Summer Travel, Breastfeeding, and the PUMP Act: What Nursing Parents Need to Know

Summer is a season of family vacations, road trips, beach days, and travel adventures. For breastfeeding parents returning to work after the birth of a baby, summer can also bring unique challenges as they balance maintaining their milk supply while navigating airports, hotels, conference centers, and temporary work assignments.

Fortunately, recent federal protections have made it easier for many breastfeeding employees to continue providing human milk for their babies. The Providing Urgent Maternal Protections for Nursing Mothers (PUMP) Act expanded workplace protections for lactating employees and has important implications for working parents who travel during the summer months.

What Is the PUMP Act?

The PUMP for Nursing Mothers Act, commonly known as the PUMP Act, was signed into law in December 2022. The law expanded existing federal protections for breastfeeding employees by requiring most employers to provide:

  • Reasonable break time to express milk during the workday
  • A private space that is shielded from view and free from intrusion
  • Protection for millions of workers who were previously excluded from federal lactation accommodation laws
  • The ability for employees to seek legal remedies if employers fail to comply

Before the PUMP Act, many salaried workers had protections under the Affordable Care Act, but millions of employees—including teachers, nurses, agricultural workers, transportation workers, and many others—were not fully covered. The PUMP Act significantly broadened coverage, helping more families meet their breastfeeding goals.

Why Summer Travel Can Be Challenging

Maintaining lactation while traveling presents logistical hurdles even for experienced breastfeeding parents. Common concerns include:

Changes in Routine

Breastfeeding and milk production often thrive on consistency. Travel may disrupt normal feeding schedules, pumping sessions, sleep patterns, and meal times.

Long Flights and Layovers

Air travel can mean extended periods away from a comfortable pumping space. Delayed flights, crowded terminals, and unpredictable schedules may make it difficult to pump as frequently as needed.

Conferences and Business Travel

Many parents travel for work during the summer months. Conferences, training sessions, and off-site meetings can create challenges when finding appropriate times and locations for milk expression.

Hydration and Heat

Summer temperatures can increase fluid needs and contribute to fatigue. While hydration does not directly increase milk production beyond normal physiological needs, adequate fluid intake helps support overall maternal health and comfort.

How the PUMP Act Helps Traveling Employees

One of the most important aspects of the PUMP Act is that workplace lactation protections do not disappear simply because an employee is traveling for work.

If an employee is attending a conference, working at a temporary site, or participating in employer-sponsored travel, the employer generally remains responsible for providing reasonable break time and an appropriate pumping space.

This means that employers should make reasonable efforts to ensure nursing employees have access to:

  • Private lactation spaces at conference venues
  • Appropriate break schedules
  • Time to express milk during long meetings
  • Accommodations during work-related travel

Many conference centers, airports, and convention facilities now offer dedicated lactation rooms, reflecting growing recognition of breastfeeding families’ needs.

Here is a link to an article that can help mothers find these pumping pods at airports.

Air Travel and Breast Milk

Parents often worry about flying with expressed milk. The good news is that breast milk, infant formula, and feeding supplies receive special consideration through airport security procedures.

When traveling:

  • Inform security officers that you are carrying breast milk.
  • Breast milk may be transported in quantities greater than standard liquid limits.
  • Ice packs, freezer packs, and gel packs used to cool milk are generally permitted.
  • Review current transportation guidelines before travel, as procedures can change.

Many airports now provide lactation pods or nursing suites that offer private spaces for pumping or breastfeeding.

Tips for Protecting Your Milk Supply While Traveling

Plan Ahead

Before traveling, identify:

  • Airport lactation rooms
  • Hotel refrigeration options
  • Conference lactation facilities
  • Nearby locations where pumping can occur if needed

Maintain Your Pumping Schedule

Milk production operates on supply and demand. Attempting to maintain a schedule similar to your normal routine can help prevent discomfort and protect milk production.

