A breastfeeding mother should avoid or severely limit alcohol, smoking, and illegal drugs, as these pass into milk and harm the baby; she should also limit caffeine and high-mercury fish (shark, swordfish), be cautious with certain medications/herbal supplements (consult a doctor!), and watch for personal food triggers (like spicy or gassy foods) that might upset the baby, focusing instead on a balanced diet and managing stress to support milk supply.
What foods and drinks should I limit or avoid while breastfeeding?
The "5-5-5 Rule" for breastfeeding is a simple guideline for storing expressed milk: 5 hours at room temperature, 5 days in the refrigerator, and 5 months in a freezer, though variations like 4-4-4 or 6-6-6 exist, with stricter rules (4-4-4) often recommended for warmer conditions, emphasizing getting milk into the fridge quickly. There's also a postpartum 5-5-5 rule for rest, suggesting 5 days in bed, 5 days near the bed, and 5 days near home to aid healing.
The "4-4-4 rule" for breast milk is a simple storage guideline: fresh milk is good for 4 hours at room temperature (up to 77°F/25°C), for 4 days in the refrigerator (39°F/4°C or colder), and up to 4-6 months (or longer) in a standard freezer (0°F/-18°C). It's a handy mnemonic, though some organizations like the CDC recommend up to 6 months in the freezer and the AAP up to 9 months, with deeper freezers offering even longer storage.
Breastfeeding and sertraline
Sertraline can often be used while breastfeeding, but it's best to check because the medicine can pass into your breast milk in small amounts. You'll usually be advised to continue taking it if the benefits to you outweigh any possible risks to your baby.
Breastfeeding while taking sertraline:
Sertraline gets into breast milk in small amounts. Most babies who are exposed to sertraline through breast milk do not have side effects. If you suspect the baby has any symptoms, such as being irritable or sleepier than usual, contact the child's healthcare provider.
Infant exposure of antidepressants through breast milk is generally low to very low. We consider that when antidepressant treatment is indicated in women with postpartum depression, they should not be advised to discontinue breastfeeding. Paroxetine and sertraline are most likely suitable first-line agents.
Breast milk does not need to be warmed. It can be served room temperature or cold.
As a general rule, exclusive pumpers need 120 minutes per day of quality breast stimulation with a hospital strength pump to maintain milk supply.
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“Fat globules” or “chunks” in milk are actually just coagulated milk comprised of normal milk contents — proteins, cholesterol/lipids, and general ductal debris (dead cells), usually in the setting of hyperlactation (oversupply) and exclusive pumping.
The 5-5-5 rule is a guideline for what kind of help a postpartum mom needs: five days in bed, five days round the bed — meaning minimal walking around — the next five days around the home. This practice will help you prioritize rest and recovery while gradually increasing activity.
Shark, swordfish and marlin
limit swordfish, marlin or shark to 1 portion a week (because of the high levels of mercury in them) do not eat more than 2 portions of oily fish a week (like fresh tuna, salmon, trout, mackerel, herring, sardines and pilchards)
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It's generally suggested that breastfeeding women consume about 13 to 16 cups (around 3 to 3.8 liters) of fluids a day, depending on activity level, climate, and body size1. This increased need reflects the extra fluids required to produce breast milk and compensate for what you lose during nursing sessions.
The "breast milk 2-hour rule" means that any leftover breast milk from a feeding, once a baby has started drinking from the bottle or cup, should be used within two hours or thrown away due to potential bacterial growth from the baby's mouth. To minimize waste, offer smaller amounts at first; if the baby doesn't finish, you can refrigerate the rest for the next feeding within that two-hour window or discard it if the time limit has passed.
The American Academy of Pediatrics and the World Health Organization recommend continued breastfeeding along with introducing appropriate complementary foods for up to 2 years or longer.
1. Demand is Equal to Supply: The principle of demand and supply is fundamental to breastfeeding. The more your baby nurses, the more signals your body receives to produce milk.
The texture of breast milk tends to curdle, and the clumps cannot dissolve, even after stirring. There was a fishy aroma. Colors that are initially white or yellowish tend to become darker and look less fresh. The taste becomes sour, because breast milk has been contaminated by bacteria so the taste is affected.
Never reheat breast milk in the microwave. Microwaves can cause uneven heating, creating dangerous hot spots that may burn your baby's mouth and destroy important nutrients and antibodies. Instead, stick to gentle warming methods, such as a bottle warmer or a warm water bath, to preserve both safety and quality.
You can also mix pumped breast milk with formula in the same bottle. If you're using a liquid-prepared formula, pour it into the bottle with your breast milk. If you're using a powdered formula, measure it and the water as directed on the label. Then prepare the formula according to the directions.
Cortisol is your body's primary stress hormone, and it controls much of your feelings. Studies have shown that breast milk from distressed mothers may contain higher levels of cortisol. As your stress level rises, the level of cortisol in your breast milk also increases.
Breastfeeding has also been shown to reduce the risk of otitis media and malocclusion, and recent studies further suggest that breastfeeding may have longer-term health benefits, such as reducing the risk of obesity and type 2 diabetes in children and adolescents, and increasing intelligence quotient (IQ) (2-5).
If you and your doctor decide that prescribed medication is the best route for you, there are several options which you can take and continue breastfeeding. They include, in no particular order: SSRI antidepressants e.g. sertraline, citalopram, fluoxetine, paroxetine all have anti- anxiety activity.