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Many women are choosing vegetarian or vegan diets, thanks to numerous reports about the health benefits of such diets, including decreased incidence of heart disease, diabetes, hypertension and obesity. For many patients who change from carnivorous diets to vegetarian or vegan diets, they report “feeling better” and in my experience have fewer issues with inflammatory diseases including eczema, asthma and arthritis, for example.

The concern some have over a vegan diet is maintaining an adequate intake of certain key vitamins and minerals. The most common issues are vitamin B12 deficiency, as well as iron deficiency. In fact, vegan mothers are some of Lactation Lab’s most common clients, eager to ensure that their babies are getting the nutrition they need.

One interesting study found that vegan and vegetarian mothers are more likely to breastfeed their children when compared to non-vegetarian mothers and they also did so for a longer period of time(1).

Although plant-based diets are at risk for nutritional deficiencies such as protein, iron, VItamin D, calcium, iodine, omega-3’s and B12, well-planned diets rich in grains and legumes combined with supplements can provide adequate nutrition to both mother and baby during pregnancy and breastfeeding.  Following a rich plant-based diet during pregnancy can also be protective against the development of preeclampsia, pregravid obesity and reduce the risk of their child developing asthma, diabetes and even some pediatric tumors (2).

In our own testing of the breast milk of vegan and vegetarian mothers at Lactation Lab,  we have seen tendencies of lower in B12, calcium and iron. We recommend all vegan and vegetarian women make sure they have an adequate source of B12, which is important for maintaining healthy a healthy central nervous system, production of DNA and RNA, formation of red blood cells and overall metabolism.

Protein intake should also be increased by 10% in vegan pregnant and breastfeeding women (3,4) and additional servings of protein-rich plant foods such as legumes, soy milk, soy yogurt, tofu, and meat analogs based on wheat or soy protein, nuts and seeds are essential.

Bottom Line: There are many benefits to vegan and vegetarian diets. We recommend that vegans that are nursing consider taking the following supplements: Calcium, iron, B12, DHA and Vitamin D (universally recommended for all breastfeeding infants).

References:

  1. Pawlak R., Ding C., Sovyanhadi M. Pregnancy outcome and breastfeeding pattern among vegans, vegetarians and nonvegetarians.

  2. Pistollato F., Summalla C., Elio I et al., Plant-based and plant-rich diet patterns during gestation: beneficial effects and possible shortcomings.

  3. Agnoli C., Baroni L., Bertini I. et al. Position Paper on vegetarian diets from the working group of the Italian Society of Human Nutrition.

  4. Kniskern, M. Johnston C., Protein dietary reference intakes may be inadequate for vegetarians if low amounts of animal protein are consumed.


Other resources:

Pawlak R., Vos P., Shahab-Ferdows S et al. Vitamin B12 content in breast milk of vegan, vegetarian and nonvegetarian lactating women in the United States

Sebastiani G., Barbero A., Borras-Novell C et al. The effects of vegetarian and vegan diet during pregnancy on the health of mothers and offspring.

Baroni L., Goggi S., Battagliano R. et al., Vegan Nutrition for Mothers and Children: practical tools for health care providers.

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Our goal at Lactation Lab is to reassure mothers about the quality of their breast milk and help them pursue their breastfeeding journey for as long as they choose.

As a result we aim to help dispel myths where justified, and to provide moms with the information and solutions they need to address any concerns they may have.

One topic of concern to some mothers with breast implants is whether they present any health risk to their baby through possible contamination of their breast milk. In particular, they ask about whether silicon, silicone gel or platinum used in implants can leak into their breast milk.

Silicon and Silicone

Moms should know that silicon occurs naturally. It is the second most abundant element in the earth’s crust. It is thought to be essential for connective tissues and is found in tendons, bone, skin, hair and nails.  Silicon is used as an anti-foaming agent in fruit juice and is found in cosmetics, pharmaceuticals and proshtheses. The only known health hazard results from inhaling crystalline silica dust into the lungs causing silicosis. Silica dust is never used in implants.

Breast implants contain silicone gel, a synthetic polymer made up of silicon, oxygen and other elements, most typically carbon and hydrogen.

Research has reported cases of esophageal dysmotility (slow movement through the esophagus) in infants that were nursing from mothers with silicone implant). Another study reported “rheumatoid-like symptoms” transferred to a child from a breastfeeding mother with silicone implants). However, this study examined only two children.

