Nutrition, Exercise, and Weight Loss While Breastfeeding
By: Anne Smith
Most mothers are highly motivated to eat a nutritious diet during their
pregnancies. Assuming that you ate an adequate diet while you were pregnant, you
can produce plenty of milk for your baby by keeping up this motivation and
making sure that you continue your healthy eating patterns during lactation.
While you should attempt to eat a "good diet" while you are nursing, you need to
be aware that your diet doesn't have to be perfect in order to support
lactation. You can still breastfeed even if your diet is less than ideal. You
may be surprised to learn that studies have shown that maternal nutrition has
only a minor effect on the composition and quantity of breastmilk produced.
Usually, unless a mother is severely malnourished, her milk is fine. Mothers
whose diets are poor deplete their own energy levels, and may become anemic, but
their bodies will continue to produce the milk their baby needs by pulling from
the mother's energy stores at her expense, but not her baby's. Most women in
this country don't suffer from a lack of food, but rather from eating too much
of the wrong kinds.
There are no special dietary rules to follow during lactation. If your eating
habits are fairly healthy, there is no reason to change them while you are
nursing. There are no special foods to avoid, or certain foods that you need to
eat (like milk) in order to produce a plentiful supply of nutritious breastmilk.
With rare exceptions, nursing mothers can eat pretty much anything they want to
eat - including chocolate, broccoli, pizza, and diet soda - in moderation. Some
dieticians and lactation experts feel that one advantage to breastfeeding may be
that the milk is flavored by the foods the mother eats, so the baby becomes used
to a variety of taste sensations, and tends to have fewer feeding problems as he
gets older. One famous study showed that when mothers ate lots and lots of
garlic, their milk tasted and smelled like garlic. Not only did the babies who
drank the milk not have any digestive problems, but they actually preferred the
garlicky milk over the unflavored milk. Think about it - women in South America
who eat lots of peppers, or women in India who eat lots of curry don't have
babies any more colicky or fussy than babies in the U.S.
You've probably heard that eating "gassy" foods like cabbage, beans, or broccoli
will make your baby gassy. I believe that this is one of many "old wive's
tales", because gas is produced when bacteria in the intestine interact with the
intestinal fiber. Neither gas nor fiber can pass into breastmilk, even when you
have gas.
Although it is possible for a baby to be sensitive to a food in his mother's
diet, he is much more likely to react to a food given to him directly. I suspect
that most mothers who swear that they can't eat (pizza, Mexican food, broccoli,
cabbage, beans, chocolate, etc.) while they are nursing are actually
overreacting to their baby's normal behavior on any given day. There is a
natural tendency for every nursing mother to attribute every little thing her
baby does to nursing. ALL babies have days when they are gassy, fussy, and spit
up. Some babies have sensitive digestive systems, and no matter what you feed
them, they will experience bouts of intestinal upsets. The one thing you can be
sure of is that there is nothing you can put into a sensitive infant's stomach
that will be easier to digest than breastmilk.
When you are nursing, you start to think "…he's so gassy today…must be something
I ate…yep, I had pizza for dinner last night…that must be it. I can't eat pizza
from now on." When taken to extremes, this sort of thinking can lead to a diet
of nothing but boiled chicken and polished rice.
In nearly 25 years of experience in working with nursing mothers I have seen
very few cases of food sensitivity. I'm not saying it doesn't exist, just that
it is highly uncommon. It is estimated that only 3-7% of babies will have any
type of food sensitivity or allergy. Signs of food sensitivity can include:
inconsolable fussiness, suddenly waking in obvious distress, skin rashes,
wheezing, and green mucousy stools. A strong family history of allergies (food
or other) can also increase the possibility of food sensitivity. If you think
your baby may be having problems with a food you have eaten, remember that it
takes 4-6 hours after ingestion for a food to affects your breastmilk. Try
eliminating the food you suspect from your diet for a minimum or 2-3 weeks. It
may take a while for your baby to improve. Of course, during that time, he may
outgrown his sensitivity anyway as his digestive system matures.
