NURSING
MOTHERS, INC.
P.O.
Box 5462 Wilmington , Delaware 19808
Nutrition
Fact Sheet 13
The breastfeeding mother does not need to follow any special diet in order to supply her baby with milk. Even if your diet is less then ideal, your milk will still be best for your baby. However, the period during lactation is an ideal time to evaluate your diet. A well balanced diet of the recommended proportions of protein, carbohydrates, fats, vitamins, minerals and fluid will help speed your recovery from childbirth, ensure a sufficient quantity of milk for the baby and maintain your optimal health.
Caloric Intake
You will require slightly more calories to support milk production than you needed during pregnancy. The mother of a newborn needs 14-15 calories per pound of her own body weight, plus 50-60 calories per pound of her baby’s weight, which generally means 500-600 extra calories per day. Extra pounds added during pregnancy are now used as an energy source for lactation. Your daily caloric intake should not be below 1800 calories. Studies have shown a direct correlation between low milk supply and a mother’s inadequate nutritional status. Other factors can influence your caloric requirements, such as your size, age activity level, and whether you are nursing more than one baby.
The Basic Nutrients
Three nutrients in foods supply needed calories: protein, carbohydrates and fats. The recommended proportions of these nutrients are: protein 12%; carbohydrates 63%; and fats 25%. On a 2500 calorie diet, this is 300 calories from protein, 1575 calories from carbohydrates and 625 calories from fats. Most Americans consume more protein and fat than they need.
Proteins
Proteins are the body’s major source of building materials for the internal organs, blood, muscles, skin, hair and nails. Proteins are necessary for production of the hormones that control the formulation of milk. Antibodies, which help you and your baby to fight infection, are also composed of proteins. You will need more protein while nursing than the average woman. Foods and the protein group of include dairy, fish, meat, legumes (dried peas and beans) nuts, seeds and soy products. A healthful diet emphasizes the low-fat protein choices such as legumes, low-fat dairy products and lean meats. Hard cheeses, eggs, whole milk products, nuts and seeds contain more fat and should be consumed in lesser quantity.
Carbohydrates
Carbohydrates are the main source of energy for body functions. Simple carbohydrates or shares are not the preferable energy source since they are often lacking in vitamins and minerals. Sugars also cause a sudden rise in blood sugar which drops rapidly after a short time and creates a craving for more food. Foods high in simple carbohydrates also tend to be high in fat which adds a lot of “empty calories” to diet. Processed snack foods, doughnuts, pastries, candies, sodas and highly processed cereals should comprise a minimal part of your diet, as these foods may displace more nutrient-rich choices.
Complex carbohydrates or starches are much better choices as these are rich in vitamins and minerals. They take longer to digest and do not cause a sudden rise and fall of the blood sugar. Fresh vegetables and fruits, whole grain cereals and breads, rice and pasta are excellent sources of complex carbohydrates. The National Cancer Institute currently recommends a minimum of five servings daily of fruits and vegetables. A review of studies done worldwide on reducing your risk of cancer found consistent evidence of a link between diet and cancer. Currently only 20% of Americans consume the minimum five servings-- most eat two or fewer servings a day.
FATS
Fats are the most concentrated energy source. Fats in meat, fish, poultry, milk products and vegetables are important for the fat-soluble vitamins and linoleic acid. Rich desserts, many junk foods, butter and oils do not supply many vitamins and are better eaten sparingly.
VITAMINS & MINERALS
Vitamins and minerals do not provide calories, but are needed for the body to work properly. Calcium and iron are a particular concern for nursing mothers. Calcium, the main structural component of bone, needs to be monitored, especially if you have nursed several babies or are an older mother. If your calcium intake is not sufficient during nursing, calcium may be drained from your bones to become available to your baby. This process leaves your bones in a weakened condition. Milk is a major source of calcium; however the nursing mother does not need to drink milk to make milk. There are many other calcium-rich foods. Calcium-rich foods include most diary products such as yogurt and cheeses (cottage cheese and cream cheese are not high calcium sources), sardines, watercress, kale, collards, tofu, canned salmon, broccoli, almonds and blackstrap molasses. Some orange juices are now calcium-fortified.
