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Pregnancy

Pregnancy is a unique time in a woman's life filled with new experiences, heightened excitement, mixing emotions, and significant physical changes. It's also a time filled with many unanswered questions.
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The following links provide much of the basic and more complex, yet essential information that can assist the mother-to-be in her quest for a smooth uncomplicated pregnancy and a healthy baby.

Chiropractic Care and Pregnancy

Regular chiropractic care is an integral part of the prenatal and postpartum care during pregnancy. It helps keep mom feeling good and assists her in coping with the physical stresses of an ever changing body.

Neuromuscular and Biochemical Changes During Pregnancy
During pregnancy, most women experience a number of neuromuscular and biochemical problems which respond favorably to gentle, safe, noninvasive chiropractic care. These include:

  • release of the hormone relaxin causes muscle and ligament relaxation

    • allows joints to more easily misalign
       

  • increased weight gain

    • increased demand and fatigue on spinal and pelvic muscles

    • increased stress on spinal and pelvic ligaments

    • increase in lumbar and thoracic spinal curves which further increase the above

    • increased joint stress and thus occurrence of vertebral and sacroiliac joint misalignments
       

  • change in weight distribution

    • increased demand and fatigue on spinal and pelvic muscles

    • increased stress on spinal and pelvic ligaments

    • increase in lumbar and thoracic spinal curves which further increase the above

    • increased joint stress and thus occurrence of vertebral and sacroiliac joint misalignments


The above changes primarily affect the pelvic and spinal ligaments, muscles, joints and other supportive soft tissues. These changes cause sprain/strains of pelvic and spinal structures, as well as alteration of the normal spinal curvatures and spinal biomechanics. The result is an increased stress on the body leading to pain and discomfort.


Chiropractic Treatment of the Neuromuscular and Biochemical Problems
Doctors of chiropractic can alleviate the uncomfortable symptoms arising from the muscular, ligamentous, and biomechanical stresses encountered during pregnancy. We accomplish this through the use of a number of highly specialized procedures and techniques:

  • Gentle Spinal Adjustive Procedures - specifically designed for use in the pregnant female

    • assist in maintaining a spine free from vertebral misalignments and fixations - optimizing spinal biomechanics

    • keep pelvis and spine in correct position/posture

    • assist in pain relief by (1) reflexively reducing pain levels, and (2) reducing spinal and pelvic stresses which produce soft tissue pain

    • keep tissues and biomechanics functioning optimally to minimize complications during birth
       

  • Therapeutic Exercises and Stretches - safe for use during pregnancy

    • keep spinal musculature strong, balanced, and pain-free

    • enable spinal muscles to maintain the spine and body in a neutral, correct posture

    • keep mom active and mobile
       

  • Soft Tissue Work - massage, trigger point work, soft tissue mobilization, etc.

    • keep muscles relaxed and flexible

    • reduces bouts of muscle aches and pains

    • reduces spinal stress
       

  • Dietary and Nutritional Counseling - unique to the pregnant mother

    • prevent neural tube and other birth defects

    • increase the chances for a healthy baby

    • assist the mother in maintaining optimal energy levels

    • keep mother happy and healthy during stressful periods
       

  • General Pregnancy Information - general info on pregnancy

    • answer mother's questions

    • improve mother's health

    • optimize birthing process

    • enhance baby's health



Frequently Asked Questions


Is Chiropractic Care Safe During Pregnancy?
Chiropractic care during pregnancy is safe for both mother and fetus. Spinal adjustments are especially gentle during pregnancy as far less force is required to correct restrictions. This is due to the increase in hormones causing significant muscle and ligamentous relaxation. Special "adjustive" positions are also used to provide comfort and safety for both mom and fetus.

How Often Should I Receive Chiropractic Care During My Pregnancy?
The frequency of care varies for a number of different reasons. Typically, regular care during a non-complicated pregnancy will range from once per week to once per month.


Chiropractic and Pregnancy Scientific Studies
'Low Back Pain During Pregnancy'
In this study, researchers identified the sacroiliac joints of the pelvis (frequently "adjusted" by chiropractors) as being responsible for the majority of low back pain cases in pregnancy. This is due to the significant number of hormonal and biomechanical changes occurring in the pelvis during pregnancy. Researchers found 7/10 women were helped by spinal manipulation in this study.

