Diet and weight loss while breastfeeding

Joy Anderson B.Sc. Postgrad.Dip.Diet. APD IBCLC Breastfeeding Counsellor

A 'perfect' diet is not required for breastfeeding. In general, your diet is important for your own health and energy levels, rather than affecting your breastmilk and your baby. Even in countries where food is scarce, mothers are able to breastfeed and their babies thrive. However, there are a few nutrients a baby needs that may be affected if the mother's intake is too low, such as iodine and vitamin B12.

Mum

When you are breastfeeding, your body is able to partly compensate for the extra demand on nutrients by using them more efficiently and there is usually an increase in your appetite as well. You can obtain the extra energy and nutrients needed by eating slightly more of the same foods you would normally eat, using up some of your fat stores laid down while you were pregnant and by reducing the amount of energy you use.

For mothers eating a normal Australian diet, the most common nutrients of concern are iodine, iron and calcium. Talk to your medical adviser or a dietitian to find out if you have enough of these in your diet. Particularly in the case of iodine, you may be advised to take a supplement, as the amounts recommended for pregnant and breastfeeding mothers are hard to obtain from a normal Australian diet. For more information about iodine needs, see the National Health and Medical Research Council publication Iodine supplementation for Pregnant and Breastfeeding Women.

The following table shows the recommendations for food groups and average serve sizes. This is only a guide showing the relative numbers of serves of food types. You should use your common sense, your appetite and any changes in your body weight to determine what is right for you.

Sample daily food patterns from Eat for Health: Australian Dietary Guidelines. Australian Government, National Health and Medical Research Council, Department of Health and Ageing, 2013.

Food GroupServes per dayWhat is a serve?
 Women 19-50 yearsPregnantBreast-feeding 
Grain (cereal) foods, mostly wholegrain and/or high-fibre cereal varieties69

1 slice (40 g) bread

½ (40 g) medium roll or flat bread

½ cup (75–120 g) cooked rice, pasta, noodles, barley, buckwheat, semolina, polenta, bulgur, quinoa

½ cup (120 g) cooked porridge

2/3 cup (30 g) wheat cereal flakes

¼ cup (30 g) muesli

3 (35 g) crispbreads

1 (60 g) crumpet

1 small (35 g) English muffin or scone
Vegetables and legumes/beans55

About 75 g:

½ cup cooked green or orange vegetables

½ cup cooked dried or canned beans, peas, lentils

1 cup green leafy or raw salad vegetables

½ cup sweet corn

½ medium potato or other starchy vegetable (sweet potato, taro, cassava)

1 medium tomato
Fruit222

About 150 g:

1 medium apple, banana, orange, pear

2 small apricots, kiwi fruit, plums

1 cup dried or canned fruit

Occasionally:

½ cup (125 mL) fruit juice with no added sugar

30 g dried fruit (4 dried apricot halves, 1½ tblsp sultanas)
Milk, yoghurt, cheese and/or alternatives (mostly reduced fat)2½

1 cup (250 mL) fresh, UHT long-life, reconstituted powdered milk or buttermilk

½ cup (120 mL) evaporated milk

2 slices (40 g) or 4x3x2 cm cube (40 g) hard cheese

½ cup (120 g) ricotta cheese

¾ cup (200 g) yoghurt

1 cup (250 mL) soy, rice or other cereal drink with at least 100 mg/100 mL calcium

100 g almonds with skin

60 g sardines, canned in water

½ cup (100 g) canned pink salmon with bones

100 g firm tofu (check label for calcium content)
Lean meats and poultry, fish, eggs, tofu, nuts and seeds, legumes/beans

65 g cooked lean red meat such as beef, lamb, veal, pork, goat or kangaroo (90–100 g raw)

80 g cooked lean poultry (100 g raw)

100 g cooked fish fillet (115 g raw)

1 small can fish

2 large (120 g) eggs

1 cup (150 g) cooked or canned legumes/beans such as lentils, chickpeas or split peas

170 g tofu

30 g nuts, seeds, or nut or seed paste

Additional serves for taller or more active people. More from above food groups or unsaturated spreads and oils or discretionary choices*

 

0-2½0-2½0-2½

10 g poly/monounsaturated spread

7 g polyunsaturated oil such as olive, canola

10 g nuts or nut paste

 

Discretionary choices:

2 scoops (75 g) ice cream

2 slices (50–60 g) processed meats, salami, mettwurst

2 thin (50–70 g) sausages

½ snack-size packet (30 g) salty crackers or crisps

2-3 (35 g) sweet plain biscuits

1 (40 g) doughnut

1 slice (40 g) plain cake/muffin

5–6 (40 g) small lollies

1 tblsp (60 g) jam or honey

½ bar (25 g) chocolate

2 tbsp (40 g) cream

1 tblsp (20 g) butter

1 can (375 mL) soft-drink (sugar-sweetened)

¼ (60 g) commercial pie or pastie (individual size)

12 (60 g) hot chips

*Note that discretionary foods only provide energy and very little nutrition, so are not good choices. For more information about the foods in this table, see Eat for Health: Australian Dietary Guidelines.

Weight loss

It is normal to store extra fat during pregnancy to be used up while breastfeeding. Mothers vary in when they lose this extra weight - some in the early weeks, some later and some not until after they have stopped breastfeeding. It is important that you do lose this extra weight at some point, however, and not carry it through to another pregnancy. If this happens, it makes it much harder to return to a healthy weight later on. Even though making breastmilk uses kilojoules, research is unclear whether breastfeeding actually increases weight loss after childbirth.

