Postpartum Nutrition

Did you know the old recommendations of 500-600 extra calories for breastfeeding were based on nutritional needs for men and assumed the parent is trying to lose weight!!

Not only that but the old guidelines don't account for recovery from birth, potential surgery, increased stress, or sleep deprivation!

Postpartum recovery and making milk takes a lot of nutrients and calories!  Focus on easy-to-digest foods like cooked vegetables and fruits, whole grains, proteins like eggs, poultry, fish, and dairy. Typically, we need an additional 1000-1600+ calories to make milk on top of our normal nutrition requirements and to help our bodies recover from the stress of pregnancy and delivery.  Eat when baby eats is actually good advice!  Keep snacks near your pumping/feeding area and ask your support people to bring you plenty of delicious snacks!

It is advised to continue taking a multivitamin postpartum (prenatal or postpartum vitamins) and additional Vitamin D (600-4000IU daily). We don't get nearly enough Vitamin D from the sun and it can be challenging to get enough in your diet. For example, 5-6 cups of fortified whole cow's milk or 4 oz of wild salmon has about 600IUs (which is only an appropriate supplement amount if your levels are not deficient).

What other nutrients should we keep in mind during lactation and postpartum recovery?

Selenium is a very important nutrient for thyroid function and adequate selenium in our diet can reduce the risk of postpartum thyroiditis, potential protection against postpartum depression, support for uterine recovery, and maintenance of healthy postpartum weight.

Dietary sources are preferred over supplements: The AAP recommends consuming 2-3 servings (4 oz each) per week of low-mercury seafood (canned light tuna, salmon), which provides selenium along with DHA, protein, vitamin B12, zinc, and iodine.

The recommended selenium daily intake for lactating women is 70-255 mcg/day doses over 400 mcg combined from diet and supplementation can cause GI symptoms and long term can be dangerous so seek specific guidance before supplementing!

 Dietary Sources of Selenium: 

• Brazil Nuts 3 nuts provides about 250 mcg (there is a safety maximum of 3 Brazil nuts daily!) • Seafood: tuna (92 mcg per 3 oz), halibut (39 mcg), sardines (45 mcg), and shrimp (42 mcg) • Meat: pork tenderloin (41 mcg per 3 oz), beef (37 mcg), chicken (36 mcg), egg (20 mcg) • Seeds and Grains: oatmeal (10 mcg per serving), sunflower seeds (20 mcg per oz)

Iron

Iron deficiency anemia is the most common type of nutrient deficiency during pregnancy and postpartum.   When you are anemic, the body prioritizes critical functions, such as blood cell production, over milk production when resources are scarce. This means addressing iron deficiency is vital for supporting both maternal health and successful lactation.

Most people are able to support their iron needs through dietary choices. If you do decide to use iron supplementation look for ferrous bisglycinate or glycine versions as ferrous sulfate is not well absorbed and can lead to constipation.  Iron supplementation is best absorbed when you supplement every other day.

Dosing depends on the level of deficiency 25-50 mg every other day is appropriate for mild deficiency.  Ask your provider about retesting your levels in about 8 weeks so dosing can be adjusted.

Heme Iron (Animal Sources): Lean red meats: beef, lamb, and pork Poultry: especially dark meat like thighs and legs Fish: especially sardines, mackerel, and shellfish

 Non-Heme Iron (Plant Sources):

Lentils and beans: chickpeas, white beans, black-eyed peas (look below for beans which inhibit iron absorption!) Spinach, kale, and other leafy greens Tofu and tempeh Pumpkin seeds and sesame seeds Note: Iron from animal sources is absorbed more efficiently than iron from plant sources, however, combining plant-based iron foods with vitamin C-rich foods can enhance absorption.

 + Vitamin C Vitamin C enhances the absorption of non-heme iron. Incorporating vitamin C-rich foods in the same meal as iron-rich foods can be beneficial.

Citrus fruits: oranges, grapefruits, and lemons.  Berries: strawberries, raspberries, and blueberries. Bell peppers, broccoli, and Brussels sprouts. Kiwifruit and papaya.  + B12 and Folate: Anemia can also be affected by insufficient B12 and folate.  While prenatal vitamins include these nutrients, the methylated versions are best absorbed - ask your provider for guidance! Look for methylcobalamin and methylfolate or L-methylfolate on the ingredient list of your vitamins and consider switching your supplement or adding in foods which are high in these nutrients. B12 is found in animal products like those listed above (very convenient!)

Folate rich foods include some animal products like eggs and also many of the same foods which are high in Vitamin C!

- Limit Calcium Intake During Iron-Rich Meals

While calcium is vital during lactation, it can inhibit iron absorption. Aim to space out calcium-rich foods or supplements from iron-rich meals.

- Avoid Tannins and Phytates During Iron-Rich Meals

These compounds, found in tea, coffee, brown rice, raw oats, soy, pinto and kidney beans inhibit iron absorption. It's advisable to consume these foods or beverages a couple of hours apart from iron-rich meals.

 Snacks: Try to have a snack with iron-rich food often.  "Snack when baby eats" is a good way to get in plenty of snacks.

 Anemia and mental health: Anemia can also manifest symptoms that resemble anxiety and depression, complicating the postpartum experience. As your anemia status improves, you should also start noticing positive mental health improvements.

Postpartum Support International 800-944-4773 

Baby Blues Connection 800-557-8375 

Compass (local group with warm line and in-person support groups)800-944-4773

Choline

550 mg of choline is recommended daily throughout the first year postpartum, 100 mg more than what is recommended during pregnancy.

 A breastfeeding parent needs extra choline to meet their own needs as well as that of her growing baby. Choline content of breast milk can influence infants' circulating choline levels. One study even suggests that choline supplementation during pregnancy and lactation reduces inflammation and the development of mastitis postpartum.

Choline has been shown to reduce breast inflammation and reduce the risk of developing mastitis.   A common recommendation for mastitis or plugged ducts is supplementation with soy or sunflower lecithin, however, we convert lecithin to choline.  Directly supplementing with choline is more efficient and reduces the digestive upset which can occur when taking lecithin.

Dietary sources of choline:

Beef liver contains about 350 mg per 3 oz Beef and lamb have 75-115 mg per 3 oz Egg yolks have about 140 mg Shiitake mushrooms have 115 mg per 1 cup of cooked mushrooms

Postnatal Vitamins with food sourced nutrients and 3rd party verification of quality:

Natalist Postnatal Mama Bird Postnatal Multi+ mykind Organics Prenatal Gummies Vitamin Code Raw Prenatal Capsules Baby & Me 2™ Postnatal Multi not sponsored or financially benefiting from these recommendations in any way!