Postpartum Nutrition and Lactation

Introduction

The postpartum period begins after the delivery of the baby and ends when the mother’s body has returned as closely as possible to its pre-pregnant state. This period usually lasts six to eight weeks.

The mother will be progressing through many changes, both emotionally and physically, while learning how to deal with all the changes and adjustments involved with becoming a new mother. The postpartum period also involves the parents learning how to care for their newborn and learning how to function as a changed family unit.

A mother needs to take good care of herself during this time to rebuild her strength.  Mothers also need plenty of rest, good nutrition, and extra help during the first few weeks.

Rest

Every new parent soon learns that babies have different time clocks than adults. A typical newborn awakens about every three hours and needs to be fed, changed, and comforted. Especially if this is their first baby, parents - especially the mother - can become overwhelmed with exhaustion. While a solid eight hours of sleep may not happen again for several months, the following suggestions may be helpful in finding ways to get more rest now.

  • In the first few weeks, a mother needs to be relieved of all responsibilities other than feeding the baby and taking care of herself.
  • Sleep when the baby sleeps. This may be only a few minutes rest several times a day, but these minutes can add up.
  • Save steps and time. Have your baby’s bed near yours for feedings at night.
  • Many new parents enjoy visits from friends and family, but new mothers should not feel obligated to entertain. Feel free to excuse yourself for a nap or to feed your baby.
  • Get outside for a few minutes each day. You can begin walking and other postpartum exercises, as advised by your physician.
  • After the first two to three weeks, introduce a bottle to breast fed babies for an occasional night-time feeding. This way, someone else can feed the baby, and you can have a longer period of uninterrupted sleep.
Nutrition

The mother’s body has undergone many changes during pregnancy, as well as with the birth of her baby. She needs to heal and recover from pregnancy and childbirth. In addition to rest, all mothers need to maintain a healthy diet to promote healing and recovery.

The weight gained in pregnancy helps build stores for your recovery and for breastfeeding. After delivery, all mothers need continued nutrition so that they can be healthy and active and able to care for their baby.

Whether they breastfeed or formula feed, all mothers need to eat a healthy and balanced diet with vitamins and minerals. Most lactation experts recommend that breastfeeding mothers should eat when they are hungry. But many mothers may be so tired or busy that food gets forgotten. So, it is essential to plan simple and healthy meals that include choices from all of the recommended groups from the food pyramid.

Although most mothers want to lose their pregnancy weight, extreme dieting and rapid weight loss can be hazardous to your health and to your baby’s if you are breastfeeding. It can take several months for a mother to lose the weight she gained during pregnancy. This can be accomplished by cutting out high-fat snacks and concentrating on a diet with plenty of fresh vegetables and fruits, balanced with proteins and carbohydrates. Exercise also helps burn calories as well as tone the muscles and limbs.  

Along with balanced meals, breastfeeding mothers should increase fluids. Many mothers find they become very thirsty while the baby is nursing. Water, milk, and fruit juices are excellent choices. It is helpful to keep a pitcher of water and even some healthy snacks beside your bed or breastfeeding chair.

Lactation is a physiological process. Human breast milk is nature’s perfect recipe for your babies growth and development. This special blend of nutrients nourishes your baby and provides a unique balance of fats, vitamins, minerals, sugars and proteins. Breast milk empowers your baby with disease fighting immunoglobulins to help protect baby during those early vulnerable first weeks of life.

Breast fed babies have fewer illnesses because human milk transfers to the infant a mother’s antibodies to disease. About 80 percent of the cells in breast milk are macrophages, cells that kill bacteria, fungi and viruses. Breast fed babies are protected, in varying degrees, from a number of illnesses, including pneumonia, botulism, bronchitis, staphylococcal infections, influenza, ear infections, and German measles. Furthermore, mothers produce antibodies to whatever disease is present in their environment, making their milk custom-designed to fight the diseases their babies are exposed to as well.

A breast fed baby’s digestive tract contains large amounts of Lactobacillus bifidus, beneficial bacteria that prevent the growth of harmful organisms. Human milk straight from the breast is always sterile, never contaminated by polluted water or dirty bottles, which can also lead to diarrhea in the infant.

Human milk contains at least 100 ingredients not found in formula. No babies are allergic to their mother’s milk, although they may have a reaction to something the mother eats. If she eliminates it from her diet, the problem resolves itself.

To maximize the benefit of your breast milk; a nursing mother must practice good nutrition. Breastfeeding is a learned behavior that needs a supportive environment. Nutrient needs of the mother during breastfeeding include a increased need for calories, vitamins and minerals, and water. Iron supplements may be necessary. Exercise is important.

Eating well during pregnancy and lactation requires a few adjustments to general good health dietary guidelines. A woman’s need for calories, protein, vitamins, minerals and water all increase. Each woman will require different amounts of foods providing key nutrients to achieve the desired pregnancy weight gain and pregnancy support. Age, weight, activity level, and metabolism all influence how much you will need to eat for optimum weight gain, health, and fetal development or breast milk production.

If you eat too little while breastfeeding, you may not produce as much milk. When breastfeeding a single baby 300-500 calories per day should be added to the diet. When feeding twins an extra 600-1000 calories per day should be added to your diet. Total caloric intake when lactating is 2300-2500 calories for singleton and 2600-3000 calories for twins

Obviously calcium for milk production comes from the mother. When calcium levels in mom’s blood are not adequate for her needs and those of her child, calcium deposited in her bones is withdrawn for milk production.

In fact, if something is lacking in mom’s current diet, mom’s body will dip into her reserves of nutrients to keep breast milk nutrient-dense. However, you are going to need your body to be healthy for a long time to take care of your growing child, so don’t short change yourself!

