Nutrition For A Nursing Mother: The Impact On The Child's Body

Breastfeeding is not only a quivering, amazing period in the life of every woman, but also an integral part of the relationship between a mother and her baby. This is a factor involved in the formation of an emotional connection, attachment between children's and adult organisms, which largely prevents the development of severe pathologies - and on both sides.

How to eat right mother and newborn? What is colic and is diet therapy effective in combating them? Let's understand the new trends prescribed in the world of pediatrics.

Benefits of breastfeeding

Growth factors contained in the secretions of the mammary glands, vitamins and minerals are the basis for the normal development of the child, as well as the differentiation of its organs and systems - in particular, the nervous tissue, the cells of which undergo a number of important transformations after birth.

WHO (World Health Organization) emphasizes that breastfeeding is critical during the first 4-6 months of a baby. It is a decisive factor that could save more than 800,000 children every year. In addition, this is an excellent way to prevent breast and ovarian cancer, although it does not provide a 100% guarantee against oncogenesis.

Thus, the somewhat radical statement of the American pediatrician F. Landrigan (https://www.who.int/bulletin/volumes/91/9/13-020913/ru/) published by WHO says that the more menstrual cycles a woman has, the higher risk of developing malignant neoplasms. Undoubtedly, the adverse environmental effects and the significantly increased statistics of obesity should be attributed to the predisposing factors: adipocytes, as is known, are the culprit of the excessive formation of estrogen, which is directly related to carcinogenesis.

The authors of an article in the New England Journal of Medicine believe that increasing the lactation period to 24 months is a decisive mechanism in reducing the incidence of breast cancer by 25%.

Of the other benefits of breast milk - already in relation to the child - several indisputable facts can be distinguished:

1. Unlike cow's or goat's milk, mother's milk is not contaminated with pathogenic bacteria.
2. Fats - the most important source of energy - are partially emulsified in breast milk, which is especially important in the context of absorption in the conditions of an underdeveloped enzymatic system of the newborn.
3. There are also differences in amino acid composition: in particular, in the milk of animals there are no sulfur-containing amino acids (taurine and cysteine), which are involved in the differentiation of neurons, the metabolism of fatty acids and the formation of antioxidants.

In addition, the researchers emphasize that the degree of absorption of iron from mother's milk is several times higher than from cow's. It also contains already active forms of vitamin D, which provides not only the formation of the bone skeleton, but also regulates the expression of a huge number of genes. However, the reserves of calciferol are very small, so from 2 weeks it is possible to take supplements with this vitamin at a dosage of 400 IU / day.

However, the choice always remains purely for the mother: nutritionists and doctors can only recommend for their part, voicing the undeniable advantages of breastfeeding for both organisms - maternal and child.

The introduction of complementary foods

From 4-6 months (depending on the readiness of the baby's body), it is recommended to start introducing complementary foods. This is due, first of all, to the inability of mother's milk to cover the growing needs of the child's body in minerals and vitamins - primarily in iron. At the same time, it is recommended not to stop breastfeeding (if the woman's body allows this), and still leave him the dominant role.

The timing of the introduction of complementary foods is extensive and is determined purely individually. Both early and late exposure of a child to a new food can lead to a number of negative consequences: in particular, in the first case, the risk of aspiration increases, and in the second, anemia.

In addition, the developmental characteristics of premature babies will also lead to a later introduction of complementary foods - all these consequences once again emphasize the need for prior consultation of the mother with a doctor or infant nutrition specialist.

Products are recommended to be introduced sequentially, starting with small portions, gradually increasing and dividing them, moreover, into several doses. The intervals between them are also necessary to detect intolerance associated, say, with a defect in the enzymatic system.

As the first acquaintance of the baby with a new type of food for him, preference is given to cereals or vegetable puree - in the first case, it is desirable that they be gluten-free. This is due, as previously mentioned, with the increased need of a developing and growing organism for iron, which, nevertheless, it should be noted, is in this category of products in a non-heme form, which means that it is absorbed much worse. At the same time, meat puree is also added - turkey, rabbit, veal and even lamb are perfect (especially for children whose nationality is characterized by the use of this particular type of meat products).

It is important to add that fruits are not complementary foods at all, which follows from their insufficient energy value. However, even in adults, as you no doubt remember, the simple sugar contained in them - fructose - albeit does not affect the secretion of insulin as such, but bypasses all satiation pathways, only fueling the feeling of hunger. Sweet food, in general, can make it difficult to introduce vegetables: it is natural that the latter do not seem so tasty.

You should also be careful with honey, which, by the way, is akin to a sugar bomb, being a mixture of the previously mentioned fructose and glucose. In official recommendations, it is emphasized that it is desirable to introduce it to a child no earlier than at the age of one.

