Clinical Questions/LactFacts

The Pharmacology of Opiates in Breastmilk CQ #125 – January 1, 2019 by Anne Eglash MD, IBCLC, FABM #LACTFACT Breastfeeding mothers who use narcotics for pain control are advised to limit around-the-clock pain medication to 2-3 days, to prevent infant sedation and respiratory depression. Breastfeeding mothers who were opiate dependent during pregnancy may use methadone […]

One of the most amazing and little-studied phenomenon shared on social media is the change in breastmilk appearance when an infant is ill.

After 18 months postpartum, breastmilk carbohydrates decrease, while fat and protein increase. The source of calories in breastmilk for older children is primarily fat.

Breast Imaging During Lactation CQ #122 – December 11, 2018 by Anne Eglash MD, IBCLC, FABM #LACTFACT Breast ultrasound is the first line imaging examination for a breast mass during pregnancy and lactation. If the ultrasound is negative or there are suspicious findings, mammography or digital breast tomosynthesis may be indicated. ACR Appropriateness Criteria Breast […]

Infant Stooling Patterns and Type of Feeding CQ #121 – December 3, 2018 by Anne Eglash MD, IBCLC, FABM #LACTFACT Exclusively breastfed infants have a higher stool frequency than exclusively formula fed infants in the first 2 months of life. Infrequent stools (3 days or more) are 3.5 times more common in breastfed vs formula […]

Cup-feeding Preterm Infants CQ #120 – November 26, 2018 by Anne Eglash MD, IBCLC, FABM #LACTFACT Cup feeding preterm infants in the neonatal ward is associated with higher breastfeeding rates at discharge, and at 3 and 6 months post-discharge. Cup Feeding as a Supplemental, Alternative Feeding Method for Preterm Breastfed Infants: An Integrative Review Matern […]

Personality and Breastfeeding CQ #119 – November 20, 2018 by Anne Eglash MD, IBCLC, FABM #LACTFACT After controlling for depression and anxiety, women who have personality traits described as open and agreeable are more likely to breastfeed exclusively for 6 months, whereas extraverted women are less likely to breastfeed exclusively for 6 months. Personalities Predict […]

Breastfeeding Within the First Hour Postpartum CQ #118 – November 12, 2018 by Anne Eglash MD, IBCLC, FABM #LACTFACT Initiation of breastfeeding within the first hour of life is associated with a marked decrease in infant mortality around the world. Capture The moment; Early initiation of breastfeeding: the best start for every newborn WHO, UNICEF […]

Breastfeeding and Non-Alcoholic Liver Disease CQ #117 – November 5, 2018 by Anne Eglash MD, IBCLC, FABM #LACTFACT Breastfeeding for longer than 6 months is associated with a lower risk of maternal non-alcoholic fatty liver disease in mid-life. Longer Lactation Duration is Associated with Decreased Prevalence of Non-Alcoholic Fatty Liver Disease in Women J Hepatology […]

Maternity Leave and Breastfeeding CQ #116 – October 29, 2018 by Anne Eglash MD, IBCLC, FABM #LACTFACT Women with a maternity leave of 3 months have at least a 50% greater likelihood of extending breastfeeding duration as compared to women with a shorter maternity leave. Maternity Leave and Its Impact on Breastfeeding: A Review of […]

Breastfeeding Support and the American College of Obstetricians and Gynecologists CQ #115 – October 22, 2018 by Anne Eglash MD, IBCLC, FABM #LACTFACT The American College of Obstetricians and Gynecologists recommends that clinical management of lactation be included in reproductive health care. Further, all obstetrical providers should develop and maintain skills in breastfeeding support and […]

Maternal High Blood Pressure and Breastfeeding CQ #114 – October 15, 2018 by Anne Eglash MD, IBCLC, FABM #LACTFACT Breastfeeding for just 1 month reduces a woman’s future risk of hypertension for decades. Pregnant women should be counseled about this. Effect of Lactation on Maternal Hypertension: A Systematic Review Breastfeed Medicine, published online Oct 6th, […]

Bottle Feeding, Breastfeeding, and BMI CQ #113 – October 8, 2018 by Anne Eglash MD, IBCLC, FABM #LACTFACT Bottle feeding expressed breastmilk leads to a higher infant BMI than direct breastfeeding. Formula feeding via bottle leads to the highest infant BMI at 12 months of age. Infant Feeding and Weight Gain: Separating Breast Milk From […]

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 […]