Lactation and Supplementation

Lactation and Supplementation

Since you found out you were pregnant it is likely that the majority of your decisions have been focused on one thing—preparing for the healthy birth of your baby. From attending doctor’s appointments to choosing nutrient-dense foods to designing the nursery, you have been making choices for the health of your baby. Now that the baby is born, what changes? Nutrition continues to play a key role in your baby’s health as well as your health as you recover from labor and begin breastfeeding. Lactation requires about 500 more calories per day and additional nutrients. Can diet alone provide the necessary nutrients during lactation to fuel your body and nourish your baby? Below we outline key nutrients and whether supplementation is necessary.

Protein:

Lactation requires an additional 25g per day of protein on top of the normal 0.8g/kg/day (4). Protein is especially important right now as the body’s tissues heal from giving birth. Recently, many people have turned to collagen powder as a protein supplement. Collagen powder, derived from animal sources like fish or beef, has been found to improve hair, skin, and nail health in non-pregnant women. However, there are some risks of contamination with heavy metals and other toxicants. These can be harmful to the baby during pregnancy and through breastmilk exposure. Collagen powder should be avoided until breastfeeding has stopped. Instead focus on a variety of lean sources like chicken breast, fish, beans, nuts, and quinoa to ensure you are getting the protein you need to support lactation and healing.

Zinc:

Zinc is necessary for supporting your baby’s growth and development. The breastmilk of well-nourished mothers can adequately meet zinc needs for the first few months, but the zinc concentration in breastmilk declines with time (3). At around 6 months complementary foods containing zinc, like fortified rice cereal, should be introduced or a zinc supplement should be provided to the infant.

DHA:

The amount and type of fat in breastmilk varies based on maternal diet (5). The fatty acid DHA is important for its anti-inflammatory properties as well as its role in brain development. Eating fish once or twice a week is a great way to include DHA in your diet.

Choline:

Choline has many purposes playing a key role in brain development, memory, cell membrane structure, and communication between the nervous system and other body systems (1). A large amount of choline is secreted in breastmilk providing enough of this multi-purpose nutrient to meet the baby’s needs (3). However, since so much is secreted into breastmilk it is important that breastfeeding moms eat choline rich foods like eggs. Supplementation may be necessary on an individual basis.

Fat-Soluble Vitamins:

Fat-soluble vitamins A and E are sufficiently provided in breastmilk (5). Newborn babies have low stores of Vitamin A. Luckily, breastmilk from well-nourished mothers meets this increased need. To meet the baby’s and mother’s needs more Vitamin A is needed during lactation than during pregnancy (3). However, Vitamin A can concentrate in the breastmilk potentially reaching toxic levels (2). Focusing on eating more Vitamin A rich foods like carrots or sweet potatoes should provide enough Vitamin A to meet the increased needs while preventing the risk of toxicity. Vitamin D levels in breastmilk vary based on maternal diet and sun exposure. Given the risk of skin cancer from sun exposure, the American Academy of Pediatrics recommends a supplement of 400 IU to all breastfed infants (6). These can be administered directly to the baby as drops.

During breastfeeding, it is important to continue eating a variety of nutrient-dense foods to support milk production, your baby’s development, and your health. While most nutrient needs can be met through diet, supplementation may be needed on an individual basis. Are you concerned you may not be getting enough of a nutrient? Make an appointment to determine if supplementation is necessary.

References

  1. Academy of Nutrition and Dietetics. (2020). Eatright Essentials: Nutrient Library [PDF]. Chicago.
  2. Drugs and Lactation Database (LactMed) [Internet]. Bethesda (MD): National Library of Medicine (US); 2006-. Vitamin A. [Updated 2018 Dec 3]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK513060/
  3. Gluckman, P. D., Hanson, M. A., Chong, Y. S., & Bardsley, A. (2015). Section 2 Nutritional requirements of pregnancy and breastfeeding. In Nutrition and lifestyle for pregnancy and breastfeeding (pp. 32-209). New York, NY: Oxford University Press.
  4. Kominiarek, M. A., & Rajan, P. (2016). Nutrition Recommendations in Pregnancy and Lactation. The Medical clinics of North America, 100(6), 1199–1215. https://doi.org/10.1016/j.mcna.2016.06.004
  5. McMahon, K. (2018). Chapter 4 Nutrition Needs During Lactation. In Nutrition across life stages (pp. 92-115). Burlington, MA: Jones & Bartlett Learning.
  6. Loyal, J., & Cameron, A. (2020). Vitamin d in children: Can we do better? Pediatrics, 145(6). doi:10.1542/peds.2020-0504

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