Be assured that the composition of nutrients in human milk is consistent. A nutrition shortage for mom is more like to reduce the quantity of milk than the quality of the milk for baby.

Vitamins
  • Vitamin D - If mother/infant is not exposed to sunlight or the diet is low in Vitamin D, then breast fed infants need to be supplemented 5-7.5 ug/day.
  • Vitamin B12 - If mother is a vegan, the infant will be B12 deficient, even if mother shows no sign of deficiency.
  • Vitamin K - There is a very low risk for developing hemorrhagic disease, but all infants are given 0.5-1 mg injection of 1-2 mg oral Vitamin K.
Iron
  • Usually adequate for 6 months, unless infant is supplemented with food too quickly.
  • Solid food may decrease iron absorption and the diet may need to be supplemented.

 

Our Phytogenic Liquid Trace Mineralsprovide the entire spectrum of necessary trace minerals and elements for a healthy mother and baby.  Our supplement comes from a plant source, which makes it more bioavailable to the body.  We also offer a quality Liquid Calcium/Magnesium Supplement for a nursing mother’s extra needs.

 

Vitamins

Vitamin levels in breast milk can be affected by maternal intake as well as length of lactation.  Vitamin A decreases as lactation progresses from 2,000mg/L to as low as 300mg/L. Low doses of exogenous Vitamin A (<15mg/day) seem to have little effect, but larger doses (>15mg/L) will increase vitamin A concentration in breast milk. Unless maternal intake is marginal to poor, the amount supplied is adequate and supplementation is not necessary.

Breast milk contains about 0.1-1.0mg/L of vitamin D and metabolites, which roughly represents approximately 1.5 to 6 percent of maternal plasma concentrations. Maternal intake does not seem to predict the milk content, but low maternal vitamin D plasma levels may limit transfer into breast milk. Mothers who have restricted intake of foods rich in vitamin D, such as strict vegetarians, and those who are exposed to limited sunlight may have critically low plasma levels. In this case, the infant may need vitamin D supplements of 10mg/day.

Vitamin E is present in high concentrations in colostrum (8mg/L) and decreased to 3 to 4mg/L in mature milk. Vitamin E concentration in breast milk is responsive to maternal intake; supplementing the infant is usually not necessary, provided the mother has adequate intake.

Vitamin C is usually found in adequate concentrations of about 100mg/L of breast milk in well-nourished mothers. Intake less than 100mg/day may decrease milk content, but doses over 100mg/day will not increase it. Vitamin C content in breast milk is eight to ten times higher than maternal plasma concentration.

The quantity of vitamin K in breast milk is approximately 0.8 to 1.0mg/L, and this can be increased to 60mg/L with maternal supplementation of 5mg/day. Vitamin K supplementation for newborns may be recommended for infants at risk for hemorrhagic disease. A single intramuscular (IM) dose of 1 to 5mg IM can be given to the mother 12 to 24 hours before delivery, 0.5 to 1mg can be given within one hour of birth, or 2mg orally can be given to the infant. Higher doses may be needed if the mother has been taking anticoagulants.

Thiamine is present in low concentrations in early milk at a concentration of 20mg/L, but the concentration increases significantly in mature milk to 175-250mg/L, which is adequate for the infant. Riboflavin concentrations are high in early milk and decrease to 400-600mg/L in mature milk. The amount of niacin present is dependent upon maternal intake, rising from 0.5mg/L in early milk, to 1.8 to 2.0mg/L in mature milk, and possibly reaching as high as 6mg/L with higher intake. Vitamin B6 starts low in colostrum and increases as much as ten-fold from 0.09 to 0.31 mg/L in mature milk. Vitamin B6 levels in breast milk increase with increased maternal intake, but may be reduced in women who have been using oral contraceptives for an extended period of time.

Vitamin B12 and folate are usually found in excess because they are secreted bound to whey proteins. In well-nourished mothers, vitamin B12 concentrations are adequate (0.5 to 1.0mg/L) and supplementation has little effect. However, levels as low as 0.05 to 0.75mg/L have been reported in cases of women who were strict vegetarians, malnourished, or had hypothyroid-induced pernicious anemia. Infant supplementation would be recommended in such cases. Folate concentrations usually remain adequate in breast milk in spite of maternal plasma concentration or intake. The average folate concentration in breast milk ranges from 80 to 140mg/L.

Minerals

Unlike vitamins, minerals do not seem to correlate with maternal intake or maternal plasma levels. Phosphorous seems to be highest in early milk, at 147mg/L, decreasing to 107mg/L in mature milk. Calcium increases from 259mg/L to 290mg/L and magnesium increases from 248mg/L to 330mg/L. It has been speculated that these three minerals in these concentrations are important in bone remodeling occurring in infancy.

Copper, iron, and zincconcentrations seem to be strongly related to liver stores of the mother accumulated during the third trimester. Maternal intake has very little effect on them. Copper and iron concentrations start high in early milk, leveling off to 0.3mg/L of each. Zinc also starts higher (4mg/L), declining to 1.1mg/L at 6 months postpartum, and decreasing still to 0.5mg/L after 1 year. Both iron and zinc have a high bioavailability in breast milk, but the bioavailability of copper is unknown.

Manganese declines from 6mg/L after 1 month of lactation to 3mg/L after 3 and 6 months, but is much better absorbed than the manganese found in infant formulas. Selenium is strongly influenced by maternal selenium status. It tends to be high early in lactation (40mg/L), decreasing in mature milk. Iodine in breast milk varies according to maternal intake and geographic region. In iodine-sufficient areas, the breast milk content is approximately 150mg/L, and in iodine-deficient areas it can be as low as 15mg/L.

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One Response to “Postpartum Nutrition and Lactation”

  1. Joshua Williams Says:

    Botulism knows where you live! o_o

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