A larger study did not show any adverse outcomes in infants of breastfeeding mothers with silicone implants. Another study found that there were actually higher levels of silicon in cow's milk infant formulas than in human milk. (It should be noted that this study was funded by the plastic surgery industry.)

The silicon-containing anti-colic agent simethicone has been widely used for decades and there have not been shown to have any toxic side effects to infants.The American Academy of Pediatrics therefore recommends that mothers with silicone breast implants should breastfeed if they choose to.

The American Academy of Pediatrics Committee on Drugs does not feel that the evidence currently justifies classifying silicone implants as a contraindication to breastfeeding.

Bottom line: There is very little reliable data about breastfeeding with implants. Given that silicon is so abundant in our environment, and that there are overwhelming advantages of breastfeeding we strongly encourage women with breast implants to breastfeed if they wish to.

Platinum

While the limited evidence available suggests there is little risk from silicon, this may not be the case with platinum, which is used in silicone and saline implants. Platinum is a toxic metal that is especially damaging to early development.

There have been some studies showing significant levels of platinum in silicone breast implant gel and envelopes. Platinum has also been shown to leak out of the implant and accumulate in the tissues of women exposed to silicone breast implants . The question then becomes should women with saline or silicone breast implants be concerned about platinum?

Our research has found only one study to date that looked at platinum in breast milk in mothers that had silicone breast implants. It included 18 women with silicone breast implants and 5 women without ( the control group). The authors examined blood, urine, hair, nails, sweat and the breast milk of these women.

The concentration of platinum in blood did not differ between mothers with exposure to silicone through implants and those without. Both groups did have detectable levels of platinum thought to be related to environmental exposure. Similarly the concentration of platinum in urine did not differ between mothers with exposure to silicone through implants and those without.

However, there was a significant difference in platinum concentration in the hair, nails, sweat and breast milk in the implant group versus the control group, where no platinum was detected.

The study concluded that women with silicone breast implants had much higher levels of platinum than women without implants whereas saline implants did not contain any platinum. However, the methodology of the study has been questioned.

Bottom Line: Due to the small sample size, more research needs to be done to replicate these findings. However, it does raise some questions about platinum in breast milk. If mothers are concerned about platinum or silicone in their breast milk, Lactation Lab offer custom test kits to measure the levels of the components of their milk, along with recommendations for how to address any concerns.

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References:

  1. Levine J., Ilowite N. Scleroderma Like esophageal disease in children breast-fed by mothers with silicone breast implants. JAMA 1994;271:213-216.

  2. Levine J., Trachtman H., Gold D., Pettei M. Esophageal Dysmotility in Children of breast fed by mothers with silicone breast implants: long-term follow-up and response to treatment. Digestive Disease Science 1996;41:1600-03.

  3. Semple J., Lugowski S., Baines C., Smith D., McHugh A. Breast Milk Contamination and Silicone Implants: Preliminary Results using SIlicon as a proxy measurement for silicone. Plastic and Reconstructive Surgery. 1998;102:528-33.

  4. Lee J., Zuckerman D. Silicon, SIlicone, and Breast Implants. Pediatrics. 2002;110:1030.

  5. Lykissa E., Maharaj S. Total Platinum Concentration and Platinum Oxidation States in Body Fluids, TIssue, and Explants from Women Exposed to Silicone and Saline Breast Implants by IC-ICPMS. Analytical Chemistry 2006, 78:2925-33.

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Fenugreek is one of the most popular supplements used to increase milk supply, and while some studies show promising results, women taking thyroid medication should avoid it or carefully monitor their thyroid levels if they choose to use it.

As we’ve written about before (Do Supplements Really Work To Increase Milk Supply?), there are a number of supplements promoted to breastfeeding mothers to improve their milk production, with varied results. Fenugreek has been used for many years to promote wellness, increase milk supply and help with inflammation (particularly arthritis and urethritis). It’s a member of the pea family, sometimes used in artificial maple flavoring and a common ingredient in Indian and Chinese cooking.

A meta-analysis (which is a study that looks at all of the studies together to draw a conclusion) showed that it was superior to placebos and can help increase a woman’s milk supply, within as little as 24-72 hours. There are many different ways to take it: teas, capsules, liquid, seeds and powders. The recommended dose of fenugreek is 2-3 capsules (580-610 mg per capsule) 3-4 times per day, and it may be discontinued once milk supply has increased to the desired level.

