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Nutrition, Dieting & Breastfeeding
A Q & A Forum with Dr. Judith Roepke 2

 

Dr. Judith Roepke, R.D., Ph.D., has answered many of your questions about nutrition and dieting. Dr. Roepke is a perinatal nutritionist, researcher and member of the Breastfeeding.com medical advisory board.  Look for more Q&A forums with Dr. Roepke in the future.




 






Will working out and tanning change my breastmilk?

NAME: Elizabeth
BABY'S NAME: Josef
BABY'S AGE: 2 months

 I am 18 years old and I had my baby boy on January 8, 2000.  I want the best for my baby, so I decided to breastfeed.  I was told that I should not do too much exercising for the first month. I have now joined the gym near my house.  My question is will working out and lifting weights change my breastmilk in any way?  Also, is it okay to go tanning in a tanning booth?  I have tanned in the past and I would like to start tanning again if it won't do anything to my breast milk.  Thank you for your help.





I am glad that you made the decision to breastfeed your son.  You should feel reassured that moderate exercise and weightlifting will not adversely affect your breastmilk, and it may enhance your own sense of well-being.  My concern, however, is that you not go too far with your exercise, especially since your baby is so young.  Many breastfeeding women find that, even without exercise, they lose about two pounds per month and are back to their pre-pregnant weight by about six to eight months postpartum.  This is a healthy pattern of weight loss.  Your objective now should be to breastfeed and be fit, not to breastfeed and lose weight. When you begin exercising, make sure that you do not compromise your diet and that you do not lose weight too quickly.

I am not aware of any impact of tanning on the quality of breastmilk, other than that it might enhance the Vitamin D levels in your breastmilk slightly. However, I am very concerned about the long-term damage of the tanning booth to your skin. Young women of your age have lovely skin, and it is a tragedy when they are prune-like and wrinkled by my age (65 years)!






Do you have to eat a "perfect diet" to produce milk?

NAME: Jessica
BABY'S NAME: Hannah
BABY'S AGE: 4 months

I have met many women who are convinced that their poor diet meant they would be unable to produce enough milk for their babies.  (By poor I mean skipping a meal or not choosing healthy foods).  I have always thought that, unless a mother is severely malnourished or is crash dieting and is loosing more than 4-5 pounds per week consistently, she doesn't have to eat perfectly or even eat a lot to produce milk.  What are your thoughts on this?





You are correct that most mothers, even those that do not eat healthy foods or consume sufficient calories, produce sufficient milk for their babies.  A woman's body adapts, amazingly, to efficiently use any nutrients taken in.  Think of the quite malnourished mothers in developing countries who breastfeed their babies for years!

A breastfeeding mother should, however, be concerned that her own nutrition is not compromised.  This is particularly important if she becomes pregnant again. Breastfeeding women also should be cautioned against severely restrictive diets, especially during the early months postpartum.  Any weight loss more than about two pounds per week is not advised, as the long-term consequences of such rapid weight loss on the breastfed baby are not known. Most new mothers can lose the weight they gained during pregnancy by breastfeeding, exercising moderately, and eating a healthy diet.  A restricted caloric intake usually is not necessary.






What is the proper diet for a nursing mother?

NAME: Tonya
BABY'S NAME: Brianna Leigh
BABY'S AGE: 4 1/2 months

 I was wondering if I am still giving my daughter the best (breastmilk) even if I don't always eat the proper diet?  For example, how does not eating vegetables or fruits affect the milk I provide to her?  What is the proper diet for a nursing mother?





Breastmilk does provide the best nutrition for your baby, even if you don't always eat a nutritious diet.  Some vitamins and minerals in your breastmilk may be slightly diminished if you do not eat enough vegetables and fruits, though this should not affect your baby much. If you don't eat many vegetables and fruits, try drinking vegetable and fruit juices instead.

A more important issue than how your nutrition affects your breastmilk is the behavior you are modeling for your daughter when you eat foods that are not healthy.  Toddlers and children learn what to eat and how to eat by observing their parents.  You and your child's father are modeling behavior now that your child will adopt when she can make decisions of her own (or at least assert her own opinions about the decisions made for her).  You need to decide if you want your daughter to be well-nourished after she is no longer receiving your breastmilk. If this is important to you, now is the time to make sure that your diet is healthy.  Later your child will follow suit.

You asked about the proper diet for a nursing mother.  To maintain optimum nutrition, breastfeeding mothers should follow the same diet recommended for all women.  I find it easiest to simply use the food pyramid as a guide.  Starting at the bottom of the pyramid, plenty of whole grains (i.e. bread, cereal, pasta, rice, etc.) should be the foundation of the diet.  Moving up in the pyramid, you should eat at least five servings of vegetables and fruits each day.  Make sure this includes dark orange fruits and/or vegetables and leafy greens.  Then comes two to three servings of protein rich foods (i.e. fish, meat, eggs, cheese, tofu, beans, etc.), and three to four servings of milk products.  The average woman needs 1,000 mg calcium each day.  This is equivalent to about three 8-ounce glasses of milk, plus calcium consumed in other foods (i.e. dried beans and peas, fortified orange juice, dark green leafy vegetables, etc.).  Lactating women may need to consume additional calories, enough to maintain a normal weight while nursing.  A limited amount of processed sugars, fats, and oils are recommended.  Finally, sufficient fluid intake, especially water, is an easily forgotten component of a nutritious diet.






Can I drink a glass of wine with dinner?

NAME: Corrina
BABY'S NAME: Jeffy
BABY'S AGE: 10 months

My question concerns the intake of substances that I have avoided up to this point but now wonder if I can consume in small doses, in particular: wine with a meal and medicine such as cough syrup and/or products for colds.  Thanks.





By ten months of age, your baby is probably eating a considerable amount of other foods and still breastfeeding some.  Most experts would agree that a mother who sips a glass of wine with a meal is taking in a rather modest amount of alcohol over a extended period of time, and that the effects of this alcohol on her breastmilk would be modest.  I cannot tell you whether or not you should drink a glass of wine with dinner while you are still nursing.  But I can reassure you that if you choose to do so, the effects on your ten month old baby will be minimal if your intake is modest.  According to Dr. Lawrence's text, "when a nursing mother does have a drink or two she should avoid breastfeeding for at least 2 hours. Pumping and discarding milk does not hasten the removal from the milk because the level in the milk matches that in the plasma at the time of the feeding." (page 371).

Your question about cough syrups and cold medications is one that I am less prepared to answer.  If your doctor recommends cough syrup or other cold medications, make sure that he or she is aware that you are breastfeeding.  I am not familiar with the pharmokinetic properties of many of these drugs.  If you are concerned with how a particular cough syrup or cold medication affects your breastfed baby, I suggest contacting an International Board Certified Lactation consultant (IBCLC) who should have access to information about drugs and human milk.






Do carbonated beverages affect a breastfed baby?

NAME: Dana
BABY'S NAME: Jordan
BABY'S AGE: 1 month

Does drinking carbonated beverages (2 in a day) affect the breastfed baby?





It is very unlikely that drinking two carbonated beverages per day would affect your breastfed baby.  However, if the carbonation makes you feel bloated and uncomfortable, your discomfort may be sensed by your baby.

The primary concern with drinking carbonated beverages while breastfeeding is that the high load of phosphorus contained in the carbonated beverage may reduce the efficiency of calcium absorption in the mother.  This is not unique to lactating women, however, and should be a concern of all women at risk of osteoporosis. Thus, the impact is more on your nutritional status than on your baby's.  For your own health, I would advise that you drink more 100% fruit and vegetable juices-calcium enriched orange and apple juice are a good choice.





 

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