The frequency of meals and the amount of food

The recommendations of the American Academy of Pediatrics include the following parameters for different age groups:

Nutrition during lactation

(National Institutes of Health, USA)

I would like to add about polyunsaturated fatty acids separately: they play a huge role not only in the mechanisms of the formation of the placenta, but then, by the end of the third trimester, and immediately after birth, they are involved in the development of the nervous system, differentiation of neurons and their migration, in the formation of chemical bonds - synapses. So, some researchers note: additional intake by women during lactation of docosahexaenoic acid (DHA) - one of the main omega-3 fatty acids - was associated with a significant increase in IQ in their children upon reaching primary school age.

No less important is the use of choline, which is not only part of the phospholipids of cell membranes, but also involved in the formation of one of the main neurotransmitters of both the somatic and autonomic nervous systems - acetylcholine. In addition, it is a gastroprotector, which, in addition, is also involved in lipid metabolism in hepatocytes. They are rich in:

• beef liver;
• egg yolks;
• soya beans;
• pink salmon;
• oat groats;
• pine nuts;
• sunflower seeds.

The daily requirement for choline for the gestation period is 450 mg; lactation - 550 mg.

In addition to choline, inositol, a polyhydric alcohol formed from glucose and sometimes called vitamin B8, also participates in the development of nervous tissue and fat metabolism. This chemical compound has already proven itself as an effective tool in the context of the treatment of disorders of carbohydrate metabolism - in particular, insulin resistance and the closely related polycystic ovary syndrome.

Thus, breastfeeding women need to follow a balanced diet that would fully cover the nutritional needs of the newborn baby, and would also contribute to postpartum weight loss.

Colic: causes and relationship with maternal nutrition

It is believed that up to 25% of babies are subject to this process, which is poorly explained from a scientific point of view, which, among other things, plays one of the decisive roles in a mother's decision to stop breastfeeding. However, according to scientists, this has no causal relationship: after all, bottle-fed children also suffer from them.

Colic, it must be said, is rather a diagnosis of exclusion, made not only on the basis of the collected anamnesis, but also requiring careful differentiation from regurgitation (i.e., gastroesophageal reflux), constipation, exposure to medications taken by the mother, infection, and even hidden, non-obvious fractures.

The etiology of colic is still unclear, although many mechanisms and factors contributing to their development have been proposed. Scientists suggested that the likely triggers are:

• baby food allergy;
• dysbacteriosis;
• immaturity of the gastrointestinal tract and enzymatic systems;
• milk protein intolerance;
• reflux disease;
• increased gas formation;
• violation of intestinal motility;
• maternal postpartum depression;
• lactose intolerance.

However, all these reasons require further consideration with their subsequent refutation or proof. A combination of some of them is also possible.

First of all, speaking about treatment, the parents of such children need moral support. They also need to explain about the possibility of aggravating colic in their baby with the instability of their emotional background.

Effective swaddling, light massage (clockwise) of the tummy, gentle and gentle rocking of the newborn, tactile contact, and white noise are often factors that help to calm the baby.

In addition, it is necessary to differentiate colic caused by instability of the state of mind, primarily of the mother, from those that involve violations of the enzymatic systems - in this case, a pediatrician's consultation is required. It is possible to switch to treatment-and-prophylactic or therapeutic mixtures.

The elimination diet that a nursing mother adheres to, unfortunately, does not always give positive results - not every baby has a benefit. Strict control over the food consumed by a lactating woman is justified only if there is really an effect on the baby's body.

The American Association of Pediatricians emphasizes that there is no evidence to reduce and/or stop colic in children who switch to lactose-free or soy formulas—certainly not in the context of already clinically apparent lactose intolerance.

The effects of medications and probiotics also require further study and further research.

Prohibited foods while breastfeeding

In general, more and more doctors are inclined to believe that without certain indications and, importantly, subsequent positive results on the part of the child's body, it is not worth prescribing elimination diets for the mother.

However, the use of certain foods during lactation still leads to adverse effects on the baby. The first and most obvious among them is alcohol.

The statement published on the website of the American Association of Pediatricians is impressive: the use of alcohol by women during breastfeeding leads to a decrease in the mental activity of the baby - in particular, to a deterioration in abstract thinking at the age of 6-7 years.

However, having delved a little into pharmacology, the causal relationship also becomes obvious: it turns out that just an hour after taking it, the concentration of alcohol in mother's milk will be equivalent to that in the blood.

Given that the nervous system is actively developing after birth, the harmful effects of such drinks on the baby's brain are understandable. In addition, this is a serious trigger that can aggravate various kinds of functional deficits that have arisen during gestation.

In general, the rest of the products that are not recommended (as, indeed, outside of gestation) include:

• refined sugars: candy, marshmallows, chocolate;
• carbonated drinks;
• fatty meats;
• smoked products;
• fast food and other sources of trans fats;
• fried foods.

Approved Products

We have already written about the lack of a proper evidence base in relation to elimination diets, which, we repeat, unfortunately, do not eliminate colic in a certain percentage of babies.