It’s not clear exactly how fenugreek works, but some have proposed that it increases sweating and the breast is essentially a large sweat gland. Others have suggested that it increases certain naturally occuring hormones that stimulate milk production.

Fenugreek is listed as generally recognized as safe (GRAS) by the Food and Drug Administration.

While there is little published research on the side effects of fenugreek, some generalized side effects that have been reported include nausea, headaches, vomiting, increased gas and gastrointestinal motility with loose stools. Some women have reported increased breast congestion and a maple-like taste to breast milk. As with all dietary supplements, it’s important for mothers to be aware of side effects and to monitor themselves and their infants. They should discuss supplements that they are taking with their primary care providers and lactation consultants.

That’s especially important for women who take thyroid medication, who should be careful when taking fenugreek and consider monitoring their thyroid functions carefully while taking it. Some women who have trouble conceiving are placed on thyroid medication if their doctors detect hypothyroidism (and underactive thyroid gland), which is often continued during pregnancy. Many women with normal thyroid levels and no difficulties with conception develop thyroid abnormalities during pregnancy and are placed on levothyroxine (or equivalent) medication. Other women experience changes in their thyroid hormones during pregnancy.

While there isn’t much published research on the efficacy and safety of taking fenugreek in women with thyroid conditions, animal studies have shown that fenugreek decreased blood T3 levels when given to mice and rats and also created hypoglycemic effects (low blood sugar). It’s not clear why, but the ingestion of fenugreek by mice and rats inhibited T3 synthesis in mice and rats (References 1 and 3). Another study similarly found that fenugreek when administered to rats showed changes in T3, T4, glucose levels as well as G-6-phosphatase levels ( References 2 and 4).

Based on data from animal studies, it’s recommend to proceed with caution and perhaps even avoid fenugreek if you are struggling with regulation of thyroid levels after pregnancy and during lactation. I would also recommend that if someone is taking fenugreek regularly, even if they have never been found to have had a thyroid problem, that they have their thyroid functions tests measured just to be safe.

Bottom Line: Fenugreek is listed as generally recognized as safe (GRAS) by the FDA and as long as mothers are aware of the possible side effects, this is a good option to try to increase supply. However, mothers with thyroid conditions should proceed cautiously and consult with their physician before taking a fenugreek supplement.

Click Here for a Completed List of Recommended Lactagogues on Amazon

References

  1. Panda S, Tahiliani P., Kar A, Inhibition of Triiodothyronine Production by Fenugreek Seed Extract in Mice and Rats. Pharmacological Research, Vol 40., no 5, 1999

  2. Tahiliani P., Kar A., The Combined Effects of Trigonella and Allium Extracts in the Regulation of Hyperthyroidism in Rats. Phytomedicine 10:665-68, 2003

  3. Tahiliani P., Kar A., Mitigation of Thyroxine-Induced Hyperglycemia by Two Plant Extracts. Phytotherapy Research 17, 294-96, 2003

  4. El-Wakf A., Hassan H., Mahmoud A., Habza M. Fenugreek Potent Activity Against Nitrate-Induced Diabetes in Young Rats and Adult Male Rtas. Cytotechnology 67:437-47, 2015.

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HOW CAN I BE SURE TO PUMP ENOUGH MILK?DO SUPPLEMENTS REALLY WORK TO INCREASE MILK SUPPLY?


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Becoming a mother is one of life’s great joys -- but given the pressures of modern life, it can also be one of life’s most overwhelming challenges.

 A group of entrepreneur moms gathered recently at Palisades Village to discuss how they’re working to support moms through the new challenges of modern motherhood. In an honest, unfiltered conversation, they shared their own ups and downs as parents, and shared advice and tips.

The panel, moderated by KTLA’s Serene Branson, included Lactation Lab founder Stephanie Canale, MD, lactation and parenting expert Elyse Bennett, and Anna Schafer and Sarah Wright Olsen, founders of BAEO organic skin care products. It was assembled by Little LAMMA, a personal concierge service for children’s gifts that aims to take the stress out of gift giving, that was recently featured in The Wall Street Journal,

The discussion covered a range of issues, including how to get kids to eat healthy, managing kids’ “big feelings” and using meditation and essential oils to de-stress.

One recurring theme was the importance of paying attention to what we put into and on our bodies, minimizing exposure to toxins and other environmental hazards.

