1. What’s in breast milk?
The composition of breast milk
changes in the first few days after birth from colostrum, which is rich
in protein and protective factors, to mature milk. It also changes
during each feed from fore milk, which is more watery, to hind milk,
which contains more calories and nutrients. It even varies with the
time of day and with the weather, so your baby gets more fluids when
it’s hot, and really does get just what he or she needs.
On average, breast milk
contains about 70kcal per 100ml. It is 1.3% protein, 4.1% fat and 7.2%
carbohydrate and has a range of vitamins and minerals. In addition to
providing nutrition, breast milk contains growth factors, hormones and
other special proteins, antibodies, white blood cells and nucleotides,
which help protect against infection.
2. How your diet affects your milk
Some components of breast milk are
affected by the food you eat. The protein and carbohydrate content
doesn’t seem to vary, but studies have shown fat content can be
altered. If you have a low-fat diet and low fat stores, the amount of
fat in your breast milk is reduced. The levels of different fatty acids
can also be altered. Women who eat more butter have higher levels of
saturated fat in their breast milk, and women on macrobiotic diets have
lower than average levels of saturated fat. In addition, women who
consume more of the long-chain omega 3s DHA and EPA have more of these
fatty acids in their milk. The breast milk of lacto-ovo-vegetarians
contains more ALA (a short-chain omega 3) but less DHA (a long-chain
omega 3) than that of meat-eaters. Vegans’ breast milk has even more
ALA and less DHA than that of lacto-ovo-vegetarians. It is also known
that three-month-old babies breastfed by vegan mothers have around a
third the amount of DHA in their blood compared to babies of
meat-eaters. There is no evidence of health or developmental problems
caused by vegans’ lower DHA levels, but there hasn’t been much research
into it. Some experts argue that long-chain omega 3s are vital in the
diets of breastfeeding mothers, and including some in your diet or
taking supplements should be considered.
There have been a small number of cases of vitamin B12
deficiency in babies of vegan mothers with low intakes of the vitamin
and low levels in their breast milk. Deficiency results in
megaloblastic anaemia and symptoms such as weakness, refusal to eat and
delayed development. Most of the cases have involved babies who have
been exclusively breastfed for up to 10 months to a year. A recent
case, however, involved a five-month-old Italian boy who was admitted
to hospital with severe growth and developmental problems and an
enlarged liver and spleen. He was vitamin B12
and iron deficient, and although his mother had taken multivitamin and
vitamin supplements during pregnancy, she had stopped when he was born.
Mild vitamin B12 deficiency in breastfed babies can be
treated by giving the mother a supplement, but the Italian boy needed
injections as he was severely deficient. These raised the level of
vitamin B12 in his blood, but seven months later he still
showed developmental delays. The supplements this vegan woman took
contained 2.5µg vitamin B12 and it may be that a higher dose would have given her son larger vitamin B12 stores at birth. Lacto-ovo-vegetarians usually have higher intakes than vegans, but levels of vitamin B12
in breast milk have been found to be lower among lacto-ovo-vegetarians
than among meat-eaters, and it is important for all vegetarians to be
vigilant about this while breastfeeding.
As milk is rich in calcium, you may
worry about getting enough calcium for your body to make breast milk.
However, it has been found that breast milk calcium levels are fairly
stable, irrespective of a mother’s calcium intake. Research with
macrobiotic women with very low calcium intakes found they had normal
levels in their breast milk. Nevertheless, following pregnancy you will
have less calcium in your body than normal, no matter how well you ate
during pregnancy. Also, your body may be producing calcium-rich milk at
the expense of your own needs. This could mean poor future bone health
if you aren’t careful. Calcium requirements increase from 700mg to
1250mg per day for breastfeeding, so it’s a good idea to check you’re
eating enough calcium-rich foods to meet these high requirements.
If you’re not, then it’s best to take a supplement. Although calcium
levels in breast milk are fairly stable, vitamin D levels are lower if
mothers have lower levels, and this could affect calcium absorption.
Vegetarians have been found to have lower vitamin D levels in winter
and spring, and all breastfeeding women are advised to take a
supplement.
The myth of poor-quality milk
Women
sometimes believe their milk isn’t very good. They may even be told
they have ‘poor-quality milk’. In reality, the composition of breast
milk is unlikely to vary enough to affect your baby’s feeding pattern
or immediate growth, unless you are severely malnourished. It is much
more likely that your baby’s positioning and attachment while feeding
need attention. If you are concerned about your milk supply and are
thinking about giving your baby the odd bottle or switching to formula
completely, don’t rush into it. Make sure you first talk to your
midwife or health visitor or call one of the breastfeeding helplines . They should be able to offer you plenty of advice on establishing good breastfeeding.
3. Yummy – garlic milk
The foods, spices and drinks you
consume while breastfeeding directly affect the flavour and odour of
the milk you produce. You might think that garlic-flavoured milk would
put a baby off feeding, but this doesn’t seem to be the case. It is
known that garlic transfers into breast milk – the odour has been
detected by scientists, who report that it is at its strongest two
hours after garlic is eaten – but babies seem to like it. In fact,
babies have been found to stay at the breast longer, suck more often
and consume more milk when their mother has eaten garlic.
Another great advantage of
flavoured breast milk is that it prepares babies for weaning and
enjoying a varied diet in later life. Breastfed babies are less likely
to become fussy eaters. A greater acceptance of different flavours is
apparent right from the beginning. A number of studies have found that
babies exposed to certain flavours while breastfeeding, including garlic and aniseed, are more likely to enjoy the taste later when they are weaned.
