Clinical Questions

Medications for High Blood Pressure When Breastfeeding CQ #112 – October 1, 2018 by Anne Eglash MD, IBCLC, FABM #LACTFACT First line medications for high blood pressure during breastfeeding are ACE inhibitors, calcium channel blockers and low dose diuretics. Beta blockers, even labetolol, have a higher risk of infant side effects. Treating Hypertension During Breastfeeding […]

When Breastmilk is Not White CQ #111 – September 25, 2018 by Anne Eglash MD, IBCLC, FABM #LACTFACT The most common documented cause of breastmilk discoloration is medication. There is little to no documentation that the natural color of foods changes the color of breastmilk. If the breastmilk is pink, suspect Serratia Marcescens breast infection. […]

Breast Implants and Breastfeeding CQ #110 – September 17, 2018 by Anne Eglash MD, IBCLC, FABM #LACTFACT Breast implants do not have a major impact on breastfeeding success, whether they are silicone or saline. Placing the implants behind the pectoralis muscles decreases the risk of low milk supply. Lactation Outcomes in More Than 3500 Women […]

Stress Life Events and Breastfeeding Initiation CQ #109 – September 10, 2018 by Anne Eglash MD, IBCLC, FABM #LACTFACT Evidence indicates that women exposed to prenatal life stress (financial, trauma, emotional) have a lower breastfeeding initiation rate, even after controlling for maternal age, race, ethnicity, parity, insurance type, mode of delivery, gestational age, and NICU […]

Pregnancy, Breastfeeding and Marijuana Use CQ #108 – September 4, 2018 by Anne Eglash MD, IBCLC, FABM #LACTFACT The American Academy of Pediatrics recommends not using marijuana during pregnancy due to the negative effects of fetal growth, and long term neurodevelopmental outcomes due to prenatal exposure. Use of marijuana is also discouraged during lactation. Marijuana […]

Breastfeeding and Maternal Stroke Risk CQ #107 – August 26, 2018 by Anne Eglash MD, IBCLC, FABM #LACTFACT Ever-breastfeeding reduces the rate of strokes by 23% even when other risk factors are controlled for. Breastfeeding longer reduces the risk further. This relationship is strongest for non-Hispanic black women in the USA. Breastfeeding History and Risk […]

by Anne Eglash MD, IBCLC, FABM To what extent do the father’s breastfeeding preferences influence maternal breastfeeding behavior? Several studies have shown that family and other social support are very important to breastfeeding success. In fact, The Lancet, in its 2016 landmark series on the importance of breastfeeding, published its issue with the following quote […]

by Anne Eglash MD, IBCLC, FABM What are the current recommendations for feeding children older than 6 months of age? We’ve known for several years that it is best to introduce complementary foods at 6 months of age for all infants. Waiting until 6 months helps to decrease the risk of colds and diarrhea. But […]

by Anne Eglash MD, IBCLC, FABM Does the probiotic Lactobacillus reuteri (L. reuteri) have the same beneficial effect for colic in breastfed vs formula fed infants? In CQW #85 we highlighted a December 2015 systematic review on interventions that are likely to be helpful for colic. L. reuteri DSM 17938 had the strongest evidence for […]

by Anne Eglash MD, IBCLC, FABM Does the smell of mother’s milk help reduce procedural pain in newborns? Studies show that infants by the age of 28 weeks gestation have a sufficient sense of smell that they are able to distinguish an odor of amniotic fluid. Further, amniotic fluid and human milk have several fatty […]

by Anne Eglash MD, IBCLC, FABM Which flu vaccine is safer and more effective during breastfeeding? Sorry folks, but it is time to think about flu season once again! Last year in the USA the Center for Disease Control recommended against the use of the nasal flu vaccine, which is a live attenuated (weakened) influenza […]

by Anne Eglash MD, IBCLC, FABM Why do women ingest their placenta and how does this effect breastfeeding? A recent review of placentophagy (consumption of the placenta after birth) has shed some light on the history of this behavior, motivation for it, and evidence. According to the authors, although there is no contemporary human culture […]

by Anne Eglash MD, IBCLC, FABM What are current recommendations for feeding the premature NICU graduate? The Academy of Breastfeeding Medicine recently updated their Clinical Protocol #12: Transitioning the Breastfeeding Preterm Infant from the Neonatal Intensive Care Unit to Home, Revised 2018 For many premature infants in the USA, post-discharge care is done by physicians […]

by Anne Eglash MD, IBCLC, FABM When is the optimal time for a mother to follow up with her maternity care provider postpartum? The American College of Obstetrics and Gynecology recently published ACOG Committee Opinion Number 736 in May 2018 entitled Optimizing Postpartum Care Women who give birth often seek care from their maternity providers […]

by Anne Eglash MD, IBCLC, FABM What are current recommendations for drinking alcohol while breastfeeding? The Center for Disease Control recently published an educational page on its website regarding alcohol consumption while breastfeeding. A standard drink of alcohol is considered to be 12 oz of 5% beer, 8 oz of 7% malt liquor, 5 oz […]

by Anne Eglash MD, IBCLC, FABM Does breastfeeding reduce the risk of hospitalization for infection among children less than 5 years of age? Studies from high income countries have demonstrated that 25% of hospitalizations for children under age 5 are due to infection. A group of Australian researchers evaluated a population of 488,603 children, and […]

by Anne Eglash MD, IBCLC, FABM What are the barriers to breastfeeding among women who are incarcerated during pregnancy and childbirth? According to a recent article on breastfeeding during incarceration, approximately 3-4% of women who enter the prison system in the USA are pregnant. Since prison sentences are often a year or longer, most pregnant […]

by Anne Eglash MD, IBCLC, FABM How do the breastfeeding rates in the United States compare with other countries? UNICEF recently published its document entitled ‘Breastfeeding: A Mother’s Gift, for Every Child’. According to UNICEF, increasing breastfeeding rates could save 850,000 children under age 5 each year, most of whom are under 6 months of […]

by Anne Eglash MD, IBCLC, FABM Are women more likely to be successful breastfeeding if they receive care from one type of birth attendant vs another? There has been a rise in the % of pregnant women whose pregnancies and births are managed by midwives versus obstetricians or family physicians. Studies of breastfeeding knowledge among […]

by Anne Eglash MD, IBCLC, FABM Does exposure to peanut protein in breastmilk reduce the risk of childhood peanut allergy? We know that when a mother eats peanuts, the peanut protein is present in her breastmilk. Waiting to introduce peanut, egg, and fish until one year of age was a previous recommendation by national pediatric […]