Pack Extra Supplies

Consider bringing:

  • Extra pump parts
  • Additional milk storage bags
  • Cleaning supplies
  • Portable battery packs
  • Backup manual pumps

Unexpected travel delays are common during summer vacation season.

Learn to Hand Express (if you don’t already know)

This is another great reason to be sure you know how to hand express your milk. You can find information on hand expressing here.

Hand expression has no parts to pack and can be an easier way to maintain your expression schedule while traveling.

Know Your Rights

Employees should familiarize themselves with workplace lactation protections before traveling. Having a conversation with supervisors or human resources departments ahead of time can prevent misunderstandings and ensure appropriate accommodations are available.

Breastfeeding-Friendly Travel Benefits Everyone

Supporting breastfeeding employees is not simply a legal obligation—it is also good for families and workplaces. Research consistently demonstrates that breastfeeding is associated with improved maternal and infant health outcomes. When employees receive adequate lactation support, they often experience greater job satisfaction and are more likely to remain in the workforce.

The PUMP Act represents an important step toward recognizing that breastfeeding and employment can coexist successfully. As more workplaces, airports, hotels, and conference centers adopt lactation-friendly practices, traveling while breastfeeding becomes increasingly manageable.

Looking Ahead

Summer travel should be an opportunity for connection, professional growth, and family memories—not a source of anxiety about maintaining milk production. The protections established by the PUMP Act help ensure that nursing parents do not have to choose between their careers and their breastfeeding goals.

Whether you’re heading to a family reunion, attending a professional conference, or embarking on a summer vacation, preparation, knowledge of your rights, and access to supportive accommodations can help make the journey smoother.

Breastfeeding parents deserve the time, space, and support necessary to continue providing human milk for their babies and to continue their journies along the Milky Way—at home, at work, and wherever summer adventures may lead.

On being present, not perfect: compassionate communication in healthcare

It was over a decade ago that Elaine C. Meyer, PhD, RN, MBE, FSSH presented her TEDx Talk On being present, not perfect. Her message remains crucial, relevant, universal especially within maternal child health.

Image source. Used with permission.

Dr. Meyer’s powerful piece incorporates personal and professional examples which bring life to the importance of holding space for compassionate communication and difficult conversations in healthcare.

She notes the essential ingredients of these conversations: Courage, Brains, and Heart, a clever Wizard of Oz mnemonic, and she emphasizes that “Practice makes better”, not perfect, as alluded to in her title. 

Reflecting back, Dr. Meyer reports that we’ve accrued more awareness about these conversations. Compassionate communication is no longer a nice-to-have-it item; it has become an essential part of healthcare. Overall, Dr. Meyer has noticed that patients are more empowered, expecting this connection and level of care. Online rating tools have allowed for patients to evaluate providers specifically on their bedside manner.

Across the globe, On being present, not perfect has been incorporated into nursing and medical school curricula placing value on providers’ relational capacity early on in their careers. 

In a culture where health care providers are often massively stressed and burnout can be of real concern, Dr. Meyer makes clear that honoring conversation is not only of benefit to the patient. 

“… Being in relationship with the patient can be very fulfilling,” she begins. “This matters. At the end of day, a healthcare provider can say What I did matters. It can be the words that we speak, just being present, and showing up in all of your humanity. This doesn’t necessarily require extra time.” 

Take for instance the personal vignettes she shares in On being present, not perfect: a nurse who held her hand, squeezing back in reciprocity, an anesthesiologist who told her “I will be with you the whole time. I will watch over you. We’ll get you through this.” Simple yet profound, words and actions that sustained her during harrowing procedures. “Gestures of humanity,” Dr. Meyer calls them.    

What’s more, when this kind of respect and communication are established, patients have significantly better health outcomes and provider job fulfillment and retention increases. 

“If a clinician feels like I did a good job today, I connected, that buoys the clinician. The clinician feels more efficacious,” she explains. 

