Index

A

Acquired immunodeficiency syndrome (AIDS), see Human immunodeficiency virus (HIV)

Activity level

during lactation, 100

and milk volume, 6, 94

research needed on, 238

Adipose tissue, in lactating women, 201-202

see also Fat

Adolescent mothers

breastfeeding rate and duration of, 4, 33

determinants of breastfeeding in, 44-45

dietary intake by, 67, 70, 71

milk volume in, 87

Adolescents

iron intake by, 229

vitamin A intake by, 229

Age

and breastfeeding rate and duration, 32, 33

gestational, 86, 116-118

and milk volume, 87

and RDAs, 214

Agent Orange, in human milk, 178

AIDS, see Human immunodeficiency virus (HIV)

Albumin, in human milk, 136

Alcohol consumption

and infant health, 9-10, 176-177

and milk volume, 89

recommendations on, 15, 104

research needed on, 242

Alkaline phosphatase, in human milk, 139

Allergies

in breastfed vs. formula-fed infants, 167-168, 180

elimination diet for, 12, 182

Amenorrhea, 10, 198-200

American Academy of Pediatrics, recommendations of, 131, 157, 161

American Indians, dietary intake by, 67, 70, 71, 73

Amylase, in human milk, 139

Anemia, iron deficiency, 159

Anovulation, 10, 198-200

Anthropometric measurements

changes occurring during lactation, 202-203

in lactating women, 54, 58-62, 63

and milk volume, 98-99

and successful lactation, 5

use of, 53-54

Antibodies, in human milk, 119, 134-137, 140



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Nutrition During Lactation Index A Acquired immunodeficiency syndrome (AIDS), see Human immunodeficiency virus (HIV) Activity level during lactation, 100 and milk volume, 6, 94 research needed on, 238 Adipose tissue, in lactating women, 201-202 see also Fat Adolescent mothers breastfeeding rate and duration of, 4, 33 determinants of breastfeeding in, 44-45 dietary intake by, 67, 70, 71 milk volume in, 87 Adolescents iron intake by, 229 vitamin A intake by, 229 Age and breastfeeding rate and duration, 32, 33 gestational, 86, 116-118 and milk volume, 87 and RDAs, 214 Agent Orange, in human milk, 178 AIDS, see Human immunodeficiency virus (HIV) Albumin, in human milk, 136 Alcohol consumption and infant health, 9-10, 176-177 and milk volume, 89 recommendations on, 15, 104 research needed on, 242 Alkaline phosphatase, in human milk, 139 Allergies in breastfed vs. formula-fed infants, 167-168, 180 elimination diet for, 12, 182 Amenorrhea, 10, 198-200 American Academy of Pediatrics, recommendations of, 131, 157, 161 American Indians, dietary intake by, 67, 70, 71, 73 Amylase, in human milk, 139 Anemia, iron deficiency, 159 Anovulation, 10, 198-200 Anthropometric measurements changes occurring during lactation, 202-203 in lactating women, 54, 58-62, 63 and milk volume, 98-99 and successful lactation, 5 use of, 53-54 Antibodies, in human milk, 119, 134-137, 140

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Nutrition During Lactation Antiinfectious agents, in human milk, 133-137, 139, 166 Anti-inflammatory agents, in human milk, 138, 166 Antimicrobial factors, in human milk, 133-137, 139, 166 Antiprotease, in human milk, 139 Anxiety and milk volume, 88 research needed on, 241 Apoproteins, in lactating women, 54, 58 Arsenic, in human milk, 178 Ascorbic acid, see Vitamin C Assessment, see Nutritional status, assessment of Atherosclerosis, effect of infant feeding on development of, 172 Atopic dermatitis, 168 Attitudes, and breastfeeding rate, 22 Autocrine control, of milk production, 84 B Basal metabolic rate (BMR), during lactation, 100 Benefit, indicators of, 51-52 Beriberi, 126 Biceps skinfold thickness, 60, 62 Bile salt-dependent lipase, in human milk, 132, 139 Bioavailability, of nutrients, research needs, 239 Biochemical indicators in lactating women, 54, 55-57 and successful lactation, 5 use of, 52-53 Biotin in human milk, 116, 128 in lactating women, 57 Birth weight cigarette smoking and, 89 and milk volume, 85-86 and nutrient utilization, 154-155 Black mothers breastfeeding rate and duration of, 4, 29-30, 32, 33 determinants of breastfeeding in, 39-42 Black women calcium intake by, 229 magnesium intake by, 229 vitamin A intake by, 229 Blood lipids, 54, 58 BMR, during lactation, 100 Body mass index, 60 and milk volume, 98 Body weight, see Weight Bone mass, lactation and, 205-206 Bone metabolism, during and after lactation, 204 Bone mineralization, effect of lactation on, 204-206 Botulism, infant, 174 Breads, recommended daily servings of, 230 Breast(s), development and physiology of, 83-84 Breast abscesses, continued breastfeeding with, 169 Breast cancer, effect of breastfeeding on, 10, 206-208 Breastfeeding beliefs about, 45-46 capability for, 10-11 current statistics for, 32-39 determinants of, 39-46, 240 exclusive, 3, 24, 37, 179 extent of, 24, 63-64 external constraints on, 46 frequency of, 14, 85, 104 health care in support of, 12-14, 240 history of, 28-32 lactation vs., 28 minimal, 25 partial, 3, 24, 37 reasons to support, 22-23 at work, 44 Breastfeeding duration adolescent mothers, 33 age and, 32, 33 black mothers, 29-30, 32, 33 current statistics on, 4, 32-39 defined, 24 determinants of, 39-46 employed mothers, 38-39, 40-41 geographic differences in, 35 Hispanic mothers, 37 marital status and, 32, 33 parity and, 32, 33 Southeast Asian mothers, 38 white mothers, 32, 33 WIC mothers, 36 Breastfeeding practices, recommendations for, 14

