Lifestyle Choices

Alcohol Use

Breast implants/breast augmentation

Cigarette smoking

Co-sleeping

Exercise

Hair products & dye

Massage

Medications

Nipple piercings

Restricted diets

Sex & Fertility

Tattoos

Topical skin products & tanning beds

Vaccines

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What if I drink alcohol?

Read here.

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What if I smoke cigarettes?

All mothers who smoke should make every effort to stop (at the very least, cut way down). They’ll live longer and get to spend more years with their children in the long-term and also more minutes with their children today, in the short-term, because they won’t need to duck outside for a fix (which they’ll need to do OFTEN because secondhand smoke is the primary issue affecting breastfed babies of smoking mothers).

Cigarette smoke has the same types of harmful effects on infants as it does on others. What about cigarette smoking’s effects on the nursing mother? Nicotine use can interfere with let-down, decrease milk production and, as a result, lead to poor infant weight gain. It can also cause early infant weaning and low levels of iodine for at-risk women.

So, are you ready to KICK BUTT at kicking the butt, or what?! Click here to get started with quitting!

Minimize Effects

If a breastfeeding mother truly cannot cease the habit, she should continue to breastfeed but never smoke near her child, avoid nursing immediately after smoking, always wear fresh clothing around the child, and wash hands after smoking. Though women who smoke are less likely to breastfeed–and those who do breastfeed tend to do so with less frequency and duration–it has been observed that the effects of smoking on breastfeeding may by psychosocial rather than physiological. Therefore, a smoker may greatly benefit from proper education in lactation management.

Still, even if a mother smokes cigarettes, breastfeeding is considered a better choice than formula feeding as it offers greater protection against the passive effects of smoking on the infant than does formula feeding, a belief supported by the Committee on Drugs and American Association of Pediatrics. One study reported that the incidence of acute respiratory illness is decreased among the infants of women who continue to smoke cigarettes throughout breastfeeding, compared with formula-fed infants whose mothers also continued to smoke.

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What if I co-sleep?

Read (coming soon)

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What if I exercise?

Read “Milk & Muscle: Exercise During the Breastfeeding Period.”

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What if I dye my hair or use hairstyling products?

It’s understandable to want to get a bit ritzy-glitzy, fancy-schmancy every once in a blue boob–to emerge from that new mom’s “perma-frump” that has hardened like a frozen glacier upon every inch of style that was once had. But if Stacy’s mom has got it going on, there’s no reason why moms of kids other than Stacy can’t have it going on, too.

Thankfully, no special products are necessary for a breastfeeding mom who wants to polish up her ‘do. According to La Leche League International’s The Breastfeeding Answer Book:

“No evidence exists that the nursing mother’s use of hair-care products, such as hair dyes and permanents, has any effect on her breastfeeding baby. When a mother uses hair-care products, some of the chemicals will be absorbed through her skin. If her scalp is healthy and intact, less will be absorbed than if the skin on her scalp is scratched or abraded.”

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What if I get a deep tissue massage?

Then you will be one relaxed, zen mama! No type of massage is contraindicated for breastfeeding. Lactic acid is released with muscle stimulation, and it’s the same process with massage as with exercise. It’s usually recommended that anyone who receives a massage treatment should flush toxins away with water before and after. You might also want to bring breast pads in case you start leaking milk during the session, but other than that no special precautions are necessary. According to American Pregnancy:

“Studies show that massage increases prolactin levels, a lactation hormone. Relaxation in the chest muscles opens the shoulders and improves lactation. New research indicates that breast massage helps relieve breast pain, decreases breast milk sodium and improves newborn suckling.”

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What if I take medications?

Read “Medications” section.

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What if I have nipple piercings?

There is no evidence that a pre-existing nipple piercing will put a “dent” in your ability to breastfeed. Still, besides running the risk of infection, it’s best to avoid getting a new piercing for the duration of nursing because you’ll have to remove the jewelry prior to feeding or pumping and it’s recommended by certified piercers to leave nipple jewelry in a new piercing for six to ten uninterrupted months. During breastfeeding, jewelry left in the piercing can get lodged in the baby’s throat if it comes loose, and it can also rub against the tongue, palate or gums, or pose a threat to a baby with a metal allergy.

In this Q&A piece, Anne Smith, IBCLC, explains what to expect and considerations to make while nursing with pierced nipples.

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What if I have a restricted diet?

Read “How Can You Breastfeed With a Restricted Diet? (Dairy-Free, Weight Loss, Religious Fasting, Vegetarian/Vegan).”

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What if I have sex?

Breastfeeding doesn’t directly interfere with sex, but in some sneaky indirect ways it might, for better or worse. You’d be surprised about all the misinformed ideas that are circulating about this, so here we go.

