Nutrition during Lactation

Just like pregnancy, producing milk requires extra energy and nutrients. That's why it is essential to follow a diet based on balance, variety, moderation and enjoyment.

Balance, variety, moderation and enjoyment

The essential elements of healthy eating are balance, variety, moderation and enjoyment.

For optimal health, your body needs the right balance of macronutrients (carbohydrate, protein and fat), micronutrients (vitamin, minerals and trace elements) and other healthy substances in food such as fibre and phytochemicals, such as lycopene in tomatoes, pink grapefruit and watermelon.

· Variety is important, because by eating a number of different foods you can ensure you are getting a number of different nutrients in the right balance. While some foods are healthier and higher in specific nutrients (nutrient-dense) than others, no single food or food group has every nutrient. Eating a variety of different foods is critical to obtaining all of your needs. Variety allows for all of the food groups to be included: Bread, cereals, rice and pasta

· Fruit

· Vegetables

· Milk and dairy products

· Meat and meat alternatives

· Fats and oils

Moderation is eating neither too much nor too little of any food or nutrient. Add: a balance between needs and intake. Too much food can result in excess body fat gain and even an excess of certain nutrients, while eating too little can lead to nutrient deficiencies and low body mass. Practise moderation (by checking on portion sizes) in what you eat for most of the time.

Eating is not just for nourishment, it is one of life's great pleasures. In today's world, concern about the relationships between health and food can make it too easy to overlook the important social functions of eating. It must be remembered that eating food should be enjoyable.

Foods to favour

You should focus on eating whole grains and cereals, fresh fruits, vegetables and foods that provide plenty of protein, calcium and iron as well as the other micro nutrients.

You may still need to keep taking your pregnancy vitamin-mineral supplement while feeding and you may also need additional iron. If you continue with a vitamin-mineral supplement, it should not make up for poor eating habits. Always strive to eat a well-balanced, varied diet.

The United States Department of Agriculture recommends the same number of servings from each food group for pregnancy and feeding:

· 7 to 11 servings of breads and cereals

· 4 to 5 servings of vegetables

· 3 to 4 servings of fruit

· 3 to 4 servings of calcium foods (eg milk, yoghurt and cheese)

· 3 servings of protein foods (eg extra lean beef, skinless chicken, fish and legumes).

Serving sizes

· Bread and cereals: 1 slice of bread, 1/2 a cup of cereal/rice/pasta or 1/2 roll

· Vegetables:1 cup of raw leafy vegetables, 1/2 a cup of cooked vegetables or 125 ml (1/2 cup) vegetable juice

· Fruit: 1 cup of fruit salad, 1 medium fruit, 2 tablespoons dried fruit or 125 ml (1/2 cup) fruit juice.

· Milk and dairy products: 250ml milk (1 glass), 30g cheese or 2 tablespoons cottage cheese.

· Meat and meat alternatives: 90g red meat or chicken or fish, 1 whole egg or 1/2 a cup of cooked dry beans, soya mince or pulses.

Essential fatty acids, especially omega 3 fatty acids, should be included daily. Omega 3 fatty acids can be found in oily fish, such as mackerel, pilchards, salmon and sardines. Saturated fats (from animal products, such as meat and dairy) and trans fatty acids (from processed and baked goods) should be limited, while a moderate intake of monounsaturated fats (from olives, olive oil, avocados) and polyunsaturated fats (from pant oils, such as sunflower oil) is encouraged.

The American College of Obstetricians and Gynaecologists recommends drinking at least eight to 12 glasses of water a day to stay hydrated.

Suggestions for a balanced meal plan for feeding

Breakfast 

· 1 piece of washed fruit or a small glass of fruit juice

· 1 cup of high fibre cereal plus 1 cup of fat free or low-fat milk

· 1 to 2 slices of high fibre bread with thinly spread margarine or butter

Morning snack

· 3 wholegrain crackers (eg Provitas or Ryvitas) with a scrape of peanut butter

Lunch 

· 2 slices of whole-wheat bread

· 1/2 cup of drained canned tuna and 1 slice of reduced fat cheese

· 1 cup washed salad

· 1 piece washed fruit

Afternoon snack

· 1 fat free or low fat yoghurt and fruit

Dinner 

· 150 grams of freshly cooked lean beef, chicken or fish

· 1 1/2 cups of steamed vegetables (eg carrots, broccoli and cauliflower)

· 1 cup cooked brown rice, pasta or potato

· Fresh or tinned fruit in natural juice and low fat yoghurt

Evening snack

· 1 cup Milo (made with fat free or low fat milk) and 1 plain biscuit.

Foods to limit or avoid

In general, no food is excluded from the list of foods a feeding mother should eat but it's obviously best to ensure the foods you eat are fresh and clean. Follow food safety principles when handling, preparing and storing food.

Foods with strong or spicy flavours, such as garlic, may change the flavour of milk. Some herbs may also enter the milk and should be avoided.

Alcohol or caffeine

Limit or avoid caffeine and alcohol as they can be excreted into your milk and potentially harm or irritate your baby.

Alcohol easily enters milk and its concentration peaks within an hour of ingestion. Infants drink less milk when their mothers have consumed even a small amount of alcohol. An occasional glass of wine or beer is considered safe, but feeding mothers should consume little or no alcohol. There is no truth in the concept that beer (stout) can stimulate milk production.

Caffeine may cause irritability and wakefulness in a fed baby. As during pregnancy, caffeine consumption should be moderate - approximately one to two cups of coffee a day. Larger doses of caffeine may interfere with the bioavailability of iron from milk and impair your baby's iron status.

Food-induced sensitivity

Food-induced sensitivity varies between babies. If you suspect a particular food you're eating is causing your baby discomfort, discuss it with your physician and consider eliminating it from your diet to see if your baby's reaction subsides.

If it does, include the food again but monitor your baby's reactions. If a food must be eliminated for an extended period, substitutions must be made to ensure adequate nutrient intake.

A registered dietitian should be consulted for more individual feeding nutritional advice.

(Reworked from article by Discovery)