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Nutrition During Lactation Breastfeeding rates adolescent mothers, 33 age and, 32, 33 black mothers, 29-30, 32, 33 current statistics on, 4, 32-39 day care and, 22 decline in, 22, 29-30 determinants of, 39-46 educational differences in, 30-33, 45 employed mothers, 22, 38-39, 40-41 ethnic differences in, 29-33, 39-43 geographic differences in, 32, 34, 35 Hispanic mothers, 32, 33, 37 history of, 4, 29-32 income and, 29, 30, 32, 33 limitations of data on, 36-37 marital status and, 32, 33 Objectives for the Nation and, 21 parity and, 32, 33 social attitudes and, 22 Southeast Asian mothers, 38 white mothers, 32, 33 WIC mothers, 29n, 32-36 work and, 22 C Cadmium, in human milk, 178 Caffeine and infant health, 10, 176 recommendations on, 15, 104 research needed on, 242-243 Calcium absorption during lactation of, 204, 225 age and RDA for, 214, 224-225 amount in human milk, 116, 283 body content and output in milk of, 204, 219 dietary sources of, 231 estimated vs. recommended intake of, 224-225 intake by black women, 229 intake by low-income women, 229 long-term demand for, 218, 219 margin of safety in RDA for, 224 maternal intake and milk content of, 8, 128 mean daily intake of, 68-70, 223 milk content and increment in RDA for, 217 nutrient density for, 223 and osteoporosis, 204-206, 225 RDA for, 204, 223 in serum, 55, 204 supplementation of, 232 Carbohydrates, in human milk, 114, 124, 133-134 β-Carotene blood of lactating women, 57 colostrum, 115 human milk, 125 Case fatality studies, 258-259 Caseins, in human milk, 121 Cells, in human milk, 114, 137 Centers for Disease Control (CDC), recommendations concerning breastfeeding and HIV, 171 Cereals, recommended daily servings of, 230 Child spacing breastfeeding and, 200 and infant morbidity, 166 and infant mortality, 174 Chloride, in human milk, 116, 129, 283 Cholesterol and atherosclerosis, 172 levels in lactating women, 54, 58 maternal intake and milk content of, 124 Chromium, in human milk, 116 Chronic illnesses, protective effect against, 168-169, 243-244 Cigarette smoking and infant health, 9-10, 177 and milk volume, 88-89 recommendations concerning, 15, 104 research needed on, 242 Circumference measurements, of lactating women, 61 Cocaine in human milk, and infant health, 177 Coffee, effect on iron content of human milk, 176 see also Caffeine Cognitive development, and infant feeding method, 165-166 Colic in breastfed infants cigarette smoking and, 88 maternal diet and, 12, 168, 180, 182 Colostrum, 115 vitamin E content of, 126 vitamin K content of, 126 zinc content of, 130 Committee on Nutritional Status During Pregnancy and Lactation, 2, 24

