Maternity Nursing: Postpartum Q 17
Which of the following factors might result in a decreased supply of breastmilk in a postpartum (PP) mother?
A. Supplemental feedings with formula
B. Maternal diet high in vitamin C
C. An alcoholic drink
D. Frequent feedings
Correct Answer: A. Supplemental feedings with formula
Routine formula supplementation may interfere with establishing an adequate milk volume because decreased stimulation to the mother’s nipples affects hormonal levels and milk production. Especially in the first couple of weeks, supplementing with formula tricks the breasts into producing less milk. “In the early weeks, the breasts’ capacity for milk production is calibrated in response to the amount of milk that is removed,” says lactation consultant Diana West. “If less milk is removed, the breasts assume that less milk is needed, so the capacity is set at a lower point.” When the baby is given formula supplements, she naturally eats less at the breast, and the breasts respond by making less milk. If supplementation is necessary, pumping as well as breastfeeding can help to promote a higher volume of milk production.
Option B: A high diet in Vit C does not decrease the supply of breastmilk in the mother. Another cause is the use of birth control. Many mothers who breastfeed and take birth control pills find their milk production doesn’t change, but for some, any form of hormonal birth control (the pill, patch or injections) can cause a significant drop in their milk. This is more likely to happen if they start using these contraceptives before the baby is four months old, but it can happen later as well. The first step to increasing the milk supply again is to stop the medication, but talk to a doctor before doing so and be prepared to change birth control methods. Some mothers also need extra help (such as prescription medication, herbal supplements, and/or pumping) to boost milk production.
Option C: Alcohol levels are usually highest in breast milk 30-60 minutes after an alcoholic beverage is consumed, and can be generally detected in breast milk for about 2-3 hours per drink after it is consumed. However, the length of time alcohol can be detected in breast milk will increase the more alcohol a mother consumes. For example, alcohol from 1 drink can be detected in breast milk for about 2-3 hours, alcohol from 2 drinks can be detected for about 4-5 hours, and alcohol from 3 drinks can be detected for about 6-8 hours, and so on.
Option D: The breasts make milk continuously, but the rate at which milk is made depends on how empty they are. The woman will make more milk when her breasts are close to empty and less milk when they are already filled up. When the baby is feeding infrequently, because the mother has put him on a three- or four-hour schedule for example, or because she is giving him a pacifier to stretch out the time between feedings, the breasts are fuller for longer periods of time. That means milk production slows down. When babies are breastfed in response to their cues, they tend to have shorter, frequent feedings and this means the breasts are emptier most of the time and so they continue to produce plenty of milk.