These conversations matter across the lifespan in any specialty, of course; however, the perinatal period is of special importance, because perinatal experiences have generational physiological and psychological implications. This time period influences the mother-child relationship for a lifetime.   

Having endured multiple pregnancy losses and IVF, Dr. Meyer shares that when her son was born, her initial focus on breastfeeding was primarily nutritional. 

“The connection and attachment that breastfeeding can foster wasn’t as much on my radar,” she says. “But after rising from the ashes of infertility, being able to nurse my baby boy was restorative and healing.” 

Though she and her son were not up against monumental feeding challenges, she consulted a lactation professional as a support person. She says this was immensely helpful to have someone who believed in her, someone joining her in the journey, someone to fortify what was important to her. 

As a provider, Dr. Meyer recalls a few highly distressing stories related to birth and infant feeding when she needed to show up with Courage, Brains, and Heart. She shares one in particular:  

There was a preterm newborn who was admitted to the Intensive care unit with severe birth complications and prolonged anoxia. The baby’s mother was determined and dedicated to breastfeeding her baby. The baby was unable to nurse because she was sustained on life support with a ventilator. Dutifully and with great care, the mother pumped her breastmilk and the baby received the milk through a small nasogastric tube. As a psychologist, I had the great privilege of meeting with the parents to listen to their story, to bear witness to their fledgling parenthood, and to offer support….Those were tender and difficult conversations. We held several family meetings with the team to help determine the baby’s treatment. Given the infant’s devastating brain injury, and poor prognosis, the parents and team agreed with the difficult decision to withdraw life support treatment. After the ventilator was withdrawn, the baby passed away peacefully in her mother’s arms with the father at their side. In a final act of love and dignity, as the parents left the hospital for the last time, the mother left a little bottle of breastmilk at the nurses’ station counter. Testament to a mother’s love, it was a most precious parting gift. The parent-child relationship transcends death. The lactation consultant offered ongoing education and support to the mother who went home without her baby- to pump for comfort and to stand in a warm shower with her back toward the shower head, so as to ease any discomfort. Courage, brains and heart….

As she concludes her Tedx Talk, Dr. Meyer offers some final inspiration: “Once upon a time you wanted to change the world. You still can, one conversation at a time.” 


Learn more about Dr. Meyer’s efforts here.  

 

Lactation and menopause

*This piece contains curse words. 

Conjunctivitis? Eczema? Diaper rash? Just put some breast milk on it. [Witkowska-Zimny, et al  2019]

[Source]
Breastfeeding is more than nutrition. Read our Breastfeeding is series to learn more about how breastfeeding is beyond what most people assume. Basically, breastfeeding and human milk are miracle elixirs, cure-alls!

Of course this isn’t entirely true. Read more about what we mean in A different angle and Still watching our language. Also check out Parts One and Two of Potential consequences of invoking ‘natural’ in health promotion. 

[Source]
Like Nikki Lee once analogized: “Human milk is not magic fairy dust. Human milk is nature’s seatbelt. A seatbelt does not guarantee survival in a car crash. We wear seatbelts because they increase our chances of survival…” 

Thanks to breastfeeding, my family and I survived infancy, toddlerhood, and beyond. 

Thinking back, my coffee dates were once accompanied by my nursing toddlers, their chubby little fingers cupping mini hot chocolates, scribbling with crayons, and chit-chatting with the elderly patrons; now, I spend more one-on-one time with friends at the coffee shop. With many of them quite a bit older than me, I am learning about their experiences going through menopause. It’s a new chapter.  One morning, I observed a dear friend breathe through hot flashes, her face flush, as she shed her vest and scarf, then bundled up again, then squirmed out of them, over and over throughout our visit. I sat there entirely helpless, but not entirely speechless. 

Breastfeeding. The magic elixir. The cure-all. 

Her eyebrow raised. 