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Nutrition During Lactation Complement, in human milk, 136 Copper in human milk, 116, 129-130 in infant nutrition, 160 serum, 53 Cortisol, in human milk, 138 Cotinine, 177 Crohn's disease, infant feeding method and, 169 Cytomegalovirus, transmission via breastfeeding, 9, 169, 181 D Dairy products avoidance of, 232 and colic of breastfed infants, 12, 168 Day care, 44 and breastfeeding rate, 22 DDE, in human milk, 178 DDT, in human milk, 178 Demand feeding, 86-87, 104 Dermatitis, atopic, 168 Developed countries, see Industrialized countries Developing countries energy reserves and milk volume in, 98-99 gastrointestinal infections in infants in, 166 infant mortality in, 172-174, 263-276 maternal nutrition and infant growth in, 164-165 milk volume in, 81, 82 patterns of infant growth in, 161-162 Development, of infant, see Infant growth and development Diabetes mellitus, 169 Dichlorodiphenyl ethane (DDE), in human milk, 178 Dichlorodiphenyltrichloroethane (DDT), in human milk, 178 Dietary intake changes during lactation in, 62-63 data from nationally representative samples on, 64-67 data from nonrepresentative samples on, 65, 66-67, 68-73 data from various population groups on, 73 determination of usual, 62-73 difficulties in measuring, 62 estimated vs. recommended, 220-228 extent of lactation and, 63-64 longitudinal data on, 65 and milk volume, 5-6 recommendations on, 12, 64, 66-67, 229-231 research needed on, 18 with restrictive eating patterns, 13, 15 see also Energy intake Dietary restriction, see Restrictive eating patterns Dieting, 13, 15, 104 Dioxins, in human milk, 178 Drug use and infant health, 9, 10, 175-176, 177 recommendations on, 15, 16, 181 E Eczema, human milk and168, 180 Educational differences, in breastfeeding rate, 30-33, 45 EGR activation coefficients, 158-159 Electrolytes, in human milk, 116, 129 Elimination diet, 12, 180, 182 Employed mothers barriers to breastfeeding for, 44 breastfeeding rate and duration of, 22, 33, 38-39, 40-41 determinants of breastfeeding in, 43-44 Energy balance, research needed on, 18, 238 Energy demands, of lactation, 213 Energy intake breastfed vs. formula-fed infants, 162 by lactating women, mean values for, 68-70 RDA for, 215, 231 weight and, 214 see also Dietary intake Energy reserves, and milk volume, 98-99 Energy restriction, see Restrictive eating patterns Energy supplementation, and milk volume, 94-98 Energy utilization infant nutrition, 154-155 during lactation, 99-100, 215 research needed on, 239 Engorgement, 84 Environmental contaminants, in human milk, 10, 16, 177-179 Enzymes, in human milk, 138, 139

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Nutrition During Lactation Epidermal growth factor, in human milk, 132, 138 Erythrocyte glutathione reductase (EGR) activation coefficients, 158-159 Ethnic differences, in breastfeeding rate and duration, 29-33, 39-43 Exclusive breastfeeding, 3, 24, 37 recommendations on, 179 Exercise during lactation, 100 and milk volume, 6, 94 research needed on, 238 F Famine, and milk volume, 92 Fasting during lactation, 15 and milk volume, 92, 104 Fat body, 124, 201-202 see also Adipose tissue; Lipids; Obesity Fatty acids in human milk, 6 origins in human milk of, 120-121 and vegetarian diet, 123 Fatty acid synthetase, in human milk, 139 Fibronectin, in human milk, 136 Fluid intake and milk volume, 6, 101-102 recommendations on, 12 Fluoride in human milk, 116, 131 infant nutrition, 160-161 supplementation of, 16, 160, 161, 180 Folate amount in human milk, 116, 127-128, 216 biochemical values for, 56 body content of, 219 dietary sources of, 231 difficulty in measuring, 119 estimated vs. recommended intake of, 228 increment in RDA for, 216 infant nutrition, 158 long-term demand for, 218, 219 maternal nutrition and milk content of, 8, 127-128 mean daily intake of, 71-72, 222 nutrient density for, 222 RDA for, 222 reserves of, 218, 228 Food allergies, in breastfed vs. formula-fed infants, 167-168, 180 , 182 Food guides, summarized, 229-231 Food supplementation, and milk volume, 94-98 Formula, supplemental and infant nutrition, 154 for slow weight gain, 16 G Gastric filling and emptying, in breastfed vs. formula-fed infants , 165 Gastrointestinal infections, in breastfed vs. formula-fed infants, 166-167 Gastrointestinal maturation, of infant, 165 Geographic differences, in breastfeeding rate and duration, 32, 34 , 35 Gestational age and milk composition, 116-118 and milk volume, 86 Glucoconjugates, in human milk, 133-134 Glucose level, in lactating women, 52 Glutamic pyruvic transaminase activity coefficient, erythrocyte, 56 Glutathione peroxidase in human milk, 139 and selenium, 131 Glutathione reductase activity coefficient, erythrocyte, 56 Gonadotropin-releasing hormone, in ovulation, 198 Growth, of infant, see Infant growth and development Growth charts, 162-163, 241 Growth factors, in human milk, 138 H Health care plan, recommendations for, 12-14, 240 Hemorrhagic disease of the newborn, 156-157 Hepatitis B virus, transmission via breastfeeding, 169, 181 Heroin, use by lactating women and infant health, 177 Hispanic Health and Nutrition Examination Survey, 37 Hispanic mothers breastfeeding rate and duration of, 32, 33, 37

