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NUTRITION IN LACTATION

The human milk of an adequately lactating mother offers nutritional, immunological and
psychological benefits not paralleled by bottle-feeding with milk formulas. Breastfeeding is the
preferred feeding choice for infants for at least the first 6 months of age. Hence, lactating
mothers during the first 6 months after the baby is born has a higher intakes for some
nutrients, compared to the 7th to 12th months.

Ideally, breastfeeding should be continued until the 12th month of age if supplementary
weaning foods are given. On the average, a lactating mother produces 750-1000 ml of milk per
day. Nutrient requirements of the mother during lactation are increased to provide for normal
secretion of milk and for recovery from pregnancy and delivery.

Note that the caloric requirement is increased by 300 to 400 kcal/day for lactation over
tht of the non-pregnancy state for ages 19 years and over. Similarly, intakes of protein,
minerals and vitamins are increased.

Nutritional Requirements in Lactation

Energy/ Nutrient 1st 6 2nd 6 months


months

Energy, kcal 500 500

Protein, g 16 16

Vitamin A, RE 325 225

Vitamin C, mg 35 30

Thiamin, mg 0.4 0.4

Riboflavin, mg 0.4 0.4

Niacin, NE 5 5
Folate, micro g 100 100

Calcium, mg 400 400

Iron, mg 23 23

Iodine, micro g 50 50

*supplementation is recommended

To be assured of adequate fluid intake, it has been suggested that a lactating mother
should drink at least a glass of fluid (water/juice) at each meal and each time the baby is
breastfed.

Caffeine-containing beverages and alcohol should be avoided for it pass into the breast
milk. Certain drugs are excreted in breast milk; breastfeeding may be contraindicated or the
infant must be observed for adverse effects when these medications are taken. Obese mothers
who are breastfeeding should not be placed on a low-caloric diet. Caloric intake of <1500
kcal/day can result in reduced breast milk production and inadequate nutrients for the infant.

FACTORS AFFECTING MILK SECRETION

1. Diet
a. Volume of milk secreted is affected by the diet, but the protein and calcium
compositions are not.
b. Meat and vegetable soup (tahong, tulya, malunggay), milk and fruit juices have been
referred to as “galactogues” i.e., milk-secretion stimulating.
c. Water should be drunk beyond the level of natural thirst because it suppresses milk
secretion through its action on the pituitary hormone that regulates milk production.
d. Avoid foods which may cause colic to infant and skin rashes like onions, turnips,
cabbage, chocolates, spices and seasonings.

2. Nutritional state of mother


a. Energy yielding constituents of human milk are maintained at the expense of the
maternal stores while the water soluble vitamins and vitamin A are low in poorly
nourished mothers.
b. Sufficient nutrient reserves in the mother’s tissues before conception and during
pregnancy influence milk secretion.
c. Malnutrition and illness such as cardiac and kidney diseases, anemia, beri-beri,
tuberculosis and infections can lessen the quality of milk flow.

3. Emotional and physical state


a. Attitude affects milk secretion. When the mother worries or frets about the sufficiency of
her milk, about her breast contour and about being tied down in her home, the flow of
milk stops.
b. A relaxed temperament, pleasant surroundings, lots of rest and good sleep enhance milk
secretion.

4. Suckling
a. The presence of the baby and suckling, immediately after delivery, stimulate the milk
producing glands.
b. As the baby feeds for longer periods of time, the supply of milk increases inproportion to
his demands.
c. Increased frequency of nursing is positively associated with infant weight and lactation
period.

5. Use of contraceptives and drugs


a. Women who use contraceptives like pills while breastfeeding depress milk flow and the
insufficiency of milk triggers the cessation of lactation.
b. Most drugs, including alcohol and nicotine from smoking, reach the milk sometimes in
physiologically large doses, thus affecting the quality of milk secreted.
CRITICAL THINKING EXERCISE