The nurse is teaching a new mother about diet and breastfeeding. Which instruction is most important to include in the teaching plan?

• A. Avoid alcohol because it is excreted in breast milk.
• B. Avoid spicy foods to prevent infant colic.
• C. Increase caloric intake by approximately 500 calories/day.
• D. Double prenatal milk intake to improve Vitamin D transfer to the infant.

Answer: (A)

Alcohol easily passes into breast milk in concentrations similar to the mother’s blood. Because an infant metabolizes alcohol much more slowly than an adult, even modest amounts can affect the baby’s sleep, feeding cues, and overall development. That’s why the most important message for breastfeeding teaching is to avoid alcohol while nursing. If drinking cannot be avoided, plan to refrain from breastfeeding until the alcohol has cleared from the mother’s system, which is typically about 2 to 3 hours for a standard drink, and consider pumping ahead if necessary.

Spicy foods do not have a proven link to infant colic, so avoiding them specifically to prevent colic isn’t necessary. For lactation, many healthy mothers need about 500 extra calories per day, but this is a general nutrition guideline and not a safety measure for the infant. Vitamin D transfer to the infant isn’t increased by doubling prenatal milk intake; infants should follow pediatric guidance on vitamin D supplementation.