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Nutrition During Lactation determinants of breastfeeding in, 42-43 Hormones, in human milk, 138 Human immunodeficiency virus (HIV), transmission via breastfeeding , 9, 170-171, 243 Human T lymphocytotropic virus type I (HTLV-1), transmission via breastfeeding, 9, 170 25-Hydroxycholecalciferol, in infant nutrition, 155-156 I Illness infants, see Infant morbidity research needed on, 241 Immune function, research needed on infant's, 238-239 Immunoglobulin A (IgA), in human milk, 119, 132-136 Immunoglobulin G (IgG), in human milk, 136 Immunologic composition, of human milk, 134-137, 140 Immunologic diseases, chronic, 168-169 Immunoreactive parathyroid hormone (iPTH), serum levels of, 204 Income, and breastfeeding rate, 29, 30, 32, 33 Inducers, in human milk, 138-140 Industrialized countries energy reserves and milk volume in, 98 energy restriction and milk volume in, 92 folate content of milk in, 127 gastrointestinal infections in infants in, 166 infant mortality in, 174-175 maternal nutrition and infant growth in, 164-165 milk volume in, 81, 82 patterns of infant growth in, 161 Infant growth and development assessment of, 162-163 breastfed vs. formula-fed infants, 8-9, 16, 161-163, 179 cognitive, 165-166 gastrointestinal and metabolic responses, 165 long-term, 163-164 maternal nutrition and, 164-165 patterns of, 161-162 recommendations on, 15-16, 181, 241 Infant health, 3 long-term effects of breastfeeding on, 243-244 recommendations concerning, 16, 181 Infant morbidity, 9 allergies, 167-168 atherosclerosis, 172 chronic diseases with immunologic basis, 168-169 infectious agents in human milk, 169-171 obesity, 171 protection against infectious diseases, 166-167, 173 short-term, 166-168 Infant mortality abstracts of studies on, 252-260, 263-276 chronological list of studies on, 250-251 developing countries, 9, 172-174, 263-276 industrialized countries, 9, 172, 174-175 research needed on, 242 Infant nutrition copper in, 160 fluoride in, 160-161 folate in, 158 indices needed for, 239 iron in, 159-160 maternal nutritional status inferred from, 53 nutrient stores and, 154 recommendations on, 179, 180-181 riboflavin in, 158-159 supplementary foods and, 154 vitamin A in, 156 vitamin B12 in, 157-158 vitamin D in, 155-156 vitamin K in, 156-157 zinc in, 160 Infectious diseases protection against, 133-137, 139, 166-167, 173 research needed on, 238-239 transmitted via human milk, 9, 169-171 Insecticides, in human milk, 10, 16, 177-178 Insulin human milk, 138 lactating women, 52 Interferon-α167 Iodine amount in human milk, 116, 131-132, 217 increment in RDA for, 217 maternal intake and milk content of, 6, 8 mean daily intake of, 223

