So you’ve made it through the pregnancy and birth and are now realising that this is where the hard work really begins! If you decide, and are able, to breastfeed your child then well done. It is not always possible and not always the easiest the option. There is something really special about having a totally homegrown baby, well at least until you introduce solids, but that is a topic for another blog.
I was asked to write about diet and breastfeeding by a friend who couldn’t find any answers to this question. My response was ‘that’s because your diet doesn’t really have to change when you breastfeed,’ and her response was ‘well you need to tell people that!’. The more I thought about it, I realised there were a few things it is useful to know, so I’ve put together this list of six things to know about diet and breastfeeding:
- General healthy eating principles apply when breastfeeding
As with pregnancy there is no special diet advised for breastfeeding and now the baby is born you can go back to eating those pregnancy-forbidden foods you’ve been missing for the last nine months, such as pâté and mould ripened cheese. It is as important as ever that you try to eat healthily not only for yourself but also for your baby.
- Toxins can pass through breastmilk
It is still a good idea to avoid alcohol and limit caffeine, as well as limit oily fish to two portions a week, because toxins, such as alcohol, caffeine and pollutants and mercury are passed through to breastmilk.
You don’t need to take folic acid as this is advised only until 12th week of pregnancy, but you should continue to take a daily 10µg supplement of vitamin D. You also need to give vitamin D supplement drops to your baby, unless they are getting more than 500ml of formula a day, as recommended by the NHS.
- Will what I eat affect my baby’s wind/colic?
When your baby is a newborn, their digestive system is brand-new and so it may take a while to adjust to digesting milk, and this may result in some gas production resulting in some discomfort and maybe explosive poos. If the discomfort is consistent and causing significant distress then seek advice from your health visitor or family doctor as it may be that they have an allergy to cow’s milk protein or an intolerance to the lactose in the milk. Ensure you speak to a qualified dietitian before excluding any key food groups, such as dairy from your diet.
If your baby is just a bit windy, you may have been advised (as I was) to limit consumption of other foods such as onions, garlic, citrus fruits, green vegetables etc, as it is thought among some that components of these foods may pass into breast milk and be responsible for excessive gas production in your baby. The UK’s National Institute for Health and Clinical Excellence (NICE) however concludes that there is insufficient good quality evidence to suggest that any specific foods are routinely the cause of gas in newborns. Generally, these symptoms pass relatively quickly unless there is an underlying allergy or intolerance to a food, so I will leave it up to you to decide whether to try excluding any single food items. As a lover of fruit and vegetables I decided just to put up with changing the nightly explosive (projectile!) poos for a few weeks, because there seemed to be no pattern between the timing of gassy episodes and my diet, (or if there was, I was too sleep deprived to notice it), and I couldn’t cope with making any changes to my diet on top of everything else there was to worry about.
- Keep an eye on your weight, but don’t crash diet
You may take a while to return to your pre-pregnancy weight, or you may have a very hungry baby and the weight just falls off. While breastfeeding can help you to lose weight as you use up your fat stores laid down in pregnancy, the first few weeks can be a difficult time. The broken nights of sleep take their toll and it can be hard to get others to help out with feeding as the baby is dependent on your milk. With tiredness comes the temptation to eat more to make up for the energy you are not getting from sleep. I remember having an insatiable appetite while breastfeeding. I would tuck into my mother-in-law’s flapjacks in the middle of the night to get through the torture of our child not sleeping and her explosive poos. Whether you are breastfeeding or not, there is little time for exercising or putting thought into healthy meal plans, so it can be really easy to eat more than you need, not lose the pregnancy weight and even put on more weight. While I would not advocate dieting while breastfeeding as this may affect your milk supply, a gradual weight loss of up to 2kg per month is unlikely to affect milk volume.
I found after having both of my babies I didn’t get back to my pre-pregnancy size until after I had stopped breastfeeding, a year after they were born. Perhaps this was also because life stepped up a gear when I returned back to work and there was no longer the excuse ‘I’m breastfeeding I need a mid-morning snack!’ It can become a problem if you don’t manage to get back to your pre-pregnancy weight before getting pregnant again, not only because of the risks associated with being overweight in pregnancy, but also the cumulative effect of the weight gain for each pregnancy. If you notice that you are still overweight a month or two after having stopped breastfeeding, I would advise actively trying to reach a healthy weight before planning another pregnancy.
- Your diet can affect the composition of breastmilk
You are no doubt aware of the changes to the consistency of breast milk during the course of a feed. The first part of the feed is more watery (i.e. foremilk) and throughout the course of the feed more of the fat is emptied from the breast and the milk becomes thicker (i.e. hind milk). The composition of the milk also changes during the course of the baby’s life, for example, the first fluid they taste is the colostrum containing concentrated levels of nutrients and antibodies, the milk then changes in consistency after a few days. While working at the Department of Health I co-carried out a literature review into the composition of breast milk as part of the Diet and Nutrition Survey of Infants and Young Children (DNSIYC), which sparked my fascination in this area. A more recent and comprehensive piece of research looking into the composition of breast milk found that the macronutrient content (i.e. carbohydrate/sugar, total protein and fat content) seems to be protected from changes in the mother’s diet and remains relatively constant, although the composition of individual fatty acids and amino acids (i.e. the building blocks of protein) can vary, for example the milk would increase in omega-3 fatty acid content after the mother consumed oily fish. The content of some vitamins and minerals change during the first few months of the baby’s life and some vary depending on the mother’s diet (e.g. water- soluble vitamins including vitamin C and B vitamins), while others do not and the infant must rely on their stores obtained from birth (e.g. iron). This helps to explain why it is so important to obtain a healthy diet in pregnancy, to ensure stores of vital nutrients are built up in time for the birth, and while breast feeding, because your baby is relying on the nutrients you are providing through your milk to grow strong and healthy.
Whether you breastfeed your baby or not, it is important to remember that diet plays a key role in the health of your child from conception to graduation. Enjoy the next six months and I’ll be back to help you through weaning.