BAEO co-founders Schafer and Wright Olsen said concern over environmental toxins inspired them to create their line of bare essential organic skincare products. It wasn’t until she was trying to get pregnant with her first child that Wright Olsen started researching not only the foods going into her body, but also the products she was using on her skin. 

Dr. Canale, who created a breast milk testing kit so women could know more about what is in their breast milk, expressed her surprise at the levels of environmental toxins such as arsenic that have shown up in the breast milk of some of her patients. The initial impetus for the breast milk test kits that she developed was to make sure babies get sufficient levels of key nutrients such as protein, fat, vitamins and amino acids. 

For example, she noted that little attention is paid to Vitamin A levels because dairy products are fortified with vitamins A and D. However, the increasing number of moms who do not consume much or any dairy (such as vegans) make it more important to make sure they are getting enough vitamin from other sources.

Increasingly, Lactation Lab’s test kits are being used to check for toxins, especially as there is mounting evidence of toxins such as arsenic making their way into the food supply. Sometimes the solution is a simple as reducing or eliminating rice from the diet, according to Dr Canale. Rice is now known to frequently contain unacceptable levels of arsenic, and newborns’ developing brains and nervous systems are more vulnerable to the adverse effects of toxins.

Most of the panel used meditation for themselves and even for their toddlers, though Canale (a Canadian) said she has an unusual distressing technique for a mom: a family hockey scrimmage, which requires her total focus and therefore no opportunity to dwell on the issues causing stress!

One technique for dealing with kids’ emotional outbursts offered by Wright Olsen is a “thinking chair,” which is used not as a punishment but as an opportunity for alone time to think about what’s going on.  

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In case you missed it, Lactation Lab’s cutting edge breast milk tests were recently featured in a segment on ABC’s Good Morning America called, “What parents should know about the new test for your breast milk.”

The story profiled Casey Gorham, who took the Lactation Lab breast milk test (a “food label for breast milk”) when her baby was struggling to gain weight. After analyzing a sample of her milk, she was able to optimize her diet by adding more fat and calories, resulting in weight gain for her baby. Casey was someone who wanted to breastfeed her child, and due to the information provided by our test, she was able to continue that journey.

That’s exactly why we created Lactation Lab -- so that moms who may be struggling with breastfeeding can have more support and information about their milk. Dr. Canale created the test out of her own frustration as a breastfeeding working mom whose daughter wasn’t gaining enough weight. As a physician and a mother, she wished she had more information about her milk. She wanted to give other mothers a way to tweak their milk and celebrate the fact that they are able to breastfeed to provide what we know is the best nutrition.

There were a number of questions about Lactation Lab that the Good Morning America segment didn’t have time to address, so we asked Dr. Canale to answer a few of those topics here.

Can one sample of milk at one point in the day accurately reflect the quality of the milk? How does your collection method account for variability in breast milk from woman to woman, hour to hour, day to day, the beginning versus the end of the breastfeeding session?

Studies show that there are only slight variances in breast milk qualities (protein, carbohydrates, etc.) over a 24-hour period. To get the best results, we recommend collecting a small amount of milk as you pump throughout the day.

Much of the controversy around testing one sample of breastmilk centers around foremilk versus hindmilk. Foremilk, which is typically referred to as milk from the first three minutes of feeding, contains less fat than hindmilk, which comes towards the end of a feeding. Most feedings last longer than three minutes and typically include both foremilk and hindmilk. Foremilk also contains higher concentrations of important amino acids and fatty acids.

Bottom line, the most accurate test will be performed when mom collect milk for the test sample over a 24 hour period and not just one point in time.

Does the idea of testing milk create more fear about whether a mom’s milk is “good enough”?

I am the founder of Lactation Lab, and both of my kids had breast milk and formula. We strive to make sure that moms get the takeaway that their milk is amazing and that it is not about looking for deficiencies but instead fine-tuning their infants’ nutrition.

We live in a world of information, data and personalized medicine. We believe that knowledge leads to confidence and that confidence leads to empowerment. By offering insights, resources and support, we inspire confidence in moms by providing information based on hard science and academic research. We believe that our kits are a tool for mothers to learn more about their milk and feel less worry, guilt or shame.

For example, several mothers have taken our test and found that their milk contains significantly less calories than the average infant formula. These moms can objectively see why their babies need more and have felt less shame in introducing formula as they try to improve their milk. Many of our patients say they feel empowered to make better health choices and know exactly which supplements they should take. We have also had other moms take the test and found that their calorie count was in fact much higher than the average formula, leading to further diagnostics as to why their child was not thriving. In those cases, the information was an important indicator for other issues.

