Transcript: This Week in Breastfeeding - Jan 29, 2021

Welcome back to The Breastfeeding Talk Podcast. This is the first episode in a series that I'm calling ‘This Week in Breastfeeding’. And this short but sweet version of the podcast is meant to be an update for anyone who listens on sort of the latest in breastfeeding news. Sometimes this might be things like sharing new information or learning about breastfeeding through studies. It could be celebrity gossip, it could be new products that are on the market and me sharing some reviews of that or anything else that just happens to come up. That's new in the world of breastfeeding and lactation. So it's going to be a little bit of a mix of things. And I will do my best to link up everything that I discussed that's relevant in the show notes. So if you're wanting to go look at some studies yourself, or particular articles, you will find those in the show notes. So today is Friday, January 29, 2021. 

 

And I'm sharing this article that came up and it's from January 25 of 2021. It is an integrative review the role of the doula in breastfeeding initiation and duration. Now I do not have access to the full text of this particular article this study that was done. But the abstract shows some very promising results which I would certainly expect we know that doulas do create better birth outcomes. But it also turns out that they help create better breastfeeding outcomes for their clients. So from the abstract here, it says that six key themes were identified, and doulas may acquire only modest amounts of lactation-specific education. However, doula care still enhances the breastfeeding care provided by health care professionals. doulas offer prenatal and intrapartum support that encourages breastfeeding initiation in the hospital, as well as providing breastfeeding support in the community and home settings. So this is really great. 

 

You know, it. It does say, though, that the effect of doulas on breastfeeding duration is less clear. So, you know, very helpful in terms of breastfeeding initiation. Many doulas do postpartum visits as well. So they're, you know, certainly, they're a care provider in the home that is, you know, looking after the mother her postpartum well being. And usually that includes checking up on how things are going with breastfeeding. I know for myself in my practice, that I get a lot of referrals from doulas in my local community. And so they are usually the ones to link up their clients with a lactation consultant when it's needed, they're able to identify that that level of support is needed. So they can be quite helpful because they usually are coming to visit. You know, once, you know the Mother has given birth is returned home, and checking on the mother and the baby. So I thought that was really great. 

 

Now there's another news piece that came out from the Harvard health publishing, so from Harvard Medical School, and it was an article by Ilana T. Goldfarb. She's an MD, she's a Master of Public Health. And the title, this article was wondering about COVID-19 vaccines if you're pregnant, or breastfeeding. And I did a podcast episode on this last week about COVID-19 and breastfeeding, including information that we know up to date about the vaccine. And she's sort of confirming what I said. And she said that, you know, we don't know how the vaccine necessarily affects pregnant or breastfeeding people because they weren't studied. But that doesn't mean that it's necessarily unsafe. It's just this unknown. But we do know that COVID-19 affects people who are pregnant much more differently. And so that's an important risk factor to take into account. I won't we really address the pregnancy side of things since I don't really work with anything related to pregnancy. I just do you know, breastfeeding so I may work with people while they're pregnant, but I don't discuss pregnancy issues, since that's not in my scope of practice. 

 

But you know, the the vaccine trials for the mRNA vaccine did not deliberately include pregnant or breastfeeding individuals. So again, we don't have that knowledge. But there were some trial participants who inadvertently became pregnant, and 18 of those received the vaccine. And so they're going to release some further information on that in the coming months. Obviously, these people have not given birth yet. And then when they studied during animal tests, they showed that the mRNA vaccines did not affect fertility or cause any problems with pregnancy. And so you know, that's also promising. We know that the mRNA vaccines do not contain any virus particles. So getting the vaccine does not mean that any virus will go into your breast milk or into your baby. And within hours or days, our bodies eliminate the MRN excuse me, I can't even talk mRNA particles using the vaccine, so they're unlikely to reach across the placenta, they are also pretty unlikely to reach or go into the breast milk. So that's, you know, something to think about.