The Sensuality of Making Milk

Breastfeeding itself is not a barrier to sex, and in fact the sensuous aspects of milk-making can be made fun and incorporated amorously (did I really just say “amorously”?) if the woman and her partner are interested in such dalliances. Adult nursing is a “thing,” it turns out (feel free to investigate on your own time…search key phrase: erotic lactation).

Breasts are for feeding babies, it’s true. But breasts are interesting and attractive for many other reasons, including wielding power over men and romantically interested women (I’m kidding on both fronts…but am I really?). Find out the real history of mammary purpose on the “Another Round of Anatomy” page.

Fresh Milk: The Secret Life of Breasts by Fiona Giles is a must-read anthology of eyebrow-raising, taboo-shattering, funny, and titillating stories and secrets from both women and men about their breastfeeding experiences. Fresh Milk helps us understand the provocative and intimate aspects of breastfeeding, and how normal infant feeding can gain the respect it deserves through embrace rather than suppressing of its ability to sensually empower. Giles pushes the boundaries of “TMI,” and I for one am grateful for it.

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“Fresh Milk: The Secret Life of Breasts” by Fiona Giles

Breastfeeding & Libido

So, we get that a nursing mom doesn’t need to go nookie-free for fear that her milk will dry up, that it’ll all drain away in a fateful last milky stream if she has “too much” fun, or that her breasts will burst like popped milk balloons if touched or grabbed by an adult, or whatever other nonsense I’ve heard. However, for many breastfeeding women, decreased or absent libido is an even greater concern than whether or not she’s allowed to romp. In the period of time following birth, a drop in libido is normal for both a woman and a man, stemming from (for the woman) still-alive physical and emotional birth trauma compounded with baby blues, breastfeeding hormones, and trying to understand life in the Fourth Trimester as it plays out.

FOR THE MEN:

“Why doesn’t she want to have sex with me after the baby?”

  • All new fathers will benefit from reading this. It’s also helpful to keep in mind that “after the baby” doesn’t limit itself to a proscribed window of time as individual women are affected differently. An aversion to sex “after the baby” can mean two weeks, two months, perhaps even two years or anything below, between, and beyond. Truth.

FOR THE LADIES:

“Libido and Breastfeeding”

  • If libido isn’t your issue, this will still help you to understand how important hormones are to relationships. Ironically, as for when that mojo returns oh-so-welcomed, breastfeeding can end up helping out! How, you ask? I’ve got three words……

Natural Birth Control!

Also called Lactational Amenhorrea Method (LAM), exclusive breastfeeding is a pretty solid way to have control over family planning (it doesn’t protect against sexually transmitted infections, though). According to Planned Parenthood, less than 1/100 women who follow the LAM criteria (below) perfectly will become pregnant. Imperfect adherence to the criteria will make 2/100 of the women pregnant. By comparison, 1/100 perfect users of the birth control pill will get pregnant; 9/100 imperfect pill users will get pregnant. Is that more than you expected?

Comparatively, typical use of a male condom as contraceptive leaves 18/100 women pregnant.

Several key points must be fulfilled for LAM to work optimally:

  • Exclusive breastfeeding, which means no solids or other liquids including water and formula (this should continue for at least the first six months).
  • Baby is breastfed at least every 4 hours during the day and every 6 hours at night.
  • The mother hasn’t had a menstrual cycle yet.
  • Baby is not given dummies or pacifiers.

If you’re really not ready for another addition to the family, as with any contraceptive method you should always incorporate a back-up. Still, Dr. Sears says that if you’ve practiced “perfect use” of LAM as described above…

“…you may enjoy a period of lactation amenorrhea (no menstrual periods) that lasts thirteen to sixteen months. In fact, research has shown that women who practice natural mothering according to the above rules will average 14.5 months without a period following childbirth. Remember, this is only an average. A few mothers will experience a return of menstrual periods by six months, others not until two or three years.”

Increasing Fertility

Wait, but what if you’re having sex for the primary purpose (making babies, remember?), and breastfeeding appears to have delayed your ovulation longer than you’d hoped?

Try these links:

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What if I have breast implants/had breast augmentation?

Many women are blessed with a set of “twins” born ready to breastfeed. Others are not quite born with their current set of twins, and it’s up for individual debate as to whether they may or may not be ready to take on breastfeeding.

Fifteen million plastic surgeries were performed in 2011. As the second most popular cosmetic surgery, breast implants have enjoyed an increasingly augmented “lift” in popularity each year since 2011 among American women, from high schoolers to grandmothers. In fact, more than triple the number of women opted for breast implants in 2011 than in 1997.

Surprisingly, only a small number of these women are celebrities and Baywatch floatation devices–I mean, lifeguards! Many more are neighbors, teachers, stay-at-home mothers, yoga instructors, college students, anyone you might regularly encounter in day-to-day life. Including anyone, of course, who plans to breastfeed a child one day.