  1. Bery G, Hammar M, Moller-Nielsen J et al. Obstet and Gynecol, 72:71-75, 1988.


​TextBook on Chiropractic & Pregnancy
According to Dr. Fallon, author and internationally recognized "chiropractic pediatrician", statistics from her office "have demonstrated that chiropractic adjustments effectively reduce the average amount of time spent in labor." Her data shows a nearly 25% reduction in the average labor times in those receiving chiropractic care versus the generally accepted average labor time - in women who had given birth in the past, there was a 33% reduction in average labor time.

  1. Fallon J. International Chiropractic Association. 1994 - Arlington, Virginia.

Back Pain and Pregnancy

Common Causes of Back Pain During Pregnancy

Back pain is the most common soft tissue complaint pregnant women generally encounter. There are a number of reasons for this, including:

  • increased ligament laxity due to the release of the hormone relaxin

  • increase in weight gain and forward weight bearing

  • poor body mechanics and postural habits

  • ribcage enlargement increasing rib restrictions

  • nerve and vascular impingement from mechanical pressure

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The above factors increase the frequency of vertebral restrictions, muscular spasms, soft tissue pain and altered spinal biomechanics - all of which respond exceptionally well to regular chiropractic care.

What Can You Do?

Spinal Adjustments
Spinal adjustments are safe, natural treatments chiropractors use to successfully manage soft tissue abnormalities in pregnancy. The adjustments are used to treat muscular, ligamentous, joint and neurological problems of the neck, back, pelvis and extremities. They help alleviate pain originating from the spinal and pelvic regions, reduce muscle spasm and tightness, correct biomechanical stresses, and keep the nervous system free from irritation and impingement. Chiropractic spinal adjustments are a safe and successful adjunct to any prenatal care program.


Soft Tissue Work
Muscles frequently become fatigued, irritated, spasmed and achy during pregnancy for the reasons previously mentioned. Chiropractic doctors utilize various soft tissue techniques such as trigger point work, soft tissue mobilization and massage to keep muscles relaxed, healthy, and functioning optimally.


Stretches and Exercises
Therapeutic stretches and exercises are an excellent way to keep the pregnant body flexible, strong and mobile. Chiropractic doctors utilize these therapies to assist the muscles in coping with the increased demands caused by the sudden weight gain and change in weight distribution - which fatigues and irritates unconditioned muscles. Keeping the pregnant body strong and flexible increases comfort and improves the likelihood of having a successful pregnancy.


Proper Body Mechanics and Postural Practices
Sudden weight gain and altered weight distribution also lead to a number of improper postural and biomechanical habits. Improper postural and mechanical habits further increase spinal and pelvic stress which increase tissue irritation and produce frequent bouts of pain and discomfort. Chiropractors focus on teaching proper postural habits and body mechanics to minimize stress on the body, minimize the risk of injury and keep mom functioning optimally and without discomfort throughout her pregnancy. To see the proper standing posture, click here or continue to scroll down.


Special Orthopedic Supports
Certain orthopedic supports and other products may be beneficial during pregnancy. This includes orthotics for the feet and certain orthopedic belts specifically designed for pregnancy (i.e. maternity belts, trochanter belts, etc.)

Prenatal Care

Chiropractic adjustments quicken recovery time and assist the body in normalizing overall pelvic and spinal biomechanics. Prenatal care during pregnancy assists mom in having a successful pregnancy and birth. It keeps mom and baby healthy and provides mom with needed physical and emotional support.


