Breast milk has always been touted as the healthiest option for babies. Indeed, it contains just the right amount of nutrients for the little one, not to mention immune boosters that keep her from getting sick. So it’s almost unthinkable that the very milk that mom produces might not be nutritious enough for the baby.
However, it is possible, although very unlikely. And to understand how this works, it’s important to know about just how breast milk is produced.
Milk is made by the mammary gland, a collection of specialized tissue within the breast. There are numerous milk-production sacs called alveoli, located within these glands. Milk produced in the alveoli then travel through the mammary ducts before they are released in the nipple.
The mammary glands produce milk by signalling to the body that certain nutrients are required. When the body receives this signal, it is obliged to comply, sometimes at the expense of the mother. You see, breast milk production is a high-priority for nutrients. Sometimes the body will take nutrients at the expense of the mother, just to ensure that there’s enough of it in the milk. Hence, even moms on low-nutrient diets can produce nutritious milk.
However, there are many factors in play as well. This mechanism may vary between moms, so there are rare cases in which the body will prioritize the mom’s health over breast milk, especially when she’s not getting enough of a certain nutrient.
This means that the very best measure for whether breast milk is providing enough nutrition or not is to look at both the baby’s and the mom’s health. Here are fifteen warning signs that might make mom want to check with the doctor as to the nutrition in her milk.
15 Baby Not Gaining Weight
For many parents, the first noticeable sign of the lack of nutrition in breast milk is when the baby fails to gain weight. Of course, just because the little one doesn’t gain weight for a period of time doesn’t mean that this is automatically due to the breast milk. Sometimes the failure to gain weight is due to other factors. Even babies have normal periods of no weight gain, which are then followed by growth spurts. Failure to gain weight may also be the result of an illness or perhaps a stressful life event.
Make sure, however, to tell the doctor about this, as he can diagnose the condition with further testing. Usually, the breast milk will be considered only when all other causes have been ruled out. This is because, as we’ve said earlier, the likelihood of this happening isn’t huge. Nevertheless, it’s still important to keep track of the little one’s weight.
14 Baby Losing Weight
Not gaining weight is one thing, but losing it outright is another. If the little one isn’t getting enough nutrition, her body is going to turn to her own fat deposits for energy. The burning of these fat deposits will result in weight loss, something that can be unhealthy as the baby’s fat helps keep her warm. But again, it’s important to distinguish this nutrition-related weight loss from normal weight loss. During the first week of life, for instance, the little one is likely to lose up to 10 percent of her body weight. This is perfectly fine if the lost weight is regained within two weeks, perhaps a little more for premature babies.
Again, it’s best to consult the doctor about any worrying weight loss. As this may also be the result of illness or stress, all other possibilities will need to be ruled out as well.
13 Sickly Baby
When a baby is not getting enough nutrition from breast milk, she might get sick more often. As such, a little one who is frail and sickly might need to see the doctor, especially when the illness is accompanied by weight loss. Of course, most illnesses are independent of breast milk itself. It’s just that the chance of getting them increases when there isn’t enough nutrition. In fact, the spread of infectious disease is often high among people who do not receive adequate nutrition, as in during a famine.
In particular, when there isn’t enough protein in the milk the body fails to produce immunoglobulins and other important hormones that regulate the immune response and fight infection. In addition, if there isn’t enough potassium in the diet, certain immune cells may not be activated when there is an infectious intruder in the body. However, this also makes it necessary to determine whether the vulnerability is caused by low-nutrition breast milk or another condition altogether.
12 Developmental Delays
Most parents have the developmental milestones printed out or on an easily accessible file on their cell phone. We all know the drill: at two months she’ll smile and turn her head to sounds, at four she’ll babble and reach for toys, at six she’ll have stranger anxiety and respond to her name, and so on. However, babies who are not hitting these milestones may have nutritional problems. After all, nutrition is what the little one’s body actually uses for body and brain development. Failure to get certain nutrients may physically prevent the little one from building the muscle or the brain tone to do certain tasks.
Of course, as with all other symptoms, there could be other reasons that the baby isn’t hitting the milestones. Some babies are just late bloomers, after all, and just because she hasn’t taken her first step at nine months doesn’t mean she has a problem. On the other hand, certain illnesses can also cause developmental delays. Again, it’ll take a doctor to diagnose exactly what’s wrong.