I quoted Wenda Trevathan: 

“Why is menopause stressful? The short answer to this question is that it is not stressful for most women in the world, as far as can be ascertained by social scientists… Anthropologists Jane Lancaster and Barbara King propose that modern women may experience the end of ovulation under a different hormonal milieu from that of our ancestors and women in ‘natural fertility’ populations today. For example, !Kung women reportedly breastfeed their last infant for a longer time than for previous infants and when they terminate breastfeeding, perhaps in their mid-40s, they simply do not resume ovulation. Thus, the hormonal milieu of menopause includes the hormones of lactation (especially prolactin and oxytocin), which may modulate the effects of other changes…”  [Ancient Bodies, Modern Lives, 2010, p 168-169] 

Her brow remained raised. 

I offered: Christine R. Langton, MSW, MPH, et al, in Association of Parity and Breastfeeding With Risk of Early Natural Menopause, discovered an increase in parity decreased the risk of early menopause. What’s more, the authors note, “Breastfeeding was associated with significantly lower risk, even after accounting for parity. Breastfeeding at levels consistent with current recommendations may confer an additional benefit of lower risk of early menopause.” 

And then, Natalie V. Scime, et al found that “In a dose-response manner, longer lactation was associated with reduced risk of natural menopause before age 50 (for ≥ 13 months of lactation, adjusted hazard ratio at age 45: 0.68, 95% CI 0.59–0.78), surgical menopause before age 55 (age 45: 0.56, 0.50–0.63), and indeterminate menopause before age 50 (age 45: 0.75, 0.69–0.82). Longer lactation was associated with lower odds of surgical (adjusted odds ratio 0.54, 95% CI 0.45–0.66) and indeterminate menopause (0.63, 0.55–0.73), compared to natural menopause.” [2024]

So you see, it’s breastfeeding, breastfeeding is the answer. 

My friend was now not only struggling to regulate her body temperature, she was struggling to regulate her patience with me, because of course, this was all very interesting, but not relevant to her current challenges. 

And that’s when all of the rage we’ve both learned to suppress and breathe through and gratitude-journal and downward dog away came boiling out into a frothy fuck you to the medical-industrial complex, to the patriarchy, to anything that’s gotten in the way of women enjoying healthy, fulfilled existences.  

I was pissed because I know what the infant feeding landscape looks like in America and what this means for the future health of our offspring, ourselves, and our planet. She was pissed because she knows what it looks and feels like to get “care” during menopause (but really her entire lifespan) in America. So, basically, we were pissed, some might say hysterical, about the same thing.

We’re not the only ones. 

Brené Brown spoke with Dr. Mary Claire Haver, a board-certified OB/GYN, on the Unlocking Us podcast, and they too, are fired up about women’s health care. 

During all phases of our lives, we are considered emotional, dramatic, attention-seeking, imaginative (not in a good way), fragile, crazy over things that have major and long-lasting implications like family planning, birth, infant feeding, menopause. We are laughed at, dismissed, lied to, pitied… 

In Unlocking Us, Dr. Haver says: “There’s a reason why hysterical is a word and we don’t have testerical. And that has got to stop…” 

She goes on to explain: “I was taught that there’s a significant percentage of hyperemesis, now, this was in the ’90s, that is psychological. We were putting people on antipsychotics for hyperemesis. That has been completely debunked. We have found the receptor in the brain that is causing this. And I have to shout out to Shannon Clark, right in Galveston, who presented to the FDA, she’s done the most research on this.”

Dr. Haver compares this to current menopause care: “One of the most popular treatments for hot flashes that is being touted as, this is the route we should go, especially in Europe, is cognitive behavioral therapy. Which I love, for a multitude of things…

And Brown interjects: “I mean, I love too, but shut up and sit down.”

