A monthly newsletter from the office of Dr Mary Kirk
April 2016
Nutrition While Breastfeeding

In recent years, breastfeeding has seen a great revival. It seems as though a new study is published every day that demonstrates the plethora of benefits for both mother and child. However, it can seem like a daunting subject for new mothers. There are many different topics to cover when discussing breast feeding. We will cover several related to diet in this issue.

The process of making milk is amazingly complex with many moving parts. Larger breasts are not necessarily better at milk manufacture than smaller ones. It's the amount of glandular tissue and the efficiency of the whole system that makes the difference, not the amount of fatty tissue 1  a nd, although the breasts contain the highly sophisticated milk factory, your brain, lymphatic system, and nerves also play an important part! Many mothers are overwhelmed by the sheer magnitude of advice they receive regarding what they should eat. Tradition and superstition abound in this matter. Thankfully, the truth is a simple concept. The best way to ensure that you can provide quality nutrition for your infant is to provide a well-balanced diet for yourself. A mother's body automatically prioritizes resources for milk production. The only difference between the healthy diet recommendations for non-breastfeeding and breastfeeding women is an average of about 400-500 calories of extra consumption2.  These additional calories should come from natural nutrient-rich sources. It is advised that a woman continue taking her prenatal vitamins as long as she is breastfeeding. Beyond this, in most cases, additional supplementation is not recommended. There is simply no substitute for obtaining the necessary vitamins and minerals through nutritious food intake. It is also important to remember than the amount of milk a mother produces relies almost exclusively on demand and supply to the infant, not elements within the diet. Apart from this, here are two things to take special note of:

Vitamin D:  Studies have shown that mothers who are deficient in Vitamin D during pregnancy will give birth to vitamin D deficient babies. Furthermore, the quantity of Vitamin D in a mother's milk is dependent upon her own levels. Humans obtain most of their Vitamin D from exposure to sunlight and deficiency has become a real problem in modern society. A baby's body does have the ability to maintain sufficient levels of Vitamin D with normal amounts of exposure to sunlight, but most infants in industrialized societies rely on the their mother's milk for it. Due to the modern style of living, it usually isn't there. In children, Vitamin D deficiency can be a serious business. Children who are Vitamin D deficient are at risk for Rickets, a softening or weakening of the bones. The American Academy of Pediatrics has recommended that an infant be supplemented with Vitamin D drops 3 .  

Supplementation in the infant has shown to be far more effective than simply supplementing the mother, although she likely needs it as well (It's always better for the mother to get her Vitamin D from food and sunshine rather than supplements). This is especially important for infants and mothers who are darker skinned. The darker a person's skin, the more protection they have from UVB radiation, and the longer it takes to acquire healthy levels of Vitamin D. Therefore, mothers and babies with darker skin are at much higher risks for deficiency.  

Hydration:  Breast milk is mostly water and by 6 months postpartum, the mean intake of a breastfed baby is about 854g/ a day (roughly 30oz) 4 A breastfeeding mother's body will need more water than usual to compensate for this. According to one article published in the The Journal of Perinatal Education, a good rule of thumb is to drink a glass of water with meals and one for each breastfeeding session 5 . There is no need to drown oneself with gallons of extra water. Drinking far in excess can actually be counterproductive. The breastfeeding mother simply needs to consciously intake fluids throughout the day to replenish her stores. Remember, drinking more water creates a healthy body, it does not automatically equal more breast milk. Breast milk production is all about supply and demand. 

If you are interested in learning more about breast feeding or are struggling with it, never be afraid to reach out for help! There are more resources available today than ever before, and one of the most important factors for success is a good support system!

We will cover other useful information for breastfeeding in later newsletters, but until then, here are some great links for breastfeeding education and support groups: 

1. Blackburn, Susan Tucker. "Reproductive and Developmental Processes." Maternal, Fetal, & Neonatal Physiology: A Clinical Perspective. St. Louis, MO: Saunders Elsevier, 2007. 146. Print.
2. "Infant and Toddler Health." Breast-feeding Nutrition: Tips for Moms. The Mayo Clinic, 05 Mar. 2015. Web. 25 Mar. 2016.  
3. "Vitamin D Supplementation for Infants." American Academy of Pediatrics. AAP Pressroom, 22 Mar. 2010. Web. 17 Mar. 2016.
4. Butte, Nancy PHD, Lopez-Alarcon, Mardia G. MD PHD, Garza, Cutberto MD PHD. "Nutrient Adequacy of Exclusive Breastfeeding for the Term Infant During the First Six Months of Life." Department of Nutrition for Health and Development, Department of Child and Adolescent Health and Development, World Health Organization. France: WHO, 2002. Print.
5. Montgomery, Kristen S. Nutrition Column: "An Update on Water Needs during Pregnancy and Beyond." The Journal of Perinatal Education 11.3 (2002): 40-42. PMC. Web. 25 Mar. 2016.

Allergies in Pregnancy

Spring is a wonderful time of greening and warmer weather! But, while flowers bloom, trees bud, mold grows, and winds blow... allergies abound. During this time of year, our office becomes inundated with calls from worried breastfeeding mothers and mothers-to-be that are concerned about what they can and cannot take for their allergies.

It is desirable to keep medications to an absolute minimum during the first 12 weeks of pregnancy. If you need allergy relief during this time, there are a few things that can be recommended with limited use. Call your doctor's office to be advised on this. After 12 weeks of pregnancy and while breastfeeding, Sudafed, Benadryl, Tylenol Cold & Sinus, Chlor-Trimeton, Claritin D, and Zyrtec are all approved for the relief of allergies or colds. Absolutely no Phenylephrine. If you desire something other than those listed, speak to a pharmacist and/or your doctor to discuss options. Note, that for all questions regarding medications for baby's allergies, your pediatrician needs to be consulted rather than your Ob-Gyn.

Fun Facts

Sneezes do not produce the gale-force velocities that myth has attributed to them. 
A sneeze's maximum velocity is actually around 10mph. However, sneezes create invisible turbulent clouds that tend to stay airborne and travel great distances! Yuck! 
This makes covering one's mouth more than just the polite thing to do.


The English name for our Galaxy, the "Milky Way", has its origins in the Greek's name for it, the Milky Circle. In Greek mythology, the Milky Way was formed by the goddess Hera's spilt breast milk.

Dr Mary C Kirk | 918-508-2200 | www.kirkobgyn.com