On the basis of a comprehensive literature review and analysis, Nutrition During Lactation points out specific directions for needed research in understanding the relationship between the nutrition of healthy mothers and the outcomes of lactation. Of widest interest are the committee's clear-cut recommendations for mothers and health care providers.

The volume presents data on who among U.S. mothers is breastfeeding, a critical evaluation of methods for assessing the nutritional status of lactating women, and an analysis of how to relate the mother's nutrition to the volume and composition of the milk.

Available data on the links between a mother's nutrition and the nutrition and growth of her infant and current information on the risk of transmission through breastfeeding of allergic diseases, environmental toxins, and certain viruses (including the HIV virus) are included. Nutrition During Lactation also studies the effects of maternal cigarette smoking, drug use, and alcohol consumption.

Contents

• SUBCOMMITTEE ON NUTRITION DURING LACTATION
• COMMITTEE ON NUTRITIONAL STATUS DURING PREGNANCY AND LACTATION
• FOOD AND NUTRITION BOARD
• Preface
• 1. Summary, Conclusions, and Recommendations
  • Origin Of This Study
  • Approach To The Study
  • What Was Learned
  • Conclusions And Recommendations
  • References
• 2. Introduction
  • Purpose And Scope
  • Methods
  • Organization Of This Report
  • References
• 3. Who Breastfeeds in the United States?
  • History Of Breastfeeding In The United States
  • Current Statistics For Breastfeeding In The United States
  • Determinants Of Breastfeeding Distribution
  • Conclusions
  • References
• 4. Nutritional Status and Usual Dietary Intake of Lactating Women
  • Assessment Of The Nutritional Status Of Lactating Women
  • Usual Dietary Intake During Lactation
  • Conclusions
  • Recommendations For Clinical Practice
  • References
• 5. Milk Volume
  • Measurement Of Milk Volume
  • Normal Range Of Milk Intake And Production
  • Breast Development And Physiology
  • Infant Factors Influencing Milk Production And Transfer
  • Maternal Factors
  • Conclusions
  • Recommendations For Clinical Practice
  • References
• 6. Milk Composition
  • Characteristics Of Human Milk
  • Methodologic Issues
  • Origin Of Milk Constituents
  • Maternal Nutrition And The Composition Of Human Milk
  • Constituents Of Human Milk With Other Biologic Functions
  • Summary
  • Conclusions
  • Recommendations For Clinical Practice
  • References
• 7. Infant Outcomes
  • Infant Nutrition: Vitamins And Minerals
  • Growth And Development
  • Breastfeeding And Morbidity
  • Breastfeeding And Mortality
  • Medications, Legal And Illegal Drugs, And Environmental Agents
  • Conclusions
  • Recommendations For Clinical Practice
  • References
• 8. Maternal Health Effects of Breastfeeding
  • Short-Term Health Effects
  • Long-Term Health Effects
  • Conclusions
  • References
• 9. Meeting Maternal Nutrient Needs During Lactation
  • What Are The Nutritional Demands Of Lactation
  • Can Nutrient Needs During Lactation Be Met By Usual Dietary Intake Alone
  • Food Guidance For Lactating Women
  • Conclusions
  • Recommendations For Clinical Practice
  • References
• 10. Research Recommendations
  • Recommendations That Focus Primarily On Nutrition
  • Recommendations That Focus On Nonnutritional Factors Influencing Breastfeeding
  • Recommendations That Focus Primarily On Growth And Health
  • References
• Appendixes
  • Appendix A Detailed Abstracts of Studies in Industrialized Societies Relating Breastfeeding with Infant and Child Mortality
  • Appendix B Detailed Abstracts of Studies in Developing Societies Relating Breastfeeding with Infant and Child Mortality
  • Appendix C Summary of Composition Data for Macronutrients of Human Milk
  • Appendix D Biographical Sketches of Committee Members
• Acronyms
• Glossary

This study was supported by project no. MCJ 116011 from the Maternal and Child Health Program (Title V, Social Security Act), Health Resources and Services Administration, U.S. Department of Health and Human Services.

"This study was supported by project no MCJ 116011 from the maternal and child health program (Title V, Social Security Act), Health Resources and Services Administration, U.S. Dept. of Health and Human Services"—T.p. verso.

NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance.

This report has been reviewed by a group other than the authors according to procedures approved by a Report Review Committee consisting of members of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine.

The Institute of Medicine was chartered in 1970 by the National Academy of Sciences to enlist distinguished members of the appropriate professions in the examination of policy matters pertaining to the health of the public. In this, the Institute acts under both the Academy's 1863 congressional charter responsibility to be an adviser to the federal government and its own initiative in identifying issues of medical care, research, and education. Dr. Samuel O. Thier is president of the Institute of Medicine.