Scientific works are contradictory - and we will demonstrate this again a little lower. It is important to rely on your own, both objective and subjective feelings and evaluate the development of the baby in dynamics, how comfortable he is with breastfeeding and with the introduction of certain mixtures. Current trends are leading to a gradual rejection of the so-called "forbidden foods" - although in many respects everything will depend on the course of the birth itself. New WHO protocols give pediatricians more and more freedom of choice: this is evident at least in the recommendations for the introduction of complementary foods.

However, for nursing mothers whose babies suffer from allergic or, much more unpleasant, autoimmune diseases, a much smaller range of products is available, at least for the moment. So, in particular, for the period of lactation, women whose babies have developed atopic dermatitis are required to give up cow's milk - this is where diet therapy plays a key role. In addition, they should also eliminate the waste products of bacteria - for example, kefir.

On the whole, apart from such exceptions in the form of aggravating pathologies, mothers, as already mentioned, have few limits. Of course, in the context of body adaptation, restoration of depleted resources, replenishment of vitamin and mineral deficiencies, careful work with nutritionists is recommended.

We will not get tired of repeating that the diet is not just a diet (again, without taking into account treatment protocols): it is a way of life. Regardless of the period of gestation or lactation, it is always desirable to treat your body with the same love and respect that it replies to you - in the form of organs and systems that tirelessly function and compensate each other in case of unforeseen incidents. And first of all, this is just about the food that enters the gastrointestinal tract. We are what we eat - and this fact remains unshakable.

Try to focus on organic, natural and, importantly, properly processed food. Let the essential classes of organic substances occupy the bulk of the plate - proteins, fats and carbohydrates - and take only a small fraction of your diet to far less healthy foods.

Do not get carried away with simple sugars - this is not only a favorite food of pathogenic microflora, but also a trigger factor for a huge range of pathologies - and not only carbohydrate metabolism. Give preference to complex ones: long-cooked cereals, root vegetables, vegetables and, of course, greens - the latter is not only a storehouse of folic acid, but also a source of fiber - the simplest and most effective way to prevent constipation.

Provide the body with building material: do not neglect protein foods. Of course, no less important is the proper secretion both from the stomach of hydrochloric acid and enzymes, and from the pancreas of the necessary enzymes. The first and easiest step available at any time in life is dealing with stress. Believe me, this is not just a phrase hackneyed by psychologists: the less cortisol is secreted by the adrenal cortex, the better the gastrointestinal mucosa is supplied with blood.

In the context of supplements (the use of which we strongly recommend discussing with a competent nutritionist and / or doctor), for our part, we can advise magnesium - its deficiency (especially against the background of widespread stress factors) is one of the most common problems of modern society.

hypoallergenic diets

In the context of the need for a temporary ban on allergenic products for breastfeeding women, an interesting study was recently published (although, we emphasize once again, any work on maternal nutrition and the neonatal period in general requires additional evidence).

One hundred and twenty women participating in it were divided into three groups:

• 40 of them followed a diet high in eggs;
• 36 - completely eliminated this product from their diet;
• 44 - moderately consumed it.

After 6 weeks of the diet, the results showed that the first category in breast milk showed significant concentrations of ovalbumin, the main protein in egg white, which correlated with a significant concentration of antibodies to it in the child's body. This gave grounds to assume the development of oral tolerance - that is, the absence of reactions (local and systemic) from the immune system to a certain antigen that comes with food - a foreign substance.

In general, many scientists are inclined to the existence of the so-called critical window - these are the first 1000 days of a baby's life, during which the immunity mechanisms are adjusted. It is believed that external influence on key links in this period can lead to a significant reduction in the risks of allergic diseases.

Of course, the first acquaintance with allergens takes place in the mother's body - in particular, microbial alien patterns can also act as them. Then, after birth, immunocompetent cells continue to meet various antigens - all this should ultimately lead to a clear distinction between "own" and "alien".

The results of a study of those babies who adhered to artificial feeding are noteworthy - in particular, the preventive effect of hypoallergenic mixtures (based on protein hydrolysates) was also noted. For example, children born to allergic parents (and, therefore, are at a sufficiently high risk) and during the first six months of their lives received a partially hydrolyzed mixture (that is, the protein molecules in which were already “cut” into smaller fragments, which in greatly facilitated the process of digestion and absorption), at 6 months and at 3 years they had absolutely identical IgE levels (antibodies directly involved in the development of allergic (anaphylactic) reactions of the first type), with babies who were fed with standard mixtures.

However, it must be said that neonates on a hypoallergenic diet had a higher level of T-cells - an indicator of oral tolerance.

Both studies cited in our article are contradictory. Perhaps the truth really lies somewhere in between. However, given the scale and duration of the studies necessary for an accurate establishment, this will not be known soon.