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Maternal malnutrition and breastfeeding

This question was posted the Infant and young child feeding interventions forum area and has 11 replies.

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Anonymous 36057

Normal user

16 Nov 2019, 11:45

Hi there, 

I am looking for a good summary with evidence around maternal malnutrition and impact on breastfeeding. Something to answer the question: "does maternal malnutrition affect breastfeeding (breastmilk quality and/ quantity) and how?". 

I know the answer but really want a nice written one with relevant references. Is there one or should I just formulate my own? 

Thank you very much. 

Mohammed Mudarrifu

Nutritiob Assistant

Normal user

16 Nov 2019, 17:52

I can see that people on this platform are busy so can you just formulate your own for the sake of knowledge?

Thank you.

Alessandro Iellamo

Save the Children UK

Normal user

16 Nov 2019, 17:56

Excellent question. I have a powerful reference. I am now in a bus and ill send it tomorrow morning

Best

Dr Mohamed

Normal user

16 Nov 2019, 18:11

Producing human milk depends on baby's suckling breast milk. In terms of quantity, this can make it easy for every lactating mother easy ( baby - breast and brain) 

However, Malnutrition occurs when the body does not receive enough energy, protein and nutrients to function properly in terms of quality.

Florence

Normal user

16 Nov 2019, 18:13

See this review by Ann Prentice 

https://doi.org/10.1177%2F156482659601700406

Florence

Normal user

16 Nov 2019, 18:29

This thesis gives more info on supplementation and breastmilk composition

https://www.repository.cam.ac.uk/handle/1810/271808

ABDI MOHAMED ISAK

nutritionist

Normal user

17 Nov 2019, 02:45

for my view Maternal malnutrition breastfeeding is behind the nutrients of the mother during pregnant, when the mother did not get macro and micro nutrients, it is the time happen maternal malnutrition breastfeeding, this impact affected poorest population which susceptible for famine drought or in food security that missed mother to eat food rich with four food groups, when the mother get nutrient we can talk about the qauntity and quality of the breast milk

Alessandro Iellamo

Save the Children UK

Normal user

17 Nov 2019, 07:27

Dear all

please use this fantastic publication of WHO that contains several important answers to your questions...in partocicular on the issue of maternal nutrition and breastfeeding 

https://www.who.int/nutrition/publications/infantfeeding/9240686703/en/

an interesting paper on water needs during pregnancy and beyond

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1595116/

A cochrane review on the needs of extra fluids during lactation

https://www.cochrane.org/CD008758/PREG_extra-fluids-for-breastfeeding-mothers-for-increasing-milk-production

Anonymous 36057

Normal user

18 Nov 2019, 09:00

Thank you very much to all. it is very helpful.

Issack Yakub

Normal user

18 Nov 2019, 11:12

Unless extremely malnourished, nearly all mothers can produce adequate amounts of breastmilk. There is a common fallacy that malnutrition greatly reduces the amount of milk a mother produces.  The amount of breastmilk produced depends mainly on how often and how effectively the baby sucks on the breast. However maternal malnutrition may affect the quality and quantity of the milk the mother produces when extremely malnourished .When the mother is undernourished it safer to feed the mother and less expensive than not breastfeeding the child and exposing risk associated to breastfeeding alternatives.

Anonymous 36057

Normal user

18 Nov 2019, 11:29

Many thanks again. 

Here is the reply that I forumlated based on your responses - please feel free to use/adapt if needed. 

------------ 

My short answer is that breast milk quantity is mainly regulated and is dependent on the baby’s suckling on the breast. The more stimulation, the more the body produces breast milk. So only in severe cases of malnutrition that the quantity may be affected.

As for the quality of the milk, it is true that maternal nutrition is important, however, even mothers with poor nutritional status are able to breastfeed and will produce breast milk that has most of the essential components and usually at the determinant of her health. In general, total fat, protein, and sugar are relatively insensitive to maternal nutritional status while you may see a change in micronutrient content (water soluble) and possibly fatty acids. That is why, the recommendation is to feed the mother so she is able to feed the baby. Breastmilk contains not only nutrients but also non-nutritional components that promote infant growth and development including antimicrobial factors, digestive enzymes, and hormones. Therefore, it is very important that infants are breastfed even if maternal nutritional status is not optimal but at the same time provide nutritional support to mothers especially in times of emergencies.

Here’s a review by Ann Prentice: https://journals.sagepub.com/doi/10.1177/156482659601700406

Quote from paper: “In the past it was commonly believed that poorly nourished mothers had reduced lactational performance, in both the amount and the quality of breastmilk produced. is view has now been shown to be largely incorrect [4]. A recent examination of the world literature could not demonstrate any convincing relationships between maternal nutritional status, as indicated by body mass index (BMI), defined as weight/height2, and either breastmilk output or energy content [52], even in very thin mothers (BMI < 18.5 kg/m2)”. 

Here’s a bulletin from WHO that also discusses this: https://www.who.int/nutrition/publications/infantfeeding/9240686703/en/

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Isabelle Modigell

IYCF-E Consultant

Frequent user

19 Nov 2019, 12:43

Many thanks for sharing your response with us. In addition to the above, it may be helpful to acknowledge that despite it being physiologically possible (and beneficial), it can be very challenging for a malnourished woman to breastfeed (e.g. when feeling weak) 

Adding to your recommendation to feed the mother so she is able to feed her baby, I would therefore stress the importance of immediate support from aid workers, healthcare professionals, families and communities - including skilled breastfeeding support and provision of safe drinking water (NB: severe dehydration DOES reduce milk output). 

One more reference for you here: http://www.tensteps.org/pdf/breastfeeding-faqs-matnut.pdf 

All the best,

Isabelle

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