an infant that is being held turns their head toward the person's body and opens their mouth as if to begin nursing. This is a sure sign that the infant wants to nurse.

By looking for feeding cues, you can help to satisfy your child's need to suckle and encourage your body to produce an adequate supply of milk.

How often is your baby able to nurse? The more a baby can suckle, the more hormones necessary for milk production are released. In fact, prior to a growth spurt, a child will seem to want to nurse all day long. This is nature's way of meeting the demand. As the child nurses, the mother's body is encouraged to produce more milk to meet the needs of increased growth. If you are back to work or unable to nurse often for whatever reason, try to pump as often as possible. (Every 2-4 hours) Even if you aren't able to excrete much milk at a time, it is the stimulation of the nipples that will help to secrete these necessary hormones and encourage more milk production.

Are you able to reduce your stress? I know, easier said than done! However, a relaxed body is able to produce more milk than a stressful one. Is someone else able to help with chores? Can you delegate other responsibilities? It is necessary to allow some time for yourself. Try to "get away" and enjoy an uninterrupted bubble bath, or a nap. Fatigue and stress are the number one cause for a decreased milk supply. Try to make de-stressing a priority.

Are you able to consume a nutritious diet with lots of high quality water? Strangely enough, a woman's body requires more nutrients while breastfeeding than while pregnant. I also recommend that you eat and/or drink something when you sit down to nurse. Studies show that more of the milk-producing hormones are secreted while eating. Also, more milk is produced if a mother eats right before or during a feeding. Remember to consume high-quality, nutritious foods with adequate protein, calories, vitamins and minerals. A severely strict diet will impede milk production efforts. If you are trying to get back to pre-pregnancy weight, allow yourself to do it very gradually. After all, the weight didn't come on overnight.

When the milk does "come in" you may notice an increased fullness in your breasts. However, some women don't notice much change at all. If you are nursing on demand, the baby is latching on correctly, and the baby is gaining weight, chances are that your milk has definitely come in.

However, an infant usually experiences a growth spurt around this time. Therefore, this increased nursing is merely the baby's way of helping mom to produce more milk. If you do supplement with formula, and don't pump or express your milk, your body won't produce more milk. Therefore, if you choose to continue breastfeeding, it would be most advantageous to nurse often without supplementing.

Once the baby has been delivered, many women want to immediately return to their pre-pregnancy weight. However, if calories and nutrients are severely restricted, this may hinder the development of the mother's milk supply. Once this milk supply is established (within the first 3 months), a moderate restriction of calories along with moderate exercise would be more appropriate. This would help to encourage a gradual weight loss while not hindering milk production.

Within those additional 500 calories, a woman needs to obtain additional protein, vitamin A, Vitamin D, vitamin C, vitamin E, Folic acid, Riboflavin, Niacin, Vitamin B6, Thiamin, calcium, Iron and Zinc. By choosing foods that are nutritious, and organic (when possible), will provide many healthy benefits to both mother and baby.

Alcohol, nicotine, and many over-the-counter and prescription medications can affect milk production and/or be secreted in the milk. Even some herbal remedies and dietary supplements can hinder milk production and/or be detrimental to a nursing baby. It is vital to use caution with these drugs and consult a health care provider prior to use.

Sometimes, a mother can consume any foods without it affecting their infants. At other times, certain foods that a mother consumes may pass through the milk and cause discomfort to a nursing child (e.g., gas, bloating, etc). Some of these foods that may be irritating include: milk and dairy products, gaseous foods (such as cabbage or dried beans), and caffeinated beverages. If consumed, these foods may affect the milk for the next few hours after consumption. If there is a history of food allergies/intolerances in the family, it may be more likely that those same foods may affect a nursing baby. However, it may take 'trial and error' period to determine any culprit foods for your specific child.

As a child ages, the stool frequency and weight also changes. Constipation, however, is defined as a change in the normal pattern of stools for a particular infant or as an extremely hard, dry, or small stool. Breast fed children rarely show signs of constipation. Constipation more commonly occurs with bottle fed infants. With constipation, dietary intervention can help increase fluids into the intestinal tract and alleviate symptoms very easily. If you believe that your child is showing signs/symptoms of constipation, I encourage you to consult with your child's health care provider.

It is vital to make sure that you are mixing the formula appropriately. If the formula has inadequate amounts of water, it can easily lead to constipation and/or dehydration. A formula that is too dilute will not provide the child with adequate nutrition.

Occasionally, when changing a child's diet, they may need an "adjustment phase" to the new food. By helping to alleviate symptoms of constipation, you will avoid any discomfort while "adjusting". If your child is experiencing any discomfort, pain, or cramping, your physician should be notified immediately!

Remember, a baby's stomach is only about the size of their own fist. Because it is small, it can only tolerate small amounts of feedings. A large feeding would increase the pressure within the stomach and would facilitate more spitting up. Offering a child with GER smaller more frequent feedings is one of the treatment measures to help minimize GER. Other actions include: placing the baby in semi-upright position while feeding, trying to encourage release of any air (burping) throughout the feeding, keeping the baby in a semi-upright position after the feeding (i.e., don't lie baby down immediately after a feeding), and avoiding tight fitting clothing and/or diapers.

It may also help to avoid certain foods in a child's diet that increase the pressure in the stomach which can lead to symptoms of GER. These foods include: citrus, tomato, chocolate, peppermint, and high fat foods. Usually babies out grow symptoms of GER as their bodies grow.

Occasionally, health care providers may recommend that infant cereal be added in order to thicken the formula as a treatment for GER. However, this treatment is controversial and has not been proven to reduce reflux. Thickening the formula in this way can increase coughing after feedings, delay gastric emptying, and can reduce the nutrients a child consumes because the formula would be displaced by the cereal.

For breast fed infants, the AAP recommends that they consume iron-fortified foods when solid foods are initiated (usually between 4-6 months) in order to ensure adequate iron intake. For children who consume formula, the AAP recommends that they consume only iron-fortified formula throughout the first year of life.

The American Dietetic Association strongly encourages that vitamins and minerals be obtained from whole food sources rather than from supplementation when at all possible.

We live in a period where there are many more options, nutritionally speaking, than there were even 20 years ago. How often are we bombarded with new products in the grocery store? Granted, many of these can be left in the store. But, now we can use a greater variety of foods in order to consume a nutritious diet. We no longer have to rely on only one food to meet a specific requirement.

There are many good, healthy foods out there. Yet, when we rely on only one of these foods, we miss out on all of the pleasures and the benefits that some of the other foods can provide. Remember the saying, 'Too much of a good thing will hurt you'? Well, it's the same for healthy foods. If we rely on a limited variety of foods in our diet, our diets may get too much of one kind of nutrient, and not enough of another. We lose sight of the 'balance' of a healthy diet.

By offering your child a variety of foods you will help to not only encourage a healthy diet, but he/she will learn the joy of various tastes and textures. In addition, he/she will also be able to model your willingness to try new and healthy foods.

A healthy diet consists of a variety of nutritious foods. Of course, whenever possible, organic foods will help to minimize consumption of harmful pesticides, chemicals, antibiotics, and/or hormones.