Kathryn H. Thompson, Ph.D.

April 11, 2001

Lactation Management

  1. Benefits of Breast-feeding
    1. Infant
      1. Decreased incidence of infection
      2. Protection against auto immune diseases
      3. Good jaw and tooth development
      4. Mother - Infant bonding
    2. Mother
      1. Accelerated weight loss
      2. Delayed return of ovulation
      3. Improved bone remineralization
      4. Reduced ovarian and premenopausal breast cancer risk
      5. Easy, clean economical
  2. Maternal nutritional requirements
    1. Energy: + 500 kcal progressive weight loss not to exceed 4.5 lb/month
    2. Protein: RDA = 65 g
    3. Calcium 1200 mg (same as prenatal)
    4. Iron requirement is decreased until menstruation resumes
    5. Prenatal supplements are often continued
    6. Fluids 2-3 quarts/day
  3. Contraindications
    1. Maternal infections: TB, typhoid, herpes, rubella, mumps, HIV and CMV
    2. Maternal medications: most chemotherapeutic agents, illegal substances. "If you wouldn't prescribe it for the baby, think carefully about giving it to the mother."
    3. Infant: galactosemia, some congenital deformities of the palate
  4. Breast-feeding promotion and support
    1. Education of mother and family
    2. Provision for early and frequent mother infant contact
    3. Concept of "demand and supply"
    4. Solutions for work related concerns: pumping and storage
    5. Proper feeding technique and breast care