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General Guidelines for Breastfeeding Women

Drink plenty of liquids each day, since milk production uses additional water. Pour yourself a glass of water or nutritional beverage each time you sit down to nurse. Pay attention to your body's thirst cues. For example, some women report that their mouth goes dry as they start to nurse. Feeling thirsty is an important signal that you need to drink extra fluid. Constipation is another common indicator of the need for additional water. Staying well hydrated helps keep your bowels regular. Drinking scant fluids or becoming dehydrated can diminish your milk supply. However, contrary to popular belief, consuming excessive quantities of liquids offers no advantage over drinking to satisfy thirst.

In general, you do not have to restrict the kinds of foods you eat while you are nursing. One of the most popular myths related to breastfeeding is the widespread belief that nursing mothers must refrain from eating spicy foods, chocolate, beans, onions, and a host of other foods that could upset their infant's digestion and cause their baby to be fussy. The perpetuation of this misbelief only serves to make women view breastfeeding as excessively restrictive. The fact is that women all over the world breastfeed their babies while eating local diets that represent a wide diversity of foods, including curried and spicy foods and other fare that nursing mothers in America are cautioned to avoid. Ordinarily, you do not need to eliminate any specific foods from your diet if you are breastfeeding. Certain dietary restrictions are recommended, however, if you, the baby's father, or another of your children suffers from food allergies, asthma, eczema, or other type of allergic disease. A baby whose close relatives have allergic symptoms is at greater risk for developing allergic disease himself. Prolonged, exclusive breastfeeding is important for infants at high risk for allergic disease. The protective benefits of breastfeeding are further enhanced when the mother excludes common allergenic foods-milk and other dairy products, egg, fish, peanut, soy-from her diet during pregnancy and lactation. The allergic risk to her baby is also reduced if the mother rotates her foods, avoiding eating any single food on a daily basis. I must emphasize that women who eliminate major food groups, such as dairy products, from their diet will need nutrition counseling by a registered dietitian or their physician.

Continue to take your prenatal vitamins. Breastfeeding women risk depleting their reserves of vitamins and minerals. The vitamin content of milk depends on the mother's vitamin intake or stores. Ideally, foods, not supplements, are the preferred source of all nutrients. But for extra assurance, breastfeeding women usually are advised to continue taking any multivitamin-mineral supplements that were prescribed for them during pregnancy. Strict vegetarian mothers, in particular, should take a supplement of vitamin B12.

Getting Your Figure Back.
Immediately following delivery, women lose about twelve pounds, which represents the weight of the baby, placenta, amniotic fluid, and blood. In the following weeks, excess water is lost, amounting to approximately another five pounds. After the first month, breastfeeding women can expect to lose about one to two pounds each month while they nurse. The reason for the steady weight loss is that the process of lactation uses the extra body fat that was stored during pregnancy. Each day you breastfeed, your body subsidizes lactation with about five hundred calories from fat stores. After the first three months, breastfeeding women generally lose weight more rapidly than bottle-feeding mothers and return to their prepregnancy weight sooner.

Avoid rapid weight loss during breastfeeding. Many new mothers are preoccupied with their body image and find the idea of rapid weight loss highly desirable. But trying to return too quickly to your prepregnancy weight by drastically reducing your calorie intake is likely to result in diminished milk production. Women who were at normal weight prior to their pregnancy are advised not to lose more than two pounds per month after the first month of breastfeeding. Overweight women can lose up to four pounds a month. More rapid weight loss, or consuming fewer than 1,800 calories per day, places a woman at risk for reduced milk production. Remember, lactation is the body's only elective process. Inadequate caloric intake is perceived by the body as a form of stress. Your body might try to conserve energy in reaction to this stress condition by reducing the energy needs of lactation. Inadequate milk supply can result. It is far preferable to lose weight gradually after pregnancy (after all, it took you nine months to gain it!). Increasing your physical activity through moderate exercise and adhering to a healthy diet will result in steady-and more permanent-weight reduction, without compromising your breastfeeding goal. Instead of resorting to drastic dieting measures, just focus on reducing the total fat and saturated fat in your diet and on reducing your intake of high-calorie snack foods. For most women, breastfeeding provides an ideal time to accomplish gradual weight loss because of nature's plan to use body fat for milk production.

Seek professional help if you think you could have an eating disorder. Our society's preoccupation with thinness has contributed to an epidemic of eating disorders, principally among young women. Anorexia nervosa is one of the most extreme eating dis-orders. Life-threatening emaciation can result from the relentless pursuit of thinness by active food-restricting practices and severe weight-control measures. Bulimia is another common eating disorder that is characterized by episodes of binge eating (rapid consumption of a large amount of food in a short period of time). Binge episodes are frequently followed by self-induced vomiting and use of diuretics and laxatives to rid the body of food. Obviously, such eating behaviors can severely interfere with successful breastfeeding. Reduced body fat stores and highly erratic eating patterns can prevent a mother from producing an adequate milk supply. It is beyond the scope of this book to offer specific help for women with eating disorders, but I feel compelled to mention the problem because it is so prevalent and so devastating. Countless women remain chronic victims of eating disorders and the often incapacitating psychological difficulties that accompany them. If I am speaking to you, I urge you to obtain a referral for professional help from your physician. As a new parent, you owe it to yourself and your baby to reclaim your health.

Let the nutritional implications of breastfeeding renew your emphasis on lifelong healthy eating. Many women, myself included, are particularly receptive to nutrition information during pregnancy and the course of breastfeeding. I found I was more motivated to eat in a healthful manner while I was nursing a baby. Somehow, my conviction to give my baby ideal nutrition served to heighten my awareness of my own and my family's eating habits. The increased attention I gave to learning more about good nutrition had a positive ripple effect on my whole family's long-term health.



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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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