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Nutrition During Lactation nutrient density for, 223 RDA for, 223 supplementation of, 141 iPTH, serum levels of, 204 Iron amount in human milk, 116, 129, 217 body content of, 219 coffee consumption and, 176, 242-243 deficiency in, 159-160 increment in RDA for, 217 infant nutrition, 8, 16, 159-160 intake by adolescents, 229 long-term demand for, 218, 219 mean daily intake of, 68-70, 223 menstruation and, 218 nutrient density for, 223 RDA for, 223 recommendations on, 16 reserves of, 218 supplementation of, 159-160, 180 L β-Lactalbumin 132 Lactation, vs. breastfeeding, 28, see also Breastfeeding Lactation performance, 25 maternal nutrition and, 237-238 Lactoferrin, 132, 133, 134 Lactogenesis, 83 Lactose amount in human milk, 116, 124, 280 intolerance, 232 ovulation and, 124 variations in milk content of, 117, 118 Lactose synthetase, in human milk, 139 Lead, in human milk, 178 Let-down, 84 alcohol consumption and, 89 stress and, 88 Leukocytes, in human milk, 119, 137 Linoleic acid, in eczema, 168 Linolenic acid, in eczema, 168 Lipases, in human milk, 139 Lipids amount in human milk, 116, 281-282 blood values in lactating women, 54, 58 maternal intake and milk composition of, 123-124 origins in human milk of, 120-121 types in human milk, 114 variations in milk content of, 118 Lipoprotein lipase human milk, 139 lactating women, 202 prolactin and, 121 Liquid diets, 15, 104, 232 Lymphocytes, in human milk, 137 Lymphoma, 169 Lysozyme, in-human milk, 133, 134, 135-136, 139 M Macrophages, in human milk, 137 Magnesium amount in human milk, 116, 217, 284 deficiency of, 226 dietary sources of, 231 estimated vs. recommended intake of, 225-226 incremental RDA for, 217 intake by black women, 229 maternal intake and milk content of, 127 mean daily intake of, 71-72, 223 nutrient density for, 223 RDA for, 223 serum, 55 Malnutrition, and milk volume, 91-94 Manganese, in human milk, 116, 130 MAR, 65n Marijuana use by lactating women, and infant health, 177 Marital status, and breastfeeding rate and duration, 32, 33 Mastitis continued breastfeeding with, 88, 169, 181 and electrolyte level of milk, 129 Maternal health, effects of lactation on breast cancer, 10, 206-208 chronic illness, 244 obesity, 10, 201-204 osteoporosis, 204-206 return of ovulation, 10, 198-200 sexuality, 200-201 Maternal nutrition, see Nutritional status Maternity leave, and breastfeeding rate, 22 Mature human milk, 115 Mean adequacy ratio (MAR), 65n Medications and infant health, 9, 175-176 recommendations on, 16, 181

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Nutrition During Lactation Menaquinone, 156 Menstruation iron loss through, 218 return of, 10, 198-200 Mercury, in human milk, 178 Metabolic rate breastfed vs. formula-fed infants, 165 during lactation, 100 Methylmalonic acid, urinary, 157 Micronutrients, mean dietary intake of, 65, 71, 72-73 Milk composition antiinfectious agents, 133-137 anti-inflammatory agents, 138 carbohydrates, 124 classes of constituents, 113-114 colostrum, 115 difficulties in measuring, 118-120 electrolytes, 129 enzymes, 138, 139 hormones, growth factors, and inducers, 139-140 lipids, 123-124 literature survey of data on, 279-284 mature human milk, 115 minerals, 128, 129-132 nonnutritive substances, 132-140 nutritional status and, 6-8, 121-132 origin of constituents, 120-121 preterm milk, 116-118 protein, 121-123 transitional milk, 115 variations in, 115-118 vitamins, 124-128 Milk-ejection reflex, see Let-down Milk intake by infant, 81 see also Milk volume Milk production, 8 potential for, 5, 83 see also Milk volume Milk volume age and, 87 alcohol consumption and, 89 birth weight and, 85-86 breast development and physiology in, 83-84 cigarette smoking and, 88-89 dietary intake and, 5-6 and electrolyte level of milk, 129 energy balance and, 90-100 energy reserves and, 98-99 energy restriction and, 91-94 energy supplementation during lactation and, 94-97 energy supplementation during pregnancy and, 97-98 energy utilization during lactation and, 99-100 fluid intake and, 101-102 gestational age at delivery and, 86 illness and, 88 infant factors influencing, 84-87 maternal factors influencing, 87-102 measurement of, 81 normal range of, 5, 81-83 nursing frequency and, 85 nutritional status and, 5, 90-100 oral contraceptive agents and, 89-90 parity and, 87 protein intake and, 100-101 self-regulation by infant of, 86-87 stress and, 88 substance use and, 88-89 weight loss and, 6, 93-94, 104 Mineral(s), in human milk, 114, 128, 129-132 Mineral intake mean values for, 68-70, 72-73 and milk composition, 6 research needed on, 18 Mineral supplements, recommendations on, 12 Minimal breastfeeding, 25 Molybdenum, amount in human milk, 116 Monosialogangliosides, in human milk, 133-134 N NAR, 64n National Health and Nutrition Examination Surveys (NHANES), 60 National Survey of Family Growth, 30, 31, 32, 89-90 Nationwide Food Consumption Survey, 64-67 Native Americans, dietary intake of, 67, 70, 71, 73 Neutrophils, in human milk, 137 Niacin amount in human milk, 116, 127, 216 increment in RDA for, 216

