Clinical Questions/LactFacts

Intimate Partner Violence and Breastfeeding Rates CQ #139 – April 8, 2019 by Anne Eglash MD, IBCLC, FABM #LACTFACT Women who experience psychological intimate partner violence during pregnancy have twice the rate of breastfeeding avoidance. ACOG recommends screening all women for intimate partner violence during wellness, prenatal, and postpartum visits. Breastfeeding avoidance following psychological intimate […]

Breast Masses and Other Breast Complaints During Lactation CQ #138 – April 1, 2019 by Anne Eglash MD, IBCLC, FABM #LACTFACT The majority of breast masses during lactation warrant diagnostic imaging. The Academy of Breastfeeding Medicine’s Protocol #30 covers diagnostic and treatment considerations for a comprehensive list of masses and other breast concerns during lactation. […]

Traveling While Breastfeeding or Lactating CQ #137 – March 25, 2019 by Anne Eglash MD, IBCLC, FABM #LACTFACT The US Center for Disease Control’s webpage on Travel Recommendations for Nursing Families is a helpful clinical resource for supporting breastfeeding families. Travel Recommendations for Nursing Families https://www.cdc.gov/nutrition/infantandtoddlernutrition/breastfeeding/travel-recommendations.html What are key recommendations for breastfeeding families during travel? […]

Oropharyngeal Mother’s Milk for Extremely Low Birthweight Infants CQ #136 – March 18, 2019 by Anne Eglash MD, IBCLC, FABM #LACTFACT Oropharyngeal treatment with mother’s milk for extremely low birthweight infants provides immune support, enriches the intestinal mucosa, decreasing the risk of necrotizing enterocolitis. Oropharyngeal Mother’s Milk: State of the Science and Influence on Necrotizing […]

Vegan and Vegetarian Diets During Pregnancy and Lactation CQ #135 – March 11, 2019 by Anne Eglash MD, IBCLC, FABM #LACTFACT A well-planned vegan or vegetarian diet with appropriate vitamin supplementation during pregnancy and lactation is safe for the mother and infant. The Effects of Vegetarian and Vegan Diet during Pregnancy on the Health of […]

Sweeteners in Breastmilk CQ #134 – March 6, 2019 by Anne Eglash MD, IBCLC, FABM #LACTFACT Many artificial sweeteners have low levels in breastmilk and are considered safe during breastfeeding. High fructose corn syrup in the maternal diet may affect infant weight. How Sweet It Is: Sweeteners in Breast Milk Breastfeeding Medicine 14(1) 2019 p. […]

Bacteria in Breastmilk CQ #133 – February 25, 2019 by Anne Eglash MD, IBCLC, FABM #LACTFACT The bacteria in breastmilk is different for women who exclusively pump vs women who directly breastfeed, possibly influencing the health of the infant. Composition and Variation of the Human Milk Microbiota Are Influenced by Maternal and Early-Life Factors Cell […]

Bottle Nipple Flow Rates CQ #132 – February 19, 2019 by Anne Eglash MD, IBCLC, FABM #LACTFACT Bottle nipple flow rates are not always as described by the manufacturer. Know the Flow; Milk Flow Rates from Bottle Nipples Used in the Hospital and After Discharge Advances in Neonatal Care 19(1) 32-41 What is the difference […]

Carotenoids and Breastfeeding CQ #131 – February 11, 2019 by Anne Eglash MD, IBCLC, FABM #LACTFACT A maternal diet high in carotenoids is beneficial for pregnancy and infant health. Health Effects of Carotenoids during Pregnancy and Lactation Nutrients 2017 Aug 4;9(8) What are carotenoids and why do they matter in the maternal diet? Few people […]

Breastmilk for the Umbilical Cord CQ #130 – February 4, 2019 by Anne Eglash MD, IBCLC, FABM #LACTFACT Applying breastmilk to the umbilical cord stump has been shown to speed separation without increasing risk of omphalitis. Systematic Review of the Effect of Topical Application of Human Breast Milk on Early Umbilical Cord Separation J Obstet […]

The First Newborn Bath and Exclusive Breastfeeding Rates at Hospital Discharge CQ #129 – January 29, 2019 by Anne Eglash MD, IBCLC, FABM #LACTFACT Delaying the newborn bath for the first 24 hours is associated with higher exclusive breastfeeding rates at discharge. Initiative to Improve Exclusive Breastfeeding by Delaying the Newborn Bath JOGNN January 2019 […]

Breastfeeding and Maternal Type 1 Diabetes CQ #128 – January 21, 2019 by Anne Eglash MD, IBCLC, FABM #LACTFACT Breastfeeding has not been shown to cause significantly more nighttime hypoglycemia among mothers with type 1 diabetes mellitus. Breastfeeding at night is rarely followed by hypoglycaemia in women with type 1 diabetes using carbohydrate counting and […]

Vaccines During Breastfeeding CQ #127 – January 15, 2019 by Anne Eglash MD, IBCLC, FABM #LACTFACT The only vaccine with a strict contraindication during lactation is smallpox. The source is a search for ‘vaccines’ in Lactmed, National Library of Medicine, and the Center for Disease Control on Vaccines The National Library of Medicine Lactmed Database, […]

Model Maternity Policy Supportive of Breastfeeding CQ #126 – January 7, 2019 by Anne Eglash MD, IBCLC, FABM #LACTFACT The Academy of Breastfeeding Medicine, in its updated Protocol on Model Maternity Policy Supporting Breastfeeding, recommends skin to skin for all infants during first 2 hours after birth, or until the first feeding, and delaying the […]

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 […]