Via keenlykristin.com

“30 percent of the women who get breast implants are in their 20s…About 35 percent are women in their thirties, many of whom lost breast volume after childbirth. Some want to recapture their pre-pregnancy breast size, while others liked the breast fullness they had during pregnancy and want to recreate it with implants.” – FOX News

For women of child-bearing age it’s important to know whether or not they can hope to breastfeed at some point after receiving breast implants, or if they even should. Fortunately, contraindication of silicone implants to breastfeeding is not confirmed and an attempt at breastfeeding is highly encouraged.

While the implant itself may not pose a threat to breastfeeding, any prior breast surgery can affect a woman’s ability to produce milk or maintain supply if any nerves have been cut or damaged without “recanalizing” (growing back). This is more likely if the incisions are made around the areola, and less likely if the cuts are made under the breast, through the belly button, or in the armpit. Damage to breast tissue is also decreased if the implant is placed behind the chest muscle rather than on top of it.

How about a possible invasion of toxins in the mother’s (and by default, baby’s) system in the event of an implant rupture or leak? A study in 1994 suggested a link between abnormal esophageal motility in children who were breastfed by mothers with silicone implants. More recently the Committee on the Safety of Silicone Breast Implants has written off these claims as “insufficient or flawed.” This issue deserves a more conclusive assessment.

In report of a study by the Institute of Medicine:

“It is important to note that much higher levels of silicon—from which silicone is derived—have been found in cows’ milk and commercially available infant formula than are found in the breast milk of women with implants. In fact, there is no evidence of elevated silicone levels in breast milk or any other substance that would be harmful to infants, nor are there any differences in silicone levels in the milk and blood of nursing mothers with implants and those without them.”

Per Dr. Nancy E. Wight MD, FAAP, IBCLC:

“The type of silicone polymer used in implants has extremely large molecules, which would be highly unlikely to pass into mother’s milk or be absorbed in an infant’s gastrointestinal tract. Analyses of breastmilk samples from mothers whose implants have ruptured have found no silicone in the milk. We ingest silicone compounds through cosmetics such as lipstick, over the counter drugs such as antacids, and the coating of fresh fruits and vegetables. Silicone is also used to lubricate syringes and to make silicone nipples for baby bottles and pacifiers. Mylicon drops, which contain the same kind of polymer as silicone breast implants, are given to colicky babies as a gas reducer and work by coating the digestive system. In short, breastfeeding with silicone breast implants should be encouraged.”

In short:

“The committee finds no evidence of elevated silicone in breastmilk or any other substance that would be deleterious to infants; the committee strongly concludes that all mothers with implants should attempt breastfeeding.”

While we’re busy slaying myths, I will also add that nursing with implants does not cause extra sagging (for that, you can thank pregnancy and age).

In New Beginnings (Vol. 10 No. 4, Jul-Aug. ’93, p. 114-5), Patricia Macaluso penned these questions that mothers should ask if they want to breastfeed with implants:

  1. What kind of implant did I receive? (Find out the type, manufacturer, and date of production. The surgeon should have this information.)
  2. Were there any complications associated with this type of implant within a few or several years after insertion?
  3. Is my health practitioner and/or pediatrician supportive? (If not, find a new one who does support breastfeeding. They are out there.)
  4. What are the provisions for breastfeeding at the hospital where I will be delivering? (Patients can request their routine and not have to be intimidated by complaints from the staff!)
  5. How does my husband feel about my breastfeeding with implants? (Don’t listen to friends, family, or strangers about breastfeeding. Your husband and you are the only ones who should make decisions about your child’s upbringing.)
  6. Read books on breastfeeding and contact La Leche League International. (I found these to be a help, even though I had successfully breastfed two children.
  7. Listen to your baby! (The best way to a successful nursing relationship. Let him decide when he is hungry. What may be a good suggestion for one child is disastrous for another.)

Links:

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What if I want to get a tattoo?

Read “For The Breastfeeding Mom With Body Mods.”

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What if I use topical skin products or tanning beds?

Insect Repellent

“There are no reported adverse events following use of repellents containing DEET in pregnant or breastfeeding women,” according to the CDC.

New information regarding the common active ingredient in insect repellent, DEET, led to updated usage recommendations in 2001 for application on children and adults. Click here to find out what the U.S. Environmental Protection Agency recommends as the best type of insect repellent for you.

From InfantRisk Center, here are the CDC recommendations for safe DEET usage on adults (including pregnant and breastfeeding women):

Use enough repellent to cover exposed skin or clothing. Don’t apply repellent to skin that is under clothing. Heavy application is not necessary to achieve protection.

