Breastfeeding Nutrition

By Carly Hill

After nine months of food restrictions, food aversions and food cravings, by the time you give birth, you’re probably yearning for some normalcy to return to your diet. The good news is, now you can – even if you’re breastfeeding. You don’t have to keep nearly as close of an eye on your diet after you give birth as you did while your baby was in utero. In addition, you have a whole lot more wiggle room to indulge in luxuries like soft cheeses, wine and sushi. That being said, while you are breastfeeding, you do need to keep in mind that certain things you put into your body do pass through to your breast milk and can even affect your supply. Healthy breastfeeding nutrition is of the utmost importance for new moms.

What SHOULD I Be Eating?

Putting parameters on a breastfeeding diet can get a little complicated. Planning is great, but once you have your baby, you may learn that certain food groups will upset your baby’s stomach. Many babies have reactions to dairy and improve when dairy is cut from their mothers’ diets. So, this is just a set of guidelines, provided your baby cooperates.

What to Expect suggests the following daily diet for breastfeeding moms:

  • Protein – 3 servings
  • Calcium – 5 servings (that’s an increase from your pregnancy requirement of 4)
  • Iron-rich foods: 1 or more servings
  • Vitamin C: 2 servings
  • Green leafy and yellow vegetables, yellow fruits: 3 to 4 servings
  • Other fruits and veggies: 1 or more servings
  • Whole-grain and other concentrated complex carbohydrates: 3 or more servings
  • High-fat foods: small amounts – you don’t need as much as you did during pregnancy
  • 8 cups of water, juice, or other non-caffeinated, nonalcoholic beverages
  • DHA-rich foods to promote baby’s brain growth (look for it in wild salmon and sardines, as well as DHA-enriched eggs)
  • Prenatal vitamin daily

Choose Organic Options Whenever Possible

Whether it is medicine, alcohol, or pesticides – any types of contaminants will pass through to your breast milk, having an effect on you and your baby. The best thing you can do to avoid contaminants is to eat organically, as much as possible. If you’re unable to drop the extra bucks it takes to maintain an exclusively organic diet, just make sure that your diet is varied.

If you’re on a corn-on-the-cob kick and you buy it from the same supermarket that gets it from the same farmer, and those corncobs are heavily coated with pesticides, your breast milk will be heavily laced with pesticides.

Just make organic choices when you can, and when you can’t, make sure your diet has plenty of variety.

Loosening the Reins on Pregnancy No-No’s

If you’re pregnant, you probably have a long list of things you want that you’ve been unable to have while pregnant. The good news is, if you’re breastfeeding, you can loosen up with the restrictions quite a bit, but there are still some precautions to take with your diet when breastfeeding.

Alcohol

Sipping on a glass of your favorite wine is a no-no when you’re pregnant, but you can be a little more flexible when you’re nursing. When it comes to alcohol, it’s all about timing. If you’re going to have a drink, you’ll want to do it right after a nursing session, then, to be on the safe side, you’ll want to “pump and dump” as they say. For your baby’s next feeding, offer a bottle of previously pumped breast milk, and instead of nursing the baby, pump that milk (which probably still has traces of alcohol in it) and dump it down the drain.

Caffeine

When you were pregnant, you were told to avoid caffeine altogether, or at least limit it to one 12-ounce cup a day, since high caffeine consumption has been linked to risk of miscarriage and stillbirth. But, once you birth that baby of yours, you can loosen up on the caffeine a bit.

According to La Leche League, you can down up to five 5-ounce cups (less than 750 ml) of coffee a day with no effect on your baby. Trust me, that extra cup of coffee will do wonders when you’re living on random sleep-spurts. Just don’t overdo it.

Also, keep your other sources of caffeine in mind. Teas, sodas, chocolate and many medications can contain caffeine and if you are overdoing your intake, you’ll notice your infant jacked up on the drug too – “wide-eyed, active, alert, and perhaps fussy.”

The take-away from this is, you can loosen up and pick up your caffeine habit where you left off, just be mindful of how much you are consuming and pay attention to your baby. If you are having too much caffeine, it can affect your infant.