 

And the components of the vaccine, the ingredients of either the mudrunner, or Pfizer ones are not known to harm breastfed infants. So it doesn't mean that they can't, but as far as we know, there's there's nothing there that if it's injected would be harmful to breastfed infants. And when a person who gets vaccinated while they're breastfeeding, their immune system develops those antibodies that help protect against COVID-19. And those antibodies can be passed through the breast milk to the baby. So newborns of vaccinated mothers who breastfeed could potentially benefit, you know, from those antibodies against COVID-19. So that's what we know. So basically, you know, her article that she wrote, just reviews that information and states, basically the obvious if you've been following the details of vaccine, which, you know, a lot of people have not, so I like to just share that. Now, here's an article from the sun, which is a publication out of the UK, one that probably most people don't take seriously, but I actually really enjoyed it was written by Kate wills. And the headline is breastfeeding should incite all and compassion, not stairs and accusations of inappropriateness. 

 

Now, this is really important, actually. Because next week, I have Professor Amy Brown on the podcast, and she is in the UK, specifically Wales, and the UK has some of the lowest breastfeeding rates in the world. And we discuss on the episode, not just the UK, but worldwide what's going on with breastfeeding and the rates and why we are still struggling to see proper support for it. And one of the things that she talks about is that in the UK, culturally, breastfeeding is not very accepted. So Kate wells does a wonderful job in her article of sharing her experience of breastfeeding in public. And I don't want to sit here and just read the entire article to you. But I'm gonna just read, you know, a little bit here so you can get an idea. She said something strange happened when I went out for lunch a few weeks ago, before being plunged into tier four. Now, if you're not familiar, they're in very strict lockdowns over there in the UK because of the pandemic. But she said, when this incident happened between courses, I am buttoned my shirts to give my daughter Blake some lunch. And her friend her dining companion said, Do you want to switch places with me? So your work private, and she was shocked. You know, she she said that she hated making her colleague or her or her companion there make a feel uncomfortable. 

 

But I feel adamant that women shouldn't feel awkward or ashamed about feeding their babies. I didn't want to banish myself to a corner of the room or the bogs or erect some sort of pop up tent around me. Having breastfed for three months, I've become used to whipping out my boobs. I've nursed Blake everywhere from a kebab shop, to a fancy hotel, and even during a work zoom call. So, you know, she goes on to state you know, she's even breastfeeding as she's writing this article. Because that's what you do when you're breastfeeding your babies to feed and you feed them. So she makes the point that the more we see other women breastfeeding, the more we can normalize it. And know it's not always easy, especially if you know you're struggling with, you know, some pain from breastfeeding or you have a letdown that tends to shoot across the room and maybe doesn't want a ladder unlatches and looks away and gets distracted. 

 

But just like her headline, you know, she says that breastfeeding should incite on compassion, not stairs and accusations of inappropriateness. And I could not agree more. So she makes a really important points here about the low rates of breastfeeding in the UK. And she said I think it's sad that a third of women feel too embarrassed to breastfeed in public and that breastfeeding was only finally allowed in the House of Commons last year. So that is shocking actually didn't know that. But I like this part of the article here. It points out some other cultural things going on in the UK. And she says in the first episode of the undoing. Nicole Kidman and Hugh Grant's much talked about whodunit TV show, one of the characters Elena breastfeeds at the table, much to the shock and snickering of the other women, spectacular breasts one comments afterwards. 

 

So these are the things that women you know, breastfeeding even even in the media and popular culture powerhouses such as Nicole Kidman and Hugh Grant in this in the show, breastfeeding is being mocked. Now, I didn't because I'm just now starting the series of this week and breastfeeding. I didn't address this, but I think it was a couple weeks ago where there's an article that came out about Cardi B. She actually made headlines for breastfeeding her daughter culture in a music video for the song money, and she fought back at some people who had trolled her online I think specifically on Twitter, but possibly also Instagram. The nipple shamed her for the size of her areolas.