A deficiency of iron can cause you to tire easily and can affect your milk supply. Iron-rich foods include egg yolks, liver, red meats, whole grain and cereal products, dried fruits and blackstrap molasses. Prenatal vitamins and minerals are recommended for lactating women because the increased requirements are proportionally greater than the increased calories needed. We encourage you not to use supplements as a substitute for good nutrition. A good diet provides many trace nutrients and fiber not found in supplements.
FLUIDS
The “Food Guide Pyramid” (see chart below) from the U.S. Department of Agriculture and the Department of Health and Human Services will help you decide what, and how much to eat. The Pyramid is divided into six parts: the five lower sections represent five different food groups. No one food group is more important that another -- for good health, you need to consume foods from all groups, according to the USDA and the USDHHS. The top section of the Pyramid, “Fats, Oils and Sweets,” is best eaten in limited quantities.
Below the name of each food group are numbers which indicate how many portions to eat from that particular group on a daily basis. Breastfeeding mothers on a 2200 calorie diet would need at least nine portions from the bread group, four portions from the vegetable group, three portions from the fruit group, three portions from the milk group and two portions from the meat group. Eating the recommended amount of portions from each group will help you get the nutrients you need for good health.
*Studies have shown that some foods in the
maternal diet are linked to intolerances in the breastfeeding baby.
For a list of common suspect foods, click here (http://www.askdrsears.com/html/4/t041800.asp).
For a list of dairy-containing products, click here. (http://www.drjaygordon.com/nutrition/dairy.htm)
TIPS FOR HEALTHY EATING
For many new mothers, knowing what to eat is the easy part of being well-nourished. It can be a challenge to take care of yourself when you are meeting the demands of an infant. Planning for, shopping for and preparing meals can seem an impossible task. Many foods are both nutritious and convenient for snacks and quick meals (see the table below for ideas). Smaller meals eaten throughout the day may be less stressful and are just as nutritious as three main meals. Eating foods that are processed as little as possible, and choosing more foods from the bottom sections of the Food Pyramid will result in a healthy diet for you and your baby. Remember that your eating habits will also likely determine the food patterns of the whole family for years to come.
For more information on nutrition, consider purchasing
a book from the list below. You can also contact your county’s extension home
economist, public health nutritionist or a dietician in hospitals, community
organization or private practice.
VEGETARIAN DIETS
Mothers on vegetarian diets can successfully breastfeed their babies. Most vegetarians are aware of their nutritional requirements and how to combine several types of vegetarian diets. That are defined by whether or not they include dairy products. Strict vegetarians, or vegans, avoid all foods of animal origin and that contain any animal byproducts. Because dairy products are a major source of calcium, the vegan mother needs to choose enough alternate calcium sources such as broccoli, kale, collards and tofu. The iron and zinc found in plant foods are not as well-absorbed as those present in meat. Beans, potatoes, dried fruit fortified cereals and breads supply iron. Peas, lentils and wheat germ are good sources of zinc. Vegetarian mother can talk to a health professional to help evaluate their diets and decide if supplements are necessary.
FOODS TO LIMIT OR AVOID
Should I avoid some foods?
No, it is not usually necessary to avoid any food while breastfeeding. Some moms may find that some foods affect their babies. If your baby experiences excessive gassiness, diaper rash, or irritability, it may be related to maternal consumption of a food sometimes associated with these problems. Symptoms can appear from a few hours to a few days later. Talk to your Nursing Mothers counselor or a health care professional if you think you and baby are experiencing food-related issues. Typically, foods that cause problems need only be eliminated temporarily. As the baby matures, his or her physiology many be better able to tolerate the food in your diet after several weeks, while other need longer elimination periods.
Can I have foods or beverages
that contain caffeine?