Fish

Good news. You can make date night a sushi night once again. In fact, according to the FDA and EPA’s latest guidelines, pregnant and breastfeeding moms don’t eat enough fish. With all the restrictions you’re given during pregnancy, it’s easy to just say, “Eh, there are too many ‘don’t’s,’ so I’m just going to avoid fish altogether.” But, that’s no good. According to these new guidelines, breastfeeding moms should be eating 8 to 12 ounces of low-mercury fish each week – that’s 2 or 3 servings a week.

That being said, you’ll still want to avoid high-mercury fish such as tilefish, shark, swordfish, king mackerel, fresh tuna, sea bass, mahi-mahi, grouper, amberjack, and of course, fish from contaminated waters.

When it comes to canned tuna or any other type of canned fish, you’ll want to limit yourself to 6 ounces per week.

Eating fish is good for you and your baby, as along as it’s the right kind of fish and the right serving size. Keep a copy of this page handy when you’re ordering out or grocery shopping so you can be sure to get those omega-3s!

What About Medications? 

When breastfeeding, you need to be mindful, just as you were during pregnancy. There are certain medications that are fine to take during pregnancy and others that are not. If you are medicating yourself and feeding your baby exclusively breastfed milk, your baby is getting traces of the medication you’re taking. So, don’t take any medication without asking your doctors and/or pharmacist if the medication you’ve been prescribed is safe to take while breastfeeding.

The reason it’s important to consult a doctor is that there is not a pat answer for every medication. There are a myriad of factors to take into consideration. Luckly, doctors and pharmacists are well trained and will be able to direct you, but as a mom, you always want to understand the “why” behind the decision.

So, here is a complete list of questions and answers, taken straight from La Leche League that will be considered by the experts when it comes to selecting medication for breastfeeding moms.

What is the age of the baby? The younger the baby, the less able he is to eliminate a drug from his system. A full-term newborn can metabolize a drug easier than a premature baby, but is less able to metabolize a drug than an older baby. At about two weeks of age, the full-term baby’s liver is mature enough to metabolize most drugs.

What is the baby’s weight? The more the baby weighs, the less likely he will be affected by a drug, as drug doses in children are usually calculated by weight.

How much human milk is being consumed? A baby who is exclusively breastfed will receive more of a drug than a baby who is receiving solid foods as well. A toddler who receives more nourishment from food than from breastfeeding would receive even less of a drug.

What is the general health of the baby? Is the baby premature? Does he have any illnesses or health problems? These kinds of problems could make the baby more susceptible to medication.

What is the nature of the mother’s illness? It helps to get as much information as possible from the mother regarding her medical problem, including what her health care provider may have said.

Has the drug been given to infants? A drug commonly prescribed for infants is usually a good choice for a breastfeeding mother.

Has the drug been given to other nursing mothers? A drug that has a history of use by nursing mothers is a better choice than a new, possibly untested drug.

What is the duration of the drug therapy? The duration of the drug therapy can affect its compatibility with breastfeeding. A drug considered compatible with breastfeeding when taken for a few days may not be compatible when taken over a long period of time.

Is the drug short-acting? A short-acting form of the drug may be a better choice for a breastfeeding mother than a longer-acting form that stays in the mother’s system for a longer period.

How is the medication being given? A drug given by mouth is less concentrated than one given intravenously. However, a drug may be given intravenously because it is inactivated or not absorbed by the digestive system, so the baby’s digestive system would also inactivate or not absorb the drug.

How well can the baby excrete the drug? Some drugs accumulate in a baby’s system and can potentially build to toxic levels. A drug that is quickly eliminated by the baby is more compatible with breastfeeding.

Does the drug interfere with lactation? Some drugs should be avoided by breastfeeding mothers because they affect breastfeeding itself (the let-down or milk supply).

If you do need to take medication while breastfeeding, be sure to schedule your medicine intake around your nursing so that your baby will only have minimal exposure.

