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Nutrition for Breastfeeding Moms

with Vearle Avni, IBCLC Lactation Consultant & Midwife

Dr Jack Newman, Paediatrician and the world’s much loved breastfeeding guru says …”Breastfeeding is a relationship over and above a feeding method. Breastfeeding should never be expendable. Only under extraordinary circumstances should breastfeeding be interrupted. It is too important to the physical and mental health of the child and the mother for them to give it up the way one might give up ice cream.”

So considering what is healthy for moms, breastfeeding has many immediate and longterm benefits for mom’s health too, such as helping prevent postpartum hemorrhage and help the uterus remain contracted after delivery promoting uterus involution. Breastfeeding lowers your risk of breast cancer, ovarian cancer and osteporosis, while helping you lose weight gained during pregnancy. Breastfeeding provides positive psychological benefits too for both you and your baby. So let’s look at the nutritional requirements for breastfeeding moms to successfully breastfeed and enjoy this peace of mind.

You’re overwhelmed with joy and yes, elated exhaustion too after the birth of your baby. That tiredness that seeps deep into your bones is indescribable, only understood by another mama. It’s important that you keep yourself well nourished so that you can recoup your strength but also to assist your body in producing adequate milk. Unfortunately certain birth practices and some medical conditions can delay milk arriving. If you experience this please speak to a Lactation Consultant. Although a woman’s body will nearly always produce enough milk to feed her baby, being adequately nourished does improve the quality of milk as well as help your energy levels.

Colostrum, produced from about 16 – 22 weeks of your pregnancy is uniquely perfect and full of all the nutrients for your baby’s needs. But what about your nutritional needs in these early weeks after your baby is born and leading into the months ahead? The first thing to know is that staying calm and not becoming anxious is the best support you can give baby and yourself. Do not fret thinking that you ‘do not have enough’ milk. Baby only needs 2-10 mls of this highly concentrated miracle milk, colostrum, in the first 24 hours increasing up to 30-60mls by day 3.

So put your mind and heart at rest; rather relax and keep baby close, preferably skin to skin as much as possible and feed baby frequently whenever baby wants to, at least 2-3 hourly and sleep when baby sleeps. Let baby lead and let common sense prevail when it comes to choosing your foods; lots of fresh fruit and vegetables and avoid the trans fatty acids (e.g. hydrogenated oils), junk foods, commercial fried foods, sugar, white flour, soft drinks, caffeine, alcohol, cigarettes and drugs (even prescription drugs). Your breast-feeding diet should include plenty of fresh fruits and vegetables, while an occasional treat won’t decrease the quality of your breast milk, you should limit how much sugar you eat to keep your diet as nutrient-dense as possible.

Let’s look at some common questions around food.

Are there any foods I should avoid?

Not to get too complicated here, but breastfed babies can react to foods that mom consumes to a greater or lesser degree. Generally, thank goodness, it’s to a lesser degree though traces of your diet do pass into your breast milk. You can continue eating your normal balanced diet though obviously avoid the reactive foods either you or your husband may be allergic to.

There are certain foods that could make some people more gassy than others such as onion, chickpeas, lentils, cabbage but research has not pinpointed any particular food. So stay alert to baby’s behaviour.  If baby appears constantly fussy and irritable after you have had specific foods like diary or bread, then you may want to consider an elimination diet. My son became clogged up the morning after I had eaten yellow cheese so I stopped eating hard cheeses and he was able to breathe easier.

Certain seafoods have high levels of mercury so there are recommended maximum intakes of certain fish, such as oily fish up to twice a week. There are some foods and supplements that are thought to increase milk supply such as Fenugreek, Fennel Seed, Red Raspberry Leaf, Brewer’s Yeast, Alfalfa, Milk Thistle, Anise Seed and Blessed Thistle, so if you have an over abundant supply, avoid these. Brewers yeast although increasing milk supply, causes a lot of gas in baby, so always research supplements in breastfeeding and check with your Lactation Consultant.

If you’re really undernourished or particular nutrients are missing in your diet, this can affect the quality of your breast milk though a balanced nourishing diet will provide all you need.

Must I eat for two?

You should only drink for thirst and eat for hunger so there is no need to over consume however you will need at least 500 calories more per day as breastfeeding uses up your energy to produce milk.

Drink enough to keep your urine pale and so that you don’t feel thirsty. Preferably stick to clean or naturally flavoured water. Drinking more fluid does not increase your milk supply. Emptying your breasts efficiently and continually, preferably by baby who is the best milk remover, increases your production. Keep water close when feeding as a release of oxytocin can make you thirsty.

Should I take a multivitamin?

The evidence does not suggest routine vitamin-mineral supplementation for breastfeeding women though where nutritional sources are marginal then calcium, multivitamin-mineral supplements, or both are advised. Follow a sensible balanced diet instead though if you do choose to take a supplement remember to research the quality of the supplement and make sure it is organic and well balanced using non GMO ingredients and sustainable methods.

I’ve been prescribed Vitamin D – should i take it?

