Sunday, July 12, 2015

Are Dietary Changes Necessary During Breastfeeding?

I have never experienced such intense hunger or thirst as I did during the first month home with my oldest child as I adjusted to exclusive breastfeeding. Now Baby #2 is due to arrive any day and I have been stocking up on easy to eat snacks and meals available at a minute's notice. None of these snacks or meals are different than what I normally eat, but the frequency and amount that I will be eating in the days to come will vary drastically from my normal intake.

What Should I Eat?

Breastfeeding requires only a well balanced and varied diet, with slightly larger portion sizes or additional snacks to provide approximately 300-400 extra calories per day to support adequate milk production. This is not a time for weight loss attempts via calorie restriction or intense exercise, which could decrease your milk production and drain yourself of energy.

There is no worry about counting calories to ensure you are getting enough either. If you are hungry, eat! Your body will tell you through hunger or decreased energy levels that you are not getting enough food to meet the needs of you and your baby. When you promptly and adequately respond to those signals with healthy foods, the enhanced need you have for vitamins and minerals will also be met. For although your body is fairly sufficient at ensuring adequate vitamin and mineral levels in your breast milk using your own nutritional stores during the production of milk, your breast milk will in part mirror your own dietary intake. Therefore an adequate diet will make sure you avoid unnecessary nutrient deficiencies such as iron and calcium in yourself, while enhancing the vitamin, mineral, and fat composition available to your baby.

Need Food Ideas?

For practicability, don't try and follow unfamiliar meal plans when you have a new baby as this is a stressful time already. Make small changes to your diet if needed such as:
  • Switch out a few refined grains such as white bread, refined pastas or white rice with whole grains. Whole grains include wheat, brown rice, oats, corn, barley and rye in which the germ and bran remain intact. Whole grain breads, pastas, tortillas and even crackers/chips are typically easy to find.     
  • Add a side of eggs or yogurt with whole fruit to your breakfast routine to enhance protein and fiber content of potentially high carbohydrate main dishes with syrup (such as pancakes or waffles).
  • Add yogurt or milk in place of juice in smoothies. 
  • Drink milk in place of soda pop at meals to provide calcium and protein, and quench thirst with water between meals.
  • Have snacks on hand such as:
    • Homemade muffins (pumpkin muffins are a favorite)
    • Plain yogurt with fruit and/or granola 
    • Nuts and seeds 
    • Hummus with vegetables
    • Cottage cheese with avocados, crackers, or tomatoes 
    • Tuna fish or peanut butter sandwiches
    • Plain vegetables and fruit (carrots, celery, bananas, apples, etc.) with peanut butter
    • String cheese

A Word on Dietary Restrictions

As I was nursing my firstborn, she developed a chronic diaper rash and I soon found myself swamped with well meaning family and friends suggesting elimination of dairy, wheat, eggs, soy and nuts from my diet. After much stress and with some variation to their recommendations, I discovered the underlying problem was excess consumption of apricots (we had a tree in season and I was eating a lot of fresh apricots), and a skin sensitivity to the diaper cream I was using. The solution was merely eating apricots in moderation and discontinuing the use of the cream with no further problems. On the other hand, I have a friend whose son had chronic eczema which only cleared up after she eliminated eggs from her diet under a doctor's direction. 

So yes, if there is a true food allergy, a mother's consumption of the allergen will negatively affect the baby as manifested in eczema, rashes and projectile vomiting. Yet, food allergies are not the only cause of these symptoms in infants, and it is best to work with a pediatrician to determine possible causes and treatments. If a food allergy is suspected, a good place to start is the elimination of known food allergens in the family. Be cautious of mass food group elimination as this causes difficulty in meeting nutrient needs. If the baby's reactions are severe, speak to your doctor and if food groups are to be eliminated reintroduce as quickly as possible to restore adequate nutritional intake. 

Another piece of advice I've heard countless times is to avoid gassy vegetables and spicy food as they can upset your baby's stomach or cause gas and colic. Although I have not taken the time to research this fully, there appears to be little evidence that these foods in moderation cause any significant changes in the baby's ability to digest your milk or impact their demeanor. In fact, variety in a mother's diet creates variety in the breast milk that may decrease picky eating later in life. 

Samour PQ, King K. Handbook of Pediatric Nutrition. 3rd ed. Sudbury, MA: Jones and Bartlett Publishers; 2005.

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