The World Health Organization recommends breastfeeding for infants during the first six months of life. Despite this, many women wean their babies because of their perceived insufficient breast milk production. In many cases where mothers are concerned about their milk production they are encouraged to increase their fluid intake. The mother also needs water to meet her own needs. Water and all the constituents of body fluid are continually being lost in urine, stool and sweat and, therefore need to be replaced.
This review aimed to assess whether increasing fluid intake of breastfeeding mothers has a beneficial effect on breast milk production and infant growth. However, the review only identified one small quasi-randomised controlled trial (involving 210 women). The trial was of low quality and did not report on two of this review's important outcomes (satisfactory weight gain in the infant or duration of exclusive breastfeeding). The study did report on breast milk production (this review's other main outcome), but the data were not in a format that would permit further analysis in this review. The trial reported that advising women to consume extra fluids did not result in increased breast milk production, as measured by test feeds (also known as test weighing). In the 1950s, when the study was conducted, it was common for babies in developed countries to be weighed before and after a feed, known as test weighing or test feeding. However, this practice is not now routinely practiced for term infants due to concerns about lack of precision as a measure of breast milk production. The included study did not report any of this review's secondary outcomes: duration of any breastfeeding; mother's satisfaction with breastfeeding; hydration in mother; dehydration in the infant; or episodes of gastrointestinal illness.
The effect of additional fluids for breastfeeding mothers remains unknown, due to a lack of well-conducted trials. However, because the physiological basis for any such improvement remains unclear, the conduct of further clinical trials may not be a priority. There is not enough evidence to support an increased fluid intake beyond what breastfeeding mothers are likely to require to meet their physiological needs.
Ndikom, C.M.; Fawole, B.; Ilesanmi, R.E. Extra fluids for breastfeeding mothers for increasing milk production. Cochrane Database of Systematic Reviews (2014) Issue 6, Art. No.: CD008758. [DOI: 10.1002/14651858.CD008758.pub2]