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Nutrition During Lactation mean daily intake of, 68-70, 222 nutrient density for, 222 RDA for, 222 Nicotine, see Cigarette smoking Night waking, in breastfed vs. formula-fed infants, 165 Nitrogen balance, in lactating women, 52-53 Nitrogen compounds, in human milk, 114, 121-123 Nursing frequency, 14, 24 and maternal dietary intake, 63-64 and milk production, 85 recommendations on, 104 Nutrient adequacy ratio (NAR), 64n Nutrient densities, 4, 220, 221-223, 224 Nutrient intake, see Dietary intake Nutrient output daily, 213-214, 215-217 long-term, 214-220 Nutrient utilization infant nutrition, 154-155 during lactation, 99-100, 215 research needed on, 239 Nutritional monitoring, recommendations for, 16-17 Nutritional risk, identification of women at, 11, 17-18, 237 Nutritional screening, recommendations for, 12-14, 240 Nutritional status assessment of, 4-5, 50-62 biochemical measures of, 54, 55-57 blood lipids and, 54, 58 effect of breastfeeding on, 10 changes in body weight and, 54-61 changes in skinfold thickness and, 62, 63 indicators of benefit for, 51-52 indicators of risk for, 51, 237 infant, see Infant nutrition and infant growth, 164-165 and milk composition, 6-8, 121-132 normative indicators of, 51 research needed on indicators for, 17, 237 and return of ovulation, 198-200 use of anthropometric indicators for, 53-54 use of biochemical indicators for, 52-53 O Obesity breastfed vs. formula-fed infants, 171 breastfeeding effect on maternal, 10, 201-204 and weight loss during lactation, 15 Oligosaccharides, in human milk, 133-134 Oral contraceptive agents and milk volume, 89-90 and vitamin B6 content of milk, 127, 226 Oral elimination-challenge trial, 12, 180, 182 Osteocalcin, serum levels during lactation, 204 Osteoporosis, 204-206, 225 Otitis media, 167 Ovulation, effect of breastfeeding on, 10, 198-200 Oxaloacetate transaminase activity coefficient, erythrocyte, 56 Oxytocin alcohol consumption and, 89 cigarette smoking and, 88-89 in human milk, 138 in lactogenesis, 84 P Pantothenic acid difficulty in measuring, 119 in human milk, 116, 128 supplementation of, 128 Parathyroid hormone, immunoreactive, 204 Parity and bone mass, 205 and breastfeeding rate and duration, 32, 33 and milk volume, 87 and weight gain, 203 Partial breastfeeding, 3, 24, 37 PCBs, in human milk, 178 Peroxidase, in human milk, 139 Pesticides, in human milk, 10, 16, 177-178 Phosphoglucomutase, in human milk, 139 Phospholipids in blood of lactating women, 58 maternal intake and milk composition of, 124 Phosphorus amount in human milk, 116, 217 increment in RDA for, 217 maternal intake and milk content of, 128 mean daily intake of, 68-70, 223 nutrient density for, 223 RDA for, 223 Phylloquinone, 156

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Nutrition During Lactation Physical activity during lactation, 100 and milk volume, 6, 94 research needed on, 238 Plasma volume, in lactating vs. nonlactating women, 52 PLP, see Vitamin B6 Polychlorinated biphenyls (PCBs), in human milk, 178 Postpartum care, and breastfeeding rate, 22, 240 Postpartum period, variations in milk composition in, 115, 117 Potassium, in human milk, 116, 129, 282 Preterm infants and human milk composition, 116-118 and milk volume, 86 zinc and vitamin A in, 120 Progesterone in lactogenesis, 83 and oral contraceptive agents, 90 Prolactin cigarette smoking and, 88 energy restriction and, 92, 93, 96 in human milk, 138 in lactogenesis, 83, 84 and lipids in human milk, 121 Proteases, in human milk, 139 Protein(s) amount in human milk, 116, 122, 215, 280-281 body content of, 219 long-term demand for, 218, 219 measurement of, 122 metabolism in lactating women, 52 nonnutritive functions of, 132, 134-137 nutrient density for, 221 types in milk, 114, 121-122 Protein intake increment in RDA for, 215 mean values for, 68-70, 221 and milk composition, 122 and milk volume, 6, 100-101 RDA for, 221 research needed on, 18 Psychological benefits, 23, 242 Pyridoxal 5-phosphate (PLP), see Vitamin B6 R Racial differences breastfeeding rate and duration, 4, 29-30, 32, 33, 37, 38 determinants of breastfeeding, 39-43 nutrient intake, 229 Radionuclides, in breast milk, 179 RDAs, see Recommended Dietary Allowances (RDAs) Recommendations breastfeeding all infants, 11 breastfeeding practices, 14, 104 health care plan, 12-14 identifying risk of depleted nutrient stores, 11 infant growth and nutrition, 15-16, 180-181 infant health, 16, 181 maternal diet, 12, 13, 140-141, 181, 233 maternal weight, 14-15, 104 milk volume, 104 nutritional assessment, 74 nutritional monitoring, 16-17 physical activity, 104 research, 17-18, 237-245 substance use and abuse, 15, 104 Recommended Dietary Allowances (RDAs), 64 age and, 214 energy intake and, 231 estimated intake vs., 64-74, 220-228 incremental vs. absolute values for, 214 margin of safety in, 224 nutrient secretion in milk vs., 213-214, 215-217 Research needs and recommendations, 17-18, 21, 54, 71, 137, 167, 171, 174, 175, 176, 200, 201, 206, 237-245 Respiratory syncytial virus infections, 167 Restrictive eating patterns, 13, 232 allergies and colic, 12, 180, 182 and lactation performance, 238 and milk volume, 91-94 and nutrient intake, 229-232 weight loss, 13, 15, 104 Retinol-binding protein, in lactating women, 57 Retinyl esters, in human milk, 125 Riboflavin amount in human milk, 116, 126-127, 216 increment in RDA for, 216 infant nutrition, 158-159 mean daily intake of, 68-70, 222 nutrient density for, 222 RDA for, 222 urinary, 56