While breastfeeding, it is best to lose the extra weight gradually, using healthy eating principles and adding in some extra exercise. A loss of up to about half a kilo per week is safe for breastfeeding mothers. Don't use crash or fad diets, where you lose weight quickly, either during pregnancy or breastfeeding. These diets don't have a good balance of important nutrients needed for both you and your baby.

If you feel that you need to lose a lot of weight and more quickly, consult your medical adviser or a dietitian for advice on a balanced weight-reducing diet.

Some hints if you are trying to lose weight:

  • Avoid shopping when you are hungry. Write a shopping list and stick to it. Don't be tempted to buy high-fat or high-sugar snack foods.
  • Use smaller plates for your meals.
  • Eat slowly. Don't put more food on your fork until you've eaten the last mouthful. This gives you time to feel full.
  • Don't eat on the run - sit down at the table and relax.
  • Choose snacks of wholegrain products, vegetables and fruits.
  • Cut down on fat (and kilojoule) intake by choosing low-fat or fat-free dairy products, cutting off all visible fat from meat before cooking and using only a small amount of oil during cooking.
  • Choose foods that contain little or no added sugar. Note that foods labelled 'low-fat' are often very high in sugar. Foods with added fruit or fruit juice concentrate, but labelled 'no added sugar', can be just as high in kilojoules as some others with added sugar. Check labels for energy (kJ) content.
  • Increase the amount of exercise you do.

For more information about looking after yourself, see the booklet Breastfeeding: diet, exercise, sex and more.

Losing too much weight?

Some breastfeeding mothers have the opposite problem and find that they lose too much weight, too quickly. In this case, try to increase the number of serves of food you eat across all food groups. Avoid the temptation to eat foods high in saturated fats or added sugar - the 'discretionary choices' listed in the table above. These foods might help you gain weight, but are not good sources of the extra nutrients you need. Try having frequent, small meals or at least have snacks between each regular meal. Consult your medical adviser or a dietitian if you are concerned about your weight loss.

Thirst

Making breastmilk uses extra fluid, so breastfeeding mothers are often more thirsty than usual. There is no one figure for how much you need to drink, as it depends on the weather conditions, your activity level and the foods you eat. Be guided by your thirst; don't be tempted to ignore it because you are busy. Perhaps make it part of your breastfeeding routine to have a glass of water or a water bottle next to you each time you give your baby a feed. Carrying a water bottle with you when out and about also makes it easy to have a drink when you need it.

Special diets

Vegetarian

There are two types of vegetarian diets:

  • those that include some animal products, such as dairy products and/or eggs, and in some cases fish or some other animal products
  • those that do not contain any animal products (vegan)

The nutrients of most concern when animal products are not eaten or only in small amounts are protein, iron, calcium, vitamin B12 and omega-3 fatty acids. While breastfeeding, well-planned vegetarian diets are able to satisfy these needs, with the possible exception of vitamin B12 in a vegan diet. If you have followed a vegan diet for a long period of time prior to having your baby, it would be wise to have your vitamin B12 levels checked and you may require a vitamin B12 supplement. If you are unsure at all, check with your medical adviser or a dietitian regarding nutritional adequacy of your diet for both yourself and your baby.

Food allergy or intolerance in baby

Some babies can be food-sensitive and react to traces of foods that come through their mother's breastmilk. This can include allergies and food intolerances. The most common food allergies in babies are those to cow's milk, eggs, peanuts and tree nuts. A baby can also have food intolerance (along with an allergy or alone) and react to a range of other foods in the mother's diet. However, there are many reasons a baby may be unsettled or have other symptoms that are like those of food intolerance. Seek professional advice to help you determine if your baby is food-sensitive. Each mother and baby pair is different. Even if you are sure that it is something in your diet, it can often be very difficult to identify which foods are causing problems. Avoiding a whole food group, such as dairy products, may make it more difficult for you to eat a balanced diet. A dietitian will be able to help you sort out what the problem foods are and ensure that your diet contains all the nutrients you need.

Dairy-free diets

Some mothers follow dairy-free diets for either cultural reasons or because they or their babies have an intolerance to cow's milk. Some cultural groups don't traditionally eat dairy products and need to get their calcium from other foods. Dairy products primarily supply calcium in the Western diet, but they are also a valuable source of protein and some vitamins like A, B2 (riboflavin) and B12. When dairy substitutes are used instead, consideration has to be given to replacing all of these from other sources in the diet. A dietitian is able to advise on this on an individual basis and take into account a mother's cultural background.

Mothers with medical conditions

Mothers may have conditions such as coeliac disease, food allergies or another medical condition that requires a special diet. Provided these conditions are well managed, there should be no reason why these mothers cannot breastfeed. Breastfeeding helps to protect babies against also developing these conditions as they grow up. The diet can be well balanced and nutritionally complete for both the mother and her baby. If you are unsure if your diet is adequate, you can consult a dietitian for assessment and advice.

What about alcohol?

Avoiding alcohol altogether while pregnant or breastfeeding is known to be the safest option. However, you don't have to abstain for the whole time you are breastfeeding. It is best to wait until your baby is at least 1 month old before having a drink, by which time your baby may have a predictable feeding pattern. You are more likely then to know when the next feed will be and can time your drink to minimise the alcohol in your breastmilk.

On average, it takes about 2 hours for your body to clear the alcohol per standard drink. If possible, time your drink so that your body can clear the alcohol before your baby's next feed.

Perhaps you have an occasion when you are planning to have more than two drinks. In this case, plan ahead and express some breastmilk beforehand to be fed to your baby while you have alcohol in your system. Also consider the care of your baby if you are affected by alcohol.

For more details see Alcohol and breastfeeding.

References and further reading:

© Australian Breastfeeding Association Reviewed April 2013