Dr. Haver continues sarcastically: “…cognitive behavioral therapy, if you just out think your hot flash, if you change your perception of your menopause…”

Dr. Trevathan wonders in Ancient Bodies, Modern Lives, “…does menopause have to be a ‘bad’ thing? This question derives from a fairly Western perspective that has pathologized the period of time when a woman is experiencing the physical and emotional transitions to a post reproductive state… It is often likened to diabetes as a disorder characterized by hormonal deficiency. In fact, menopause has been called an ‘estrogen deficiency disease.’” (p 161) 

Laurel Wilson has looked extensively at estrogen and its interplay with lactation and [peri]menopause. Find her work here. 

Trevathan goes on to offer  “Whether perceived as a medical ‘problem’ or not, the menopause transition is associated with a number of physiological changes that are experienced by women at this time and are usually explained by changes taking place in ovarian function. (p 163)   

Finally, she suggests: “The perspective of evolutionary medicine would argue that ‘returning’ to the lifestyles under which human reproduction evolved would alleviate some of the problems that women face today with menopause. Without taking the recommendations to extremes (no birth control, self-imposed undernutrition), it seems possible that by increasing exercise, reducing fat intake, and minimizing exposure to industrial biochemicals, women would experience fewer problems at menopause. In this way, adopting the behaviors and diets of our ancestors may go a long way toward not only reducing the stresses of menopause but prolonging healthy lives as well.” (p 169-70) 

So, like I said, breastfeeding is (at least part of) the answer.

Another installment of Weird Findings

In the era of the International Breastfeeding Conference, Cindy Turner-Maffei and Karin Cadwell would present their beloved Weird Findings segment on the last day of the conference. I always found it delightful and now wistfully reminisce about the session sometimes.

Photo by michael podger on Unsplash

One year, we learned about pink yak milk, spider milk, goat wet nurses and donkeys with “good moral reputations” with the alleged ability to cure distemper and poisoning. That year, I was also introduced to the jaunty tune “I’m a Mammal”.  It was all great fun, entertaining, and educational.  

This week’s post is another attempt at a Weird Findings collection, a nod to all that is quirky. I landed on quirky as the best word applicable to most of the items below, but quirky and weird are really just umbrella terms for those things that might also be totally awesome, maddening, unique, perplexing and all of the things in between and just outside of these descriptors. 

Tools and theories of the past 

First up is highly disturbing if you’re squeamish. The chainsaw originated as a tool to aid in childbirth.  

Toby Saunders reports that Scottish doctors John Aitken and James Jeffray designed a flexible saw “‘to be used when there is ossification…,’ according to 1785’s Principles Of Midwifery, Or Puerperal Medicine.

The crude chainsaw was designed to aid and speed up the process of symphysiotomy (widening the pubic cartilage) and the removal of disease-laden bone.

The flexible saw, which later became the osteotome … was used to cut away flesh, cartilage, and bone from the mother during childbirth if the baby became stuck in the birth canal.” 

Here’s one more article on the matter. 

Also disturbing, in Big Think’s Is consciousness an illusion? 5 experts explain, Melanie Mitchell, a professor at the Sante Fe Institute says that just several decades ago, many used to believe that infants didn’t feel pain, so there would be surgeries done on newborns without anesthesia (around 29 minutes). Thankfully, our understanding of how consciousness develops is expanding. 

In another glance back, Nikki Lee reports on aluminum cup baby mits. 

Lee writes: “My father wrote about remembering seeing his baby brother, born in 1933, wearing the same aluminum cups that he himself wore as an infant. 

According to Evan Michelson, star of the Science Channel series, ‘Oddities,’ the strange sounding devices were actually common in the early 20th century.

‘They would go over the hands and the lower part of the arm to prevent the babies from scratching themselves or others,’ Michelson said…

The metal balls make a weird clicking noise when banged together that Michelson admits would sound ‘creepy’ coming out of the nursery.” 

Also of decades ago, after reading The postpartum experience,  (which deserves its own Weird Findings segment in itself) Karin Cadwell shared, “When I had babies you went to your six week visit to get permission to drive again. Somehow, we thought using your feet on pedals would make your uterus fall out before six weeks!”  