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Nutrition During Lactation Rickets, 155 Ross Laboratories Mothers Survey, 29, 31-38 Rotavirus, 167 Rubella virus, transmission via breastfeeding, 169, 181 S Salmonella, in breast milk, 169 Selenium amount in human milk, 116, 130, 217 biochemical values for, 55, 130 increment in RDA for, 217 maternal intake and milk content of, 6, 8, 130-131 mean daily intake of, 72-73, 223 nutrient density for, 223 RDA for, 223 Self-regulation, of milk intake, 86-87 Sexuality, in postpartum period, 200-201 Shigella, in breast milk, 169 SIDS, 174, 257, 258 Skinfold thickness measurements of, 60-61, 62, 63 and successful lactation, 5 Social attitudes, and breastfeeding rate, 22 Socioeconomic status, and breastfeeding rate, 29, 30, 32, 33 Sodium, in human milk, 116, 129, 282 Solid foods and infant nutrition, 154 effect on human milk intake, 86 Somatostatin, in human milk, 138 Southeast Asian mothers breastfeeding rate and duration of, 38 determinants of breastfeeding in, 43 Special Supplemental Food Program for Women, Infants, and Children (WIC) breastfeeding rates in, 29n, 32-36 food packages by, 22 studies of dietary intake by participants of, 67, 72, 73 Stress and electrolyte level of milk, 129 and milk volume, 88 research needed on, 241 Substance use and abuse, maternal and infant health, 9, 10, 176-177 and milk volume, 88-89 recommendations concerning, 15, 242-243 Sucking strength, and milk volume, 85 Suckling inadequate, and electrolyte level of milk, 129 and return of ovulation, 198 Sudden infant death syndrome (SIDS), 174, 257, 258 Sulfhydryl oxidase, in human milk, 139 Sunlight, infant exposure to, 16, 155-156 see also Ultraviolet light Supplements, recommendations for, 12, 13, 15, 16, 227, 232, 233 Surgeon General's Workshop on Breastfeeding & Human Lactation, 21 T Taurine, in human milk, 122-123 T cells, in human milk, 137 Teenage mothers, see Adolescent mothers Test weighing, 81 Thermogenesis, during lactation, 100 Thiamin amount in human milk, 116, 126, 215 dietary sources of, 231 estimated vs. recommended intake of, 227-228 maternal intake and milk content of, 126 mean daily intake of, 68-70, 222 nutrient density for, 222 RDA for, 222 urinary, 56 Thioesterase, in human milk, 139 Thymic-dependent lymphocytes, in human milk, 137 Thyroid hormones, in human milk, 138 α-Tocopherol, see Vitamin E Transitional milk, 115 Transketolase activity coefficient, erythrocyte, 56 Triglycerides in blood of lactating women, 54, 58 origins in human milk of, 120, 121 Triplets, breastfeeding of, 83, 214 Tumor necrosis factor-α138 Twins, breastfeeding of, 83, 214 U Ultraviolet light, exposure to, 13 and vitamin D content of milk, 125 see also Sunlight