 

And she retorted, because I breastfed a baby for three months, tidies got bigger, so nipples got bigger. It's okay, let me know if your daddy want to get breastfed. Now that's Cardi B. So I don't necessarily advocate for the way she handled that situation. But that is very Cardi B. But good for her honestly, good for her for standing up. Yeah, it's great that she breastfed. And obviously her breasts are in every music video very prominently on every public outing she seems to make. But just because that's the case, doesn't mean that we always have to sexualized press right. So unfortunately, that's just what's sort of been happening in popular culture. So, you know, if, if women grew up as young girls and saw, you know, more women breastfeeding their babies out in public, you know, would that make breastfeeding easier for the next generation? I truly think it would. 

 

I recall a time where I think I was maybe about I want to say eight or eight to 10 years old. And I went to this woman's house after school, she took care of a lot of kids whose parents worked. And so it's kind of like an after school, sort of, you know, babysitting service until her parents were off work. So I would go with a few of my friends. And she had a friend over. And the friends just unlatched her baby, or amend her shirt, latched her baby and breastfed, and I had never seen that before. And as a child, I didn't have any sort of context for it, or whatever I just thought is completely normal. Like, oh, cool. That's how you feed babies. Neat. You know, I had also seen bottles being used, and I had seen formula being used far more than I had seen seen breastfeeding. But I will tell you this, that is the only time that I've ever seen another real person breastfeed. 

 

And when I had my son, you know, I intended on breastfeeding, but I honestly think that the intention of like, there was no question in mind that mind that I would breastfeed had a lot to do with that image that stayed in my mind when I was somewhere between the ages of eight and 10 that I saw someone breastfeeding, like it was no big deal. There was no shame around it. It was just something that had to be done. And I saw that and I remembered that that image was burned into my mind as a child. And I recalled it often remembering, like, when I was breastfeeding, my son like, wow, had I not seen that example of breastfeeding. But I'd be breastfeeding today. And the answer is, I don't know. I really don't know.

 

Now, here's kind of a related article that's from Ms. Magazine. This is from January 26. So just a few days ago, and the headline is, is online breastfeeding, and you think how the pandemic is changing everything and nothing. And so they kind of make the point here, the author Corrine bots, that we had selfies, right, breastfeeding selfies, and that was something that we used to sort of advocate for breastfeeding on a grassroots level, right sharing these things on social media. But now because there are mothers who are working from home and they are using zoom or some other video conferencing type of tool to you know, collaborate in in the workforce, that they may be found breastfeeding their babies. 

 

And so I'm going to read this this excerpt because I think this is definitely something that a lot of mothers who are working and doing video calls are thinking about. She says I was recently preparing to sign on to an online faculty meeting when my two year old began to scream TTTT the French for boob and suckling. I might be saying that wrong. 30 seconds before start time was little time to think I had joined meeting put them on the breast and attempted to smile. But Wait, should I turn the camera off? As a legal scholar who writes about lactation as an underrecognized and unrewarded form of gendered labor? I could not possibly turn it off. I noticed that there are 50 participants on the call, but I come across as unprofessional or just French keep the camera on. I told myself, it was a bit scary, uncomfortable, but I'm tenured. I'm a white sis white woman. Who has privileged in many ways, the type of person who ought to use her position to make lactating labor more visible? 

 

A couple of minutes in a senior colleague texted me, are you nursing, I wrote back trying to project confidence, of course, online public nursing my current research topic. So she goes on to say, you know, just some of the issues with this, that lactation has become something that's more visible, but at the same time, also less visible, right, because we're not out in public, there's social distancing. So you know, if we are walking along somewhere, chances are no one's really just sitting casually, and just breastfeeding their baby, right, we're all trying to get home or keep our distance, you know, notice that we making less eye contact, things of that nature. But then it's transitioning to online where we might be seeing this more online, you know, workplaces, you know, have been required, in some cases, to provide lactation rooms, and things of that nature. 

