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Daily Dietary Reference Intakes - Women aged 19-50(click here for information for teens aged 14-18) Additional information and references
Biotin is a water-soluble vitamin that is present in every living cell. Human milk normally contains variable amounts of biotin. The biotin content of human milk increases with the progression of lactation, and is directly related to the amount of biotin in mom's plasma (blood). The biotin content of human milk is hundreds of times greater than the content in maternal plasma. (from "Nutrition During Lactation," Institute of Medicine). Taking a biotin supplement might change the taste of your milk.
Per Hale, (Medications and Mothers' Milk), breast milk levels of chromium are independent of dietary intake in mother, and do not apparently increase with increased maternal intake.
Per "Nutrition During Lactation" (Institute of Medicine, 1991), there is no relationship between maternal copper status and concentrations in human milk.
According to "Nutrition During Lactation," (Institute of Medicine, 1991), reports indicate that there is relatively little effect of maternal fluoride intake on the fluoride concentration of milk.
Dr. Hale's text lists glucosamine as category L3 or "moderately safe" while breastfeeding. It is unlikely that the baby would receive an amount from breastfeeding that would be clinically significant. No pediatric concerns have been noted from breastmilk exposure. See his book for more information.
Per Hale (Medications and Mothers' Milk), no pediatric concerns have been reported via breastmilk when mom is taking iron. Rarely, iron supplements taken by mom may produce constipation in baby. Iron supplements taken by the mother will not increase iron levels in breastmilk, even if the mother is anemic. Anemia in the nursing mother has been associated with poor milk supply, however. Nursing moms need 9-18 mg daily of iron (this includes all food sources) - the higher level would be for a mom who has resumed menstruating. If you are anemic, ask your DR what dosage of iron supplement (if any) is recommended. You can often bring your iron levels up just by changing your diet a bit - getting more food sources of iron and vitamin C (which increases iron absorption) - more on this in the link below. The standard iron supplements are mineral-based (ferrous sulfate). There are also a chelated iron supplement (iron bisglycinate) and a liquid plant-based iron supplement (one brand is called Floradix) that are reported to be easier absorbed and non-constipating. Tinctures containing herbs such as yellow dock and dandelion (here's an example) are also high in iron. See also Is Iron-Supplementation (for baby) Necessary? (includes a list of iron-rich foods)
There are no known contraindication to the use of moderate amounts of lecithin by breastfeeding mothers. See Lecithin treatment for recurrent plugged ducts for more information.
Lysine is a normal amino acid. There is no evidence that this is a problem for babies via breastmilk.
Per "Nutrition During Lactation" (Institute of Medicine, 1991), manganese concentration in human milk may be influenced by maternal diet.
Per "Nutrition During Lactation" (Institute of Medicine, 1991), pantothenic acid content of human milk increases with increased dietary intake.
Selenium toxicity is very rare and results from levels significantly higher than normally found in human milk. The EPA Reference Dose (RfD) is 5 µg/kg body weight/day. Selenium Tolerable Upper Intake Level is 45 ug/day for 0-6 months, increases for older children, and is 400 ug for adults (including lactation). Selenium levels in human milk average 20 ug/L, or 20 ug per 35 oz milk, and range from 10-30 ug/L. For comparison, a brazil nut weighs about 1/7 oz and 1/4 cup (2 oz) contains 1036 ug selenium; so one brazil nut would contain around 74 ug selenium. The main problem appears to be getting *enough* selenium. Ruth Lawrence notes "Although selenium toxicity is possible, deficiency from low intake is a problem".
Per Breastfeeding: a guide for the Medical Professional (Lawrence & Lawrence, 1999, p. 309), "maternal supplementation [of Vitamin B1/thiamin] does not increase milk levels beyond a certain limit... In malnourished women, evidence indicates that supplementation does increase thiamin levels in milk." Per Nutrition During Lactation (Institute of Medicine, 1991, p. 126), that limit has been estimated to be 200 micrograms per liter, which is the Daily Reference Intake for infants 0-5 months old.
Per Hale, vitamin A is a fat soluble vitamin that is secreted into human milk and primarily sequestered in high concentrations in the liver. Overdose of vitamin A is extremely dangerous and adults should never exceed 3000 µg per day. Use normal doses. DO NOT use maternal doses greater than 3000 µg per day. Maternal milk is rich in vitamin A. Infants do not generally require vitamin A supplementation.
Per Hale (Medications and Mothers' Milk), no pediatric concerns have been reported via breastmilk. Approved by the AAP for use in nursing moms. This vitamin can turn your urine a fluorescent yellow color, and has been known to tint mom's milk yellow also.
Per Hale (Medications and Mothers' Milk), no pediatric concerns have been reported via breastmilk. Approved by the AAP for use in nursing moms. According to Hale ("Medications and Mothers' Milk"), Vit B6 shouldn't be taken in excess of 25 mg per day. Very high dosages (600 mg/day) suppress prolactin secretion and therefore will reduce milk production. Excessive oral doses in infants have been reported to produce side-effects in infants (sedation, hypotonia and respiratory distress), but no concerns have been reported via breastmilk. The vitamin B6 content of milk is directly related to maternal intake, but vitamin B-6 deficiency is rare in the United States. According to one study, B6 levels in women who supplemented with 2.5 mg per day are twice as high as those of unsupplemented women. As far as I could see, this reference didn't discuss moms supplementing with more than 10 mg per day (they were concerned more with deficiencies).
Mothers who are on strict vegan diets (that do not include fish, meat, and dairy products) may benefit from vitamin B12 supplements. Mothers who have had gastric bypass surgery are also at risk for vitamin B12 deficiency, and may also need small supplements of this vitamin. For a more detailed writeup on vitamin B12, see Does my baby need vitamin B12 supplements? Per Hale (Medications and Mothers' Milk), no pediatric concerns have been reported via breastmilk. Approved by the AAP for use in nursing moms.
Vitamin C (ascorbic acid) is secreted into human milk, but excessive vitamin C intake in the mother does not alter (or increase) the controlled secretion into breastmilk. Maternal supplementation is only required in undernourished mothers. Pregnant women should not use excessive ascorbic acid due to metabolic induction in the fetal liver, followed by a metabolic rebound scurvy early postpartum in the newborn.
It is not recommended that nursing moms overdose on vitamin E - the recommended intake for nursing mothers is 19 mg/day. Too much vitamin E can raise baby's vitamin E levels to toxic levels.
Increasing mom's zinc intake does not increase the amount of zinc in her milk. Per Hale (Medications and Mothers' Milk): "The Recommended Daily Allowance for adults is 12-15 mg/day. The average oral dose of supplements is 25-50 mg/day, higher doses may lead to gastritis. Doses used for treatment of cold symptoms averaged 13.3 mg (lozenges) every 2 hours while awake for the duration of cold symptoms. The acetate or gluconate salts are preferred due to reduced gastric irritation and higher absorption. Zinc sulfate should not be used. Excessive intake is detrimental... higher levels of oral zinc intake probably have minimal effect on zinc concentrations in milk... no pediatric concerns reported via milk." Avoid taking more than 150 mg/day of zinc (from all sources). It's a good idea (for anyone, not just nursing mothers) to avoid taking higher amounts of zinc (more than the recommended daily intake of 8-12 mg/day) for more than 7 days. See also (not lactation related): Berger A. What
does zinc do? BMJ 2002 (9 November);325:1062. Science
commentary from the British Medical Journal.
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