If you think the test will cause you to be more anxious about learning what is in your milk, then please do not do the test.

Is the test for all breastfeeding moms, or just those who are having trouble with weight gain?

As mentioned above, we’ve found that the test can certainly be extremely useful when a mom is struggling with baby weight gain. If she wants to continue to breastfeed, this can be a helpful tool in considering whether mom’s diet can help optimize the milk and her baby’s health.

The test has also been helpful for other moms as well. One mom that we tested found high levels of arsenic in her milk, which we traced back to a diet heavy in rice. Once she cut back on her daily rice consumption, the arsenic levels were nearly undetectable. The test is for any mother who wants more information about her breast milk.

What’s the science behind Lactation Lab?

Our unique and proprietary tests were researched and developed at a top academic institution with one of the most advanced laboratories in the world. Our facilities adhere to the highest standards and scientific methods for testing.

We only test for vitamins and nutrients that are affected by maternal diet; we do not test for Vitamin D, zinc, phosphorous, sodium or selenium given that these levels are not affected by maternal nutrition.

Finally, what should I do if I’m a mom struggling with breastfeeding or my baby not gaining enough weight?

If you are struggling with breastfeeding, the first step is to speak with your pediatrician and/or lactation consultant. Our kits are sold by many lactation consultants and by The Pump Station in Santa Monica, CA, as a tool to augment the understanding of the breastfeeding experience.

Anything else you’d like to share about questions or reactions to the GMA piece?

Given how emotionally charged breastfeeding can be, I understand why there are questions, and sometimes skepticism, about what we do. But every day, we focus on how we can help and support women through one of the most emotional, sometimes challenging aspects of new motherhood, to create tools that enable women to have the choice of whether to breastfeed or not. It’s our hope that our ongoing development and research around breast milk will help women make informed choices, and provide new understanding of an incredibly powerful substance.

Breast milk is so poorly studied and researched - most studies are dated and small, even though breast milk is so beneficial. It’s also our belief that our Lab will uncover new scientific knowledge about breast milk that will have implications far beyond our individual test results.

If you have any further questions about our tests, methodology or approach, please don’t hesitate to reach out to me directly at stephanie@lactationlab.com.

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Not only must women watch what they eat and drink during pregnancy and breastfeeding, they must also be mindful of the drugs they take to treat common and not-so-common illnesses. This is made even more challenging by the fact that very little research is available on the use of drugs during pregnancy and breastfeeding.

According to NPR,  pregnant women have been excluded from medical research, because scientists and ethicists were concerned that experimenting on them could hurt them or their fetus.

Dr. Catherine Spong, chief of maternal-fetal medicine at the University of Texas Southwestern Medical Center in Dallas says when women are pregnant, their blood volume doubles and their liver and kidney function change. No one knows how that affects the medication.

So doctors across the country find themselves prescribing medications, or taking patients off them, without evidence based research to support their decisions either way.

By keeping pregnant women out of studies, Spong says, "You are putting them and their fetuses more at risk."

Spong was chair of a federal task force that studied the gaps in health care knowledge about pregnant and lactating women. The group issued a 388-page report in September that recommends that pregnant women be routinely included in research studies, that the government devote time and money to studying existing drugs in pregnant women and that the government help develop new drugs to treat problems related to pregnancy and breastfeeding.

Lactation Lab founder Dr. Stephanie Canale has seen the impact this lack of research can have. She is researching the effects the chemotherapy drug cisplatin can have on breast milk using the same technology she pioneered in her breast milk test kits. While patients are typically cleared to resume breastfeeding 72 hours after treatment with cisplatin, Dr. Canale found evidence of platinum in a chemotherapy patient's breast milk more than 100 days after her last treatment.

Cisplatin is a cytotoxic drug and prolonged excretion in human milk might have adverse effects on newborns if women are cleared to breastfeed too soon. “The side effects of the drug can seriously impact infant health. Women who have taken cisplatin should be very cautious about resuming breastfeeding before the drug has cleared their bodies,” says Dr Canale. “ We recommend waiting a minimum of 4-5 months after their last dose, or to have their milk tested prior to breast feeding their child.”

Photo by Drew Hays on Unsplash


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Evidence is mounting that the challenges of breastfeeding at work can have negative consequences for mother and baby.