 

So usually, you'd be using a lactation room and taking a break. Now that work has moved to home, you might be nursing and and working through that time period, instead of actually taking a designated break. So she brings up some really excellent points here, and honestly, it's an excellent article, and I don't want to go through all of it. But I'm curious, you know, if you the listener, or have experienced this, have you been in a situation where you're on a video call, maybe it's even helping your older child sign on to their, you know, zoom or Google classroom or something like that in your nursing the baby in the background there? How have you felt during this time with that? Do you feel more exposed? Do you feel like you're you're setting an example? Do you try to avoid nursing? Or do you turn the camera off? I'm just so curious about how people are managing this sort of situation. Now, I guess I should have gone in maybe a better order here. But

 

just, you know, there's an article from the World Health Organization here, which I always like sharing their information, because, you know, it gives us a global perspective instead of something that's so us centered where I am, and you may not be listening from the United States. So I always like to just, you know, make that assumption I have, I have clients all over the world. So I'd like to speak to them as well. But they talk about the Maderna COVID-19 vaccine specifically and what you need to know. And they do talk about, you know, who who else can take the vaccine, meaning just, you know, people other than high priority groups, and they have a specific sentence here that says the vaccine can be offered to a breastfeeding woman who is part of a group recommended for vaccination, eg health workers, discontinuing breastfeeding after vaccination is currently not recommended. 

 

So I like that they clarified that because yeah, definitely, we're not, we're not suggesting that anybody wins, or ceases breastfeeding, just because they've gone ahead and gotten the vaccine, there's no evidence to support that you do that. So if that's something you're choosing for yourself, please note that there is no reason for you to wean or or pump and dump her, you know, anything like that. Please, please don't do that. And if you're having some questions about that, this is really something that you should discuss with, you know, your health care provider team, you know, before and after you go ahead and get a treatment like that. So I wanted to move on and share something else here, something that I've known for a long time, but it's always great to see more research, validating these things, you know, the the point of science really, is to not just look at something once but to see if we can repeat the outcome. Right? Can we come to the same conclusion, looking at this multiple times, or changing some variables, things of that nature. 

 

And so this article I found from the Baylor College of Medicine, it is from January 26 2021. And it says, connecting the dots between lactating mothers diet, milk composition, microbiome, and benefits of mother's milk. And so they're just going into, you know, confirming that, you know, human milk is the optimal nutrition for newborns and infants. And this study was done by researchers at Baylor College of Medicine, and they have uncovered by the way, someone else has already uncovered this, but they've really uncovered a mechanism by which nutrition can modulate the beneficial composition of the mother's milk. So here's what they say. Mother's Milk confers protection against both immediately life threatening infant diseases, such as necrotizing enterocolitis, as well as later onset diseases in adults like obesity, diabetes and inflammatory bowel disease. Now, that's a quote from Dr. Kjersti Adguard. I believe I'm saying that correctly. She is the Henry and MMR chair in obstetrics and gynecology and Professor of Molecular and human genetics at Baylor and Texas Children's Hospital. 

 

And then she goes on to say, scientific evidence suggests that what a mother eats, while she is breastfeeding can modulate the beneficial composition of the mother's milk. But the underlying mechanisms involved have not been elucidated. So she really gets into, you know, the metabolic health lifelong for the child, and that what a woman eats during pregnancy can affect that, and also obviously postpartum when she's breastfeeding, and they start going into the human milk oligosaccharides. Now, if you didn't know this already, human milk contains over 200 all go saccharides. And we're always discovering more, and there's quite a few components, I would venture to say, in breast milk that we've never, we still have yet to discover. So it's a very cool living tissue, amazing, incredible substance. That is really, you know, one part one tiny part food, you know, one other parts, directing, you know, the completes child development on a genetic level, or microbiome level, neurological level, really on every level. So it's pretty amazing stuff. 