These examples absurd, they are a good reminder to reflect on the products and practices we accept today but may one day wince at. In some ways, it might be argued that not much has changed. This essay by Katherine Harvey explores how “medieval parenting was full of familiar dilemmas…from mansplaining about breastfeeding to debates on developmental toys.”  

Our current, curious culture 

Co-sleeping, Bed-sharing, C position, Twins
Image courtesy of Rob Mank. https://www.basisonline.org.uk/co-sleeping-image-archive/

Brilliant ones are putting strange cultural practices of today into perspective.  For instance, while rooming-in, co-sleeping, and bedsharing are getting more attention in the public health space and beyond, the conversations are limited. I’ve noticed that the focus is typically 1. On infant safety and 2. Always quantified. That is, bedsharing is framed in terms of being inherently risky and its function mainly to make more milk and sleep more.  Elena Bridgers of Motherhood Until Yesterday wrote a beautiful piece about sleeping with her children with a different takeaway. Her sentiment is so relatable, so the Weird Finding here is that I have never read about bed sharing in this light with a focus on relationship.

Another glorious reflection comes from Valerie McClain in Fear of Falling. It’s commentary on how we approach learning to breastfeed.  

McClain writes:

“If we treated babies who were trying to walk like new mothers trying to breastfeed, how many babies would learn to walk? First we would tell babies that walking doesn’t matter. Walking isn’t important, so don’t feel bad if it doesn’t work out for you. Then we would tell babies that walking can be painful, and that is normal. Wheelchairs maybe needed for babies that fall down too much or are taking too long to learn how to walk. Babies will have walking classes in which an expert will explain the process of walking, the muscles involved, slides will be shown of the muscles used, and bright shiny wheelchairs will be part of the slide presentation. The expert will explain that she or he sells or rents wheelchairs, if you need them. The expert says that babies should try to walk; but not be surprised, if it doesn’t work out.”

The egg’s orbit 

Photo from Wild Moon Doula Facebook post: https://www.facebook.com/photo/?fbid=648174793962647&set=a.623112939802166

Next up is a shift in how we frame human reproduction. Kelsey McEuen aka Wild Moon Doula offers commentary on a 2020 study by Fitzpatrick, et al: “Human reproduction is commonly portrayed as a gigantic marathon swimming event in which the fastest, fittest sperm wins the race and prize of fertilising the egg. Yet another male dominated fantasy about the creation of life. The notion that human sperm once ejaculated, begin a frantic race to reach the egg has completely overshadowed the real story of reproduction…in fact there is a communication system between the EGG and sperm. The egg has the ability to repel certain sperm with a molecular mechanism causing them to swim slower and also attract certain sperm by releasing a chemoattractant helping them move faster. Cervical mucus called L- Mucus helps filter out any low quality sperm, Bye Boy!…Once SHE makes her choice and the sperm begins to penetrate the egg, the egg then releases a chemical response that causes all of the other sperm’s heads to pop off. Yep, mass decapitation. And to keep things in perspective, the male sperm is the smallest cell in the human body while the female egg is the largest, who run the world? #girls” 

Rachel E. Gross has written about the “Macho sperm myth” too. Gross writes spiritedly in Ovaries Are Prone to ‘Exhaustion’ and ‘Fatigue.’ Or Are They? : “…We now know that the vagina is no passive receiver but a muscular organ lined with billions of microbes that have likely evolved with humans over millenniums. Recent research has shown that the egg is no patient damsel but a dynamic cell that undergoes brutal competition and draws flailing sperm into its orbit…” More on female power here. 

Tissue and fluid as a commodity

High school students dissect human placenta. Read more at https://www.ourmilkyway.org/high-schoolers-explore-human-placenta-learn-about-physiological-birth/

The placenta is generally considered medical waste, though in certain groups like some Indigenous groups, the placenta holds sacred significance so rituals and ceremonies are performed around the organ.