Do not apply repellent to cuts, wounds, or irritated skin.

After returning indoors, wash treated skin with soap and water. (This may vary depending on the product. Check the label.)

Do not spray aerosol or pump products in enclosed areas.

Do not spray aerosol or pump products directly to your face. Spray your hands and then rub them carefully over the face, avoiding eyes and mouth.

  • Use enough repellent to cover exposed skin or clothing. Don’t apply repellent to skin that is under clothing. Heavy application is not necessary to achieve protection.
  • Do not apply repellent to cuts, wounds, or irritated skin.
  • After returning indoors, wash treated skin with soap and water. (This may vary depending on the product. Check the label.)
  • Do not spray aerosol or pump products in enclosed areas.
  • Do not spray aerosol or pump products directly to your face. Spray your hands and then rub them carefully over the face, avoiding eyes and mouth.

– See more at: http://www.infantrisk.com/content/insect-repellent-safety-and-usage#sthash.QkPeGfrh.dpuf

CDC Recommendations for Usage of DEET on Adults (including pregnant and breastfeeding women):

  • Use enough repellent to cover exposed skin or clothing. Don’t apply repellent to skin that is under clothing. Heavy application is not necessary to achieve protection.
  • Do not apply repellent to cuts, wounds, or irritated skin.
  • After returning indoors, wash treated skin with soap and water. (This may vary depending on the product. Check the label.)
  • Do not spray aerosol or pump products in enclosed areas.
  • Do not spray aerosol or pump products directly to your face. Spray your hands and then rub them carefully over the face, avoiding eyes and mouth.

– See more at: http://www.infantrisk.com/content/insect-repellent-safety-and-usage#sthash.QkPeGfrh.dpuf

Topical Skin Products (including sunscreen, skin bleach, self-tanner, acne treatment, makeup, skin creams & other ointments, oils and lotions)

These are considered safe to use while breastfeeding since only a minimal amount is absorbed through the mother’s skin, and the ingredients won’t make it into breast milk. To prevent the baby from ingesting any residue from topical skin products that were applied to the breast, simply rinse and wipe off the area before latching. The main issue is that you’ll want to keep the baby from directly consuming the product or getting any on his/her skin.

Click here for sunless tanning preparations for breastfeeding mothers, by Debbi Donovan, BCLC.

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Tanning Beds

Debbi Donovan, BCLC, says there is “no research to indicate any problem directly related to use of a tanning bed while breastfeeding,” however she does emphasize that the risks of tanning booths to a mother’s health (or other users) are seriously not worth that popular “fresh from the beach” look.

LLLI advises:

“It is important to limit exposure so that burning is avoided. Some mothers have reported getting burnt nipples and breasts when using tanning beds. This is extremely painful so be sure to cover your nipples and breasts and use caution. If any vitamins or medications are suggested to enhance the tanning, be sure to check with your health care provider before taking them.”

Self-tanner, on the other hand, is considered a safer alternative to booths. For directions regarding sunless tanning products (including cream, lotion, foam, oil. self-spray, and spray-tan booths), see Topical Skin Products above.

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What are my options for immunizations?

Informed Consent or Refusal

Ask Dr. Sears about vaccines — Learn about alternative & regular schedules.

Hepatitis B vaccine for newborns

National Childhood Vaccine Injury Act of 1986

National Vaccine Information Center

Vaccines during pregnancy – protection across the placenta for the infant

Vaccine Package Inserts — Includes ingredients and possible side effects, via US Centers for Disease Control

Breastfeeding and Immunology

Evidence shows that breastfed babies produce higher antibody levels in response to vaccines than formula-fed babies. Click here to find out which viruses that can be transmitted through breast milk (scroll down the link). Breastfeeding does not substitute a vaccine…but how does breast milk protect against vaccine viruses?

According to the 2002 document General Recommendations on Immunization by US C.D.C.:

Neither inactivated nor live vaccines administered to a lactating woman affect the safety of breast-feeding for mothers or infants. Breast-feeding does not adversely affect immunization and is not a contraindication for any vaccine. Limited data indicate that breast-feeding can enhance the response to certain vaccine antigens.

Although live vaccines multiply within the mother’s body, the majority have not been demonstrated to be excreted in human milk. Although rubella vaccine virus might be excreted in human milk, the virus usually does not infect the infant. If infection does occur, it is well-tolerated because the viruses are attenuated. Inactivated, recombinant, subunit, polysaccharide, conjugate vaccines and toxoids pose no risk for mothers who are breast-feeding or for their infants.”

Breastfeeding mothers should not receive the smallpox vaccine. The close physical contact that occurs during breastfeeding increases the chance of inadvertent inoculation. It is not known whether vaccine virus or antibodies are excreted in human milk.”

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