 

So what they say here is that, since human milk oligosaccharides, or HMOs, as we call them, for short, are basically inert substances to a mother and her baby. However, they exert their health benefits by acting as food or fodder to microbes, both bacteria and some viruses. Now, not all viruses are bad. By the way, this appears to be a very interesting example, where what we eat affects our microbes via an intermediate, the HMOs, which we make, but don't directly benefit from, it gives us a fascinating glimpse into what we and others believe is a natural co evolution process. So just so you guys understand HMOs are there to feed the microbiome in the gut of the baby. So when people say things like, breast milk is all used up by the baby, and it's normal for them not to poop for several days? That is not true. That is a complete falsehood. And if you have a healthcare provider who's telling you that one, I would ask them, where's the evidence to support that claim? I'll give you a hint. There's none. And you know, you may hear anecdotes from people when my baby didn't poop for 14 days. And then he went and he was fine. Well, how do we know that they were fine. I would say that if you didn't poop for 14 days, or if your dog or cat didn't poop for 14 days, you'd be rushing to the doctor. 

 

So it is not normal for human infants who are exclusively breastfed to not poop for 14 days. And the reason for that is because of these human milk oligosaccharides. They're feeding the gut bacteria. And they will then get disposed of they're basically it's like, if you took Metamucil because you want to have you know, more sort of, you know, substance to your stool, right, human milk oligosaccharides work much in the same way. They're basically this fiber, right, that doesn't really get digested, it's there to feed the microbiome. And then it is going to come out in their stool, along with dead parts of the microbiome. So bacteria is constantly, you know, replicating, reproducing, so to speak, and then it's dying off. And that dead bacteria is also going to come out in the stool, so there's always ways to be expelled, if our body is not expelling it starts to become toxic. So that's sort of the rundown on HMOs. 

 

My perspective, and past previous research I've looked into, but they were looking specifically at breastfeeding mothers and their meals in a controlled setting at the USDA children's nutrition research center. So they consumed a particular diet for 30 to 70 hours. And then after a two-week, what they call washout period, the same woman ate a different diet, also provided by the researchers. So then the researchers collected milk samples from all the different points in time, including when the diets switched. So this way, she could kind of serve as her own control, like each participant. And they call this a crossover trial design. So if you're wondering what kind of trial design this is, it's a crossover trial design. And so this helps the researchers to control for the possibility of how individual women might vary from one to the next. And of course, they're going to because they're going to make milk specific to their babies and to their physiology, but they're trying to control for diet and look at, you know, a group of people here. And they were looking specifically at the number of human milk oligosaccharides that were made, as well as the possibility of microbes in the milk with environmental contaminants. 

 

So they looked at that, and here's what they found. So then they say that we found that the steamed maternal carbohydrate and energy sources in the diets where we provided preferentially altered the milk concentrations of HMOs and this was accompanied by changes in the metabolic capacity of the milk microbiome. So then they go on to say it is not that the maternal diet itself is directly affecting the microbes, but that the diet affects the microbes. Food, the HMOs, which in turn shape the functional capacity of the community of microbiome microbes in the milk that will be consumed by the baby. And it says, interestingly, the changes in HMO occurred quickly in a matter of two to three days after the mothers changed their diet. So if we think of HMOs as sort of prebiotics, it's not that the changes, the maternal diet affected the milk directly, it or the microbes in those organs, instead, it affected those HMOs. And that affected the microbes in the milk. So that's really cool to know, it's cool to know that if you make changes to your diet, you can quickly see improvements or, you know, things getting worse, I suppose. But this has a lot to do with the baby's health and development. And we are, you know, just now scratching the surface of the role of HMOs in breast milk for promoting the gut integrity of the infant. 

 

So it's very, very cool to take a look at this. And then there's another aspect of the study that they talk about. And it says that the suggestion that HMOs seem to preferentially affect the growth potential of microbes that may also impart health risk are a benefit for the mother, for instance, by shaping the community of microbes in the milk in ways that may favor the growth of certain beneficial microbes via the simultaneous exclusion of those that caused mass mastitis during breastfeeding. So if we are changing the microbiome of the human milk inside the mother's breasts, and we're changing that to preferring more probiotic bacteria, and less of the, you know, sort of negative pathogenic bacteria, this can also help prevent mastitis, we already know that certain probiotic strains a mother can take, and those will be helpful for preventing or treating mastitis. But what if we can just control that through diet. So this is really, really cool, exciting stuff, not only is our certain diet changes, you know, beneficial for the baby, but also for the mother directly. So it's a win win. 

