Nutrition Support for the Lactation
Let’s talk about lactation nutrition! Most importantly, I want you to know that you don’t have to eat perfectly while you are breast or chestfeeding. You don’t have to eat specific foods to make milk and you don’t have to eat “healthy” to make healthy milk. In fact, studies have shown us that even malnourished women, with poor access to food, produce high quality milk with many ingredients that cannot be matched in an artificial milk. In addition to growing our babies, our bodies store nutrients and fat during pregnancy for lactation. These stored nutrients fuel lactation when we aren’t eating perfectly.
Having said that, I encourage all postpartum moms to nourish themselves well. Nourishment to recover lost nutrients is an important part of recovering from pregnancy and childbirth. You’ll feel better and have more energy if you nourish yourself well during the postpartum period and beyond. Read more about nutrition for recovery in my last blog, “Fourth Trimester Nutrition”.
The ideal postpartum lactation diet is similar to the ideal pregnancy diet. You are recovering nutrients that you lost during pregnancy, healing wounds and growing your baby on the outside. Eat more real foods made with simple ingredients that are not overly processed like vegetables, fruit, meat, poultry, seafood, nuts, seeds, and legumes. Make sure to include healthy fats. A prenatal vitamin is recommended for at least 6 months to recover lost nutrients and should continue throughout breastfeeding.
Eating balanced meals will ensure you get all the nutrients you need to recover and to support a robust milk supply. Low carb diets and low calorie diets have been shown to reduce milk supply so balancing your plate and honoring your hunger will be something you will want to continue to do throughout lactation. Every food group holds nutrients needed for your recovery. Balancing your plate ensures normal blood sugars which can help some women with milk production
Fill half your plate with fruits or vegetables or both
These provide micronutrients needed for your immune system, fiber to maintain a healthy gut / microbiome and electrolytes for hydration.
Fill a quarter of your plate with carbohydrates
These foods provide fuel needed for energy and a healthy milk supply.
Fill a quarter of your plate with protein rich foods
Protein is needed for healing wounds, repairing skin and tissues that have been stretched and helping your uterus to shrink back into its previous size.
Balancing your plate is not meant to be restrictive. Eat this way whenever you can. You don't have to overthink it. Be sure to include your favorite foods on your plate when you want them. Healthy eating is what happens over a period of time and not at any single meal. If you need help figuring out how to include all components in most meals, you can download my balanced plate meal planning guide or sign up for weekly meal plans from my meal planning service.
Breastmilk is a dynamic, living fluid that changes daily to meet your baby's needs. However, there are a few nutrients in breastmilk that we can enhance with our diets. B12, Iron, vitamin D, and DHA are important for recovery, lactation and postpartum mental health.
B12 is one nutrient needed for recovery. If you are eating meat at least a few times per week, you likely have enough B12. Women that do not eat animal products can be at higher risk for B12 deficiency. You cannot get enough B12 from a vegan diet and breastmilk can also become deficient in B12. Vegetarians should take a daily supplement that contains at least 2.8 mcg of B12 per day.
Nearly everyone is deficient in Vitamin D during the winter. We don't get enough sun exposure in colder climates and the position of the sun in the winter makes it more difficult to obtain enough from the sun. Inadequate vitamin D puts our immune system at risk and is associated with many illnesses. Inadequate vitamin D in infants, is associated with a bone condition called Rickets. For that reason the AAP recommends that infants be supplemented with 400 IU of vitamin D per day. The birth parent should already be taking 2000 - 4000 IU during pregnancy. This is enough for the parent, but still does not provide enough for breastmilk. Dr Bruce Hollis, a leading Vitamin D researcher, recommends that lactating women take 6400 IU per day to pass enough vitamin D into their breastmilk.
Just as during pregnancy, iron continues to be an important nutrient in the postpartum period. Low iron levels are associated with fatigue, depression and poor brain function in the birthing parent. Low iron has also been associated with decreased fat in breastmilk and low milk supply. Meats and beans are important foods for recovery during the postpartum period. Vegetarians and parents with anemia should supplement with iron or spirulina. Spirulina is a powder made from blue-green algae you can add to soups or smoothies that is naturally high in iron.
DHA continues to be an important nutrient to consume during lactation and beyond. This fatty acid impacts brain development. When the lactating parent consumes more DHA, the level of DHA in their breastmilk increases. This improves brain and eye development in the infant. Salmon, Herring and Sardines are good sources of DHA and should be eaten 2-3 times per week. If you don't eat fish, you can take a daily fish oil supplement. Algae oil is another option if are vegetarian. DHA is also good for moms and fish oil supplementation has been shown to decrease risk of postpartum depression.
Prenatal vitamins continue to be important in the postpartum period and throughout lactation. They help secure nutrients for recovery and can serve as an insurance policy when we can't eat a variety of foods. Not all prenatal vitamins are equal and many use less bioavailable forms of nutrients and can be missing some nutrients. Select a prenatal vitamin with activated B vitamins. These are easier for your body to metabolize. Folate as L-methylfolate is important. Many of us cannot metabolize folic acid. Folate continues to be important in the postpartum recovery period.
One of the most common questions I field from lactating parents is, “What foods should I avoid while breastfeeding. The general answer is that any foods that you could safely consume during pregnancy are also fine to consume while you are breastfeeding. There is no need to limit or eliminate any particular foods. There are a lot of myths about what you can and can't eat. In most cases your gut is doing a good job of digesting and breaking down foods into their smallest components and there is no effect on the baby. In rare cases, your baby may react to something in your diet. Every mom and baby dyad is different, so don't assume you have to change your diet. If you think your baby is reacting to a certain food, keep a food journal and note when reactions take place. If you suspect an intolerance, contact me or another lactation consultant/dietitian to help you figure out if an elimination is necessary. Caffeine continues to be safe to drink just as it was during pregnancy. Very little caffeine travels into your breastmilk. Just as during pregnancy, you should continue to avoid mercury during your child bearing years. Avoid Shark, King Mackerel and Tilefish.
Another common question I hear is, “What foods will help me grow a bigger milk supply?”. Unfortunately there is no evidence that any particular foods will give your supply a boost. The main factor that determines your supply is demand. The more milk removed, the more supply will go up. The golden rule to increase supply is direct feed or pump more often. Your supply will typically increase over 3-5 days of extra milk removals. Having said this, there are a couple of foods that cultures across the world recommend as galactagogues. Those are oatmeal and barley. Since these are both nutritious whole grains, there is no harm in trying them if you tolerate them.
The main takeaways here are that you can nourish your baby no matter how you eat, but it is a good idea to nourish yourself so that you can feel good and be your best self. Eating a variety of foods using balanced plates will achieve this. I recommend all my postpartum moms take a high quality prenatal vitamin, Vitamin D and DHA supplement. These supplements support postpartum recovery, mental health, immune system and can enhance your breastmilk.
Contact me if you would like a personal nutrition assessment or help with meal planning at glile@nourishwell.online.
GEORGINA LILE IS AN IN-NETWORK PROVIDER FOR AETNA and also accepts many Blue Cross Blue Shield, Cigna, and United plans through Lactation Network.
Many PPO plans cover up to 6 visits with an in-network lactation consultant if you need support with breastfeeding or a prenatal breastfeeding class; with no out-of-pocket cost to you.