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When you ​are breastfeeding your baby​, you must continue to eat well to maintain your nutritional status. Your nutrient stores may be used up for breast milk if your nutrient intake is low. In fact, your requirement for certain nutrients (e.g. energy, protein and B vitamins), are higher during breastfeeding than during​ pr​egnancy​. So if you were conscious of the nutritional quality of your diet during pregnancy, there is even more reason for you to do so when breastfeeding! 

In general, if you eat a balanced diet based on the ‘Healthy Diet Pyramid for Pregnancy’ (read ​the article on Nutrition During Pregnancy - Eating Right for Two),  you will be able to meet your basic nutritional needs during breastfeeding in order to support your baby’s growth and development, as well as protect your own nutrient stores. Eat whenever you are hungry and drink when thirsty. 

Special Formulated Milks for Breastfeeding Mothers 

Most special milks formulated for breastfeeding mothers are based on powdered skimmed or whole cow’s milk, fortified with specific vitamins and minerals, especially iron, zinc and B vitamins including folic acid. Some brands also contain fish oil, as a source of DHA (Docosahexaenoic acid). Hence, breastfeeding mothers who are unable to consume a balanced diet​ consisting of the recommended number of servings of meat (as main source of iron and zinc), citrus fruits and green leafy vegetables (as main sources of folic acid), and cold water deep-sea fishes (as main source of DHA) may benefit from drinking these special milks to supplement their usual sources of these nutrients. However, the basic nutrients, namely, calcium, phosphorus and protein, found in special milks formulated for breastfeeding mothers and regular milk are similar. 

Caffeine and Breastfeeding 

As caffeine passes from mother to baby through breast milk, excessive caffeine can cause symptoms of caffeine stimulation in your baby. Regular coffee drinkers would be glad to know that one or two cups of coffee a day will not affect babies as studies suggest that breastfeeding mothers can consume up to 650 mg of caffeine a day. However, be aware that apart from coffee, tea and cocoa products, caffeine can also be found in soft drinks and over-the-counter medications like cold medicines. 

Avoid Alcoholic Beverages When Breastfeeding 

Alcohol passes from mother to baby through breast milk. Large amounts of alcohol can affect the milk let-down (ejection) reflex. Most local lactation experts recommend that mothers refrain from drinking alcoholic beverages in the first week after delivery to avoid stressing the newborn baby’s liver. However, from the second week onwards, if baby is not jaundiced, and mother wishes to consume alcohol, she should not exceed 0.5 g alcohol for every kilogram of body weight, and breastfeeding should be delayed for at least one hour for every 10 g of alcohol consumed. (One pint of beer, one glass of wine or one standard drink of spirits is equivalent to one unit of alcohol. This equals 10 g of alcohol.) 

Case Example​​

A 60 kg woman can drink a maximum of 0.5 g × 60 = 30 g (namely, 3 units) of alcohol a day. 

If she chooses an alcoholic drink containing 20 g of alcohol, she should wait at least two hours before breastfeeding her baby.​ ​

Did You Know?

Benedictine Dom™​, an alcoholic tonic traditionally associated with good health and consumed by mothers post-delivery contains about 40% alcohol. So, 25 ml of Benedictine DOM would be quivalent to 10 g of alcohol (one unit).

Alcohol added to food during cooking does evaporate, but some alcohol will still be left. So, if you are eating dishes cooked in alcohol, for example, red wine chicken, you may wish to refrain from breastfeeding your baby for the next 1-2 hours.


Frequently Asked Questions

1. Do I need to avoid certain food (for example, eggs, cow’s milk, fish, nuts or wheat) to reduce my baby’s risk of developing allergies? 

There is not enough evidence currently that avoiding specific foods will reduce baby’s risk of developing allergies. However, if there is a family history of allergy, some doctors may recommend delaying the introduction of certain foods, e.g. eggs, cow’s milk and nuts, till the baby is older. You may wish to consult your doctor for more advice when baby is six months old and ready to start solid foods. 

2. Does eating ginger cause my baby to be jaundiced if I breastfeed? 

There is no evidence that ginger or any foods consumed by the breastfeeding mother will cause baby to be jaundiced. Jaundice is due to the accumulation of bilirubin in the baby’s body. Bilirubin is a by-product of red blood cell breakdown, which occurs naturally every day. However, as the newborn baby’s liver is immature, bilirubin breakdown is slow, hence leading to accumulation and the characteristic yellow coloration of baby’s skin and eyes.

​3. Is it safe to consume artificially sweetened foods and drinks when breastfeeding? 

Moderate consumption of approved sweeteners like aspartame, acesulfame potassium and sucralose is considered safe when breast feeding. These sweeteners are used as table top sweeteners, e.g. EqualTM, PalsweetTM, are used by food manufacturers in low calorie products like drinks, yoghurts and confectionaries. 

4. Can I go on a weight loss diet without affecting my breast milk supply? 

Most breastfeeding mothers will lose their weight gained during pregnancy. Losing 1 to 2 kg a month is considered as healthy weight loss. Going on a weight loss diet whilst breastfeeding is not recommended as you may not be consuming enough nutrients to meet your requirements, and breast milk production may be affected. Use your weight as an indicator — if you are losing more than 2.5 kg a month after the first month, you may be eating too little. 

5. Is there any special diet to increase breast milk production? 

Traditional foods such as unripe papaya cooked with fish has been advocated to increase mother’s milk. 

Fenugreek, also known as ‘venthaiyem’ (in Tamil), ‘methi’ (in Hindi) or ‘Halba’ (in Malay) is the herb that is commonly used in cooking curry. It has been used to increase milk supply traditionally. 

Fenugreek tea can be taken four times a day by adding three teaspoons of fenugreek seeds into a glass of hot water to improve milk supply. Fenugreek capsules are available from health food outlets and pharmacies and can be taken as two capsules four times a day or three capsules three times a day to improve milk supply. 

​Fenugreek is considered safe for nursing moms when used in moderation and is listed as GRAS (Generally Recognized As Safe) by US FDA. However, be cautious that an excessive amount of fenugreek may cause loose stools in the mother. See Table 46.2 for medication to increase milk flow. 

 


Acknowledgement​​

Source: Dr TAN Thiam Chye, Dr TAN Kim Teng, Dr TAN Heng Hao, Dr TEE Chee Seng John, The​ New Art and Science of Pregnancy and Childbirth​, World Scientific 2008. 


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