Caffeine may cause problems for unusually sensitive mothers and babies. Recent studies have shown a minimal amount of caffeine is present in the breast milk of mothers consuming five or fewer cups of coffee daily. If your baby is fussy or wakeful, try decreasing or eliminating your consumption of caffeine for a week or two. Monitor your baby’s response. Caffeine is also present in cola and other soft drinks, iced and hot teas (non-herbal varieties), chocolate and some over the counter drugs (cold/flu medications, etc).
Will nicotine (cigarette smoking)
affect my baby?
Studies show that cigarettes can reduce a mother’s milk supply and interfere with the milk ejection reflex (let-down). Nicotine does transfer to the breast milk. The fewer cigarettes a mother smokes each day, the more she helps her baby. However, for mothers who cannot quit, the benefits of breastfeeding outweigh the risks of nicotine in the breast milk. Second hand smoke is of greater concern—if you must smoke, do so after nursing (not during or before) and avoid smoking in the baby’s presence. Ideally, no baby would not breathe secondhand smoke or ingest nicotine through the breast milk, as the risk of Sudden Infant Death Syndrome (SIDS) and respiratory diseases are increased when these contributing factors are present.
Can I have an alcoholic beverage
while breastfeeding?
Alcohol transfers quickly to
breast milk, although in much weaker concentrations that those found in the
mother’s blood. Over time, the concentrations in the breast milk dissipate. The
effects on the baby will be related to the amount of alcohol you consume, and
the length of time between consumption and the next nursing session. Fold
wisdom that suggests a glass of beer or wine helps increase your milk supply is
unfounded, thought brewers yeast (found in beer) is known to help increase the
milk supply in some moms. The extent to which alcohol can incline a mother to
relax may have some beneficial effect, but not the alcohol itself. As a general
rule of thumb, alcohol should not be consumed on an empty stomach, and should
be kept to a minimum while breastfeeding. Parents
under the influence of alcohol or drugs should not sleep with their infant in
their bed.
Nursing
Mothers, Inc. recommends that you avoid or at least strictly limit your alcohol
intake during lactation to limit your baby’s exposure to alcohol. If relaxation is your goal, look for other
strategies (naps, warm baths, gentle walks, calming music, massage, etc.).
Can I take prescription and
over-the-counter drugs while breastfeeding?
While most commonly prescribed and over-the counter medications are considered ok during lactation, we encourage you to consult your or the baby’s health care provider, a International Board Certified Lactation Consultant (IBCLC), or a Pharmacist before taking any medications. Many drugs that you ingest transfer to you breast milk and may influence your child’s health or your milk supply. Make it clear to any health care professional who prescribes for you that you are lactating. Frequently, the doctor may be able to prescribe a suitable substitute that would be safer (ask your health care provider to consult a guide such as Medications and Mothers Milk by Thomas Hale, R.Ph., PhD. or his website Breastfeeding Pharmacology to determine which medications are considered safest during breastfeeding). Over-the-counter cough, cold and sinus medications contain drugs that may decrease your milk supply. Always check for warnings on the label about use during lactation. If you are in doubt, ask the Pharmacist. Many drugs that were safe for you to take during pregnancy may not be safe during lactation.
