The birth of a baby is a joyous occasion. However, in the postpartum period the new mother may face a host of potential problems. These include the physical problems of fatigue, anemia, pain (from the episiotomy or Caesarean section), and breast soreness. Mental disturbances such as the "blues" or postpartum depression are also well-recognized.
These complications usually occur soon after the baby is born, and by the third month after delivery most women are feeling well. Unfortunately, that is not always the case and some women do not enjoy a rapid return to good health. In the past few years, it has become apparent that some of these women are ill because of postpartum thyroid disease, and may be helped to feel better with proper treatment.
A recent Center for Disease Control report finds that an estimated 375,000 babies being born each year at risk of neurological problems due to exposure to mercury in the womb. The Mercury Policy Project report indicates that at least 10% of women of childbearing age have levels of mercury in their bodies that exceed what the U.S. Environmental Protection Agency considers acceptable – this translates to nearly six million women. In addition, the FDA has issued advice on mercury in fish bought from stores and restaurants, which includes ocean and coastal fish as well as other types of commercial fish. Women who are pregnant or could become pregnant, nursing mothers and young children should not eat swordfish/marlin, Ahi, king mackerel, shark (often sold as imitation crab), or tilefish.
Cows' Milk, Lactose Intolerance
Since lactose is found in mother's milk, almost all infants of nursing age are able to digest it. But past weaning and with increasing age, progressively fewer children retain this ability. One study of black children found lactose intolerance in 11% of four- to five-year-olds, 50% of six- to seven-year-olds, and 72% of eight- to nine-year-olds. It is usually rare among North American white children under six years of age, but increases to 30% in adolescents.
"Most formula-fed infants developed symptoms of allergic rejection to cow milk proteins before one month of age. About 50-70% experienced rashes or other skin symptoms, 50-60% gastrointestinal symptoms, and 20-30% respiratory symptoms. The recommended therapy is to avoid cow's milk." [Pediatric-Allergy-Immunology, August, 1994]
"Those who consumed cows milk were fourteen times more likely to die from diarrhea-related complications and four times more likely to die of pneumonia than were breast-fed babies. Intolerance and allergy to cow's milk products is a factor in sudden infant death syndrome." [The Lancet, Vol. 344, November 5, 1994]
Infrequently, severe cases of lactose intolerance in children have been shown to cause damage to the lining of the intestine and severe diarrhea.
Most problems with insufficient milk supply result from issues with breastfeeding during the first six weeks, when a mother's milk supply is being established. A reduced milk supply may result from an insufficient number of feedings, limiting length of feedings, or improper positioning at the breast.
There are also maternal factors that have been associated with insufficient milk supply. Some medications, such as birth control pills, antihistamines and sedatives may decrease the milk supply. Smoking, excessive caffeine intake (more than 5 cups per day), hormonal problems and fatigue have also been associated with poor milk ejection reflex.
Although uncommon, a mother may be born with insufficient glandular tissue. Breast surgery, especially breast reduction, can have a similar effect.
Babies themselves can also play a part in insufficient milk supply. A baby with a tight or short frenulum (tissue anchoring the tongue to the floor of the mouth) may not be able to nurse properly, unless it is clipped.
Should you breastfeed while pregnant?
As a general rule, if it's safe for you to have sex, it's safe for you to breastfeed. There are, of course, legitimate reasons why certain mothers may be advised to wean – and abstain from sex – when they become pregnant (such as those with a history of preterm labor, premature delivery or miscarriage, women who experience uterine pain or bleeding, and others with the potential for higher-risk pregnancies). But for most mothers, breastfeeding while pregnant is perfectly safe. In fact, in many regions of the world, women routinely breastfeed one child while pregnant with the next.
Whether to vaccinate or not is a controversial and complex subject. There are many websites dedicated to informing parents regarding this issue. Many states accept vaccination waivers based on religious grounds and samples of religious waivers are available on the Internet.
Here are some guidelines to assist you if planning to have your child vaccinated:
Blood type suggestions, for those interested in the "Blood Type Diet":
In one study of 100 nursing mothers, vitex was shown to significantly improve milk flow and milk-release when compared to placebo. Vitex is traditionally taken the first day after birth and continued for ten days. Vitex is only recommended if there are any problems with milk production.