If, of course, it is medically necessary for you to take a medication that poses health risks to your baby, you will need to discontinue breastfeeding.

What SHOULDN’T I Be Eating?

As Always, Avoid Processed Foods

Just as you always should, stay away from pre-packaged , processed, or fast food. Eating meats, fruits, vegetables, and whole grains will provide you with all the nourishment you need to survive the boot camp-like experience it is to live with a newborn baby.

Although you will produce nutrient-rich milk despite your diet, your baby does get traces of what you eat through your milk. Many people don’t think about vitamin D. If you’re not getting much vitamin D, you and your doctor will be able to pick up on that through a blood test and may recommend you take a supplement to ensure your baby is getting enough through your breast milk.

If you’re a vegetarian, you need to be taking B-12 – a vitamin found in animal-based foods that is important for your baby’s brain development.

What if My Baby is Fussy/Gassy/Colicky – How Should My Diet Change?

The first course of action any doctor or lactation consultant will take for a colicky baby is altering mom’s diet.

William G. Crook, M.D., developed what is called the “Elimination Diet” – specifically for breastfed babies that may be sensitive to food in the mother’s diet. Of course, you can alter this depending on the severity of your baby’s symptoms, but the point of this diet is to eat the least allergenic foods in every food group. Try this for two weeks, since it can take that long for the allergens to leave your system and your baby’s.

Dr Sears’ trusted website on breastfeeding lays out the plan rather simply:

  • “Eat only range-fed turkey and lamb, baked or boiled potatoes and sweet potatoes (with salt and pepper only), rice and millet as your only grain, cooked green and yellow squash for your vegetable, and for fruit, pears and diluted pear juice. Drink a rice-based beverage drink in place of milk on cereal or in cooking. Do not yet use soy beverage. Take a calcium supplement. (Rice products, such as rice beverage, rice-based frozen dessert, rice pasta, rice flour, and millet are available in nutrition stores.)
  • At the end of two weeks, or sooner if the colic subsides, gradually add other foods to your diet, one every four days, starting with those less commonly allergenic (such as sunflower seeds, carrots, beets, salmon, oats, grapes, California avocado, peaches). Wait a while before you add wheat, beef, eggs, nuts, and corn. Avoid for the longest time dairy products, soy products, peanuts, shellfish, coffee, tea, colas and other beverages containing caffeine, chocolate, gas-producing vegetables (broccoli, cauliflower, cabbage, onions, green peppers), tomatoes, and citrus fruits. Vegetables and fruits are often tolerated in cooked form sooner than in raw form.
  • Keep a record of the foods you eat and the problem behaviors; try to correlate baby’s fussy spells with what you’ve eaten in the past day or so. This gives you a clearer perspective and helps you stay objective, which is hard to do when you are sleep-deprived. This is especially important when baby has stayed fussy past four months of age.
  • Do not starve yourself. It may feel, the first day or two, as though there is not enough for you to eat; but you can still eat a nutritious diet. You just have to eat more of the “safe” types of food until you determine what your baby can tolerate. Colicky babies usually respond to mother’s diet changes dramatically and quickly, often within one or two days. With the older baby who is night waking, you may have to wait longer to see results. Typically, mothers will find that when they change their diet baby may sleep better for a few nights only to start waking again a lot for a few days or a week or so, at which time the sleep again improves. It’s important to know this so that you will not be tempted to give up when you think “it’s not working.” Older babies are often less sensitive to fruits and vegetables in mom’s diet (and their own), so at this stage we recommend mainly protein elimination, namely dairy, beef, eggs, chicken, shellfish, soy, corn, wheat, and peanuts (plus any other foods you have learned bother baby). Research has shown that some foreign proteins get into some mothers’ milk more than others’, and of course some babies are more sensitive to these proteins than other babies.”

It’s kind of like a big science experiment. Once you’ve eliminated all the foods suggested above, you can slowly add foods back in and make note of what it is you added that doesn’t agree with your baby. It may wind up only being a few foods that you need to avoid, if you keep a detailed journal and pay specific attention to what you’re eating.

