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Chapter 7

Nutrition Chapter 7 Summary.docx

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University of Guelph
NUTR 2050
Jess Haines

Nutrition Chapter 7 Summary Low milk supply - Usually caused by mother not breastfeeding or pumping often enough - Can also be caused by stress - Galactogogue- a herb used to increase milk supply eg. Goat’s-rue or milk thistle - Make sure diet is adequate and fluid intake is good Maternal Medications - 90-99% of breast-feeding women receive some medication during their first week after having the baby - Recommending that a mother discontinue breastfeeding to take a medication is almost never required and should only be done as a last resort - Be knowledgeable about medications safety during breastfeeding so proper treatment can be given and unnecessary maternal anxiety can be avoided. For example many cold medicines and antihistamines are usually compatible with breastfeeding, but they may suppress lactation - The American college of Obstetricians and Gynecologists and the World Health Organization recommend again using any combined oral contraceptives in the first 6 weeks postpartum - The La Leche League International recommends avoiding combined oral contraceptives all together because there are other forms of contraception available - Progestin only oral contraceptives and implants are safe and effective during lactation Herbal Remedies - Mothers may think that herbs are natural and therefore safe, however the risks of using some herbal remedies may outweigh the benefits - Herbs that are central nervous system stimulants, cytotoxic (destroy cells), laxatives, hepatotoxic, carcinogenic, mutogenic or contain potentially toxic essential oils are not recommended during lactation - Some culinary herbs such as sage or parsley may lead to problems if consumed excessively. Sage has a reputation for lowering milk supply - Consumed on occasion though, in small amounts these herbs do not effect lactation Specific Herbs used in the United States - Echinacea- consumption during lactation is not recommended - Ginseng root- not advisable due to side effects - St. John’s Wort- used as a mood stabilizer, many products may be poor quality and not even contain this herb so mothers should only buy from a reputable source. - Large doses can cause low milk supply - May be a reasonable treatment option for postpartum depression using only high quality products - Fenugreek- most commonly used herbal galactogogue - Goat’s rue- widely used galactogogue in Europe and South America usual dose is one teaspoon dried leaves steeped in water, no severe side effects reported - Milk Thistle/ Blessed thistle- Often combined with fenugreek Taken as a tea but also available in capsules Something to keep in mind: there are limited human studies done on these herbal remedies, safety, the proper dosing and intended/unintended effects may be unknown Alcohol and Other Drugs/ exposures - Harmful effects of drinking while pregnant are well documented - Alcohol passes quickly into the breast milk and the effects on the baby are related to how much the mother consumes - As the alcohol clears from the mother’s blood it also clears from the milk - Short term exposure to small amounts of alcohol in the breast milk lead to changes in the infants sleep patterns - If a mother does want to have a drink she can wait until the alcohol has cleared her system before nursing or can plan ahead and have milk stored Nicotine - Many health risks for infants of mothers who smoke eg. Gastrointestinal dysregulation, respiratory infections and colic - Women who smoke cigarettes are less likely to breastfeed than non-smokers - Lower milk output has been reported among smoking mothers - Mothers who smoke and breastfeed show poorer growth than other infants Marijuana - A study following marijuana exposure in infants through breastfeeding showed that there was a decrease in motor development at one year of age Caffeine - Moderate intake of caffeine causes no problems for most breastfeeding mothers and infants - Infants ability to metabolize caffeine does not fully develop until 3 to four months of age so therefore caffeine does not accumulate in the infant - Cases of excess caffeine in infants has been documented which cause infants to be wakeful, hyperactive and fussy - Most infants can tolerate a mothers caffeine intake equivalent to 5 or fewer cups of coffee a day Other drugs of abuse - Amphetamines, cocaine, heroin, and phencyclidine hydrochloride are considered drugs of abuse - Use of these substances is not advised during lactation because of the adverse effects on the mother and infant Environmental Exposures - There is now data that breast milk can accumulate potentially toxic harmful pollutants - Persistent organic pollutants, heavy metals and volatile solvents are the chemicals most often found in breast milk - A woman can come into contact with these chemicals through air pollution, drinking water, diet and even through household cleaning products - Major health organizations overwhelmingly support the importance of breastfeeding even in a world where contaminants are present - The benefits of breastfeeding may outweigh the risks of these toxic effects - Women should learn how to reduce exposure that may affect the quality of their breastmilk rather than resorting to other methods for example avoid freshwater fish from reported contaminated waters Neonatal Jaundice and Kernicterus - Jaundice is a yellowing of the skin that is caused by too much bilirubin in the blood, usually goes away on its own or with minimal intervention - 60-80% of babies will become visibly jaundice - Permanent neurological damage can occur if the problem does not resolve itself Physiologic Vs. Pathologic Jaundice Physiologic Jaundice - after the first 24 hours the bilirubin levels begin to rise due to
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