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Can Women With HIV/AIDS Breastfeed?

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The HIV epidemic has left many families broken. But fortunately, with growing awareness and advancement in medical science, people with HIV/AIDS are going on to live full lives.

But what about women with this dreaded disease? Can they build a family and have a baby? Can they breastfeed their newborn just like any other mom?

There is a lot of misinformation regarding HIV and breastfeeding. We are here to give you a clearer picture.

HIV And Breastfeeding – Is It Safe?

According to the US Center for Disease Control (CDC), HIV-infected women in the US are recommended not to breastfeed their infants (1). But is this advisory justified?

According to newer studies, the answer is no!

Till recently, the World Health Organization (WHO) recommended that women with AIDS should avoid breastfeeding. But things have changed. New studies indicate that exclusive breastfeeding along with antiretroviral treatment can bring down the chances of a newborn contracting the disease through breast milk (2).

So, now new mothers with HIV are advised to breastfeed their infants and give them all the benefits that come with breast milk. Not only will this help the newborn baby get better immunity but will also protect her from contracting HIV from her mother. But why take the risk? Why breastfeed when one can use infant formula?

Well, the fact of the matter is that infant formula is costly. Many women with HIV do not have the means to buy infant formula.

And if one can buy all the formula in the world, there’s one interesting bit of statistic to consider. A child born to an HIV positive mother and formula fed is less likely to die from HIV-related causes. He is more likely die from under-nourishment, diarrhea, pneumonia, etc. All of these issues can be prevented to a large extend through breastfeeding.

Breastfeeding And HIV Transmission – Factors That Help To Reduce The Risk:

Just blindly breastfeeding a baby does not reduce HIV risk. There are other factors that play a big role too. Here are the things that can protect a newborn baby from HIV:

1. Early Weaning:

Exclusive breastfeeding is a good idea but extended breastfeeding? Not so much! Studies indicate that children who are weaned off breast milk at six months are less likely to get HIV through breastfeeding (3).

2. Exclusive Breastfeeding:

When we say exclusive, we mean feeding an infant only breast milk without adding anything else, like juice or water, to her diet. Studies show that women with HIV produce breast milk, which can fight cells that transmit HIV from mother to child.

3. Preventing And Treating Breast Issues:

Breastfeeding comes with a horde of problems like Mastitis and cracked nipples. For most women, these are just painful conditions. But for mothers who are breastfeeding with HIV, these problems can lead to increased risk of HIV transmission. So, it is important to prevent these problems in women with HIV.

4. Preventing HIV Infection:

If a breastfeeding mother has an infection, chances of her passing on the HIV virus to her baby go up. So, it is important to keep new mothers safe and protected from minor illnesses too.

5. Preventing And Treating Sores And Thrush:

Many infants develop sores and thrush in their mouth. These factors can lead to easy transmission of HIV virus. So, it is important to prevent these problems. If a newborn does end up with these problems, treating them as soon as possible is vital for preventing transmission of HIV.

Hope you liked our post on HIV and breastfeeding. HIV/AIDS is not a life sentence. Many people with the disease go on to live healthy lives. For a new mother, breastfeeding is the ultimate bonding tool. So, don’t let HIV/AIDS keep you from giving your baby the best possible start to life. Go on, breastfeed your baby, without fear or guilt!

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Baby Breastfeeding

Is It Safe To Take Caffeine While Breastfeeding?

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Giving in to all your food cravings can be an issue when you are breastfeeding because what goes into your diet goes into your breast milk too. Not all foods that you have may end up in the breast milk, but most do. Caffeine is one such food that is craved for by a lot of women. It is a part of many day-to-day foods that is debated upon for its safety and consumption when you are breastfeeding.

As per the guidelines from Medications and Mother’s Milk, caffeine falls under the Lactation Risk Category L2 (safer) category. It was classified as a ‘Maternal Medication Usually Compatible with Breastfeeding’ by the American Academy of Pediatrics. In fact, caffeine has been directly given as treatment for breathing problems in premature babies for years, that too in much higher amounts compared to what is found in the breastmilk! MomJunction helps you understand all about caffeine and breastfeeding, how much to take and when to avoid.

Does Caffeine Affect Breast Milk?

Yes, caffeine gets into breast milk! Once you drink a cup of coffee, the caffeine is rapidly absorbed into your blood, and diffuses passively across the epithelial layers of the mammary glands. But, very low levels (less than 1% of what is consumed) may end up in the breast milk and clinically significant amount of caffeine is not found. Caffeine appears in the milk within 15 minutes of intake, while the concentration levels would be at its peak after an hour (1).

Dr. SK Gambhir of Paras Bliss hospital in Delhi says that the effect on breast milk stays for a maximum of 120 minutes.

Are Babies Sensitive To Caffeine Intake Of Nursing Mother?

Some babies, especially those under six months of age, may be sensitive to mother’s caffeine intake. More reactions can be observed in nursing infants whose mothers entirely avoided caffeine during pregnancy (2).