This is a fascinating story about how placental tissue was used to heal a burn victim’s face. 

We’ve conjured up ways to use other human tissue; in this case for cosmetic reasons. 

In a similar vein, products made from cow colostrum tout the ability to boost immune/gut health. This bovine hormone secretion is nature’s intention for the calf, just as the colostrum human mothers produce is designed to protect the human infant.  

Hanna Nur Afifah Yogar explores the treatment of non-human animals in The Price of Animal’s Soul: Late-Stage Capitalism, Animal Welfare and the Law which relates to the collection and commodification of bovine colostrum. 

And Julie Bindel shares her perspective on the commodification of human milk in  An Example of Capitalism Literally Milking the Poor: “The trade in breast milk commodifies the unique bond between a mother and child. Profit is being made from a source of nourishment that even impoverished women have access to. Unless, of course, exploiters decide to put a price on it. The milk trade is a market in hunger and misery.”

Check out the book Commodifying Bodies to dive further into the topic.

Decorating bodies  

Over the summer, Great Big Story did a feature on a Deq tattoo artist and her tradition. The practice uses tattoo ink made from breastmilk and soot. Artist Fatê Temel explains that the mother must be nursing a girl because it is believed that “the blessing of a girl brings prosperity.” (around 1:56) Temel goes on to explain that the milk is thought to speed the healing of the wound.

Babies with attitude 

Finally, I’ll leave you with this chuckle-inducing video of newborn facial expressions

 

Seductive sugar

This time of year, it’s especially easy to succumb to our Stone Aged craving for sugar.  Colorfully marketed candies and chocolates whisper seductively from stocked store shelves, then make their way into behemoth Halloween treat bags bursting at the seams. 

Global Health Media Project, an organization we first featured back in 2015, just released their fourth animated film made in collaboration with Yoni Goodman, Story of Sugar. 

The animation warns of the “harmful effects of sugar and processed food, helps people understand the risks of diabetes, and shows those at risk the lifestyle changes that can lead to better health.” 

Global Health Media Project offers many other beautiful, informative videos including more on diabetes and nutrition. Check them out here and here. The organization just announced that the Public Broadcasting Corporation of Jamaica will be broadcasting The Story of Sugar followed by the entire live action video series on diabetes.  

Infants’ food preferences are shaped first in their fetal state through amniotic fluid and subsequently through the milks fed to them. Whereas breastfed babies are exposed to the dynamic flavors of their culture, infants fed artificially are exposed to static flavors. Read more in Breastfeeding is flavor learning. 

The mother infant dyad’s health outcomes are enmeshed in other ways. Dana Dabelea’s, MD, PhD work exploring gestational diabetes (GDM) has shown that GDM diagnosis increases the risk of diabetes and obesity in a mother’s offspring.  Dabelea and colleagues studied fuels that feed the growing baby, such as fats of various types and sugars, all of which come through the placenta and umbilical cord to nourish the fetus. 

“It turns out that fatter babies –measured with an instrument called the PedPod®– had mothers with higher glucose levels during pregnancy, even if these levels were still considered in the “normal” range,” she reports. “We followed the offspring and looked at what influence postnatal feeding had as well. It turns out that breast-feeding for at least 6 months largely reverses the effects of GDM on fatness in children…” 

Read more in Parts One and Two of National Childhood Obesity Month: the links between infant feeding and obesity and in Internist, diabetologist reflects on infant feeding’s role in diabetes outcomes.

Against public health cries, commercial milk formula companies market toddler milks which are unregulated and  “can contain more calories from sugar than an adult chocolate milkshake, researchers found.” [Taylor, 2024] 

In timely fashion, Baby Milk Action reports that  “an important proposal by the EU and Switzerland to ask the Codex Committee on Methods of Analysis and Sampling CCMAS to consider validating a method for taste-testing baby formulas for sweetness did not get approved. Although strongly supported by many governments the proposal was stymied by four major exporters, the USA, Australia, Canada and New Zealand, who prioritised their fast-growing baby formula markets rather than take this opportunity to protect child health. Along with the International Special Dietary Foods Industries (ISDI) they claimed the tests would be too laborious, expensive and not validated.” 