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Nutrition During Lactation Urinary methylmalonic acid (UMMA), 157 V Vegetarian diet fatty acids in, 123 recommendations with, 13, 140, 232 studies of dietary intake by women eating, 67, 70, 71 vitamin B12 deficiency with, 8, 157, 158, 181 Vibrio cholerae, 167 Vitamin(s) difficulties in measuring, 119 human milk, 6, 114, 124-128 research needed on, 18 supplements, 12, 16 Vitamin A amount in human milk, 116, 125, 215 biochemical values in lactating women, 57 body content of, 219 increment in RDA for, 215 infant nutrition, 156 intake by adolescent women, 229 intake by black women, 229 intake by low-income women, 229 long-term demand for, 218, 219 maternal intake and milk content of, 125 mean daily intake of, 68-70, 221 nutrient density for, 221 preterm infants, 120 RDA for, 221 reserves of, 218 supplementation of, 125 Vitamin B6 amount in human milk, 116, 127, 216 deficiency in, 226-227 dietary intake and levels in milk of, 8, 127, 226 dietary sources of, 231 estimated vs. recommended intake of, 226-227 increment in RDA for, 216 margin of safety in RDA for, 224 mean daily intake of, 72-73, 140, 222 nutrient density for, 222 oral contraceptives and, 127, 226 plasma, 56 pyridoxal5-phosphate (PLP) and, 226-227 RDA for, 222 research needed on, 18, 238 Vitamin B12 amount in human milk, 116, 128, 216 deficiency in, 157 increment in RDA for, 216 infant nutrition, 157-158 maternal intake and milk content of, 8, 128 mean daily intake of, 72-73, 222 nutrient density for, 222 RDA for, 222 serum, 56 vegetarian diet and, 140, 157, 181 Vitamin C amount in human milk, 116, 126, 215 increment in RDA for, 216 maternal intake and milk content of, 126 mean daily intake of, 68-70, 222 nutrient density for, 222 plasma, 56 RDA for, 222 Vitamin D age and RDA for, 214 amount in human milk, 116, 125, 215 difficulty in measuring, 119 increment in RDA for, 215 infant nutrition, 155-156 infant supplementation of, 156, 180 maternal intake and milk content of, 8, 125 maternal supplementation of, 125, 141, 232 mean daily intake of, 72-73, 221 nutrient density for, 221 RDA for, 221 recommendations on, 13, 16, 140, 141 Vitamin E amount in human milk, 116, 126, 215 biochemical values in lactating women, 57 colostrum, 126 estimated vs. recommended intake of, 227 and immune system, 138-140 increment in RDA for, 215 maternal intake and milk content of, 126 mean daily intake of, 72-73, 221 nutrient density for, 221 RDA for, 221 supplementation of, 126 Vitamin K amount in human milk, 116, 126, 215 colostrum, 126 deficiency in newborn, 156-157 increment in RDA for, 215 infant nutrition, 156-157 maternal milk intake and, 157

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Nutrition During Lactation maternal supplementation of, 126, 157 mean daily intake of, 221 nutrient density for, 221 RDA for, 221 supplementation at birth, 8, 16, 157, 180 W Weight infant at birth, 85-86, 89, 154-155 mother and milk volume, 5, 98-99 mother and successful lactation, 5 Weight changes of mother, during lactation, 14-15, 54-61, 74, 202-203 Weight for length, in breastfed vs. formula-fed infants, 162 Weight gain breastfed vs. formula-fed infants, 8-9, 16, 161-163, 179 mother during lactation, 14-15, 59 mother and milk volume, 98-99 parity and, 203 see also Obesity Weight loss, infant, 161 Weight loss, maternal amount of, 5, 6, 58, 59, 74 long-term, 203 mother and milk volume, 6, 93-94, 104 recommendations on, 14-15 Whey proteins, 121 White blood cells, in human milk, 119, 137 White mothers, breastfeeding rate and duration of, 32, 33 WIC, see Special Supplemental Food Program for Women, Infants, and Children (WIC) Work, see Employed mothers World Health Organization (WHO) recommendation concerning breastfeeding and HIV, 171 recommendation concerning breastfeeding and oral contraceptive agents , 90, 122 X Xanthine oxidase, in human milk, 139 Z Zinc absorption during lactation of, 225 amount in human milk, 116, 130, 217 biochemical values for, 53, 55 dietary sources of, 231 estimated vs. recommended intake of, 225 increment in RDA for, 217 infant nutrition, 160 margin of safety in RDA for, 224 maternal intake and milk content of, 130 mean daily intake of, 72-73, 223 nutrient density for, 223 preterm infants, 120 RDA for, 223 supplementation of, 130

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