A recent survey of working mothers published on Medium found that new moms give up breastfeeding sooner than they would like, as a result of the stresses of being back at work. One mother responded that “My milk production went down pretty drastically, and that was really stressful for me.”

Her experience is in line with academic research showing that moms who work, especially full time, breastfeed their babies for less time than those who don’t. Some women who weren’t provided with private pumping areas resorted to pumping in toilet stalls at their place of employment, resulting in premature weaning. The research also showed that providing women with pumping equipment increases breastfeeding duration after they return to work.

Adding lactation support boosts employee retention by 27%, according to the study. 

As a physician, I watch so many of my patients struggle with the transition back to work after having a baby -- the lack of sleep, the challenge of balancing career with a newborn, and of course, the demands of breastfeeding, which often requires juggling a work schedule around pumping sessions. - Stephanie Canale, MD, Lactation Lab Founder

Companies such as Hulu, Zappos and Zillow have taken note that less than two thirds of new moms return back to the workplace after childbirth, and are adding resources such as Lactation Lab,Milk Stork or Mamava Pod to support them.  Mamava provides private pods for pumping and breastfeeding mothers. Milk Stork enables moms to get their breast milk home when they’re away on business.

Lactation Lab helps working moms, who often see more challenges in milk volume and quality, by finding solutions that enable them to breastfeed their babies for longer.

As a result, new moms don’t have to choose between their career and their commitment to breastfeeding. This in turn helps businesses keep some of their best and brightest on staff. 

The World Health Organization recommends babies consume only breast milk for the first six months of life and ideally up to one year after complementary foods are introduced. And studies show that when mom is less stressed and supported, she is more likely to breastfeed for longer.

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It could be time to add another item to the long list of the benefits of breastfeeding. A new study from Brown University and the University of Utah suggests that breastfeeding may help babies control their stress.

The study followed 42 women over five months. Half breastfed or bottle fed their new babies with breast milk, and the other half used formula.

Researchers found the brains of babies who consumed breast milk were better able to dampen stress levels under stressful circumstances.

Dr. Elisabeth Conradt, an author on the study, told the Mountain West News Bureau the study is the first to look at breastfeeding as it relates to caregiving behavior and infant stress responses. However, Conradt said it’s hard to extrapolate what this could mean for children long term.

“I think though that this could set up the child to maybe be a little bit more calm and maybe a little less stressed right from birth,” she said.

Of course, some women can’t breastfeed and many choose not to. Conradt said the study, which was published in the journal Pediatrics, doesn’t exclude them.

“I think it was encouraging in this study that we also found these effects of moms who were also bottle feeding with breast milk,” she said.

Conradt said more research is needed to understand what role the consumption of breast milk plays versus the physical touch of breastfeeding itself.

“Nurturing behavior controls a specific gene that regulates the infant’s physiological response to stress,” according to lead study author Dr. Barry Lester, director of the Center for the Study of Children at Risk at the Warren Alpert Medical School of Brown University in Providence, Rhode Island.

Researchers studied levels of the stress hormone cortisol. When infants were exposed to a stressful situation - their mothers ignoring them - researchers found less evidence of a “fight-or-flight” stress response in the babies who had nursed.

“Cortisol is part of the body’s ‘flight or fight’ reaction, the body’s major response to stress, and too much or too little cortisol can be harmful and is related to a wide range of mental and physical health disorders in children and adults,” Lester told Reuters Health.

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Consumer Reports has weighed in on the topic of exposure to toxic heavy metals by infants.

Consumer Reports’ testing shows concerning levels of arsenic, cadmium and lead in many popular baby and toddler foods.

This includes foods made just for babies and toddlers, such as popular snacks, cereals, prepared entrées, and packaged fruits and vegetables.

Over time, exposure to heavy metals can harm the health of adults and children. One of the biggest worries: cognitive development in very young children.

“Babies and toddlers are particularly vulnerable due to their smaller size and developing brains and organ systems,” says James E. Rogers, Ph.D., director of food safety research and testing at Consumer Reports. “They also absorb more of the heavy metals that get into their bodies than adults do.”

Toxic heavy metals can also be a concern for breastfeeding mothers. 

Dr. Stephanie Canale, founder of Lactation Lab, developed a unique and proprietary test kit for measuring the level of lead and other toxins in breast milk.

“We were surprised to find elevated levels of lead in the breast milk of mothers who were unaware of any exposure to lead.”

As is the case with infants, mothers can absorb heavy metals through the foods they eat and from environmental toxins in water.

