Eating While Breastfeeding

One of first things on a mother’s mind after delivering her baby is her first postpartum meal.  “When can I eat?”  Many women I help deliver have even planned in advance bringing some forbidden pregnancy food that has been elusive over the last nine months.  Hogies, sushi, alcohol, and coffee are just a few of the top menu contenders.  Being on a restrictive diet sucks and these moms are anxiously awaiting for their restrictions to be lifted with delivery. 

But what about breastfeeding?  Can we really eat anything our heart desires?  The answer is usually Yes! Some foods such as caffeine and alcohol must be consumed in moderation or timed around breastfeeding schedules, but it can be worked around.  The general recommendation for breastfeeding mothers is to eat when they are hungry and drink when they are thirsty.  There is no need to restrict diet UNLESS baby has a reaction to food.  

Lets review recommendations for a balanced diet while breastfeeding.  

Caffeine

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Caffeine is acceptable in moderation.  The generally accepted rule of thumb is 500mg of caffeine daily (about 5 5oz cups of coffee).  Don’t get too excited, one Starbucks grande coffee is 500mg. I have attached the Starbucks nutritional menu for your viewing pleasure. So here is the deal.  Caffeine is considered an L2 drug (generally safe with breastfeeding) with relatively low milk levels (0.06-1.5%).  It peaks in concentration at around 1-2 hours.  So timing your coffee around breastfeeding accordingly can help minimize infant exposure.

The problem arises from the infant’s ability to metabolize caffeine out of their own system.  While baby is only ingesting very small amounts of caffeine through the breastmilk, the half-life in a newborn is 97.5 hours (this is the amount of time for blood levels to reach half the original dose).  That is like… a really long time.  So if you are pounding coffee every morning like any sane personal trying to survive the early postpartum era, the levels in your baby’s system are gradually increasing.  

What do we do?  Nothing.  Try to minimize how much you drink and when you drink it.  If your baby starts acting irritable, fussy, and stops sleeping well (wait isn’t this the description of all newborns? Just saying…), then you may look at your caffeine intake and look to substitute some decaf.  The good news is that the older baby gets, the better they metabolize caffeine.  Check out this link from KellyMom for more details.

What should my diet look like while breastfeeding?

So here is the good news.  You do not need to eat a perfectly balanced diet to ensure your breastmilk is full of nutrients.  A mother’s diet does not influence the content of her milk.  This is all part of the exquisite design of breastfeeding. A mother can feed her baby even during times of famine.  Ultimately, any poor diet choices you make are going to be hard on YOU and YOUR health, not your baby.  Breastfeeding places high demands on the mother’s body.  You extra need calories and nutrients for you because your body is going to give everything to your baby first.

Most have heard they should be consuming an extra 300-500 calories a day while breastfeeding.  This is true but not critical.  The better recommendation is to listen to your hunger cues and eat to satiety.  It is best to not get hung up on a number.  Dieting is NOT recommended while breastfeeding and can affect supply.

A common misdirection to breastfeeding mothers is that they need to be taking a prenatal vitamin while they are breastfeeding to help ensure adequate nutrient levels.  Recommendations actually do not support this practice.  Most women in developed countries consuming a regular diet will have adequate nutrient levels to supply their milk.  

Perhaps one of the few vitamins worth supplementing is vitamin D.  Since nearly everyone is at risk for vitamin D deficiency, milk levels are also invariably low.  Most breastmilk only contains around 50 IUs of vitamin D, which is well below the AAP’s recommendation or 400 IUs.  A 2015 study by Dr. Bruce Hollis concluded that supplementing mothers with up to 6400 IUs of vitamin D a day is safe and as effective as directly supplementing babies.  

Am I drinking enough?

The idea of drinking enough water while breastfeeding is a bit of a misnomer. Research has shown that increased or decreased fluid intake is not associated with milk production.  A mother must be extremely dehydrated to affect her supply.  Again, just like with nutrients, your body will give fluid to your milk supply before you.  It is important to hydrate for your own health and well being.  The recommendation is to drink to satisfy thirst.  Forcing liquids will not increase supply.  In short, it is important to stay hydrated for your own health needs not your milk supply.

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Bottoms Up?

What about alcohol? Did you know that you do not need to pump and dump after drinking? Occasional light drinking (1-2 drinks is the usual recommendation) is considered safe when mom breastfeeds after 2+ hours(or when she feels neurologically normal: aka sober) without expressing milk. That’s right, as your blood levels drop so does the concentration in your milk!

Another myth about alcohol is that it increases your milk production. Sorry, wouldn’t that be magical if it were true? In reality, alcohol inhibits letdown. Booo to that!

What about breastfeeding a baby after a drink or two to help baby fall asleep? Nope. 👎🏻 That’s another wive’s tale. One study showed alcohol exposure in breastmilk does change an infant’s sleep-awake pattern BUT it resulted in infants sleeping less. Now that’s a buzz kill.

In summary, drinking small amounts while breastfeeding is not considered harmful to baby. Try to time drinks right after baby has fed to maximize time between consumption and the baby’s next feed. 

Are there certain foods I should avoid while breastfeeding?

The short answer is No.  The long answer is Maybe.  In general, maternal diet should not be restricted.  Spicy foods, garlic, acidic foods, or gassy (aka colicky) foods, do not need to be avoided unless baby gives you an indication that it is a problem in their diet.  Strong flavored foods can change the taste of the milk but for an infant who is use to these flavors, it is generally not a problem.  Acidic and gassy foods will not cause a problem for the infant unless baby has an actual sensitivity to the specific food.  The acidic properties or the excess gas created by certain foods may effect the mother, but are not passed through the milk.  If baby is reacting to a food in the diet, then there may be a sensitivity.  Check out my next post for more information on food intolerances and allergies!  

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References

Bonyata, K., IBCLC. (2014, Nov. & dec.). Can a nursing mother eat this food? FAQs. Retrieved November 15, 2017, from https://kellymom.com/nutrition/mothers-diet/mom-calories-fluids/

Bonyata, K., IBCLC. (2017, November 5). Do breastfeeding mothers need extra calories or fluids? Retrieved November 15, 2017, from https://kellymom.com/nutrition/mothers-diet/mom-calories-fluids/

Dusdieker, L. B., Booth, B. M., Stumbo, P. J., & Eichenberger, J. M. (1985). Effect of supplemental fluids on human milk production. The Journal of Pediatrics, 106(2), 207-211. doi:10.1016/s0022-3476(85)80288-2

Hale, T. W. (2017). Medications & mothers milk. New York, NY: Springer Publishing Company.

Maternal Versus Infant Vitamin D Supplementation During Lactation: A Randomized Controlled Trial. (2015). Pediatrics, 136(4). doi:10.1542/peds.2015-1669d

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