11 Low In Energy
Babies who don’t get enough nourishment tend to be weak and low in energy. This is especially if they don’t get enough calories. While it is normal for babies, particularly newborns, to sleep for long periods of time, these malnourished babies sleep a lot and are almost limp during their waking hours. Some of them may even have an odd, weak cry. Do note, however, that it is unlikely for most babies to reach this stage, even with breast milk that is low in nutrients.
This typically happens in babies of women in extremely disadvantaged communities, who have low breast milk output aside from having milk with poor nutrition. This lack of energy, in fact, is a symptom of marasmus, a condition where there is severe malnutrition to the point where the child’s body fat and muscles begin to waste away. Children with marasmus may also look older in appearance than they are, due to the muscle wasting patterns.
10 Low Urine Output
One early sign of lack of breast milk nutrition is a low urine output. This is particularly when there isn’t enough fluid in breast milk, typically when mom is dehydrated. It may be difficult to notice this, as diapers tend to absorb liquid and it isn’t always obvious how much fluid is in the diaper. Meticulous parents might want to weigh their baby’s diapers, but sometimes it is possible to compare the weight of diapers by the feel of it.
This symptom usually comes with poor skin turgor (or lack of “snap” to the baby’s skin) and sunken fontanels. However, low urine output could also be the result of a kidney problem or a gastrointestinal infection, especially when there is also vomiting and diarrhea. In any case, dehydration is a serious problem in infants. Whatever the reason, it is best to take the little one to the doctor if dehydration is suspected.
9 Few Bowel Movements
As with urine, the less nutrients the baby takes in, the less she’s probably going to excrete as feces. If the little one is having fewer bowel movements than usual, take notice. It’s also important to note any changes in her bowel patterns. Make sure to tell the doctor during her next checkup. If it comes with weight loss, however, an immediate appointment must be made.
Of course, there are several factors to the little one’s bowel movements. Changes in bowel patterns may occur when the little one is being introduced to solid food, or if she’s taking in occasional feedings of formula for the first time. Typically, babies who drink formula or take solids have darker, more solid poop than those who exclusively breastfeed. Dehydrated babies may also poop less, but considerably more firm stool, as their bodies try to absorb as much water in it as possible.
8 Irritable Baby
Babies who don’t get enough calories may initially be irritable. This is in pretty much the same way that any adult will get moody and irritable if they go hungry. This is because the brain is among the hungriest consumers of glucose, the sugar which is the main source of the body’s energy. Deficiency in glucose understandably makes the brain unable to produce neurochemicals that regulate the mood. Because of this irritability is also a major symptom in children with problems related to malnutrition, such as marasmus and kwashiorkor. We’ve already talked about marasmus, which is a result of general calorie deficiency. Kwashiorkor, on the other hand, is due to a deficiency in proteins, which are the other building blocks to those mood-regulating neurochemicals.
However, irritability due to other factors can be difficult to pin down as well. Babies can be irritable when they’re teething or when they’re colicky, for instance. It’s important to take other symptoms in consideration before concluding that this is due to breast milk.
Speaking of kwashiorkor, a condition which is rare in most of the Western world, one of its symptoms include edema, with possibly a bulging fluid-filled tummy. This is because protein, particularly a variety called albumin, also helps regulate the flow of body fluids. A sufficient amount of protein in the blood helps keep fluids within the blood vessels, instead of having it seep out into the interstitial space between the cells. In moms with breast milk that is severely deficient of protein, however, the fluid remains in these spaces, giving the little one a puffy, swollen appearance.
This type of malnutrition is highly unlikely in most breastfeeding babies, however. And it’s most commonly found in the most disadvantaged of communities. Edema is also associated with other conditions, so it’s always best to confirm the source of the problem, especially when it’s not always visually apparent whether there is enough protein in the milk or not.
6 Cold Temperature
As we’ve discussed earlier in this article, the baby’s body fat functions to help maintain a proper temperature throughout the body. This is especially important since babies, being small, have a larger surface area compared to adults. They can therefore lose heat and experience hypothermia much faster. Babies who have less body fat, due to it being burned for bodily fuel, therefore have trouble staying warm.
