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Expert Q&A: Tips for Successful Breastfeeding

An interview with Laurel Schultz, MD.

Do you recommend that new mothers avoid certain foods while breastfeeding?

I tell women to eat a healthy diet and observe what happens. Let your baby declare himself if he has an allergy -- if he does, it will show up by four to six weeks.

If a baby is colicky, it could be caused by diet sensitivity, but this is the case for only a small minority of kids. On the other hand, if you see a connection between your baby's distress and certain foods, by all means cut those foods out of your diet.

I tell mothers to eat gas-producing vegetables -- such as cauliflower, broccoli, and brussels sprouts -- in moderation.  Extremely spicy food should also be avoided. I also advise mothers to avoid foods their child's father is allergic to because there's increased risk that the baby will be allergic to those foods as well.

As far as wine and caffeine, a glass of wine or a cup of coffee with a meal is OK, but don't overdo it. In general, I think people are too sensitive about diet issues and nursing, and many of the behaviors they blame on diet have nothing to do with that.

What kind of support do you recommend to a mother who is having breastfeeding problems?

I routinely refer patients to lactation consultants. I'd say that over half of my patients see a lactation consultant after their babies are born, even if they don't have a significant problem, just to get some guidance and advice.

I also refer people to La Leche League on occasion, depending what the problem is. It turns out that LLL has excellent advice for weaning an older child, which is kind of surprising. 

Are there mothers who simply can't nurse for physical reasons or because they don't produce enough milk?

Yes, and I've actually seen a fair number recently. Some women can't nurse because they've had breast surgery. Others can't nurse because they're on certain medications that could harm their baby. In many cases, they stop taking the medication during their pregnancy, but their physician wants them to go back on once the baby is born.

Very few women can't breastfeed because they produce insufficient breast milk. This is rare, but it does happen, and I want to support these women and make it clear that it's not just a failure of will. Despite their best efforts, some women simply can't produce a sufficient supply of milk.

What do you tell parents who don't want to breastfeed?

This is really rare -- I'd say one in 30 of the people I see don't want to breastfeed.

When a woman says she doesn't want to breastfeed, I find out why by asking just one or two questions to determine if the decision is based on a misconception. If it is, I try to clear that up.

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