World Breastfeeding Week - The Importance Of Maternal Health During Lactation

World Breastfeeding Week (WBW) runs from the 1st-7th August every year. It is a global campaign to raise awareness and galvanise action on breastfeeding and related issues. It is coordinated by the World Alliance for Breastfeeding Action (WABA) - a global network of individuals & organisations dedicated to the protection, promotion & support of breastfeeding worldwide.

Since 2016, the WBW campaign has been aligned to the United Nation’s Sustainable Development Goals (SDGs). For more information about the campaign see https://waba.org.my/wbw/

Maternal nutrition during pregnancy and lactation has profound effects on the development and lifelong health of the child. Here we will look at how mothers can nourish themselves and their babies while breastfeeding.

A Note on Breastfeeding and Bottle Feeding

Breastfeeding may confer psychological, convenience, economic, ecological and nutritional benefits. The nutrient quality of breast milk starts with pre-conceptual dietary habits through pregnancy and through to postpartum. Any nutrient deficiency existing in pregnancy may affect the quality of breast milk and the health of the baby (1).

Some women, for all kinds of reasons, cannot, or do not want to breastfeed and this is a perfectly legitimate and healthy choice. Infant formulas are fortified with vitamins, minerals, protein, nucleic factors and omega 3 fatty acids. They are made to be consistent in composition and are monitored closely for quality (1).

What foods to eat while breastfeeding

Eating a varied and nutrient dense diet will increase the nutrients available for breast milk production. Unprocessed meat, fish, eggs, pulses, nuts and seeds are all good sources of protein. Healthy carbohydrates are found in whole grains, fruit and vegetables. Good quality fats are found in oily fish, nuts, seeds and cold pressed oils.

Diets that severely restrict any macronutrient class should be avoided unless prescribed by a medical specialist (2).

The flavour factor

If a breast feeding mother eats certain foods the flavour of her breast milk will change. This is a good thing as it means the baby gets to experience different flavours which may help them accept a wider variety of foods when they are introduced to solid foods.

How much to eat and drink when breastfeeding

You may need to eat about 330 to 400 calories extra a day while breast feeding. This provides the extra energy and nutrients to produce milk.
Drink sufficient fluids for your urine to be pale yellow in colour. If your urine is dark yellow you may not be drinking enough. Listen and respond to your thirst signals. It’s a good idea to have a drink of water or herbal tea every time you breast feed.

Foods and drinks to limit or avoid while breastfeeding

• Alcohol – it’s advised not to drink alcohol while breastfeeding. If you do drink wait until the alcohol has cleared from your body before breastfeeding. It takes 2 to 3 hours to clear a glass of wine or beer or a shot of spirits. This will depend on your body weight and alcohol processing capacity. If necessary pump some milk before you have a drink to feed your baby later.

•  Caffeine – caffeine can interfere with you or your baby’s sleep. Limit to 2 to 3 cups of caffeinated drinks a day. Caffeine is found in tea, coffee, chocolate and colas.

• Avoid fruit juices, sugary drinks and artificial sweeteners. Too much sugar can contribute to weight gain and may make it hard to lose pregnancy weight.

• Fish – seafood can be a good source of protein and omega-3 fats. However, it may be contaminated with mercury and other pollutants which may affect your baby’s health and development. Swordfish, tuna, king mackerel and shark are all high in mercury so should be limited.

• Garlic, onions and leeks – for most people these are fine but if your baby develops digestive problems or seems irritable it may be worth avoiding these for a week to see if it makes a difference.

• Brussels sprouts, cabbage and cauliflower – brassicas may cause digestive symptoms in some babies. Eliminate these foods for a week to see if symptoms settle down.

If you suspect that something in your diet might be affecting your baby, avoid the food or drink for up to a week to see if it makes a difference.

If your baby becomes fussy or develops a rash, diarrhoea, vomiting or wheezing soon after feeding consult your health care provider.

Supplements while breastfeeding

While you may be able to get all the nutrients you need from a healthy diet many women do not meet the recommendations for healthy nutrition and weight before and during pregnancy.
Micronutrients are fundamental for healthy brain development and deficiencies during early development can have a severe and lasting impact on cognitive outcomes. Evidence indicates that undernourished lactating women may produce breast milk containing lower concentrations of certain vitamins and minerals (3,4). The following supplements from Tom Oliver Nutrition may be a good insurance policy against deficiency:

• Multivitamins/Minerals – supplementation with multiple micronutrients plus balanced protein among women with inadequate nutrition has been associated with improved birth outcomes, including decreased rates of low birthweight.

• B Complex – particularly if you are vegan or vegetarian or on a restricted diet you may need to supplement with vitamin B12.

• Vitamin D3 – pregnant and lactating women and breastfed infants are at risk of vitamin D deficiency that can be avoided with supplementation (5).

• Omega 3 – important for myelination and the development of vision during the perinatal period. Omega-3 supplementation during pregnancy may result in favourable cognitive development in the child (6).

• Zinc – essential for a wide variety of cellular processes particularly during growth and development in the early stages of life.

• Protein Powders – Tom Oliver Nutrition’s protein powders come in whey and vegan formulations. These can be added to meals or smoothies to ensure you get adequate protein with meals and snacks.

Vegetarians and Vegan

For lactating women on a vegetarian or vegan diet special consideration is required for protein, calcium, iron, zinc, vitamin B12, vitamin D and omega-3 fatty acids.

References

1. Med Hypotheses. 2018 Feb;111:82-89. Breast milk is conditionally perfect. Erick M.
2. Am J Obstet Gynecol. 2022 May;226(5):607-632. The importance of nutrition in pregnancy and lactation: lifelong consequences. Marshall NE et al.
3. Nutrients. 2021 Oct 28;13(11):3848. Breast Milk Micronutrients and Infant Neurodevelopmental Outcomes: A Systematic Review. Lockyer F et al.
4. Nutrients. 2021 Feb 21;13(2):692. Nutrient Requirements during Pregnancy and Lactation. Jouanne M.
5. Br J Nutr. 2019 Feb;121(4):426-438. Influence of daily 10-85 μg vitamin D supplements during pregnancy and lactation on maternal vitamin D status and mature milk antirachitic activity. Stoutjesdijk E et al.
6. J Nutr. 2021 Nov 2;151(11):3483-3494. Omega-3 Fatty Acid Dietary Supplements Consumed During Pregnancy and Lactation and Child Neurodevelopment: A Systematic Review. Nevins JE et al.