Consumer Reports' tests had some troubling findings:

• Every product had measurable levels of at least one of these heavy metals: cadmium, inorganic arsenic, or lead.

• About two-thirds (68 percent) had worrisome levels of at least one heavy metal.

• Fifteen of the foods would pose potential health risks to a child regularly eating just one serving or less per day.

• Snacks and products containing rice and/or sweet potatoes were particularly likely to have high levels of heavy metals.

• Organic foods were as likely to contain heavy metals as conventional foods.

While those results are worrisome, parents who have been feeding these foods to their children don’t need to panic, says James Dickerson, Ph.D., chief scientific officer at Consumer Reports. He notes that consuming these foods doesn’t guarantee that a child will develop health problems, but that it may simply increase that risk. And whether problems develop depends on a host of factors, including genetics and exposure to other sources of heavy metals, such as from lead paint or contaminated water. 

Consumer Reports' testing did have some encouraging findings for parents: It showed that 16 of the products had less concerning levels of the heavy metals, suggesting that all baby food manufacturers should be able to achieve similar results.

Consumer Reports has a list of suggestions for What Parents Can Do.

Lactation Lab's Dr. Canale recommends breastfeeding mothers limit their intake of foods that have been shown to be susceptible to contamination by heavy metals, such as rice products.

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By Stephanie Canale MD

I’m often asked why it’s helpful to test breast milk -- and one of the best answers is in addressing a very common issue: helping babies who aren’t gaining enough weight through breastfeeding.

It’s a common occurance: a mom feels passionately about breastfeeding, but baby isn’t gaining enough weight; her pediatrician recommends formula to supplement and that’s the end of the story. But now that we can test breast milk for fat and calories, that story can be rewritten.

Here’s an example. Baby S’s birth and early days were normal in every respect, and he began breastfeeding with no issues. His mother was passionate about breastfeeding, but her son stopped gaining weight within two weeks of birth and started losing weight right before her eyes. He was referred to a pediatric gastroenterologist who recommended supplementing her breast milk with formula and prescribed medication to help with reflux symptoms. These are two of the most common responses from medical professionals to an inability to gain weight while breastfeeding.

Baby S’s mom expressed her concerns to me as her family doctor and we decided it was best to test her milk. Enter Lactation Lab. We tested mom’s milk when Baby S was 2-3 months old and found it to have 16 calories per oz, below the average infant formula level of 20 kcal per oz. Following the pediatric specialist’s recommendation, mom started supplementing baby’s milk with a formula equivalent to 22 kcal per oz.

After returning to work, mom noticed that she was more relaxed about nursing having accepted the fact that her son needed supplementation. Nonetheless, we continued to support mom in her journey to continue to breastfeed. After testing her milk, we placed her on specific supplements as well as goat’s rue and lactation-boosting cooking containing brewer’s yeast. Goat’s rue and brewer’s yeast can both increase milk supply.  She continued to take her prenatal vitamin as well as vitamin D 2000 IU a day, vitamin A 5000 IU a day and B12 1000 mcg daily.

Despite her reservations about some of the ingredients used in infant formulas, mom continued supplementing as recommended by the gastroenterologist. Given her reservations, we decided to follow the child’s growth more closely and weigh him every two weeks. She continue to supplement until he was 4 months old. She decreased gradually over a two-week period and stopped at 4.5 months of age.

We encouraged her to increase her calories by 500 per day and she he was easily able to add 300-400 calories daily. We asked her to continue to pump as much as possible, though volume was not the issue.

We re-tested her milk when her son was 4.5 months old and it had increased to 19.75 kcal/oz, equivalent to the average infant formula. After stopping the formula supplementation, her son gained 11.5 oz in one month. He reached the 6th percentile for weight, more than doubling from below the 3rd percentile, as shown in the graph below. He met all developmental milestones and was thriving.

Mom will be starting to introduce Baby S to solid foods, and based on the fact that her vitamin A was on the low side she will be focusing on first foods that are rich in vitamin A such as squash and sweet potato. Because her B12 was also a little low she will introduce lentils next.

This journey speaks to what Lactation Labs is about. We live in a world of information and data and we used it to reassure this mom that she could optimize her child’s nutrition. Instead of thinking her milk was not good enough, we supported her to KNOW otherwise.

Now the fun part: her son is refusing a bottle and the leftover formula is put away in the earthquake kit - we are in California after all!

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