They will feel cold easily, which is dangerous if the little one is left without adequate swaddling. Not only can the little one experience hypothermia, she may begin to shiver to bring up body temperature. Sadly, shivering brings about the consumption of extra calories, which can make the malnutrition problem even worse. It is, of course, important to address the cause of lack of nutrients, as well as to provide the baby with just the right amount of warmth to keep her from shivering.
5 Mom Is Losing Too Much Weight
In the beginning, we discussed the main reason why nutritional deficiency in breast milk is unlikely: it’s because the process of milk production takes nutrients from mom’s body by hook or by crook. A good sign of whether mom may not be taking in enough nutrients for the little one is when she’s losing way too much weight. Granted, of course, that breastfeeding moms should expect to lose some weight during the course of nursing. However, a rapid decline may signal that there aren’t enough nutrients in the diet. In particular, low intake of healthy fats can result in lower-quality breast milk.
Needless to say, breastfeeding isn’t exactly the right time to go on that crash diet. While mom may be excited to lose all that weight that she’s put on during pregnancy, it’s still best to take it slow. After all, adequate nutrition is still best for baby and herself. So a balanced, nutritious meal is still the best option over one that restricts nutrients.
4 Mom Is Dehydrated
One of the key components of breast milk is, of course, water. It’s essential that mom drinks enough water to replenish the fluids that are being lost in breast milk production. Of course, the average woman who drinks when she is thirsty is at low risk for this. However, women who spend long periods of time without drinking water, or who engage in strenuous physical activities may end up getting dehydrated. In the short-term, this may not have any adverse effect on the baby. The symptoms are more likely to appear in mom first, which she should recognize as a cue to carry along a container of water.
If mom consistently doesn’t drink enough water, however, chances are that the little one will get dehydrated as well. Granted, of course, that this is far more common in areas of the world where water supply is short, especially when mom contracts a diarrheal illness.
3 Not Enough Sun Exposure
One of the common nutrient deficiencies in babies is that of vitamin D. Since babies below six months old aren’t advised to have too much sun exposure due to the dangerous ultraviolet rays, breast milk is one of their major sources of this vitamin. However, if mom doesn’t get enough sun exposure either, this can lead to a single nutrient deficiency. Those living in parts of the world that don’t get enough sun during winter are at particular risk for this.
This is one of the reason why it’s healthy for mom to take early morning walks, as well as eat foods that are rich in vitamin D. Foods rich in vitamin D include green, leafy vegetables, fatty fish, cheese and egg yolks. If possible mom must consume any of these in moderate amounts to ensure that the little one gets what she needs. If these are not accessible to her, then supplementation may be necessary.
2 Teeth Problems
One manifestation of vitamin D deficiency is teeth problems. This is because vitamin D is essential in bone development and teeth are pretty much just pieces of bone. The teeth of babies with this deficiency will therefore have weak tooth enamel, the hard, protective outermost layer of each tooth. As a result, vitamin-D deficient babies may experience teething quite late and it might be an even more painful process, as the surface of the tooth is blunt and may have trouble getting out of the gum. Once the teeth have come through, they’re also at increased risk for dental caries.
It’s important to tell the doctor of tooth problems so that any deficiency can be determined accordingly. If vitamin D deficiency in breast milk is, indeed, the cause of the problem, the doctor will recommend adequate dental care, as well as vitamin supplementation. Left untreated, this can result in painful infections or deformities.
1 Stunted Growth
Babies not getting enough nutrition in their milk may experience stunted growth. This is distinct from weight problems in that it results in a distinct failure of the little one to grow in length. This is because some of the nutrients necessary to build additional tissue is not available, and so the baby’s body is unable to develop further. This can occur with general nutrient deficiency, although it can also pop up in babies who are deficient in vitamin D, as their bones can no longer grow in length. These kids may therefore be significantly short for their age, even when taking in consideration the normal height for their family.
There are, of course, other causes for stunted growth that must be ruled out before blaming it on the breast milk. These include metabolic conditions or genetic conditions that keep the body from producing the hormones that regulate growth. It’s important to consider these as well to ensure that the little one gets adequate treatment and is able to grow to her full potential.