Diet for Breastfeeding Mothers
If you ‘re breastfeeding, you ‘re giving your baby nutrients that will promote his or her growth and health. You might have questions, however, about what foods and drinks are best for you – and how your diet might affect your breast milk and your baby.
Breastfeeding has many health benefits for both baby and mother. Breast milk is not only a food source but contains immune-related components and various biologically active substances that contribute to efficient nutrient utilization and gives the child active and passive protection against infections.
After birth, you will probably be about 3-4 kg over your pre-pregnant weight. Don’t try to lose weight immediately – since these stores are used to make breast milk. Breast milk production itself demands a lot of energy – so breastfeeding will help you to get back to a normal weight. The principles of healthy nutrition recommended for pregnancy apply also during breastfeeding.
Energy requirements for women who breastfeed are proportional to the quantity of milk produced.
Well-nourished women who exclusively breastfeed gradually increase their milk production from 700 cc/day to 850 cc/day at 6 months. This correlates with the gradual increase of the mean human milk intake for exclusively breastfed infants from 699 cc/day at 1 month to 854 cc/day at 6 months.
The recommended energy intake during the first 6 months of lactation is an additional 500 kcal (equivalent to an extra meal). This recommendation is based on the assumption that 170 of the additional 500 kcal/day will be used from energy stores (fat) accumulated during pregnancy. Energy stored during the pregnancy period will be used to accommodate milk production.
Carbohydrates are a major energy source and should make up 55% of the total caloric intake. Mothers who consume a low carbohydrate diet may experience fatigue, dehydration, and energy loss. Lactating women should consume a minimum of 100 gm/day of carbohydrates from whole grain bread and cereals, fresh fruits, and vegetables.
Proteins are broken down and replaced as an energy source when there is a low supply of dietary carbohydrates. Proteins, which help build muscle tissues, enzymes, hormones, and antibodies, are made up of amino acids. All the essential amino acids are found in animal sources; protein from plant sources may be low in the essential amino acids. Complete proteins, such as meat and fish, can be mixed with incomplete proteins, such as cereals and legumes, to provide adequate amounts of the essential amino acids. For example, rice, which contains all the essential amino acids but not in optimal quantities, can be mixed with meat or fish to provide adequate amino acids for protein synthesis.
Fats facilitate the absorption and transport of fat-soluble vitamins A, E, and D. Of the total calories consumed daily, no more than 30% should be from fats. Saturated fats (primarily from animal sources such as milk and meat) should supply no more than 7% to 10% of calories. Ten percent should come from polyunsaturated fats (vegetables sources, nuts, and seeds), and more than 10% from monounsaturated fats. The long chain polyunsaturated fatty acids, docosahexaenoic (DHA), help promote optimal development of the infant’s central nervous system. An excellent source of DHA is fish oil, and women who consistently eat fish have higher levels of the fatty acid in their milk.
The recommended energy intake during the first 6 months of lactation is an additional 500 kcal (equivalent to an extra meal).
Recommended dietary guidelines for vegetarians during lactation are lacking. Vitamin D supplements are recommended for women who do not drink milk or other food fortified with vitamin D. A vitamin B12 supplement (2.6 μg/d) is also recommended for women who consume ovolactovegetarian and vegan diets. Another recommendation is to consume 1200-1500 mg/day of calcium because of the possible decreased intake and absorption from a plant-based diet. The FDA recommends similar precautions regarding avoiding higher mercury fish during lactation. Adverse neonatal effects have not been demonstrated with ordinary maternal fish consumption during breastfeeding.
It is recommended that the overall weight gain for twin pregnancies is 35 to 71 lbs, with an average gain of 1.5 lbs/week during the 2nd and 3rd trimesters. Mothers of twins need an extra 150 kcal/day during pregnancy and an extra 500 to 600 kcal/baby/day while lactating. A breastfeeding mother of multiples will use a combination of reserves stored during pregnancy and then increased intake during lactation.
This article highlights those nutrients and gives you tips and ideas around healthy eating.
Sources of omega-3 with DHA include:
– Fatty fish – salmon, rainbow trout, herring and sardines (all low mercury)
– Omega-3 eggs fortified with DHA
– Milk, fortified with DHA
– Omega-3 soy beverage with algae
– DHA-enriched omega-3 margarine
– Fish oil and algae supplements
Vitamin D: To get enough vitamin D in your diet:
– Drink two cups (500 milliliters) of milk each day.
– Eat fatty fish (e.g., salmon) twice a week.
– Use non-hydrogenated margarine in place of butter.
– Choose yogurt or other foods that have vitamin D added.
Folic acid (Folate):
Along with a healthy diet, take a multivitamin containing 0.4 milligrams of folic acid daily. Good sources of folate include:
– Dark green vegetables
– Legumes (e.g., beans, lentils)
– Enriched products (e.g., white flour, pasta, cornmeal)
Breastfeeding women usually need more water compared to women who are not breastfeeding. Drink based on your level of thirst but avoid forcing water down. Drinking too much water can lower your milk supply.
In addition to water, milk, fortified soy beverage, and lower-sodium broth-based soups are all good choices. Small amounts of 100% fruit or vegetable juice can also be enjoyed. Whole vegetables and fruit are high in water content so be sure to include seven to eight food guide servings each day too.