Caffeine may get accumulated in breastfeeding babies if their mothers consume high amounts and can cause irritability, insomnia, and constipation. The accumulation is due to the inability of the baby’s body to break down and eliminate caffeine.

Newborns take more time to metabolize caffeine compared to older infants because of their immature liver and kidneys. Preterm or sick infants may also have problems because of their inability to metabolize caffeine.

Age Group Half Life (Hours)
Premature neonates (3-32 days) 102.9
Term neonates (0-4 days) 80.0
Young Infants
1-2 1/2 Months 26.3
3-4 1/2 Months 14.2
5-6 Months 2.6
Adults
Non Smokers 6.0
Smokers 3.5

 

*Half-Life is the time taken for a substance to become half inside a human body.

Even though babies show sensitivity to caffeine, it may disappear as they grow older. Babies will begin to process caffeine more efficiently at about three months of age (3), and it would become much easier over time. By the time the baby is nine months old, he would develop the ability to eliminate caffeine at the same rate as you do!

How Much Caffeine Can You Have While Breastfeeding?

According to Dr. SK Gambhir, a breastfeeding mother needs to limit her caffeine intake to less than 300mg a day.

An acceptable amount of caffeine while breastfeeding varies based on factors like baby’s health, age, and tolerance levels. Moreover, caffeine is diuretic and causes dehydration, and it is important to be hydrated particularly while nursing. Thus, it is advisable to limit caffeine consumption while breastfeeding with not more than two or three cups of tea, coffee, or caffeine beverage each day (4).

In the US, not more than 200mg caffeine a day is recommended for breastfeeding mothers. It comes to about two mugs of tea or one mug of filter coffee or two mugs of instant coffee, a day. NHS recommends that you have caffeine drinks occasionally, rather than every day, if your baby is young.

As per the Breastfeeding Answer Book, caffeine consumption of over 750 mg per day by nursing mothers may result in babies showing signs of caffeine stimulation, such as:

  • wakefulness
  • fussiness
  • activeness
  • alertness
  • wide-eyed
  • less sleep hours
  • colic

Ways To Decrease Caffeine Stimulation

If you observe signs of caffeine stimulation in your baby, avoid caffeine for two to three weeks and check the difference. Reintroduce to observe if the baby shows irritability.

Few ways to decrease caffeine stimulation are:

  • Limiting the consumption of caffeine while nursing
  • Spreading the coffee intake over the course of the day
  • Breastfeeding before or after an hour of caffeine ingestion or pumping breast milk
  • Monitoring the baby’s reaction when exposed or withdrawn from caffeine consumption
  • Taking few glasses of water after caffeine consumption to dilute its effect in the body

**If you consider caffeine withdrawal as a way to soothe your fussy baby, make it happen gradually. Abrupt withdrawal may give you a headache, anxiety, fatigue, and depression.

Does Caffeine Decrease Breast Milk Supply?

No research or evidence supports the myth that caffeine decreases milk supply in nursing mothers. In fact, a study indicated that caffeine does not change breast milk composition, and rather, stimulates milk production (5). Even if the decreased milk supply is observed in few cases, it could be due to the decreased nursing of fussy babies, rather than the caffeine intake.

However, few studies suggests that the chronic caffeine ingestion could lessen the iron content in milk, which may lead to mild iron deficiency or anemia in some breastfed infants.

When Should Nursing Mothers Completely Avoid Caffeine?

If you are a nursing mother having a Raynaud’s phenomenon, a circulatory disorder, avoid caffeine. The condition is due to the constriction of blood vessels, which leads to lesser blood flow. It even affects your nipples and the constriction worsens with caffeine, ending up in painful breastfeeding.

Caffeine consumption may affect a nursing mother’s let-down reflex (the milk ejection reflex from the breasts), in case of nipple vasospasm.

What Are Different Caffeine Sources?

Caffeine can be found in:

  • coffee
  • soft drinks
  • tea
  • sports, energy drinks
  • chocolate
  • few prescription medicines
  • over-the-counter medications for cold, headache, and allergy remedies
  • coffee ice cream
  • herbal products containing kola nut/cola nitida, guarana/paullinea cupana, yerba mate, or green tea

Caffeine Content In Common Drinks

Drinks Caffeine Level (mg)
Coffee, Brewed(8 oz) >80-135
Coffee, Instant(8 oz) >65-100
Tea, iced(8 oz) 47
Tea, brewed, imported brands (avg.)(8 oz) 60
Tea, green(8 oz) 15
Hot cocoa(8 oz) >14
Dark chocolate (1 oz) >20 mg
Diet Coke(12 oz) 45.6
Red Bull (8.2 oz) >80.0

Source:

A nursing mother can enjoy caffeinated drinks and foods without any concern, as long as it is within a limit. In case the baby shows discomfort, it is better to seek a doctor’s advice and chalk out the caffeine consumption plans.

