Maternal protein-energy malnutrition and breastfeeding.

There is little scientific evidence supporting the existence of substantial effects of maternal nutritional status on lactation. Health workers should therefore not exaggerate the importance of diet during lactation, especially among first-time mothers who may be unsure of their bodies' ability to properly nourish newborn children. Despite the lack of evidence, however, health professionals and women commonly believe that maternal nutrition has a large effect upon lactation. This concern that poor maternal nutrition affects the infant has led to widespread agreement for feeding lactating mothers so that the breastfeeding infant in turn receives food. There are arguments for giving priority to lactating women in supplemental feeding programs. First, women should be targeted for the sake of their own nutritional status. Second, most lactating women will later become pregnant again, and improving their nutritional status may reduce the level of low birth weight, especially in cultures where women avoid eating more during pregnancy to avoid birth complications resulting from the delivery of large babies. It has been calculated that prenatal feeding is two-three times as cost-effective as pre-school feeding. The author also notes that many women are probably confused on the nutritional and economic issues involved and combine breast and bottle feeding in the attempt to get the best of both worlds. This practice is, however, harmful to both maternal and child health.