Vitamins are classified as either water or fat soluble. Water-soluble vitamins (B complex and C) move easily from serum to milk. Therefore, levels of these vitamins in milk are raised or lowered depending on changes in the maternal diet. Vitamin B-6 is essential in the development of the neurological system. Lactating women whose dietary intake of vitamin B-6 is low are at risk of secreting milk that has a less than adequate supply of this vitamin. Symptoms of vitamin B-6 deficiency include dermatitis (skin inflammation), glossitis (a sore tongue), depression, confusion, and convulsions. These signs occur during
later stages of deficiency when intake has been very low for an extended period of time. Foods such as pork and eggs are the richest sources of vitamin B-6. Additional sources are cereal bran, oatmeal, and legumes.
Fat-soluble vitamins (A, D, E, and K) are stored by the body in fatty tissue. Thus, levels of these vitamins are less easily improved by the dietary change. Rickets is an example of extreme vitamin D deficiency. Vitamin D is synthesized in the skin from the ultraviolet B light fraction of sunlight. However, individuals with darker pigmentation or women who use sunscreens excessively can decrease the vitamin D synthesis. Breastfed infants of mothers with inadequate vitamin D stores need a regular supply of vitamin D.
Minerals such as calcium, zinc, and magnesium are most likely to be deficient in a lactating woman’s diet, and the additional requirement for calcium is 400 mg daily above the normal levels of 1,200 mg/day. Dietary sources of calcium can be found in dairy products and green leafy vegetables. Levels of magnesium and zinc in human milk are not increased by maternal diet.
Some women at Risk for Inadequate Nutrition During Breastfeeding
Maternal Weight Loss
Lactating women who initiate a weight loss and exercise program may be at risk for developing nutritional deficiencies owing to the increased metabolic demands of exercise, lactation, and energy restriction. The nutrient of concern is vitamin B-6, which has been found to be below the RDA of 2.0 mg in lactating women. Women who restrict their food intake to lose weight may thereby decrease their vitamin B-6 intake. In addition, women who exercise frequently may increase vitamin B-6 utilization and excretion in the urine. When assessing breastfeeding mothers prior to providing nutritional education, it is important to inquire about their weight perception and determine if the mother is planning on exercising or dieting. If she is, she should be informed of the risk of vitamin B-6 deficiency and encouraged to maintain an adequate amount of vitamin B-6 in her diet. Vitamin B6 is found in a wide variety of foods. The richest sources of vitamin B6 include fish, beef liver and other organ meats, potatoes, and other starchy vegetables, and fruit (other than citrus).
Get enough of these nutrients
Omega-3 fats: Omega-3 fats, especially docosahexaenoic acid (DHA), help your child’s growth and development. Experts suggest eating at least 200 milligrams of DHA per day. You will get this amount if you eat at least two food guide servings (for a total of five ounces) of fatty fish per week.
In addition to the 400 International Units of vitamin D supplement needed for breastfed babies, you may need a vitamin D supplement if you:
– Have dark skin
– Don’t drink milk or fortified soy beverage
– Get minimal sun exposure due to long articles of clothing
Vitamin B12: Sources of vitamin B12 include:
– Milk, cheese, yogurt, fortified soy or almond beverage
– Meat (e.g., beef, fish)
If you aren’t eating or drinking the above sources, you may need to take a vitamin B12 supplement.
Be cautious of these nutrients
Trans fats: Since unhealthy trans fats are transferred through your breastmilk, limit or avoid them in your diet. Foods that are made with partially hydrogenated oils should be avoided.
Sources of trans fats may include:
– Shortening or margarines, or products made with them
– Packaged breaded foods
– Packaged snacks such as crackers and cookies
– Bakery products such as cakes, donuts, pastries, muffins, and croissants
Read the nutrition facts label and compare products. If a product lists that it has trans fat (even as little as 0.5 grams per serving) or that it is made with partially hydrogenated oil, choose a different product.
Mercury: Mercury is an environmental toxin found in most fish. Too much mercury can harm your health and your baby’s development.
Avoid high-mercury fish including fresh or frozen tuna, swordfish, orange roughy, pickerel, sea bass, shark and tilefish. Instead, choose fish that are lower in mercury (e.g., salmon and herring).
Sweeteners: Products made with sweeteners usually offer little nutrition. The following sweeteners are safe to use in moderation:
– Acesulfame potassium (Sunett™)
– Aspartame (NutraSweet™, Equal™)
– Sucralose (Splenda™)
Avoid the following sweeteners while breastfeeding:
– Cyclamates (Sugar Twin™)
– Saccharin (Hermesetas™)
Herbs and herbal teas: You may have heard that some herbs increase breastmilk production, but these recommendations are not supported by clinical studies.
Many herbs may be unsafe while breastfeeding. Before you take any herbs or herbal teas, check with your health care provider about the safety
Caffeine: Limit your caffeine intake to 300 milligrams per day. Since caffeine passes into your breastmilk, high amounts of caffeine can cause your child to become irritable and have trouble sleeping.
* Drink water, milk and fruit juices as needed.
* You need to eat more than usual to replenish energy that is lost through breastfeeding.
* Energy is essential, so eat regularly to increase your food intake and meet all your nutritional needs.
* Keep your intake of empty-calorie foods to the minimum and eat more nutrient-dense foods.
* Plan your meals well and use the food pyramid as a guide in selecting your daily foods. Include plenty of fresh fruit, vegetables, milk and milk products, fish, poultry, nuts, whole grains, parboiled rice, beans, and lentils