Don’t Beat Yourself Up

The good news is, even if you’re not getting all the nutrients you need, your baby will be well-fed because your breast milk is going to provide your baby with all he or she needs, no matter what you’re putting in (or not putting in) your body. Following “The breastfeeding diet” isn’t as much about taking care of your baby, as it is about taking care of yourself.

If you’re more causal and carefree with your diet and lifestyle choices, you might shrug a chapter like this off. But, once you have a newborn, everything changes. There’s no way you will survive sleepless nights and endless screaming spells if you’re not getting the nutrients you need to function the best you can.

Breastfeeding and Weight Loss

Now is Not The Time for Counting Calories

Gay Bearzi, RN, IBCLC, is a lactation consultant at Sinai Hospital in Baltimore. She told The Bump, “The myth was that you had to increase your calorie intake 500 calories per day to make milk, but we’re learning you don’t have to eat that much.” The reason for that is during pregnancy, your body laid down fat stores (the reason why you gained more weight than just the weight of the baby and your placenta). So, when you’re breastfeeding, you don’t have to worry that you won’t eat enough to produce milk. Just eat when you’re hungry.

“How’d you lose that baby weight so fast?” they ask you. And you smile, knowing that your rapid weight loss is thanks to the miracle workout that is breastfeeding. Women’s Health Magazine claims that breastfeeding after you give birth can burn about 350-500 calories per day. That’s like one really intense spinning class or a 5-mile run right there – all done from the comfort of your own rocking chair while bonding with your precious new baby. Amazing, isn’t it?

“But…my sister didn’t lose weight quickly…and she breastfed…”

Some women get frustrated after they give birth. They hear the talk of breastfeeding burning calories and wonder why it’s not working for them. Well, to those women, I’d say, just like any exercise program, you’re not going to see results unless you are also following a healthy diet as well. Doing the elliptical every day is all well and good, but surviving off of ice cream and Twinkies isn’t going to do much for your figure.

Crash Dieting = Bad Idea

After feeling about as dainty and fit as an obese elephant for the past year, you’re probably very ready to return to your skinny jeans and shirts that can’t double as potato sacks.

But, here’s the thing. Although your body will produce nutritious breast milk for your baby despite variations in your diet, if you are not eating enough, your milk supply could be affected – meaning, your body may not produce enough milk to feed your baby. Similarly, if your diet is heavy on one food group, completely leaving out the others, that can affect your breast milk quality and quantity as well.

You will be amazed how quickly the pounds drop off if you just eat healthy and breastfeed. Now is not the time to restrict calories, though. Just eat what your body needs, relax, and enjoy this short time you get to spend holding your baby in your arms while you nourish him with your own body. It’s amazing, really.

Thirsty as a Camel!

Given the amount of fluid your body is exporting on a daily basis, it is totally normal for you to be extra-thirsty. Make sure you’ve always got a drink by your side, as you could get dehydrated quickly if you don’t drink enough water.

Make Healthy Foods “Grabbable”

“You look overwhelmed…how can I help?”

Friends and family members will likely say this to you when you are bouncing your fussy newborn on your knee and you may shrug and say, “I… don’t know.”

Breastfed moms have the difficulty of not being able to accept much help. You can’t really rely on your mom or partner for late-night feedings when the baby is drinking out of your body.

So, your support system may not be able to be of much use when it comes to feeding your new baby, but here’s an idea. Have them prepare healthy snacks for you that are grabbable (a word we at SmartMom invented that means “easy for mom to grab”). Grabbable snacks are a new mom’s best friend. You will have so much feeding and pumping and laundry and changing diapers to do, it will be very tempting to grab whatever food is around, but usually, the most grabbable foods are not the most healthy or nourishing.

Have your loved ones help you out by cutting up raw veggies, fruits, nuts, and cheese sticks and putting them into zip lock bags or Tupperware containers that you can easily grab out of the fridge. Foods that are healthy AND “grabbable” are a new mom’s best bet.