 

I think it's really cool. I would love to get, you know, full access to this watch. I do it is an open access study. So you know, you can look at some of the changes, specific bacterial strains that they look at, and more specificity about the diet. So I will link that up in the show notes for anyone who wants to take a look. Now, this is news that has made headlines ever since the press release sort of came out on January 26. This is from the United States Army. And they have revised some regulations and grooming standards to support diversity and equity inclusion, and calling it a people first priority. Now some of these things really aren't relevant to breastfeeding. But there is one thing that they made some major changes that went in that are going to go into effect on February 24. 

 

And it's going to include implementation of the I don't even know what the stands Oh, can I find what this stands for? army green service uniform. Okay. And they clarified their policy on breastfeeding or pumping in uniform. And they're authorizing for breastfeeding slash pumping soldiers to wear an optional undershirts. So, you know, that's really great. It's something else that helps support breastfeeding. So instead of having to, you know, to say, let's say, unbutton, their uniform or what have you, and just, you know, be fully exposed, they can have, you know, an undershirt underneath to keep themselves, you know, a little more protected, offering a little more privacy. I think it's a good change. They also did go into some other interesting changes about hairstyles, like a tight bun, that definitely promotes hair loss, which is, you know, obviously not something we want. And so now they're allowing some different hairstyles that don't know to try stop hair damage and hair loss, stemming from those styles that they've previously only allowed. So I can that's great. More on the policy front here. 

 

This article was released on January 27. I haven't hear from the New Hampshire Business Review, breastfeeding, pregnancy bills get favorable reception in the New Hampshire Senate hearing. So this is really, really cool. I would like to see more seats do something like this. And I'd also like to see more be done on this front. But basically, this is a bill that has bipartisan support. It would require New Hampshire employers to have to provide reasonable accommodations to women before, during and after pregnancy. Now as that relates to breastfeeding, it would require businesses with more than five employees to provide a safe place to express breast milk and the place to do it for a year after childbirth. 

 

So currently, federal law in the United States basically requires that employers with over 15 Employees have these accommodations. Now, that actually leaves a full quarter of women unprotected in the workforce. So still, you know, if your employer has only 30 employees, they're not subject to this federal law. So, you know, they can make you pump in a bathroom, or they don't have to be pumping brakes technically. Now, I think that's horrible. But unfortunately, that's the way it is for a lot of women who are returning to the workforce. And it does happen to be a pretty big barrier in terms of, you know, continuing to breastfeed and women meeting their breastfeeding goals. So, the other problem here is that because of the pandemic, and everything that's happened in terms of the economic impact, and everything else, disproportionately women, especially working mothers have been impacted. 

 

So this bill in New Hampshire, for their state would make it easier for women to continue to work, certainly. Now, the interesting thing about this is that they do say that there was a virtual hearing of the Senate Commerce Committee on Tuesday, no one spoke in opposition to either piece of legislation and those who expressed concerns, mainly worried that the bills did not go far enough. So I was really encouraged to read that I'm so glad that there are people at that upper policy level of government who are seeing that we need to do more for our working mothers out there. And I think that would be just, you know, wonderful to see that. So it sounds like that this is going to pass. And you know, it's great. So maybe if this happens in New Hampshire, we can start to see this in other states, it may set somewhat of a precedent. Now, if this is something that you're interested in getting to happen in your state, it's really important that you, you know, stay in contact with your legislators, you know, if you don't know who they are, there's lots of tools online where you can look that up. 

 

But it's really, really important that you advocate for the things that you want, they're not going to just magically introduce a bill that they have no idea that anybody wants, right, unless it's like a personal thing for them. So perhaps someone has given birth, there may be a state representative, and they're trying to breastfeed, and they're like, Hey, I don't have a place to pump, you know, breast milk or, you know, something of that nature, right? There may be some rule that they realize is outdated. And they want to make some changes. So if you're looking to get something like this in your state past, you've got to go advocate. 