Saw palmetto should not be taken by women who are pregnant, nursing or trying to conceive, because it affects sex hormone levels.
Coffee should absolutely be avoided during breast feeding. Fetuses and newborns cannot metabolize caffeine in their livers, so it remains in their bodies for up to four days, stimulating their nervous system the entire time, causing irritability and sleeping difficulty.
Based on the recommendations of the Environmental Working Group and the U.S. Public Interest Research Group, it is recommended that shark, swordfish, king mackerel and tilefish, tuna, sea bass, halibut, marlin, pike, Gulf coast oysters and white croaker not be eaten by pregnant women and women of childbearing age who might become pregnant due to mercury contamination. It also recommended that nursing mothers and young children steer clear of these fish. In addition, the report says canned tuna, mahi-mahi, cod and pollack should not be eaten more than once a month.
On the basis of theoretical ideas about how melatonin works, some authorities specifically recommend against using it for depression, schizophrenia, autoimmune diseases and other serious illnesses, and in pregnant or nursing women.
Due to concerns regarding radiation, breastfeeding should be stopped for 48 hours after a bone scan.
Despite a growing body of evidence that docosahexaenoic acid, or DHA, is the essential structural ingredient of breast milk lacking in infant formulas, the Food and Drug Administration continues to ban its use in infant formulas in the U.S. as of 2001. A recent series of studies conducted worldwide indicate that breastfed babies have an IQ of 6-10 points higher than formula-fed babies.
Scientists and nutritional experts attribute this to DHA, an essential structural component of the brain and retina, found naturally in mother's milk. DHA has received glowing recommendations from the World Health Organization, the Food and Agricultural Organization of the United Nations and the National Institutes of Health.
Approximately 60% of the human brain is composed of fatty material; 25% of that material is DHA. Since humans cannot produce it, they must consume it. Studies show that the DHA level of women in America today is comparable to that of women in Third World countries. This is attributed to the trend against eating DHA rich foods such as fish. Fish oil is the best source of DHA and EPA.
During the last trimester of a pregnancy the mother transfers to her fetus much of the DHA needed for the development of its brain and nervous system. The DHA content in the mother's diet reflects the amount of DHA passed on to the baby. If the baby is not breastfed at all, it receives no subsequent DHA, thus hindering and impairing mental and visual acuity. DHA levels of premature infants are especially low since they miss much of that last trimester. Premature infants are also more likely to be bottlefed. If using infant formulas, make sure they contain DHA or use DHA supplementally.
In a dietary study of 119 pregnant or lactating women in the United States, the average intake of DHA was 54mg/day, only 18% of that recommended by experts. Less than 2% of these women met the FDA's recommended DHA adequate intake of 300mg per day. [Obstet Gynecol, 2000;95(4 Suppl 1): pp.S77-S78]
The risk of vitamin A deficiency is higher for young children whose mothers are vitamin A deficient. Maternal vitamin A deficiency results in reduced fetal stores and lower levels of vitamin A in breastmilk.
Infants and young children who are vitamin A deficient are at an increased risk of appetite loss, eye problems, lower resistance to infections, more frequent and severe episodes of diarrhea and measles, iron deficiency anemia, and growth failure. Infections and inflammation accelerate the use and loss of vitamin A.
The increased risk of illness leads to an increased risk of death. Studies show that in communities where vitamin A deficiency is prevalent, improving vitamin A status reduces child deaths by an average of 23%. Vitamin A is particularly protective against deaths due to diarrhea and measles and may reduce the severity of malaria symptoms.
In the first six months of life, breastmilk protects the infant against infectious diseases that can deplete vitamin A stores and interfere with vitamin A absorption. Vitamin A intake of a breastfed child depends on the vitamin A status of the mother, the stage of lactation, and the quantity of breastmilk consumed. From birth to about six months of life, frequent breastfeeding can provide the infant with all the vitamin A needed for optimal health, growth, and development. Breastmilk is generally higher in nutritional value than alternative foods and liquids fed to children in developing countries. Consumption of other foods decreases the amount of breastmilk consumed and may disrupt the infant's absorption of vitamins and minerals from the breastmilk. Therefore, exclusive breastfeeding until six months of age helps ensure sufficient vitamin A intake.
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