MATERNAL NUTRITION
In general, lactating women should be encouraged to obtain their nutrients from a well-balanced, varied diet, rather than from vitamin-mineral supplements and to drink enough fluids to alleviate thirst.
Generous amounts of fruits and vegetables, whole-grain breads and cereals, calcium-rich dairy products, and protein-rich foods (such as meats, fish, and legumes) are encouraged. A well-balanced intake adequate in calories is suggested.
BREAST-FEEDING DAILY FOOD GUIDE
- Milk, Yogurt, and Cheese
- Meat, Poultry, Fish, Dry Beans, Eggs, and Nuts
- Vegetables
- Eat at least 3 to 5 servings
- Fruits
- Eat 2 to 4 servings
- Choose two foods high in Vitamin C and Folic Acid, and
one food high in Vitamin A
- Bread, Cereal, Rice, and Pasta
- Eat about 6 to 11 servings
- Fats, Oils, and Sweets
This is just a guide, you may need to eat more than this based on your size and activity level.
DRINKING TO SATISFY THIRST
Nursing mothers need adequate fluid intake to stay healthy and hydrated. Most experts recommend encouraging drinking enough fluids to satisfy thirst. Eight, 8 ounce servings (64 ounces) of fluid such as water, milk, juice, or soup is a good goal, again depending on your size and activity level.
FOODS
Breast-feeding mothers can safely eat any foods they like. Some foods may flavor the breast milk, but babies rarely react to this. If your baby is fussy after you eat a
certain food, try avoiding that food for a while, then try it again later to see if it is a problem.
There is no need to limit your diet excessively, and you should maintain adequate nutrition for yourself and your baby. If you become overly concerned about foods or spices causing problems, try to remember that entire countries and cultures have diets that contain foods that are extremely spicy, belong to the cruciferous family, or are otherwise suggested by folklore to cause problems with nursing. In these countries, the mothers nurse their infants without problems.
It is possible that some highly allergenic foods (strawberries, peanuts) may be passed into breast milk increasing the risk of a later food allergy. If this is a concern, discuss food allergies with your pediatrician.
CAFFEINE AND ALCOHOL
A nursing mother can safely consume moderate amounts of caffeine (equal to one to two cups of coffee per day) without causing harm to her baby. Excessive caffeine intake may cause agitation and difficulty sleeping for your baby.
Since alcohol has been found in human milk and can interfere with the milk ejection reflex, alcohol consumption should be avoided while breast-feeding. An occasional drink, not exceeding two ounces of alcohol, may be safe, but you should consult your health care provider about the associated risks.
DRUGS IN HUMAN MILK
Many medications (prescription and over-the-counter medications) will pass into the mother's milk. Breast-feeding mothers should check with their physicians before taking any medications.
The American Academy of Pediatrics' Committee on Drugs releases a periodic statement with a list of drugs and their compatibility with breast-feeding. Your obstetrician and pediatrician are both likely to be familiar with this publication and can answer your concerns about breast-feeding while taking medications.
LACTATION AMENORRHEA
Most breast-feeding women do not have normal menstrual periods (lactation amenorrhea). Although the risk of pregnancy is less for a woman experiencing lactation amenorrhea, pregnancy CAN occur during this time. Breast-feeding should not be used for contraception, since failure is likely.
CONTRACEPTION
Birth control choice should be discussed with your health care provider. Barrier methods (condom, diaphragm), progesterone contraceptives (oral and injectable), and IUDs have all been shown to be safe and effective. Progesterone contraception is generally not started until the milk supply is established, usually at 4 weeks postpartum.
Estrogen containing oral contraceptives are not recommended for breast-feeding women as they may affect milk supply.
WORKING OUTSIDE THE HOME
Mothers face unique obstacles in maintaining adequate milk supply once they return to work. With planning, commitment and skilled use of a breast pump, breast-feeding mothers can maintain their milk supply and continue breast-feeding even after returning to work outside the home.
A maternity leave is helpful for establishing your milk supply and breast-feeding skills before returning to work. An ideal work place would provide a private room for breast-feeding moms, which can be locked, has a comfortable chair, and an electric breast pump for use by all nursing mothers.
However, many moms have had success using a hand breast-pump and a bathroom stall for privacy. Many women prefer the speed of the electric breast pump. Hospital quality pumps are available for rental through medical supply stores. Personal, portable models are available for purchase.
MAINTAINING YOUR MILK SUPPLY
Here are some tips which have worked well with many breast-feeding mothers who work full day outside the home:
- Before you return to work, have a helper introduce a bottle to your baby. Your baby may be confused by a bottle you offer, but will adapt easily with another familiar adult. This may help avoid "nipple confusion" where a baby gets puzzled by the different experience of the breast and the bottle from the same person.
- Two weeks before you return to work, buy or rent an efficient and comfortable breast pump and start building up a supply of frozen milk. If the day you are to return to work arrives, and you don't have a freezer full of breast milk, one bottle of formula fed to your baby is not the end of the world.
- After returning to work, express milk 2 or 3 times a day, every 2 to 3 hours to continue exclusively breast-feeding. If you can only get one break a day and you are unable to pump a full day's allotment in one pumping, a supplemental bottle of formula may be needed. Be aware however, if bottles of formula are given regularly, your milk supply will decrease accordingly.
- Nurse your baby immediately before leaving in the morning and immediately upon return from work in late afternoon. Many mothers learn that their babies nurse more frequently in the evenings on days they work. Feed on demand when you are with your baby.
- If possible, arrange to nurse your baby at lunch time.
- Try to breast feed exclusively when you are with your baby (evenings, nighttime, weekends).
- Delegate and share household responsibilities with other members of the family.
BREAST PUMPS
There are a number of breast pumps on the market, with varying degrees of comfort, efficiency, and cost. Most require time to develop the skills to use them. Pumps may
be hand-operated (manual), battery, or electrically-operated.
The most dependable, efficient, and comfortable pumps are electric, have intermittent action (creates and releases suction automatically), and require minimal training.
Your local lactation consultant can help you make realistic plans and guide you to a supportive breast pump supplier. A listing of lactation consultants is available at www.breastfeeding.com.
