Nourishing the Nurturer: Nutrition During Breastfeeding

Breastfeeding is a critical period in the life of both an infant and a lactating mother, requiring heightened attention to nutrition. Proper nutrition not only supports the mother's milk but also ensures her health, as women will often lynch from their own stores to create quality milk. Several nutrients are in much higher need compared to preconception and even pregnancy. Obtaining these nutrients requires nutrient dense foods and often a laid out plan in the busy world of a breastfeeding mom.

Breastfeeding requires significant energy and nutrient reserves. Women typically need an additional 400-600 calories per day while nursing to support breast milk production and maternal health. This increased intake should primarily consist of nutrient-dense foods rather than empty-calorie options. An observational study of breastfeeding women eating a western diet showed it took more than 3500 calories/d to obtain more than 85% of all nutrient needs. This shows the importance of nutrient density in managing postpartum weight while obtain nutrients needed for mother and babies health. This is also important when considering mothers health and the health of future children.

So what do we need and how do you obtain it?

Calcium

DRI for Lactating Women: 1,000 mg per day (1,300 mg for women aged 19 and younger).

Food Sources:

- Dairy products (milk, cheese, yogurt)

- Leafy greens (kale, collard greens)

- Fortified foods (some juices and cereal)

- Fish with bones (sardines, salmon)

- Tofu made with calcium sulfate

Calcium is crucial for building the baby’s bones and teeth. During lactation, it's important that mothers consume enough calcium to maintain their bone health as well.

Vitamin B12

DRI for Lactating Women: 2.8 mcg per day.

Food Sources:

- Meat (beef, pork, chicken)

- Fish and shellfish (salmon, tuna, clams)

- Eggs

- Dairy products (milk, yogurt, cheese)

- Fortified foods (cereals, plant-based milk)

Vitamin B12 is essential for the production of red blood cells and DNA, as well as for the proper functioning and development of brain and nerve cells. Adequate B12 intake is vital for the neurological development of the infant, especially for breastfeeding mothers following a vegetarian or vegan diet.

Folate (Vitamin B9)

DRI for Lactating Women: 500 mcg per day.

Food Sources:

- Leafy green vegetables (spinach, broccoli)

- Citrus fruits (oranges, grapefruits)

- Whole grains (brown rice, quinoa)

- Legumes (beans, peas, lentils)

- Fortified cereals

Folate is critical in DNA synthesis and cellular division. Adequate folate supports the overall growth and development of the infant.

Iron

DRI for Lactating Women: 9 mg per day.

Food Sources:

- Red meat (beef, pork)

- Poultry (chicken, turkey)

- Fish (tuna, shrimp)

- Beans and lentils

- Fortified cereals

- Dark chocolate

Iron is necessary for producing hemoglobin, which carries oxygen in the blood. While this is a lower need, women may need iron supplements depending on their baseline levels, amount of blood loss during delivery and dietary intake. Iron deficiency can cause fatigue and irritability, symptoms that may be common in the postpartum state but may be a nutrient deficiency.

Vitamin D

DRI for Lactating Women: 600 IU (15 mcg) per day.

Food Sources:

- Fatty fish (salmon, mackerel)

- Fortified milk and dairy products

- Egg yolks

- Fortified cereals

- Sunlight exposure (the skin synthesizes vitamin D when exposed to sunlight)

Vitamin D supports calcium absorption and is essential for bone health in both mother and infant. Taking 6400 IU supplementation for women may provide enough vitamin D in breastmilk to suffice infant needs. Other ways to meet infant needs during breastfeeding would be to supplement 400 IU to baby daily.

Iodine

DRI for Lactating Women: 290 mcg per day.

Food Sources:

- Fish and seafood

- Dairy products

- Iodized salt

- Eggs

- Seaweed

Iodine is vital for thyroid function and metabolism. It supports the development of the baby's brain and nervous system. Women are at a higher risk for thyroid disorders during reproductive years and obtaining enough (but not too much) iodine is important for long term health.

Vitamin A

DRI for Lactating Women: 1,300 mcg RAE (Retinol Activity Equivalents) per day.

Food Sources:

- Dairy products (milk, cheese, butter)

- Carrots

- Sweet potatoes

- Dark leafy greens

- Fish liver oils

Vitamin A is crucial for vision, immune function, and skin health, contributing to the overall well-being of the mother and the immune development of the infant.

Omega-3 Fatty Acids

DRI for Lactating Women: 200-300 mg of DHA (Docosahexaenoic acid) per day.

Food Sources:

- Fatty fish (salmon, sardines)

- Walnuts

- Flaxseeds

- Chia seeds

- Algal oil

Omega-3 fatty acids, particularly DHA, are important for brain and eye development in infants. Needs may be higher in some women. Testing your DHA blood level or breastmilk DHA blood level gives better estimation of how much to supplement (which may be up to 1000mg/d).

Choline

DRI for Lactating Women: 550 mg per day.

Food Sources:

- Eggs

- Lean meats (chicken, turkey)

- Fish

- Cruciferous vegetables (broccoli, Brussels sprouts)

- Nuts and seeds

- Legumes

Choline is an essential nutrient for brain development and functioning, and it also plays a critical role in cell structure and metabolism. Adequate choline intake supports the cognitive development of the infant. A single egg provides approximately 150mg choline, the same as 3oz chicken!

Lactation presents unique nutritional demands that require careful planning and a commitment to a balanced diet. Mothers should focus on consuming a variety of nutrient-dense foods to meet the increased DRIs essential for their health and the healthy development of their infants. Consultation with healthcare professionals, including registered dietitians, can provide personalized guidance and support to optimize nutrition during this critical time. By prioritizing these essential nutrients, breastfeeding mothers can ensure they are providing the best possible start for their babies while maintaining their own health and vitality.