 

Now, here's another study, I don't want to go on too long. I've got two more. So if you're hanging on here, and you want to hear all the all the best, I feel like sort of a catch up episode. But you would not believe how much I mean, this is not everything. Certainly that's come out in the last week or so over, you know, about breastfeeding, but you would not believe how much stuff is constantly coming out, which is why I want to do this little series of episodes for you guys. So some of you may care about this. Some of you may not. But it's always going to be relevant information. So here's here's an article about a study that was done on zinc and iron, maternal maternal intake of zinc and iron and how that affects breastfeeding. Now, zinc is a nutrients and an iron as well, both that I've known to affect milk supply, if you have nutritional deficiencies with zinc, or iron, these are things that can potentially hurt your milk supply. 

 

And so one of the things I suggest when my clients go to get lab work done to see what's going on, why do they have low milk supply, they're doing all the right things. But despite that, it's not happening for them, I have their ferritin levels checked. Now, you can't have the zinc levels checked. But usually, there's something more going on. But it's not a bad idea to have that checked as well. But there's a new Polish study that indicates that following a diet that is rich in zinc and iron, and breastfeeding mothers produce milk with a higher concentration of these trace minerals. So this is really cool. There, they actually were able to show that maternal diet influences iron and zinc content, human milk. So they are looking at mineral deficiencies. Specifically, the foods they looked at were frequency of meats, vegetables, and legumes, that those are a significant factor for incur influencing zinc concentration. 

 

You know, certainly seafood as well as actually a good source of that. And zinc and copper balance is really important. You don't want to have too much of one or the other. And then for iron levels, it was meat, fish and seafood, vegetables, legumes, nuts, and seeds that made a difference. These are all foods that are already known to be lactogenic, meaning encouraging of milk production. So you know, people always ask me, you know, what's the right diet for breastfeeding? Think of the healthiest diet that you could possibly have in terms of like getting as many rich, whole diverse whole foods into your body. That's the diet that you want. So people are like, what do I eat? What specific foods it's not one specific food, it's not five specific foods. It's a variety of foods that are good for you. And you know, assuming that, you know, you don't have food intolerances, you may need to take those into account. 

 

So what they're saying here is that the findings are significant because both iron and zinc playing a central role in many physiological processes, yet deficiencies of both minerals A public health concern during pregnancy and infancy, especially in developing countries. Iron is part of hemoglobin, and a structural component of a variety of enzymes crucial for a range of human metabolic processes. Infants are particularly susceptible to the consequences of iron deficiency due to rapid growth and brain development. Zinc plays a catalytic role in each of these six classes of enzymes, as well as having an important involvement in the regulation of gene expression, signal transduction and neuronal transmission. 

 

Zinc deficiency in infants results in stunted growth and compromised immune function with increased mortality from respiratory infections and diarrhea. Zinc deficiency is reported to be responsible for 4.4% of deaths in children aged six months to five years. So obviously, that's, you know, looking at sort of a worldwide figure. But as zinc is very important for your digestion, people with who have been on pharmaceutical medications often are depleted of zinc. So they need zinc to, you know, they need zinc supplements most of the time, or to eat high foods that are high in zinc. Zinc is very important for controlling reflux. In fact, sometimes that's an appropriate treatment for babies who are experiencing reflux or potentially reflux during pregnancy. So I like that they're really looking at how the maternal factors affect the quantities of iron and zinc and the breast milk. It's very important. Now if you want to know a little more about the study, what they did is they collected milk samples between four and six weeks postpartum for 32, healthy exclusively breastfeeding mothers, all admitted here, the sample size is not large. But they were assessing the diets via two methods, they looked at current intake in terms of a food diary that they required the participants to keep and habitual intake, sort of over the three months prior to the study. 

 

So they're looking at like, what are the kind of the habits that have been going on now we're going to see exactly what foods they're eating. Now, they calculated daily milk intake by weighing the infants, and they determined the iron and zinc concentrations in the breast milk, by inductively, coupled plasma mass spectrometer. So that's just a way of looking at, you know, some of the components of milk. So I think it's a great study, I think it just confirms some things that we already knew in the lactation community here. But for those of you listening, it's important to think about make sure that you are getting foods that are really high in all the appropriate nutrients. In my mind, taking something like a prenatal vitamin, you know, that's not there, that's there to serve as a bit of a bolster, like in case you know, you had some variability in your diet, and you didn't get certain nutrients in a certain week or something like that. But it does not replace overall good nutrition. 