The Birthing Plan
Developing a birth plan plays an important role during the prenatal period. It is a written plan which outlines the wishes and wants of the mother in relation to procedures to be followed and actions to take during the prenatal period, during the birth and postpartum. The more detailed and specific the birth plan is, the more likely a successful outcome will be achieved. The following list includes many of the points which should be addressed and determined early on in pregnancy:

  • Choice of caregiver

    • obstetrician

    • certified nurse-midwife

    • lay midwife
       

  • Other Practitioners

    • chiropractor

    • pediatrician

    • massage therapist

    • acupuncturist
       

  • Birth Venue

    • hospital birthing room/chair delivery room

    • home

    • birthing center
       

  • Prenatal care

    • frequency of visits (primary care giver & chiro care)

    • what do you do at visits
       

  • Prenatal testing

    • ultrasound frequency - abdominal vs. transvaginal (should always be performed by an ultrasonographer)

    • amniocentesis

    • CV sampling

    • alfa-feto protein tests - to identify neural tube defects

    • non-stress test

    • other blood tests
       

  • Levels of activity during the pregnancy

    • working outside the home

    • working in the home

    • other children

    • exercise
       

  • What is your view on:

    • anesthesia during birth

    • what is your c-section rate

    • how do you feel about vaginal birth after cesarean

    • how do you feel about childbirth classes

    • how do you feel about nursing

    • how do you feel about testing in women over 30
       

  • Labor

    • how long to stay home before attending birth venue?

    • how long can I labor before intervention?

    • when would pitocin be used?

    • level of monitoring during labor

    • IV

    • what positions can I assume?

    • how mobile can I be?

    • can I eat?

    • under what circumstances would a c-section be performed?

    • would you deliver a breech vaginal?
       

  • Medications during labor

    • epidural

    • anesthesia

    • IV drugs
       

  • Birth

    • can siblings be present?

    • can my husband/labor support person be with me the whole time?

    • how long can I push?

    • what signals will you have to do a c-section?

    • can I hold the baby directly after the birth before weighing etc.?

    • will you be there the entire time?

    • how often do you do an episiotomy?
       

  • Postpartum

    • can the baby room-in?

    • who can visit the baby?

    • what will the baby eat immediately after birth?

    • can I begin to nurse immediately?

    • frequency of visits?

    • which pediatrician will see the baby?

    • when can we go home after the birth?

    • given a c-section, how long will I be in the hospital?

    • should something be wrong with the baby, what type of services does the hospital offer?

  1. Fallon J. TextBook on Chiropractic & Pregnancy. International Chiropractic Association. 1994 - Arlington, Virginia.



Regular Chiropractic Adjustments
Regular chiropractic adjustments play an integral role in the prenatal and postpartum periods. The adjustments help counter the effects of increased weight gain, altered weight distribution, and excessive ligament laxity. This keeps the spinal and pelvic regions healthy, biomechanically sound, and minimizes soft tissue irritation and discomfort.


Proper Diet and Nutrition
Maintaining a complete nutritious diet accompanied with supplementation is critical for mom's health and the health of the developing fetus. Making appropriate nutritional choices during pregnancy can be confusing but your chiropractic doctor can help guide you. Also, additional supplementation of prenatal vitamins and minerals is crucial; such as folic acid to prevent neural tube defects in your child.

Pregnancy requires an additional 300 calories per day in order to maintain metabolic homeostasis. Thus, those exercising should pay close attention to ensure adequate nutritional intake.


Exercise / Physical Activity Program
Except in special cases, mild to moderate physical activity and exercise during pregnancy is not only safe, but has been shown to be beneficial.

Kegel Exercises:
Kegel exercises are extremely important for the pregnant woman. They function to improve and maintain pelvic floor muscular tone which is vital during pregnancy and delivery. These exercises are best initiated early in pregnancy and continued throughout the term of the pregnancy. This ensures that during the delivery process the pelvic musculature is able to withstand the changes taking place during labor. They're also important in decreasing the likelihood of tearing during delivery as well as the later development of hemorrhoids.

These exercises are performed by squeezing the muscles of the pelvic floor. This is done by contracting and holding the same muscles used to start and stop urination in midstream.

Exercise In Pregnancy Is Safe (For Mother and Fetus):
A recent study published in the American Journal of Obstetrics and Gynecology finds that women who exercised prior to their pregnancy can continue to do so without negatively affecting the fetus' growth or the pregnancy itself. According to the researchers, "Our results indicate that healthy and well-conditioned women may take part in exercise during pregnancy without compromising fetal growth and development as judged by birth weight or complicating the course of pregnancy or labor." Forty-two women participated in either a medium or high intensity exercise program throughout their pregnancy, including 6 weeks postpartum. The women exercised 6 times per week, participating in strength, interval and endurance training. All 42 women had been physically active prior to the pregnancy.