sNACKS
& qUICK mEAL IDEAS
|
BAGELS |
·
Top
with pizza sauce and mozzarella ·
Spread cream cheese and top with tomato and
Swiss cheese. Broil until cheese melts ·
Top with tuna salad and cheese. Broil until
cheese melts |
|
MUFFINS |
·
Make
with whole grains such as bran, oatmeal, oat bran or cornmeal · Add applesauce, fruits, shredded carrots, cheese or zucchini ·
Freeze extras for quick snacks |
|
Rice Cakes |
· Top with cheese and melt ·
Spread with peanut butter or tuna salad |
|
Whole Grain breads/rackers |
· Top with turkey, cheese, peanut butter, egg salad, or sandwich spreads |
|
Pita bread |
· Spread with hummus dip and chopped tomato ·
Fill with cheese, lettuce, tomato and |
|
Vegetables |
· Baked potato topped with melted cheese, yogurt or cottage cheese · Serve raw vegetables with hummus dip or cottage cheese dip · Make vegetable soups and freeze in small portions for quick meals |
|
Fruits |
· Dip cut up piece of fruit into peanut Butter or yogurt ·
Make fruit yogurt shakes: blend one ripe
banana, fruit of choice (Frozen raspberries, strawberries, blueberries, etc),
¾ cup yogurt, and 1 tbsp honey. Add milk for desired thickness. |
|
Nuts |
· Add nuts to salads ·
Mix with dried fruits for trail mix |
|
Granola |
· Use as a topping on fruit salad · Mix granola into yogurt ·
Makes great snack on its own |
|
Yogurt |
· Add plain yogurt to tuna salad for half the mayonnaise · Add fruit to plain or vanilla yogurt; add nuts or granola ·
Thin flavored yogurt with a bit of orange
juice to make a fruit salad topping |
|
Cottage Cheese |
· Serve with fruit or sliced tomatoes · Stir into hot pasta, add parmesan cheese and parsley ·
Puree in blender for a low fat dip |
|
cheeses |
· Serve with whole grain crackers · Serve with fruit · Add to salads and sandwiches ·
Try low fat versions of many available
varieties |
|
Tuna Salad |
· Mix into left over cooked pasta; add chopped vegetables or frozen peas · Stuff into pita bread · Serve on whole grain crackers and breads ·
Stuff into a ripe tomato |
|
eggs |
· Hard boil a dozen eggs for quick snacks · Add to salads · Make egg salad · Make an omelet; add your favorite cheese and tomato, spinach, mushrooms, or onions (or all of the above!) ·
Scrambled or fried eggs with toast |
Books & Links
Jane Brody’s Nutrition Book. (New York: Bantam Books, 1987) A lifetime guide to eating for Better Health and Weight Control. Includes recipes and nutritional information, with a special section on nutrition for pregnancy and lactation.
Alice White. The Total Nutrition Guide for Mother and Baby: From Pregnancy Through the First Three Years. (New York: Ballantine, 1983).
Jean Carper’s Total Nutrition Guide. (New York: Bantam Books, 1987). A comprehensive up-to-date source of information in nutrients you need. Identifies what they are, where to find them and how to best use them for optimal health. Charts with listings of essential nutrients in over 2500 foods.
Nutrition, Exercise, and Weight Loss While Breastfeeding by Anne Smith, IBCLC
http://www.familyresource.com/health/16/281/
Ask the Dietitian Joanne Larsen MS, RD, LD
http://www.dietitian.com/pregnanc.html
EATING VEGETARIAN
by William Sears, MD
http://www.askdrsears.com/html/4/t045400.asp
THE ELIMINATION DIET by William Sears, MD
http://www.askdrsears.com/html/4/t041200.asp
TRACKING
DOWN FOOD ALLERGIES by
William Sears, MD http://www.askdrsears.com/html/4/t041800.asp
Dairy Terminology by Jay Gordon, MD
http://www.drjaygordon.com/nutrition/dairy.htm
Losing
Weight After Pregnancy by Jay Gordon, MD
http://www.drjaygordon.com/nutrition/weightloss.htm
Caffeine Consumption
during Lactation La Leche League International
http://www.lalecheleague.org/FAQ/caffeine.html
Food to avoid during
breastfeeding La Leche
League International
http://www.lalecheleague.org/FAQ/avoid.html
Alcohol and Breastfeeding La Leche League International
http://www.lalecheleague.org/FAQ/alcohol.html
References
Mohrbacher, N. and J. Stock. The Breastfeeding Answer Book. La Leche League International.
Lauwers, J. and C. Woessner. Counseling Training Manual. Nursing Mothers, Inc.,
The Food Guide Pyramid, HG 252. United States Department of Agriculture, 1992.
Nutrition During Lactation.
Re-typed: 1/03 Megan Allen
Revised: 1/94 Cathy McCartan; 1/03 Megan Allen
If you need more information please call your counselor or Nursing Mothers, Inc., information line at (302) 733-0973.
Copyright on the Internet 2000, NMInc.
Nursing Mothers, Inc. is a non-profit organization. We never charge for our services, we would gladly accept your tax-deductible donations.