Which statement best reflects the most important instruction to include in breastfeeding diet teaching?

• A. Avoid alcohol because it is excreted in breast milk.
• B. Spicy foods should always be avoided to prevent infant colic.
• C. Calorie needs do not change during lactation.
• D. Vitamin D transfer to the infant is increased by doubling prenatal milk intake.

Answer: (A)

Alcohol in the breastfeeding diet is the key issue because alcohol passes into breast milk in amounts similar to what's in the bloodstream, and an infant’s immature liver metabolizes it slowly. This can affect the baby’s sleep, feeding cues, and overall feeding pattern, so the most important instruction is to avoid alcohol while nursing or limit it very carefully. If you do drink, plan ahead: share a drink before nursing or wait about 2–3 hours per standard drink before the next feeding; pumping and discarding milk isn’t a guaranteed way to protect the baby because alcohol clears from the milk as it clears from the blood.

Other statements don’t reflect best practice: spicy foods are not universally harmful to all babies, and many infants tolerate them; lactation does increase energy needs (roughly several hundred extra calories per day); and vitamin D transfer into breast milk isn’t reliably increased by higher maternal intake—the infant should receive a vitamin D supplement regardless of maternal diet.