The one food that is the most common offender in causing problems with
sensitivity and allergies is cow's milk. That's why it's the first food you
should work on reducing or eliminating if you suspect your baby has a food
sensitivity. It may take ten days to two weeks to eliminate cow's milk protein
from your diet, so wait at least two weeks before you decide whether cow's milk
is the problem. The problem with cow's milk is the protein, which is difficult
for babies to digest, not with the lactose. Human beings are not born lactose
intolerant, unless they are born with a rare metabolic disorder. Lactose
intolerance is caused by a deficiency of the enzyme lactase, which breaks down
lactose (milk sugar) so it can be easily digested. Mammals are born with this
enzyme in their intestines. As they grow older and wean, the lactase enzyme
decreases. That's why lactose intolerance rarely shows up in humans before age
3, since that's the average age of weaning (if that shocks you, check out the
article on "Weaning".) Lactose intolerance is more common in Asian and African
adults.
The proteins in cow's milk are primarily caseins, which are harder to digest
than whey
proteins, which are more prominent in human milk. The proteins in cow's milk
pass into your milk, and can cause digestive problems for your baby. These
proteins can even sensitize your baby before birth if you drink lots of milk
during your pregnancy. If you decide to reduce or eliminate dairy products,
remember than processed milk presents less of a problem than whole milk.
You may be able to continue eating yogurt and cheese while
cutting back or eliminating milk. Since milk and milk products are important
sources of calcium, be sure to calcium from other sources, such as broccoli,
nuts, spinach, and canned salmon. Taking a calcium supplement would be a good
idea if you are limiting your intake of dairy products. You need about 1,000 mg
of calcium each day if you are between 18-50 years of age, whether you are
lactating or not. While nursing mothers do lose some bone mass during lactation,
by the time your baby has been weaned for a year, this lost bone mass in not
only completely restored, but research has shown that women who breastfeed have
half the risk of bone fractures as women who never breasted, and the longer you
nurse, the lower the risk. Breastfeeding actually protects you from
osteoporosis.
If you are anemic, don't worry that your milk won't have enough iron for your
baby. Breastmilk contains less iron than formula, but the iron is used more
efficiently, so your baby is less likely to become anemic, even if your iron
levels are low. You will need to make iron supplements to make you feel better,
but they will not affect the level of iron in your breastmilk.
The guide to how much fluid to drink while nursing is to "drink to thirst".
There is no evidence to show that forcing fluids will increase your milk supply.
(Another "old wive's tale".) Drinking too much water (over 12 glasses a day)
can actually decrease your milk supply. The current recommendation is to drink
6-8 ounces of water each day. The problem is that when you are a new mom, you
often forget to take care of yourself while you are so immersed in taking care
of the baby. Try drinking a glass of water or juice whenever you sit down to
nurse your baby. Most mothers find that they are thirstier when they are
nursing. If you produce large amounts of pale urine and are not constipated,
then you are probably drinking enough. If your stools are hard and dry, and your
urine is concentrated and dark, then you may need to increase your fluid intake.
Remember that it is normal for your first void of the morning to be darker and
more concentrated than at any other time during the day.
A good rule of thumb is to take in 200-500 calories in excess of what you needed
to maintain your weight before you were pregnant while you are nursing.
Breastfeeding doesn't make you gain weight - in fact, you use up calories when
you nurse, and helps you get rid of extra weight more quickly while you are
nursing. Your body stores up fat during your pregnancy to provide the extra
calories needed for milk production. It is easier to lose lower body fat (hips,
buns, and thighs) when you are breastfeeding compared to the mom who is formula
feeding. (YAY!) .
If you are a vegetarian, you probably will not need to change your diet unless
your diet doesn't include any animal protein (vegan and macrobiotic diets). If
you do not want to consume any animal products, you should consider taking a
vitamin supplement containing vitamin B12. If you don't eat any dairy products,
you should make sure to get enough calcium. I recommend that every nursing mom
continue taking prenatal vitamins for as long as she lactates.