Overall, researchers discovered no differences between the high and medium intensity exercise groups in terms of labor, fetal birth weight, or the health of the infant immediately after birth. The researchers did note that women who exercised more gained more weight during pregnancy and went into labor earlier if they had a girl.

  1. American Journal of Obstetrics and Gynecology 1998;178:280-286.


Exercise may protect against miscarriage:
A study from the journal Epidemiology indicates that women who continue to exercise regularly during their pregnancy have a 40% lower risk of having a miscarriage of a chromosomally normal fetus compared with those who do not exercise. In the study, researchers interviewed 346 women who had suffered a miscarriage, asking them about exercise and other habits during their pregnancy. From these interviews, researchers were able to determine that exercise, such as swimming, jogging and aerobics, reduced the risk of miscarriage of a chromosomally normal fetus, but other physical activities such as housework, childcare or employment did not have this protective effect.

According to researchers, "The protective effect of exercise, but not of other forms of activity, may arise from the sustained aerobic nature of exercise; exertion during employment, housework and childcare is often sporadic." Of the women interviewed, approximately 25% claimed to have exercised during their pregnancy.

  1. Epidemiology 1999;10:6-7, 73-75.


Athletes Can Work Out During Pregnancy:
According to a case report in The Lancet, a 33 year old distance runner continued to exercise intensely throughout her pregnancy and gave birth to healthy twins, without complications. Throughout the woman's pregnancy, she ran an average of 66 miles per week with a heart rate of 130-140 beats per minute up until 3 days prior to giving birth. The researchers did warn that women who were inactive prior to their pregnancy would have to be more cautious.

  1. The Lancet 1998;351:1182



Soft Tissue Work
Soft tissue work includes massage, trigger point work, soft tissue mobilization, and other soft tissue procedures. These techniques assist in keeping muscles and other tissues relaxed and flexible while reducing bouts of muscle aches and pains.

Complications in Pregnancy

Bell's Palsy
​This condition involves a sudden onset of painless loss of facial muscle function. Lowering the eyebrows, closing the eye or pursing the lips is not possible. Patients may also experience a loss of taste in the anterior 2/3rd's of the tongue as well as pain posterior to the ear. While this condition has currently no known cause, many believe that vertebral restrictions are at least partly responsible.
Bell's palsy is 3 times more common in the pregnant women. Hormonal changes increasing water retention, grimacing during labor and delivery, as well as ligamentous laxity are primarily responsible. In the typical presentation, the woman awakes with a painless inability to operate the facial muscles on one side of the face. This typically occurs during the 3rd trimester. The condition tends to improve over the course of many weeks to months, depending on it's severity. Many studies have shown favorable results with chiropractic care.


Brachial Neuralgia
A large collection of nerves, the brachial plexus, from the cervical spine descend into each arm to provide sensory and motor innervation. Again, due to increases in hormonal factors, parts of the nerve plexus may become impinged or irritated. This results in radiating arm pain and may also be associated with neck pain or stiffness. Restoring cervical biomechanics and eliminating cervical restrictions is performed by the chiropractor to eliminate cervical stress and radicular symptoms.


Breast Cancer
Breast cancer is occurring earlier and earlier in women. Breast cancer occurs in approximately 1 out of every 3,000 pregnancies. It's important to have a breast examination prior to pregnancy or early on in the pregnancy to check for its presence and establish a baseline if present.


Carpal Tunnel Syndrome
Carpal tunnel syndrome, commonly associated with repetitive wrist movements, is also increased during pregnancy. This is because of hormonal changes which increases water retention, leading to increased pressure on the median nerve as it passes through the 'carpal tunnel' in the wrist, hence the name. Symptoms include numbness and tingling of the hand and fingers as well as achiness in the forearm and neck. Chiropractic adjustments applied to the cervical and wrist regions can help eliminate inflammation and quicken resolution. Additionally, vitamin B6 supplements have been shown to assist in eliminating the symptoms of carpal tunnel syndrome.