If you have been deficient in Vit D before pregnancy then it is likely that your milk will have lower levels and you’ll need to take a supplement as there are very few foods which provide this vitamin. Breast milk has low levels of Vit D. There is lots of research out there on Vit D. Some say that if the mother increases her levels adequately such as 5000 – 6000 IU/day that the Vitamin D in her breast milk will increase. There is no agreement on the dosage for supplementing during gestation or breastfeeding moms. There is a thorough article on this topic to link to in the references below. A few minutes of sun on your skin each day is the best remedy.

What about Vitamin B6?

B6 also known as pyridoxine is important in both pregnancy and breastfeeding but easily found in foods such as poultry, fish, eggs, cereals and certain vegetables such as sweet potato, sunflower seeds and banana, being good sources of this vitamin though deficiency is rare, supplementation can help with postnatal depression. Dr Jack suggests that Vit B6 can help with vasospasm or blanching of the nipple (Raynaud’s syndrome) which can be very painful though some suggest that very high doses of vitamin B6 can reduce milk supply but he has not seen this occurring.

And do I need extra iron?

Low iron during pregnancy should be resolved during pregnancy in particular to assist the mother in having enough energy to birth her baby and reduce risk of postpartum bleeding. Postnatal low iron levels or anaemia in mom can affect milk supply and of course energy levels. Iron supplements cannot increase iron levels in breast milk, and are not recommended as it can reduce the absorption of zinc and cause digestive upsets besides making you constipated. Examples of iron rich foods are some dried fruits like raisins, figs, apricots and prune juice, egg yolk, spinach/kale, tofu, certain grains like millet and brown rice, meats, dried beans, tomatoes. Check baby’s responses to the foods you eat as some babies react to certain foods such as getting nappy rash if mom has had orange or tomatoes due to the acidity.

By the way just to put your mind at ease, healthy, full-term infants who are breastfed exclusively for periods of 6-9 months have been shown to maintain normal hemoglobin values and normal iron stores.

Should I take extra calcium?

No. Both during pregnancy and while breastfeeding, additional supplementation other than a calcium rich diet is not required. The Institute of Medicine recommends that you consume the normal adult requirement of 1000mg of calcium daily. Studies have found that supplementation does not increase the calcium levels in breast milk with no impact on breast milk calcium concentration or on lactation-associated bone mineral changes.

If you do choose to take a calcium supplement it should be combined with magnesium in a 2:1 ratio and if you’re avoiding dairy then include zinc in the supplement ratio.

What about my coffee?

Caffeine, which is a central nervous system stimulant in many foods and drinks such as coffee, tea and some medications like flu medications, does enter breast milk even if only minimally at around 1%. You should keep your intake to less than 300mg caffeine per day. There’s about 100 – 150mg caffeine per cup of coffee depending on strength and brand, a cup of tea is 75mg and a 354mls coke is 40mg. The presence of chlorogenic acids in coffee can reduce the amount of iron in your breast milk. Usually a cup or two of coffee per day is tolerated but if your baby seems very awake, jittery or becomes fussy then caffeine may be the culprit. Caffeine can cause diarrhea in baby though baby’s response to caffeine is dependent on age and the quantity of caffeine you drink. Your best indicator as to how much coffee you can drink is your baby’s behaviour so watch little one closely. Caffeine accumulates in your newborn’s body so it makes sense to keep your caffeine intake low and avoid energy drinks which are very high in caffeine.

By the time your baby is 3-5 months old the half life of caffeine in baby’s body is down to 14 hours and by 6 months the half life is 2.6. Hang in there, soon you can indulge again if you’re choosing to cut caffeine out of your diet. But by then you’ll be enjoying the health benefits of cutting out caffeine and probably won’t want to go back to it.

Nicotine in breastmilk

A word of warning, studies have confirmed that nicotine does enter breast milk not only if you smoke but from passive smoke too. Cigarette smoke is a complex mixture of chemicals with about 4000 compounds including more than 60 carcinogens. Nicotine is a toxic chemical, extremely addictive and a nervous system stimulant which has other side effects like increasing blood pressure and heart rates. Even the nicotine in nicotine replacement therapy enters breast milk. Many studies confirm the levels of nicotine and its metabolite cotinine which has a much longer half-life than nicotine is found in blood, urine, saliva and even hair and nails in breastfed babies of smoking moms.

IF you have to smoke then smoke AFTER you breastfeed your baby and prevent baby from inhaling secondary smoke. Rather just QUIT!

Summary

Philippa Pearson-Glaze of breastfeeding.support.com reminds us that “There are no strict rules to follow for a breastfeeding diet and there are no particular foods to avoid during breastfeeding. Great breast milk will be made to order by the breast using a less-than-perfect diet and a mother’s body stores.”

The decision to provide exclusive breastfeeding for the first 6 months is the most important decision to make in your and your family’s health.

If you have any queries please feel free to call Vearle on 0555662773 or contact Intercare Health Centre. 

(IMAGE via health .com)