FAQs

Q. What Can I Have Instead Of Caffeine Drinks?

A. A great option would be to have decaffeinated products like coffee free from caffeine, decaffeinated green tea, or herbal tea. You could also have flavored water with a slice of lime or lemon, semi-skimmed or skimmed milk, no-added-sugar squashes. Instead of cocoa or hot chocolate rich in caffeine, go for a hot malt drink.

Q. How Many Cups Of Coffee Are Okay Each Day?

A. The American Academy of Pediatrics recommends not more than three cups daily, while La Leche League considers five cups of coffee while breastfeeding each day to be safe.

Q. How To Limit Caffeine Intake Through Coffee Or Tea?

A. Opting for espresso drinks like lattes or instant coffee, which have less caffeine than the regular brewed coffee would be better. Take a tea that is brewed for less time or tea bag steeped in water for a lesser time.

Q. Are Energy Drinks Containing Caffeine, Safer During Breastfeeding?

A. It is advisable to cut down on energy drinks altogether as they are loaded with caffeine.

Q. Is Coffee Bean Extract Safe For Nursing Mothers?

A. Green coffee bean extract is a herbal, homeopathic product helpful in lowering the blood pressure and body weight. Even though no study talks about the safety of the product for a breastfeeding mother, it is important to note few points before going ahead.

Green coffee bean extract contains caffeine if it comes in dosages of 43 mg, 93 mg, or 185 mg.  The higher the dosage, the more the caffeine. Opt for low dosage product or avoid caffeine if your baby shows reactions against it.

Moms share your experiences about consuming caffeine during breastfeeding here. How addicted or not were you?

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4 Amazingly Different Ways You Can Use Fenugreek During Your Lactation Period

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Mommies, who are concerned about how to increase breast milk, need not worry, as Fenugreek can rescue you. Fenugreek has been used popularly as a spice of an herb for ages. It is known to induce labor and also assist in childbirth.

Fenugreek seeds can be a safe answer for you as well as your baby for increasing breast milk. How?

Fenugreek For Breast Milk Production:

When it comes to increasing your milk supply, it is always better to try the non-pharmaceutical measures first. The herbal medicines will have lesser side effects compared to the prescribed medicines to increase breast milk supply. Here we shall explore the link between fenugreek and breast milk production:

  • Mothers should have noted that they find increase in milk production after 24-72 hours of taking fenugreek.
    • You need to take around 3,500 mg of fenugreek in the form of pills, seeds or herb to see the effect. With regular intake, you can slowly find increase in your milk production. After some time, you can see your urine and sweat beginning to smell like maple syrup. You must try alternative methods, if in case you face any discomforts.
  • Per Kathleen Huggins says, “Most mothers have found that the herb can be discontinued once milk production is stimulated to an appropriate level. Adequate production is usually maintained as long as sufficient breast stimulation and emptying continues.”

Different Ways You Can Use Fenugreek For Increasing Breast Milk:

Fenugreek can be taken in different ways during your lactation period. Here are some possibilities:

1. Tea: You can add around 3 teaspoons of fenugreek seeds in a cup of water and bring it to boil to make the tea. You can have this around three times a day.

2. Capsules: The seeds are available in the form of capsules as well. You need to consult your lactating doctor about the doses. You can begin with three capsules a day, and then increase it slowly till your urine smells like maple syrup.

3. Sprout The Seeds: This is one of the easiest and tastiest ways to take fenugreeks. Soak the seeds in a clean glass of water and do not disturb them for around 5 days. You can see the sprouts after few days. You can add them to your salad.

4. Fenugreek Powder: Fenugreek can be taken in the form of powder. You can mix a teaspoon of it with fruit juice and take them daily. Discontinue its use if you experience muscle cramps.

Be Careful Of The Side Effects:

You must consult with your herbal specialist or lactation doctor to know if your baby is exposed to any sorts of dangers when you take fenugreek daily. Here is a list of side effects that you should be careful while taking fenugreek for breast milk supply:

  • Fenugreek seeds induce labor, and thus it is suggested that you avoid them in pregnancy.
  • If you notice any allergic reactions, inform it to the doctor. You may be allergic to fenugreek if you have allergies from peanuts or soy.
  • If you begin with heavy doses of fenugreek, it might lead to diarrhea. The herb also passes through your breast milk and your baby might develop diarrhea as well. Thus, it is important that you start with the small dose and then increase the intake slowly.
  • See if your urine, sweat and breast milk smells like maple syrup. You must inform your baby’s doctor about your fenugreek intake.

Remember:

  • You must consult your doctor in case you feel you are not producing enough milk, despite trying different measures.
  • Your lactating consultant may suggest you to take fenugreek to augment your milk supply.
  • Make sure you are starting with a small dose to keep away the side effects.
  • You must follow the advice of your doctor at every step. This will free your mind from all concerns like if you are harming your baby in any way.

Let us know if fenugreek helped you to augment your breast milk production in the comment section below.

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