Breast-feeding in 1991

Article Abstract:

Breast milk is a truly remarkable substance. Obviously, its purpose it to provide nutrients to the infant, and both national and international medical organizations recommend that infants be nursed for the first three to six months of life. This is especially important in developing nations, where both adequate nutrition and sanitation are often a problem. Breast milk is both nutritious and clean. Formula milk, on the other hand, may be diluted too much by mothers who fail to understand the proper instructions or who are attempting to economize by increasing the dilution. Furthermore, in many nations the dilution itself may well be performed with contaminated water. Breast milk also contains many antibodies which can help protect the infant until the immune system develops to the point where it can protect against infection. The effects of these antibodies are most evident in low-birth-weight infants, and in both industrialized and developing countries breast milk may help improve the survival of premature babies. Breast milk is not without its problems, however. The AIDS virus (HIV; human immunodeficiency virus) may be present in breast milk. Mothers in high-risk groups, however, may be tested for antibodies to the virus, and breast-feeding can simply avoided by the women who test positive. Many drugs also pass from the mother's circulation into breast milk, and this fact must always be considered when prescribing medication for a nursing mother. Alcohol also enters breast milk, and concerns have been expressed about potential harmful effects on the baby as well as possible effects on future alcohol habits in the child. In the October 3, 1991 issue of The New England Journal of Medicine, researchers show that infants suck less milk after the mother has drunk a small amount of alcohol. The effects on the infants, however, are minor, and the results of this study should not be used to discourage a nursing mother from taking an occasional alcoholic drink. Among women who drink regularly or frequently, the direct results from the presence of alcohol in the breast milk are likely to be less significant than the effects of heavy drinking on the home environment and on the skills necessary for child rearing. (Consumer Summary produced by Reliance Medical Information, Inc.)

editorial

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The transfer of alcohol to human milk: effects on flavor and infant's behavior

Article Abstract:

As is the case with many drugs, alcohol ingested by a nursing mother is transferred to her milk. There is much folklore about the effects that alcohol has on breast feeding, but few scientific facts. A study was conducted to evaluate the effects that a small amount of alcohol might have on nursing infants. Twelve lactating women were given either orange juice or orange juice with a small amount of alcohol. (The amount of alcohol was less than that in an average alcoholic drink.) It was found that during the first minute of nursing after the mothers ingested alcohol, the babies sucked more frequently. Babies nursing from mothers who had ingested alcohol sucked an average of 67 times in the first minute, compared with 58 sucks when the mother had drunk the nonalcoholic beverage. However, the total amount of milk consumed by the infants was less when the mothers had drunk alcohol. An average of 120 milliliters of milk (roughly half a cup) was consumed by babies nursing from mothers who had drunk alcohol. For the babies nursing from mothers who did not drink alcohol, the average was 156 milliliters. These differences may be due to changes in the flavor of the milk. Milk samples expressed by the lactating mothers were presented to a panel of 17 adults who rated the odor of the milk. The perceived intensity of the odor of the milk was increased after the mothers drank alcohol; the peak intensity of odor was reached 30 to 60 minutes after alcohol was consumed. The human nose is very sensitive to alcohol, and, of course, odor contributes strongly to the sensation of flavor. While the actual cause of the changes in infant nursing is not known, it is clear from this study that alcohol has an immediate effect on the nursing behavior of babies. (Consumer Summary produced by Reliance Medical Information, Inc.)

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Drug therapy for breast-feeding women

Article Abstract:

Many drugs taken by women may be excreted in breast milk. One study of 838 breast-fed babies whose mothers were taking various drugs showed that most babies had no significant reaction. However, some drugs are known to be dangerous and should be used with caution while breast-feeding. They include some painkillers, arthritis drugs, anticoagulants, antidepressants, anticonvulsants, antibiotics, chemotherapy drugs, sedatives, antihypertensive drugs, immunosuppressant drugs, hormones, radioactive compounds, and drugs of abuse. A list of specific drugs to be avoided in these categories is included.

Drugs, Complications and side effects, Adverse drug reactions

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