 

Depending on the vitamins you're taking, you know, may or may not be more bioavailable forms of those minerals, and vitamins and micronutrients. But really, the best source of those sorts of things is food. So if you can get the right diet, it's very, very important. Now, last but not least, very cool study here that is in the Journal of nutrients. And it's called breastfeeding duration and development of dysglycemia. And women who have gestational diabetes mellitus evidence from the gusto cool cohort study. So basically, what this study is looking at is women who had gestational diabetes, so meaning, you know, had that during pregnancy, and what is the potential of reducing their risk of long-term diabetes. And so this is really cool, because they're looking at breastfeeding specifically. So they took data from the growing up in Singapore towards healthy outcomes study. So that's abbreviated as gussto study. And they were trying to understand the influence of breastfeeding duration, on long term dysglycemia. So despite seniors, either pre diabetes or diabetes, so they took, basically,

 

they did a Poisson regression model with a robust error variance to estimate the incident rate ratios for dysglycemia, four to seven years post delivery. And so they they grouped women in different categories, less than one month of breastfeeding, one month, or, you know, to six months breastfeeding, and then greater than six months. So they looked at this and they saw that the longer the duration of breastfeeding, the more likely the risk, the long term risk of dysglycemia was reduced. And this is an Asian setting, they are careful to say that, because you know, these things actually do matter. So Breastfeeding has benefits from others beyond just weight loss, which, you know, is one that we can see but potentially the weight loss issue there has a lot to do with regulating, you know, blood sugar and insulin resistance issues. We've already known for a while from other studies that breastfeeding actually does help to modulate, you know, blood sugar levels in breastfeeding mothers. 

 

So what's great to know is if you had gestational time Diabetes during your pregnancy, you definitely want to make sure you're breastfeeding for as long as possible in this study, you know, showing six months or greater, because that's going to significantly reduce your risk of becoming pre diabetic or diabetic later on in life. I really liked how they looked at this, you know, looking at four to seven years postpartum. Now, what I'm curious about is, you know, there is the full text available. But I'm curious to know if, you know, there were subsequent pregnancies, you know, the, the longer you breastfeed, the more children who breastfeed, actually, the more benefits that are conferred upon you in terms of, you know, reducing breast cancer risk, and, you know, things of that nature. So, you know, the final statistical analysis theory to do again, I would say it's a fairly small sample size, it's not like 1000s of women, but it was 116 women. So we have to take that into account. And sometimes when you do these long term studies, it's really hard to get participants, you know, to keep going, people are going to drop off, you know, they're going to move, you're going to lose their contact information, they change their email address, who on earth knows, right? 

 

So it's great that they did do this study. You know, I think even even studies that are not well done, are always wonderful for us to look at, because then we can see the flaws in the study and create a better study design going forward next time. So that's really all I have for you in terms of this week. And breastfeeding. I hope you found this educational and helpful. If this is too boring for you, let me know if you like this, let me know. I I'm going to definitely try include some fun things. There will be some things that certainly make me roll my eyes very hard that I'll be sharing with you too. But if there's anything in particular you want to learn more about, let me know, send me a message over on Instagram at holistic lactation is where you can find me. If you find this episode helpful. This little series, you know, let me know leave a review on iTunes that definitely helps our podcasts get found. And I just appreciate all of you listening and subscribing. If you're not already subscribed, make sure that you are so you can get these weekly updates along with all the incredible guest interviews. Like I said, coming up next week is Professor Amy Brown, who's written I believe it's seven books around the topic of breastfeeding. She's absolutely amazing, so humble and wonderful, just the sweetest soul and I'm super blessed to have had her on the podcast. And we've got many other awesome ones coming your way.