Just like "drinking to thirst", you should "eat to hunger" while nursing.
Studies have shown that most nursing mothers tend to lose up to one and a half
pounds a month for the first 4-6 months after giving birth, and continue to lose
weight at a slower rate beyond that time. They tend to lose more weight than
formula feeding moms who take in fewer calories. If you want to lose weight (and
most of us do - how depressing to still be wearing those old maternity clothes
we got so sick of after the baby is born…) plan to do so slowly. It's best not
to try to aggressively lose weight during the first couple of months after
birth, because during that time your body needs to recover from childbirth and
establish a good milk supply. Losing weight too quickly (more than one to one
and one half pounds per week) has been associated with the release of
environmental contaminants stored in body fat into the milk.
Begin your weight loss program slowly when you are breastfeeding. Increase your
activity level and eat less fat and sugar and more fruits and vegetables. Try to
take in at least 1,800 calories each day, and definitely no less than 1,500
calories. Even moderate dieting during lactation can help you lose 4-5 pounds
each month, but don't expect to lose body fat until about 2 weeks postpartum.
The weight you lose immediately after birth is usually fluid loss. Mothers who
breastfeed more frequently lose weight faster than mothers who nurse less often,
and mothers who nurse for shorter periods of time tend to lose weight more
slowly than mothers who nurse longer. You may get lucky and find that you can
eat more than you ever could before and still lose weight while nursing. That
was the case with me, but I did find that eating a whole container of Ben and
Jerry's before bedtime every night kept me from losing weight as quickly as I
would have liked.
Despite one highly publicized but very questionable study about exercising
during lactation, there is NO evidence that moderate exercise is anything but
beneficial for nursing mothers (or anyone else, for that matter.) Plan to
exercise after nursing so your breasts won't be full and uncomfortable. Wear a
supportive sports bra. Drink a glass of water before and immediately after
exercising. Drink more in hot weather. If you regularly lift weights or do other
exercises involving repetitive arm movement, start slowly. If you develop
plugged ducts, cut back and start again more slowly. Rinse off your breasts
before nursing - some babies don't like the taste of the salt. Take walks with
your baby. If you carry him in a backpack, his extra weight will use up even
more calories. Weather permitting, go for lots of walks - this counts as
exercise and gets you out of the house as well. It the weather keeps you inside,
try carrying your little one in a sling while you do housework - and try dancing
with him. You may feel silly, but he'll love it and so will you. Nobody will see
you, and postpartum mothers are supposed to act a little bit goofy - the
technical term is "baby brain".
In summary: try to eat a nutritious diet while you are nursing, for your sake
and your baby's. Don't worry if your diet isn't perfect, your milk will still be
fine. If you want to lose weight, you will probably lose it without radically
altering your diet while your are nursing. If you want to lose weight faster,
start slowly, increase your activity level, and eat nutrient dense and healthy
foods. Moderate exercise is good for both you and your baby. Try to make it fun
so that you'll stick with your exercise program. Eat anything you want to in
moderation, and remember that many mothers lose weight while lactating even
without modifying their diet or exercise regimen. You will usually keep about
three pounds of extra tissue in your breasts as long as you are nursing, so
factor that into your weight loss goals. Enjoy nursing your baby, eat a healthy
diet, and you most likely will lose weight while eating more food than you were
used to eating before your little one arrived.
Sources include: Breastfeeding and Human Lactation, 2nd Edition, Riordan an
Auerbach, 1999
LLLI The Breastfeeding Answer Book, revised edition, 1997
The Complete Book of Breastfeeding, 3rd edition, Eiger and Wendkos olds, 1999
Anne Smith is an IBCLC – International Board Certified Lactation Consultant and La Leche Leader since 1978. More importantly, she is a mother to 6 breast fed kids with twenty plus years experience of counseling nursing mothers. Her site, www.BreastfeedingBasics.com , provides expert advice and solutions to breast-feeding problems and gives basic information on how to breast feed. Anne also features her recommended breast feeding products and breast pumps.