The weeks following the birth of your baby are filled with excitement, sleeplessness and possibly stress. While during pregnancy you were most likely very attentive to what you ate, eating well with a new baby can be challenging. However, it is important to try and eat as many nutrient dense foods as possible in order to maintain breastmilk supply and for your own energy needs and postpartum recovery.

Breastfeeding mothers need an extra 500 calories a day on top of their pre-pregnancy diet (the equivalent of a banana smoothie, toasted sandwich or bowl of cereal) [1]. While factors such as weight gain during pregnancy and activity level may determine whether you need more or less calories, the best guide for caloric requirements is in the mother. Breastfeeding generally increases appetite, which is the body’s indication that more calories are needed.

Where possible, the emphasis should be placed on wholefoods, with most calories coming from nutritious foods and healthy fats. Avoid relying on processed foods and high sugar snacks for energy, as these foods do not provide adequate nutrition, and although your calorie intake may have increased, nutrient deficiencies leave the mother deplete, and in some cases lead to lower levels of nutrients in breastmilk. For example, mothers in western countries such as Australia and the USA where omega-3 intake is low typically have low levels of DHA in breastmilk, compared to mothers in Japan with a higher omega-3 intake [2]. Breastmilk with a higher concentration of DHA is associated with higher IQ in children compared to breastmilk with a lower DHA content [7].

A healthy, balanced diet should include plenty of vegetables, fruits, wholegrains, quality protein and healthy fats. Many mums find eating small additional snacks the easiest option. It can be less taxing and time consuming to grab a snack than to prepare a meal.

Ideas for nutritious meals and snacks (equal approximately 250 calories each)

• Pita bread and hummus snack
• Banana smoothie
• Toasted sandwich
• Bowl of cereal and some yoghurt
• Egg and toast
• Nuts and dried fruit
• Baked beans on toast
• Fruit and yoghurt

Fish, mercury and breastfeeding

The Food Standards Australia New Zealand (FSANZ) recommend breastfeeding women generally do not require special recommendations for fish consumption as the transfer of mercury is very low through breastmilk [3]. Still, for safety, women can continue to follow the same guidelines as pregnant women in relation to fish intake. To maintain optimal DHA concentrations in breastmilk, omega-3 from small fish or marine algae should be included in the diet.

Caffeine and caffeinated drinks

Caffeine is quickly absorbed and reaches a peak concentration in the body within an hour. While the actual amount that is transferred to breastmilk is variable, it is estimated that about 1% of the amount of caffeine enters breastmilk. Babies of mothers consuming large amounts of caffeine can show signs of agitation, jitteriness, constipation and general unsettledness [4]. Caffeine also dehydrates mum’s body and leads to loss of electrolytes, slower blood flow, muscle tension and constipation.
Caffeinated drinks, including coffee, tea and cola, also deplete iron from the body, so it is important to maintain your intake of iron. This helps to avoid developing iron deficiency and anemia.
Food Standards Australia New Zealand recommend that daily caffeine consumption of up to 200mg (about 1-2 cups of coffee) is safe for pregnant and breastfeeding women [5].

Healthy Microbiome

A mother’s microbiome influences the development of the newborn, as beneficial microbes from breastmilk are passed on which begin the colonization of the infant gut. The degree of bacterial diversity in the mother’s own digestive system will influence how diverse her breastmilk is. Mother’s that received antibiotics during pregnancy or delivery have breastmilk containing less microbial diversity compared to mothers that did not receive antibiotics [8]. Healthy levels of bacteria in breastmilk are associated with positive outcomes in the infant including improved digestive and immune system development [9].
Including cultured and fermented foods in the diet such as yoghurt, kombucha, kim chi and sauerkraut helps to introduce beneficial bacteria, while prebiotic foods such as berries, asparagus, onion, garlic and bananas help the bacteria to colonize and reside in the gut.

Recommendations for healthy breastfeeding:

• Keep your fluid intake up.
• Have nutrient dense snacks handy and frozen meals in the freezer.
• Choose quick and nutrient-dense meals such as smoothies, porridge, omelets, wraps, stir-fry’s, pastas and sandwiches.
• Plan your meals according to the Australian Guide to Healthy Eating [6], include plenty of fresh fruit, vegetables, milk and milk products, fish (particularly oily fish such as salmon and sardines), poultry, nuts, whole grains, beans and lentils
• Focus on healthy fats – fish, avocado, olive oil, nuts, seeds.
• Include fermented foods and prebiotic fibre – yoghurt, berries, banana.
• Ask family members to help prepare some meals for you.

Try to avoid:

• Processed oils, vegetable oils
• Processed saturated fats (for example from pastries, cakes, doughnuts)
• Fried foods
• Foods with high levels of added salt
• Excess caffeine
• Alcohol
• Empty calorie foods (refined carbohydrates, processed sugars)
• Becoming dehydrated

Important Nutrients for Breastfeeding

IronBrain development, neurotransmitter production & red blood cells.10 mg for 14-18 years.
9 mg for 18+.Red meat, spinach, lentils.ZincFormation and maintenance of mucous membranes (intestines), immune system development and function.11 mg for 14-18 years.
12 mg for 18+.Oysters, pumpkin seeds, meat, chicken.

References
1. http://www.cdc.gov/breastfeeding/breastfeeding-special-circumstances/diet-and-micronutrients/maternal-diet.html
2. Mosca F, et al. Pediatr Med Chir. 2017; Jun 28;39(2)
3. http://www.foodstandards.gov.au/consumer/chemicals/mercury/documents/mif%20brochure.pdf
4. http://ww.breastfeeding.asn.au/bfinfo/breastfeeding-and-maternal-caffeine-consumption
5. http://www.foodstandards.gov.au/consumer/generalissues/Pages/Caffeine.aspx
6. http://www.eatforhealth.gov.au/eating-well/healthy-eating-throughout-all-life/healthy-eating-when-you’re-pregnant-or-breastfeeding
7. Bernard JY, et al. J Pediatr. 2017 ;Apr;183:43-50
8. Hermansson H, et al. Front Nutr. 2019;6:4.
9. Isolauri, E. J Paed Ch H. 2012; 48: 1-6