Coccydynia
This condition simply refers to a painful coccyx. The coccyx bone is located on the end of your sacrum or tailbone and can become irritated and painful in pregnancy. This is especially evident in the final trimester due to the position of the baby and the lack of room for the baby to maneuver. Manual adjustment of the coccyx is often required and can be safely and successfully performed by the chiropractor.


Ectopic Pregnancy
An ectopic pregnancy occurs when implantation and subsequent development of a fertilized ovum is outside the uterus. This most commonly occurs in a fallopian tube. As the embryo develops the fallopian tube is unable to expand like the uterus and can eventually rupture. Symptoms include cramp-like or stabbing pain in the lower abdomen. In 75% of the women vaginal bleeding will occur. This is a serious condition as acute internal hemorrhaging may occur leading to possible death.
Certain factors can increase the likelihood of ectopic pregnancies including:

  • prior IUD use

  • prior pelvic or tubal infection (certain STD's)

  • tubal abnormalities



Headaches
Most headaches experienced during pregnancy are muscle tension headaches. These headaches are soft tissue and biomechanical in nature and respond excellent to chiropractic care. Fortunately for migraine headache sufferers, migraines are rare during pregnancy as hormones released counteract the processes involved that normally cause migraines.


Intercostal Neuralgia
Hormonal changes during pregnancy lead to the relaxation of ligaments and joint capsule which include the joints of the ribs. Additionally, increased weight gain increases the pressure on the rib cage. These two factors lead to increased rib restrictions and increased in intercostal nerve irritation. Chiropractors adjust the rib heads to alleviate nerve irritation and restore normal positioning of the rib heads.


Meralgia Paresthetica
This condition is a result of pressure on the lateral femoral cutaneous nerve which provides sensation to the skin of the upper lateral thigh. Increased abdominal weight and pressure as well as an increased lumbar curvature tend to place additional pressure in the area of the nerve which leads to pain, numbness and tingling in the area of the lateral upper thigh. Chiropractors commonly treat this condition successfully.


Sciatic Neuralgia
This common condition is a result of increased pressure on the large collection of nerves in the lower back. Symptoms include back pain with symptoms of pain, numbness and/or tingling radiating down the buttock and leg(s). There are also other causes of this condition which include sacroiliac joint dysfunction, lumbar disc syndrome, lumbar facet joint irritation, and vertebral restrictions. Chiropractic care is especially effective in treating sciatic neuralgia as the treatment directly addresses the cause.


Teratology of Drugs and other Substances
It's vital that all women who believe they may be pregnant or who are pregnant be 100% sure not to consume any drugs which may lead to birth defects or complications. It is estimated that 2-3% of all birth defects are drug-induced. One problem is damage to the embryo can occur early on prior to the woman knowing she is even pregnant. Vital systems such as the heart and nervous system develop in the embryo weeks after conception and are extremely susceptible to toxins such as drugs and alcohol.
Some common substances and drugs that can produce adverse effects on the growing embryo/fetus include:

  • Artificial Sweetener - Aspartame

  • Caffeine

  • Aspirin

  • Smoking

  • Antihistamines

  • Antibiotics

  • Recreational Drugs (marijuana, cocaine, etc.)

  • Antidepressant Drugs

  • Antiepileptic Drugs

  • Acne Drugs - accutane

  • Cardiovascular Drugs



Toxemia of Pregnancy - Eclampsia
This fatal condition can develop in the 2nd half of pregnancy and has no known etiology, although some believe it results from poor nutrition. In the early stages (pre-eclampsia) signs include high blood pressure (hypertension), protein in the urine (proteinuria), and excessive edema (not always present). If eclampsia develops, the following may develop:

  • epilepsy

  • subarachnoid/cerebral hemorrhage

  • preexisting brain tumors may fulminate

  • uremia

  • liver failure

  • placental necrosis

  • glomerular (kidney) and tubal necrosis



Complications During Birthing Process

Insufficient Power
Sufficient power and coordinated contractions are essential for a smooth uncomplicated labor. When the power of the contractions are weak or the pattern of contractions disorganized, the mother is more likely to become exhausted. This can cause fetal distress resulting in fetal harm and/or c-section. The following are causes of insufficient power or improper contractions:

  • disordered uterine action

  • colicky uterus

  • constriction ring - Bandl's ring

  • rigid cervix

  • edematous cervix

  • annular detachment



Passage Obstruction

Passage way obstructions (pelvic, uterine, cervix, etc.) can complicate the birthing process. These include:

  • tumors

  • cysts

  • fractures

  • flat male-like pelvis (android)

  • physiological changes (degenerative joint disease, tuberculosis, rickets, osteomalacia)



Baby Malpositions
Malpositioning of the fetus can lead to abnormal birth presentations. Some of the more common malpositioned birth presentations include:

Upside Down Presentation - This presentation occurs in approximately 13% of births and involves a presentation where the baby presents in an "upside down" or "sunny side up" position. If the baby does not turn to the proper position or turns late, the newborn will generally develop "cone head". This position also produces what is known as "back labor".

Breech Presentation - In a breech presentation, the feet or buttock present first as opposed to the head. This presentation occurs in about 1 out of every 40 births. Possible complications can be serious and include:

  • intracranial bleeding

  • neck dislocation

  • shoulder dislocation

  • hip dislocation

  • clavicle fracture

  • internal organ disruption

  • genital edema

  • premature placental rupture

  • prolapsed cord

  • uterine rupture


Face Presentation - Face presentation occurs approximately every 3,000 births. In this presentation, the baby presents face first with the neck in extension. Causes include a lax uterus, flat pelvis, multiple fetus, anencephaly, or neck spasms of the fetus.

Shoulder Presentation - The shoulder presentation occurs in every 200-300 births and involves a "shoulder first" delivery. The causes include:

  • twin birth

  • hydramnios - excess of amniotic fluid

  • placenta praevia - part of the uterus presents before the fetus due to placental malposition

  • multiparity - a women who has had 3 or more children

  • sub-septae uterus

  • unusual fetal shape

  • undue mobility of the pelvis



Forceps Delivery
In the event there is fetal or mother distress, or the labor is not going as planned, forceps assistance may be used. As forceps can cause a number of problems, forceps should only be used in absolutely necessary situations. The following injuries can result from improper/inappropriate forceps use:

  • skull fractures

  • birth marks

  • doctor-induced torticollis

  • brachial plexus damage



Cesarean Section
Although c-sections were becoming very popular a short while back, experts now recommend avoiding this procedure unless the mother or fetus are in extreme distress. This is due to the invasiveness of the procedure and unnecessary stresses placed on the baby. The indications for cesareans are:

  1. placenta praevia - part of the uterus presents before the fetus due to placental malposition

  2. fetal distress

  3. maternal distress

  4. failure for labor to progress

Postpartum

Chiropractic Care For Mother
After giving birth the woman once again undergoes many changes. Hormonal levels normalize, tissues shrink, and bones and joints shift. Throughout the pregnancy and birthing process, the woman's body has undergone many stressful events and some type of recovery/rehabilitation to reach pre-pregnancy state should be sought. Failure to restore normal biomechanics and tissue health can result in future problems in health and with future pregnancies. Chiropractic adjustments quicken recovery time and assist the body in normalizing overall pelvic and spinal biomechanics.


Chiropractic Care For Baby
Birth is generally a traumatic event for the baby. However, most newborns do not need chiropractic care. If you suspect something is wrong consult with your OB/GYN and a chiropractor who specializes in pediatrics to see if any treatment is necessary.


Exercise/Weight Loss Program
A common complaint after birth is the excessive weight gained by the mother during pregnancy. While some women do not find it difficult to shed the extra pounds gained during pregnancy, this is generally not the case for most women. Beginning a weight loss and/or fitness program not only improves the mothers health and fitness levels, but also helps mothers deal with the increased energy and psychological demands of raising a family. Many chiropractors find weight loss and health programs an integral part of the treatment program.


Baby's Nutritional Requirements

Breast Feeding vs. Formula
It's important for the new mother to understand the significance breast milk has on their baby's health. A great number of studies have consistently shown babies fed breast milk (compared to formula) are significantly healthier with a much lower incidence of sickness from various infections and diseases.

Breast Feeding Reduces Infant Illnesses
A recent study has shown that breast feeding significantly reduces the occurrence of common infant illnesses such as respiratory tract infections, pneumonia, ear infections, and gastrointestinal disorders. In the 2 year study of 977 babies, a community program was implemented which urged women to breastfeed their infants rather than use baby formula. The program resulted in a significant increase in breastfed babies - 54.6%, up from 16.4%. During this time, the number of babies who developed pneumonia in the first year of life declined by 33% and the cases of gastroenteritis decreased by 15%.

According to researchers, their results suggest that "breast milk itself or the process of breast feeding provides protection against infant illnesses." The American Academy of Pediatrics recommends that mothers breastfeed their babies for at least one year, "and longer if mutually desired by the mother and child."

  1. Pediatrics 1998;101:837-844.


Breast milk is better for premature infants
Experts believe breast milk contains a number of immune-boosting compounds which "jump-start" the infants immune system and assist the infant in fighting off infections. In this study, researchers found that preterm infants fed breast milk developed significantly fewer infections. 212 preterm, very low birth weight infants (under 3 pounds) were fed either breast milk or formula. After adjusting for all other factors, researchers determined that infants fed breast milk decreased their odds of infection by 57% - a dramatic decrease. Also, many immune system agents normally found in breast milk are in higher concentrations in the breast milk of mothers who deliver prematurely compared with mothers who delivery at term.

The American Academy of Pediatrics has long advocated the use of breast milk as the primary food source of newborn, full-term infants. In 1997, this advisory was extended to cover premature infants.

  1. Pediatrics Electronic Pages 1998;102:e38.



Iron
According to the American Academy of Pediatrics, women should breast feed until at least 1 year of age and should not feed infants under 1 year cow's milk. Doing this can lead to a deficiency of iron. However, most baby formulas now contain added iron to prevent this from occurring.


Vitamin A
Vitamin A (retinol) is available in liquid form and is also added to most baby formulas. Occasional supplementation in infants and children is recommended if deficiency is suspected. Research has shown a single dose of 100,000 IU (International Units) in children under 12 months of age and 200,000 IU in children over 12 months of age can reduce the risk of death from measles and, according to a study on Brazilian children, can help treat severe diarrhea.

  1. Butler JC, Havens PL, Sowell AL, et.al. Measles severity and serum retinol (vitamin A) concentration among children in the United States. Pediatrics 1993;91:1176-1181.

  2. Barreto ML, Santos LM, Assis AM, et. al. Effect of vitamin A supplementation on diarrhea and acute lower-respiratory tract infections in young children in Brazil. Lancet 1994;322(Jul 23):228-231.



Vitamin B's
Vitamin B is passed to the fetus and to the baby (via breast milk) by the mother. Thus, if the mother is deficient so to can the baby become deficient. In the case of mothers with vitamin B deficiencies (more common in vegetarians and vegans), supplementation may be necessary for mother and child.


Vitamin D
Vitamin D is another vitamin in which there may be a deficiency. Generally, a deficiency is most common when the mother is a vegetarian and/or lacks adequate sun exposure. In both cases, supplementation of the mother and infant is recommended. Also, mothers who breastfeed may spend 15 minutes in the sunlight daily to increase their vitamin D levels.


Vitamin K
In some infants and neonates, including those with certain malabsorption disorders, vitamin K deficiency may occur. This can lead to unexpected hemorrhagic disease (bleeding). Often, babies are give intramuscular vitamin K shots at birth to prevent this condition.


Zinc
​Zinc deficiencies can occur in infants whose mothers are deficient in zinc or if there exists a problem with zinc uptake from the mammary glands in the mother's breasts. Zinc deficiencies are also common in premature infants and children with malabsorption syndromes. Zinc deficiencies are generally not found in infants who breastfeed, assuming the mother is not deficient. Signs of deficiency include:

  • skin lesions (appear as diaper rash or candida)

  • diarrhea

  • growth failure

  • alopecia (baldness)

  • irritability

  • anorexia

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