Photo by Batang Latagaw on Unsplash

Earlier in the year, a Public Eye joint investigation revealed how “Nestlé adds sugar to its infant milk and cereal products in developing countries but not in European markets…” [Syed, 2024]  Find more about this expose here. 

Unsurprisingly, companies like Nestlé own hundreds to thousands of brands across most countries, many of them sugary beverage and candy brands.  

A market saturated by these ultra-processed foods (UPFs) including artificial baby milks has contributed greatly to the obesity epidemic in the United States and other countries. In response to this health crisis, we’ve seen an increase in the use of artificial sweeteners. 

Philip O. Anderson’s How Sweet It Is: Sweeteners in Breast Milk summarizes current knowledge regarding the transmission of sweeteners into human milk. 

Dr. Anne Eglash of the Milk Mob points out in her Clinical Question of the Week: 

There is preliminary research evidence that a maternal diet high in fructose may increase body weight and fat mass in breastfed infants. When mothers consume foods or beverages high in fructose, the level of fructose rises in breastmilk. This is not true for glucose, because maternal insulin rapidly normalizes the maternal glucose level after glucose ingestion. Insulin does not moderate the fructose level like it does for glucose.

And increasing sweetness of breastmilk via artificial or natural sweeteners in the maternal diet might predispose to later obesity. This may be partially mediated by an alteration in the gut microbiome by the sweeteners.

Similar to the increase in alternative sweeteners, varying diets that limit sugar intake have become particularly popular. 

“The ketogenic diet is a weight loss strategy involving a diet that is high in fat, adequate in protein, and very low in carbohydrates,” Dr. Eglash explains in another Clinical Question of the Week. “By eating low carbs, the body is forced to break down body fat for energy, causing a rise in blood and urinary ketones.” 

When blood ketones become too high, blood pH becomes too low, resulting in a sometimes life-threatening condition called ketoacidosis. 

While an average non-lactating individual on a keto diet probably wouldn’t reach a high enough level of blood ketones to become dangerous, lactating women are at a higher risk for ketoacidosis because of the energy expenditure required by lactation, Dr. Eglash continues. 

She concludes: “Based on the cases in the literature, it would seem wise to advise breastfeeding mothers to avoid a strict low carb diet, particularly in situations of very high energy demand, such as if she is exercising heavily, donating extra milk, or nursing multiples.” 

Photo by Luiza Braun on Unsplash

Human milk sugars tell a different story than the kind you find on the shelves at the supermarket. Vanderbilt University assistant professor of chemistry Steven Townsend and colleagues’ work, Sugars in Breast Milk Help Babies Ward Off Infection, shows that the complex sugars (called human milk oligosaccharides or HMOs)  in human milk appear to provide a growth advantage for good bacteria. 

Townsend notes, “…breastfed infants have a microbiome rich in two species of bacteria: Bacteroides and Bifidobacteria. Both species are symbiotes, meaning they live with us on a daily basis, but typically cause no harm. They live in the human gut where they use human milk oligosaccharides as energy sources to grow, whereas pathogens do not.” 

Moreover, their work demonstrates that HMOs prevent the growth of Group B strep and have antibiotic properties against a number of additional pathogens, including staph.Townsend and colleagues found that different women produce HMOs with varying levels of antibiotic activity.

More on sugar 

For an interesting historical perspective on the sugar industry, check out Throughline’s 400 Years of Sweetness. 

Public Health England finds Snacks for babies contain ‘unacceptable’ amounts of sugar

Dietary Guidelines should be led by science—not politics

How sugar affects the brain video