A recent pamphlet published by the Dairy Bureau of Canada entitled, Nutrition for breast-feeding mothers, contains some useful information, but there are a number of inaccuracies and assumptions that may be detrimental to the nutritional well being of the mother and infant to whom this information is directed.
Overall the pamphlet is complex, didactic and implies that unless all the "lifestyle rules" are followed, a woman may have difficulty breastfeeding. In fact the information is so cumbersome as to make breastfeeding appear to be alot of bother. The exagger ated emphasis on the mother's diet from additional calories to how much of what and what not to consume gives a distinct impression that breastmilk will somehow be inadequate unless all the eating rules are followed.
To begin with, the cover graphic gives an impression of discomfort. One assumes the baby is supposed to be breastfeeding but why is the baby's face turned away from the mother's nipple? And the mother is hardly the picture of comfort sitting side saddled on the ground in her private "garden robe". Not an image today's young woman would aspire to. Is the next graphic, a teddy bear, donated by Abbott Laboratories? This artificial baby milk company is a major violator of the International Code. Why use the ir symbol?
When one gets to the instructive part of this pamphlet, there are more problems. We are told that what and how much we eat will get "passed on" through our milk and that we need to pay close attention to what we eat. We are being set up for failure and do ubt and even if we go off for a meal or two we must get right back to the prescribed regimen. What does this mean? Firstly, breastfeeding is made to look complicated, the accompanying "food group chart" must be followed for one's milk to be adequate. An yone with a new baby and small children knows that a new mother has lots of time. Time to set a chart every time she pops something in her mouth and worry about whether or not she has met all the Dairy Bureau recommendations for successful breastfeeding. More than likely she will not bother and will be left with the impression that for successful breastfeeding she must follow the chart. If she cannot rigorously follow the instructions, will she continue to breastfeed? What about mothers whose cultural an d dietary backgrounds differ from upper-middle class white anglo-saxon women? What about mothers who cannot afford the expensive eating pattern being prescribed? Have these mothers been set up for failure? These are the very mothers who have the most to g ain by breastfeeding their children.
Secondly, breastfeeding is a beautiful intricate balance between a baby's needs and a mother's response. These synergistic responses are hormonally triggered particularly by the two hormones oxytocin and prolactin. A new mother needs to feel confident in her ability to nurture and feed her new infant. Unfortunately, this pamphlet is doubt inducing and potentially harmful to this delicate hormonal balance affecting milk production. Supportive, confidence building messages are what a new mother needs. Are t he - what if I don't eat enough of the recommended foods - or - what if I eat or do something wrong - designed to produce anxiety?
Calcium indeed seems to be key to this pamphlet. Other nutrients are not or only barely mentioned. The word calcium appears in the pamphlet 10 times. Is calcium some super nutrient that breastfeeding mothers require over and above all other nutrients? Cal cium of course is the nutrient used to sell the public on consuming cow's milk. The fear of osteoporosis is lurking behind "getting enough calcium is important when you are breastfeeding, because if you don't, you may decrease your own bone density and p ut yourself at a greater risk for osteoporosis later in life". However research (1),(2),(3) shows us that women who breastfeed have a reduced risk of developing osteoporosis and bone fractures o ver their non breastfeeding counterparts. Are new mothers being misinformed to frighten them into drinking their 4 glasses of cow's milk per day?
Getting calcium from cow's milk may not always be in the best interest of breastfeeding mothers and their children. A number of studies have shown that cow's milk proteins, of which more than 25 are known to be immunogenic, can pass into breastmilk. Expo sure to cow's milk antigens (4) can create havoc for the breastfed infant - allergic disease and colic are conditions that all new mothers prefer to avoid. Can the consumption of three to four servings of dairy products increase the likelihood of allergic disease and/or colic?
Other questionable statements and directives in the pamphlet, include an overemphasis on not smoking and drinking. Women know that smoking and drinking is bad for their health and the health of their children and yes, it is very important to warn about the hazards, however if she still choses to continue than it is still better to smoke and drink and breastfeed than to smoke and drink and artificially feed. Also the bit on exercising and "sour milk" is overblown. This report ca used a stir in the breastmilk research community and information (5) quickly appeared to refute this claim, yet this appears in the pamphlet.
Although some of the information in the pamphlet appears to be supportive and helpful, much of the information is not. Could the motive for "educating" breastfeeding women on their lifestyle and eating habits be to sell them cow's milk?
The Dairy Bureau of Canada is in the business of marketing cow's milk. Breastmilk is not their product, nor their specialty. We recommend that they withdraw this pamphlet and leave the information needed by pregnant women and new mothers to those who are expert in this area and who have no vested interest other than the well being of the mother and her baby.
REFERENCES: 1. Kritz-Silverstein, D. et al. Pregnany and lactation as determinants of bone mineral density in post-menopausal women. American Journal of Epidemiology 136, 1052-1059, 1992. Back
2. Sowers, M. et al. Changes in bone density with lactation. Journal of the American Medical Association 269, 3130-3136, 1993. Back
3. Cumming, R. G. et al. Breastfeeding and other reproductive factors and the risk of hip fractures in elderly women. International Journal of Epidemiology 22, 684-691, 1993. Back
4. Odze, R.D. et al. Allergic colitis in infants. Pediatrics 126, 163-170, 1995. Back
5. Dewey, G. et al. A randomized study of the effects of aerobic exercise by lactating women on breast-milk volume and composition. New England Journal of Medicine. 330, 449-453, 1994. Back
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