Episode Details

Episode 131: Breastfeeding Part 2

Lia and Aruna explain some updates given by the American Academy of Pediatrics regarding breastfeeding. Dr. Arreaza adds some comments about breastfeeding. 

Written by Aruna Sridharan, MS4, and Lia Khachikyan, MS4, Ross University School of Medicine. Comments by Hector Arreaza, MD.

You are listening to Rio Bravo qWeek Podcast, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California, a UCLA-affiliated program sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. This podcast was created for educational purposes only. Visit your primary care provider for additional medical advice.

The motivation for this episode was a recent publication by the American Academy of Pediatrics, on June 27, 2022, titled Policy Statement: Breastfeeding and the Use of Human Milk. During this episode, we included updated information along with other useful material.

Duration of breastfeeding:

The American Academy of Pediatrics (AAP), World Health Organization (WHO), and Center of Disease Control (CDC) recommend exclusive breastfeeding at least for the first 6 months, after which one can start to introduce complementary pureed foods. The US Department of Agriculture states that initiating complementary foods earlier than 6 months offers no benefit to the baby and can even be associated with a higher risk of overweight or obesity, especially if introduced before 4 months. Mothers are then encouraged to continue breastfeeding for at least one year and can further continue up to 2 years of age or longer - as long as mutually desired by mother and child. This is an update from previous recommendations regarding the duration of breastfeeding until 1 year of age.

Composition of human breastmilk:

As the sole source of nutrition for infants in the first 6 months of life, breast milk plays a critical role in development. Human milk has a unique composition of proteins, fats, and lactose, as well as vitamins, electrolytes, antimicrobial, anti-inflammatory immunoregulatory agents, and living leukocytes, all of which contribute to the developing immune system of the child. Breast milk is rich in Vitamins B1, B2, and B6, Vitamins C, A, E, Ca, Mg, phosphate, and folate. 

However, it is low in Vitamins K, D, B12, and iron, therefore supplementation of these nutrients is required. It is important for mothers to consume an adequate and healthy diet for their breastmilk to contain appropriate levels of these nutrients. 

Water-soluble and Fat-soluble vitamins can be low in breast milk if the mother has a deficiency. Selenium can be low if maternal serum levels are low. Dietary iodine deficiency may also be exacerbated by smoking; iron deficiency; and consumption of large amounts of foods that interfere with the production of thyroid hormones, known as goitrogens, including Brussels sprouts, kale, cabbage, cauliflower, and broccoli. 

Maternal diet:

Mothers should consume iodine-rich foods, such as lean meat, eggs, dairy, beans, and lentils. It is important to choose a variety of whole grains, as well as fruits and vegetables, and continue taking multivitamins. Fun fact: Different foods will change the flavor of your breast milk. This will expose your baby to different tastes, which might help him or her more easily accept solid foods down the road! It is recommended that mothers consume 290 mcg of iodine and 550mg of choline a day. 

Is there anything that mothers should avoid in their diet?

-Limit seafood: Although fish is a good source of protein and lean meat, it contains some mercury, which can be transferred to the baby’s diet. High amounts of mercury can have an adverse effect on the baby’s brain and nervous system.

-Limit caffeine: