This is going to be long. You might want to get a cup of tea and settle in!
Ruth Lawrence MD (Breastfeeding: A Guide for the Medical Profession, 6th Ed, c2005, Mosby. pp348-349) has this to say: "The concern about foods causing gas in the breastfed baby has no scientific basis. The normal intestinal flora produce gas from the action on fiber in the intestinal tract. Neither the fiber nor the gas is absorbed from the intestinal tract, and they do not enter the milk, even though they may cause the mother some discomfort. The acid content of the maternal diet also does not affect the milk because it does not change the pH of the maternal plasma. Essential oils are present in such foods as garlic, and some spices that have characteristic odors and flavors may pass into the milk, and an occasional infant objects to their presence." She then goes on to talk about studies done by Menella and Beauchamp (noted below) and how "the diet of the lactating woman alters the sensory qualities of her milk":
"They found that garlic ingestion significantly and consistently increase the intensity of the milk odor as perceived by blinded adult panelists. The odor was not apparent at 1 hour, peaked at 2 hours, and decreased therafter. Similar observations have been made in other species. Garlic is one of the most potent of the volatile sulfur-containing foods (onions, broccoli, etc.). Garlic consumption by the mother increased the length of time spent suckling and the rate of suckling of the next feeding. [referenced] This behavior is usually associated with a tendency of the breast to make more milk. The authors suggest that the mouth movements made during sucking facilitated the retronasal perception of the garlic volatile oils in the milk. This study reports only the first 4 hours postingestion and makes no reference to the period between 4 and 24 hours after ingestion, a time occasionally associated with colic in the breastfed infant after ingestion of certain foods by the mother (often called 24-hour colic.)
"When these mothers and infants were tested over an 11-day period, those infants who had garlic previously showed no response to reexposure; that is, suckling pattern and volume ingested were unchanged. [referenced] Garlic odor of amniotic fluid has been noted when the mother consumed garlic. These investigators also report that alcohol, mint, and cheese flavors are transmitted to milk. When mothers were fed carrot juice while lactating, the infant subsequently preferred cereal mixed with carrot juice rather than with plain formula or milk. [referenced]
"Animal studies show that odors in utero and early in life are associated with a preference for them after birth. ... "
"Extensive clinical experience suggests, however, that some infants do not tolerate certain foods in the mother's diet, particularly specific vegetables and fruits. Garlic and onions may cause 24-hour colic in some infants. Cabbage, turnips, broccoli, or beans may also bother others, making them colicky for 24 hours. The same has been said of rhubarb, apricots, and prunes. If a mother questions the effect of a food, she should avoid it or document its effect carefully by watching for colic in the first 24 hours following ingestion. In the summer, a heavy diet of melon, peaches, and other fresh fruits may cause colic and diarrhea in the infant. Chocolate rarely lives up to its reputation and can be consumed in moderation without causing colic, diarrhea, or constipation in most infants.
"Red pepper, which contains capsaicin and related compounds, has been repororted to cause dermatitis in the breastfed infant within a hour of milk ingestion. [referenced] The rash can last 12 to 48 hours and differs from contact dermatitis known to occur from capsaicin applied directly. When hot peppers are prepared with bare hands, an intensely painful reaction can occur. In countries where red pepper dishes such as gimchee are common (Korea), a perianal rash has long been seen in breastfed infants whose mothers ingested these hot dishes."
Interesting that she doesn't mention wheat, etc. right?
Here are her references from the above:
- Cooper, RL, Cooper, MN: Red pepper-induced dermatitis in breast-fed infants. Dermatology 193:61, 1996.
- Menella JA, Beauchamp GK: Maternal diet alters the sensory qualities of human milk and nursling's behavior. Pediatrics 88:737, 1991.
- Menella JA, Beauchamp GK: The early development of human flavor preferences. In Capaldi ED (ed): Why We Eat What We Eat: They Psychology of Eating. Washington, DC, American Psychological Association, 1996.
Now, when we turn to Jack Newman MD, he has a lot more to say about carrying babies and how that reduces colic. but on the subject of stopping certain foods if the baby is "colicky" he says, "I would first try to get more high-fat milk into the baby. Breastfeeding mothers already have too many restrictions, usually unnecessary restrictions, in our society. However, there is no doubt that occasionally, stopping certain foods may make a tremendous difference in the baby's behavior. My feeling is that it doesn't work most of the time, but it works extremely well in about one baby in 10, somewhat in another one in 10. This is not only because it isn't easy to elminate all dairy products or all wheat from your diet, but because reactions to food are rarely the cause of colic in breastfed babies." He goes on later, "True lactose intolerance in babies is very rare. What is often diagnosed as lactose intolerance may be poor lactose digestion, but this is usually due to too much low-fat milk--and that can be fixed. Remember that the reason you are eliminating foods is to prevent certain proteins from getting into your milk. If you take dairy products out of your diet, it is not to get rid of lactose. Your milk will contain plenty of lactose whether or not you eat dairy products." He then talks about elmination dieting and how/when to reintroduce foods and what happens if there's a partial response. This next part is very interesting: "More recently, we have begun giving the mother pancreatic enzymes to reduce colic and allergic colitis in her baby. The mother takes one capsule at each meal. This breaks down the protein in her own diet and decreases the baby's reactions. it does nto work in every case but has been very helpful for some mothers and babies." He also talks about eliminating everything but breastmilk from the colicky baby's diet--no extra D except in rare instances, no extra iron (obviously talking about full term infants).
The Jack Newman info is from: The Ultimate Breastfeeding Book of Answers by Jack Newman MD and Teresa Pitman. c2000, 2003, 2006 by Dr. Jack Newman and Teresa Pitman. Three Rivers Press. pp139-156
Marsha Walker: "There is little evidence to support the belief that gassy or spicy foods, when eaten in moderation by the mother causes problems in most breastfeeding infants. ... Mothers who avoid a major food (such as wheat or dairy products) must give consideration to replacing those nutrients; referral to a dietician might be needed. A Mother who has a strong family history of milk protein intolerance might pass more beta-lactoglobulin through her milk, which could cause colic-type symptoms in her baby (Jakobsson, 1991). In high-risk allergic families, mothers might be advised to avoid peanuts and other potent allergens during pregnancy and breastfeeding (Anaphylaxis Campaign)."
Marsha Walker's references:
Jakobsson I. Food antigens in human milk. Euro J Clin Nutr (Suppl 1) 1991; 29-33
The Anaphylaxis Campaign, P.O. Box 149, Fleet, Hampshire GU13 9XU, England.
I got Marsha Walker's info above from Core Curriculum for Lactation Consultant Practice by Marsha Walker, Jones and Bartlett, 2002, p80.
Jack Newman does have some very very intriguing ideas about what may be perceived as a food problem for a breastfed baby but may actually be due to lack of carrying. He talks about how these kinds of infant behaviors are not seen in developing culures where babies are carried from the moment of birth--even when those cultures restrict colostrum thinking that colostrum is bad for babies.