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General Guidelines for Breastfeeding Women

The period of lactation is a relatively brief and very special time in a woman's life that is fondly remembered with a measure of pride. During this unique phase in the childbearing cycle, a breastfeeding mother will need to take some extra care to assure that she produces and provides to her infant abundant, high-quality milk. Unfortunately, many misinformed women decline to breastfeed because they worry that they don't "know all the rules" or they fear they will have to make drastic changes in their lifestyle to accommodate nursing. Actually, most women find that few modifications in their daily life are required to breastfeed successfully. The few who do need to make significant lifestyle changes almost always discover that the rewards of nursing their baby far outweigh any temporary inconvenience in their usual routines. Once you survive the early weeks of new parenthood and get breastfeeding well established, you'll begin to appreciate just how convenient it can be to fit a nursing baby into your life. And the healthy practices you adopt while breastfeeding can become the foundation for a lifetime of increased health consciousness.

A Healthful Diet for Lactating Mothers
Because human milk represents the ideal food for young infants, it's only natural to focus first on the type of diet a mother needs to consume in order to produce nutritious milk for her baby. Concerns about the adequacy of their diet cause many women to doubt the quality of their milk. But a mother's diet doesn't have to be perfect in order for her to make adequate milk and to nourish her baby well. Human milk produced by women all over the world is amazingly uniform in its composition. When mothers are poorly nourished, the quantity of milk they produce may be reduced, but the quality of milk tends to be fairly consistent. The process of lactation assures that human milk will have the right amount of nutrients-even at the mother's expense, if she doesn't eat a balanced diet on a given day.

Keep It Simple and Build on Your Success
Since lactation follows pregnancy, chances are good that you already are familiar with the basics of sound nutrition. If you gained at least twenty-five pounds during your pregnancy and delivered a baby weighing more than about six and a half pounds, you probably already have an adequate diet. Just keep up the good work! Women who require additional nutrition counseling include those who gained less than twenty pounds during pregnancy or who gave birth to a baby weighing less than six pounds at term. Other women who should receive special dietary advice include those who are underweight with little body fat; who are on restricted or specialized diets; who have chronic health problems (such as diabetes) or medical conditions causing malabsorption (such as cystic fibrosis or inflammatory bowel disease); who suffer from eating disorders; or who delivered twins.

Specific Nutrition Recommendations for Breastfeeding Women
Eat three balanced meals a day and nutritious snacks. Consume a variety of foods in as natural a form as possible to obtain the calories, protein, vitamins, minerals, and fiber you need for optimal health. Eat plenty of fruits, vegetables, and whole-grain breads and cereals. Limit your intake of sugar, salt, fat, and highly processed foods. The Food Guide Pyramid shown on page 180 has replaced the former Four Food Groups as a suggested outline for daily eating. Because most American diets are too high in fat and saturated fat, the Food Guide Pyramid emphasizes food choices that help reduce fat intake. The layout of the guide visually reinforces the relative number of servings from each of the five major food groups. The largest number of daily food choices (six to eleven servings) should come from the bread and grain group. Whole-grain breads and cereals contain more vitamins and minerals and provide more fiber to prevent constipation. At least five servings of fruits and vegetables (two to four servings of fruits; three to five servings of vegetables) are recommended each day-most Americans fall short of this recommendation. Fruits and veggies are a nutritious, low-fat source of calories, vitamins, minerals, and fiber. Make an effort to eat vitamin A-rich produce often, such as carrots, spinach, sweet potatoes, and cantaloupe. Three servings of milk or other dairy products are suggested for breastfeeding women (four servings for teen mothers). Recent evidence has confirmed the importance of adequate calcium intake in the prevention of osteoporosis (brittle bones) in later life. Dairy products are the best source of dietary calcium. Milk and milk products also provide protein, vitamins, and minerals. If you don't like milk or have a milk allergy or milk intolerance, I advise you to get nutrition counseling and, if deemed necessary, to take appropriate supplements to replace essential nutrients in milk. Lactating mothers also should eat three servings of meat, poultry, fish eggs, nuts, or dry beans each day. Meat or meat alternates provide protein, vitamins, iron, and zinc. The small tip of the Pyramid serves as a reminder that fats, sweets, and soft drinks should be consumed only sparingly.

While your body is producing breast milk, it requires more calories than usual. Most lactating women will need to consume about 500 additional calories above their normal prepregnancy food intake. An individual mother's calorie requirements can vary widely depending upon her basic metabolism and level of activity. Nutrition experts recommend that breastfeeding women consume 2,700 calories per day. However, recent studies of healthy lactating women in the industrialized world showed their actual intake of food to be approximately 2,200 calories per day while breastfeeding, or about 15 percent less than the recommended value. Most nursing mothers will need to consume at least 2,200 calories per day to provide necessary nutrients and to maintain milk production. At this level of calorie intake, a lactating mother can still expect to lose weight gradually during the course of breastfeeding. This is because the body contributes an additional 500 calories each day from body fat stores to help subsidize lactation. Thus, it is nature's plan to store up extra fat during pregnancy so it will be available to contribute to lactation after delivery. Body fat stores are decreased during breastfeeding, particularly in the thighs and hips.



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From Dr. Mom's Guide to Breastfeeding by Marianne R. Neifert. Copyright © 1998 by Marianne R. Neifert. Used by arrangement with Plume, a member of Penguin Group (USA) Inc.

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