The first year following your baby's birth there will be many questions with answers that no one ever told you that you would need to ask. The Post-Pregnancy Handbook will help prepare you for the highs and lows from birth to age one.

Sylvia Brown and Mary Dowd Struck

The nursing mother's diet
A nursing mother produces 23 to 27 ounces of milk per day, containing 330 milligrams of calcium per quart. This requires an extra energy expenditure of at least 500 calories per day. Good nutrition is therefore just as important for you as it is for your baby.

The quality of breast milk is only affected in extreme cases of deprivation, or by excessive intake of a particular food. But the quantity of milk depends very much on the mother's diet. Food absorbed by a nursing mother not only fulfills her own nutritional needs, which are greater during the postnatal period, but also enables her to produce milk. A woman who does not feed herself properly may still have a healthy baby, but it will be to the detriment of her own health. If you lack sufficient nourishment, your body will make milk production its first priority, and your needs will go unmet. It is just the same as it was during pregnancy, when the nutritional needs of the fetus were satisfied before those of the mother. In fact, the baby, who weighs only a few pounds, will receive nearly 1,000 calories per day in breast milk!

What does it mean to feed yourself properly while nursing? We can compare a breast-feeding mother to a marathon runner-whose race will last twenty-four hours, not four.

The basics
Increase your water consumption by one quart per day, so that you are drinking a total of 2.5 to 3 quarts. Nursing women tend to be thirstier anyway, especially during feeding sessions, because part of their water consumption goes directly to milk production. But don't overdo it: too much liquid also can reduce milk production.

Increase your daily caloric intake to 2,500 calories: you can even eat more if you are planning to continue breast-feeding for more than three months (2,800 calories per day). But again, be careful: many nursing mothers are tempted by sweets. Stick to healthy foods instead! Eat more proteins. The basic rule is to eat I gram of protein each day for every pound you weigh.

Spread your caloric intake over five "meals," breakfast, lunch, after- noon snack, dinner, and an extra snack during the evening. Each snack time is also an opportunity to drink water, eat a low-fat dairy product, and a piece of fruit. As your body is continually producing milk, it needs your caloric intake to be regular.

Stay away from tobacco. Nicotine passes directly through breast milk to the baby. if you cannot control yourself, build in a gap of at least an hour between your last cigarette and your next feeding session, so that the nicotine in your system has a chance to decompose at least partially.

Avoid regular consumption of alcohol. Alcohol passes through milk in less than an hour and if the baby consumes it in large quantities it can retard his growth. if you drink an occasional glass of wine or beer, save it for after a feeding session.

Take no medication without first consulting a doctor. Most antibiotics, sulfa drugs, chemical laxatives, and all products containing iodine are contraindicated while you are breast-feeding. Other medications, taken over a long period, can also be dangerous.

Beware of pollutants. Like nicotine, pesticide residue easily passes through mother's milk. If you are nursing, stay away from insecticides (especially in airborne forms such as aerosols or coils). Try to use natural insect repellents such as citronella. Eat primarily unsaturated fats. Sunflower, corn, rapeseed, and olive oil provide fatty acids that are essential for building the baby's nervous system.

Eat food containing vitamin B 9. In Western countries, the only vitamin really lacking in women's diets is vitamin B 9 (folic acid). Birth control pills accentuate a woman's vitamin B 9 deficit, and may also contribute to a vitamin B 6 deficiency. During pregnancy, folic acid is vital to the development of the baby's nervous system. Nursing mothers are well advised to continue taking their prenatal vitamins. Folic acid also can be found abundantly in asparagus, cabbage, corn, chick- peas, and spinach. Many other foods, such as wheat and orange juice, have been enriched with folic acid. Check the package labels.

Take zinc supplements. According to a British study, pregnant and nursing women also often lack zinc. They should consume 15 to 20 milligrams per day. Zinc is found in eggs, meat, whole flour, and oats.

Consume 1,200 milligrams of calcium per day. A balanced diet only provides 800 to 1,000 milligrams of calcium daily. Because nursing mothers need 1,200 milligrams, a calcium supplement will probably be necessary. Calcium needs can also be partly met from dairy products, raw vegetables, almonds, and hazelnuts.

Do not rush to buy vitamin A supplements. People often talk about vitamin A supplements for nursing mothers, because their daily need rises from 1,000 milligrams to 1,300 milligrams. It is true that if the woman had a vitamin A deficiency during pregnancy, this problem may worsen after childbirth. But anyone who eats enough carrots, vegetables, butter, fish, and meat will absorb enough vitamin A.

We hear a lot about foods that can irritate the baby-turnips, celery, watercress, citrus fruits, onions, cabbage, spices, leeks, cauliflower-by giving him gas or changing the taste of his mother's milk. For example, some people say that garlic increases milk production; others say it gives the baby gas. There is no universal rule. Moreover, different cultures prefer foods that others consider to be "bad" for nursing mothers. Each baby reacts differently to the foods his mother consumes. If your baby is particularly disturbed one day, try to remember what you have eaten in the past twenty-four hours. If one food seems suspect, eliminate it from your diet for a while.

When nursing, observe your baby so you can eliminate from your own diet any food that seems to bother him. There exist nutritional supplements that are said to increase milk production. Their effects have not been proven scientifically, but they have a placebo (psychological) effect. Be careful, some of these supplements have a very high sugar content, and are therefore high in calories. Also, many midwives will tell you that fennel and beer increase milk production, and that parsley stops it.

Additional Resources
La Leche League International P.O. Box 4079 1400 N. Meacham Rd. Schaumburg, IL 60173 800-La Leche www.lalecheleague.org

Nursing Mothers'Counsel (NMC) P.O. Box 50063 Palo Alto, CA 94303 Referral Line: 415-386-2229

International Lactation Consultants' Association 4101 Lake Boone Trail Raleigh, NC 27602 919-787-5181 ilca@erols.com

The Art of Successful Breastfeeding: A Mother's Guide (Video) The Vancouver Breastfeeding Center 604-875-5017 millerb@direct.ca

The Womanly Art of Breastfeeding The La Leche League 1-800-La-LechePregnancyAndBaby.com

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