Expert: ruth kraft - 11/30/2009

Question
QUESTION: Hi,
How does a gluten-free diet affect the make-up of breastmilk?  Will the child get enough fiber?  What growth pattern can be expected, i.e. slower weight gain, less sleeping?  If you've been diagnosed with Celiac disease, should you add wheat to your diet for your breastmilk's sake?

Thanks,



ANSWER: Very good question. As it stands from my knowledge, I went to a conference this summer and heard a couple speakers on the subject in general of food intake and nutrition and how it effects breastmilk. Although it was not about your condition specifically, It was the general consensus that the body will make the PERFECT milk for your baby. Every time. For the most part no matter how your nutrition is. ( Even if you are malnourished, your baby gets better nutrition than you do, but it ends up hurting you more in the end ) I would surmise that the same is happening here. Your baby will get all it needs from you. However you must replenish and be healthy for yourself. Whatever you will eat that helps with fiber, the baby will get through your milk. If you don't eat enough, you will feel the consequences of that, not the baby. If the baby needs calcium it will take it from you, but your teeth could deplete early if you don't take in enough calcium.

I think that you should eat what feels best to you and your body. If you make yourself sick by eating things that don't agree with you,  you wont be much good for the baby :)

I hope that helped.

---------- FOLLOW-UP ----------

QUESTION: Thank you.  I had forgotten that the body would make the perfect milk - I'm the grandmother, so it has been a while!  I have a slow-growing grandson and I'm thinking it may have more to do with not getting to the hind milk rather than my daughter's diet.  He stays at the breast for up to 45 minutes, but he is not actively sucking.  He falls asleep quickly.  I have encouraged my daughter to pay attention to him while he is nursing and make sure he gets a good 10 - 15 minutes of ACTIVE sucking in.  She is also massaging her breast while she is nursing to bring down the hind milk.  She's discouraged and of course worried.  He's attentive, sleeps well and has regular wet and poopy diapers (although, he did not have yellow poops until around the 10th day after birth - another reason for my concern.)But he has gained only 4 ozs over his birthweight at 5 wks.  We do not have any records from the first few weeks, but he has gained 4 ozs each week for the last 2 weeks.  Progress, albeit slow progress.  Any further suggestions are welcomed.  Reassurances priceless.

Thank you

Answer
Your welcome. Congrats on the grandbaby :) at 5 weeks it would not concern me that he nurses for 45 minutes. at 9 months I would wonder what is going on. remember also that at 6 weeks there is a growth spurt so he will likely nurse longer and more frequently during that...  There are some babies who eat a little all day long and some what get it done in the first 5 minutes.... you just never know... all are fine as long as baby is where he needs to be developmentally and also is having those wet and dirty diapers. There have been recent studies also that say that hind milk is not the biggest deal as we had thought of it previoiusly. There are some babies who will only nurse for 3 minutes each side every hour 24 hours a day, and get enough. Typically we would have thought this was going to be an issue being that in 3 minutes you would only get foremilk... however, that is not the case. Some babies do fine with such a routine. SO, it always boils down to what is working for mom and baby.

So, what I gather is he is 5 weeks and is not much bigger than birth weight. I wonder if he has an effective latch. It sounds as though he might be getting enough to thrive but maybe not always getting enough. SO, being that I am not there in person, I suggest a couple things. first go to www.drjacknewman.com and watch the effective feeding positioning. I wonder if he has the draws of his chin as he should when getting much milk. I also wonder about his frenulum. Has it been checked? Can he fully latch to effectively get mouthfuls of milk? Or is he exhausting himself and burning more calories than he is taking in? Is he belly to belly? Chin pressed in , nose out? If you are unable to establish these things, I strongly suggest getting evaluated in person by someone who does this for a living. NOT the OB or PEDI. But a specific breastfeeding Doula or councelor.

Was he born via c-section or have traumatic birth? ( long labor, decels, forceps or vaccum ) that can often cause milk to elay a bit, but the yellow poop not until day 10 also makes me wonder about effective latch. He might have a perfect latch, but an effective one is often different. 4 ounces a week it a little less than we typically like to see but it could also be his norm. SO I wouldnt be too concerned as long as that pattern keeps up.

I do phone counceling if she needs someone else to speak with and trouble shoot. Knowing also that your grandma, sometimes , as a new mother, that third party can be so reassuring as we dont have the same connection.

I wish you luck and good job being a grandma :)