With so many toxins, medications, and dangerous foods out there, what's a nursing mom to do?
Credit: Shannon Greer

You've heard the phrase "You are what you eat." You're also the air you breathe, the pills you swallow, and the water you drink. You are your environment--and so is your baby.

In May 2011, we were reminded of that when small amounts of radioactive substances were found in the breast milk of five women in Japan. The news came after the devastating magnitude-9.0 earthquake and tsunami that decimated whole cities in Japan, and wrought havoc on the Fukushima nuclear plant, sending radioactive materials into the environment.

There is no reason to fear that radioactive materials from Japan will show up in amounts that are large enough to affect people in the United States. But it's enough to force us to re-examine what we should and shouldn't be doing to our own bodies, particularly pregnant and breastfeeding moms.

Breastfeeding guru Ruth Lawrence, M.D., says this vulnerability actually makes it even more important to nurse. "In most cases, the risk of a small amount of environmental contaminant doesn't begin to approach the tremendous benefits of breastfeeding," says Dr. Lawrence, who is a professor of pediatrics and ob-gyn at the University of Rochester School of Medicine and Dentistry, as well as the author of The Benefits of Breastfeeding, now in its seventh edition.

Dr. Lawrence adds that the body has a way of filtering out what it needs to, and only people who have had excessive exposure to chemicals should be concerned.

"Mother Nature is incredibly clever," she says.

Dr. Lawrence advises her patients to take a common-sense approach. "I often say all things in moderation. People get into trouble when they eat a lot of something, like a pound of chocolate. You know, a little chocolate is fine--a little of this, a little of that is probably no problem."

One thing new mothers should be aware of, she says, is that some nursing babies react with discomfort when their moms eat items that they didn't eat while pregnant, particularly strong vegetables like garlic, onions, cabbage, or broccoli. That can lead to what she calls "24-hour colic."

"They'll cry and scream and fuss for 24 hours and then they'll get over it," says Dr. Lawrence. "So I always tell mothers if they're going to eat something they haven't eaten in a long time, to try it cautiously and don't try a whole bunch of new things, because you won't know what did it and you'll have to eliminate everything."

She also advises her patients to avoid using solvents, because they're easily inhaled. "If they have to use a solvent, make sure the room is well ventilated and the windows are open--preferably you ask someone else to do it."

Texas Tech University Professor of Pediatrics Thomas Hale, Ph.D, has built his career around advising pregnant women and nursing mothers about what medications they can take and what they should avoid.

"There are millions of mothers who need help with their medications," says Dr. Hale, a trained clinical pharmacologist and the author of Medications and Mothers' Milk. "Because the hardcore reality is that doctors don't know much about the transfer of drugs into human milk. I do, but they don't."

In late 2010, Hale founded the Infant Risk Center (IRC) at Texas Tech University Health Sciences Center (www.infantrisk.com, 806-352-2519). So far, the online resource, forum, and hotline has received more than 4,000 calls from moms, healthcare professionals, and lactation consultants. Dr. Hale says the most frequently asked question he hears is "Can I take drugs for my depression?"

Many doctors don't realize it, but the answer, says Dr. Hale, is yes: "It all comes down to risk versus benefit." Dr. Hale says the risks of taking an antidepressant while pregnant are minimal. The risks of going off the medication are much higher, and could result in premature delivery and, in the worst cases, harm to the mother or the baby.

Dr. Hale advises pregnant and nursing woman to avoid elevated doses of iodine, certain chemotherapy medications, and migraine medications called ergot alkaloids. He also warns pregnant and nursing women about herbal supplements. "You've got to be careful with some of the herbal products, because we just don't know about them. And if you don't know, you've got to be careful," he says. "You have to make an assumption that all drugs, all substances, will get into breast milk."

When it comes to over-the-counter allergy medications, he advises nursing moms to stick with non-sedating antihistamines, such as Claritin, Allegra, and Zyrtec. "Some of it could transfer to the baby, and if it's one of the sedating ones, it may sedate the baby. We do not ever want a baby sedated because it increases the risk of apnea." Dr. Hale encourages mothers to call the IRC with any questions about specific medications.

Yvonne Bohn, M.D., an ob-gyn and co-author of The Mommy Docs' Ultimate Guide to Pregnancy, says that this is a challenging area of breastfeeding, because there are so many unknowns. "Part of the problem with breastfeeding, and it's the same problem with pregnancy, is that we can't expose women to toxins and then see what happens. It's completely unethical," she says. "So it's not like we can expose women to radiation and measure how it gets in the breast milk and see if it affects the baby. A lot of it always has to be based on observational studies."

Rather than providing her patients with a list of dos and don'ts, Bohn takes a simple approach: "Use common sense. If you wouldn't do this when you're pregnant, it's probably not a good idea to do it when you're breastfeeding," she says.

Certified Lactation Counselor Gina Ciagne says she tries to focus on the small steps that pregnant and nursing moms can take toward overall health. Ciagne, who is senior director of breastfeeding relations for Lansinoh Laboratories, says that new moms often get so much advice about what to eat or what not to eat that it can become overwhelming. She suggests starting off with minor adjustments, such as drinking organic milk, eating organic chicken, and cutting down on fish that has high mercury levels. She says moms can use vinegar or other natural household items as cleaners, rather than chemical products. And if parents have their clothing dry-cleaned, Ciagne suggests taking the plastic covering off of the clothes as soon as possible, to avoid trapping gases and irritants in the closet.

But the most important thing of all, Ciagne says, is to keep breastfeeding. "Breastfeeding is important because it's infection protection, it's immunity protection, it's allergy protection, it's disease protection, and it's more than just feeding," she says. "It's also the bond between the mom and the baby, and the benefits for the mom and the child."

Plus, Ciagne points out, "Human milk isn't going to get recalled."

Copyright © 2011 Meredith Corporation.

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