Pregnancy and lactation are probably two phases of life when a woman and her near ones take extreme care of the woman’s diet. It is important to understand the nutritional needs of a lactating woman. The nutritional stores of a woman may get exhausted after delivery if proper care was not taken during pregnancy.
The phase of lactation asks for increased delivery of most of the nutrients, more than what was needed during pregnancy. The raised requirements are for meeting the nutritional requirements of the woman’s body and for the production of colostrum, by the production of breast milk.
Nature keeps the composition of breast milk fairly constant, at the cost of the mother’s health. This means that the mother’s nutrient reserves are used up for keeping the quality of the breast milk, making it all the more important for the mothers to watch out for their diet. Unless the Mothers are extremely malnourished, the quantity and quality of all mother’s milk are appropriate for the infant.
The weight of an infant doubles up in the first 4 to 6 months. To facilitate this, the baby must be breastfed well and thus the mother must increase her energy intake by 600 kcals during the first phase of lactation (0 to 6 months). This number comes down to 520 kcals when the infant is 7 to 12 months old.
The milk produced in the first four months of lactation constitutes an amount of energy that is equivalent to the total energy expenditure of gestation.
One must never attempt to have energy less than 1800 kcals a day through weight loss diets. Insufficient energy consumption puts one at the risk of breaking the protein down for energy, which is very detrimental. At the same time, there have been cases reported where lactating women have been restricted on fluids which eventually lead to urinary tract infection(UTIs), dehydration, kidney stones, constipation, haemorroids, etc.
The protein requirement between 0 to 6 months of lactation increases by 17 grams a day, followed by 13 grams during 7 to 12 months. A good supply of protein is needed for a mother to maintain her muscle mass as well as to provide adequate protein to the infant.
To meet the needs of essential fatty acids and for attaining the increased calorie requirement, fats, the energy-dense nutrient is required in higher quantities (45 grams). Fat is energy dense nutrient and is usually needed in 20 grams but the need is increased during lactation.
4. Vitamins and minerals
The concentration of water-soluble vitamin in breast milk is highly dependent on maternal intake levels. The fat-soluble vitamin concentrations depend mostly on maternal stores, although they may be increased by exogenous sources. The micronutrients which are needed in increased amounts are Vitamin A, B1, B2, B3, C, folic acid, and vitamin B12.
Calcium is needed for replenishing a mother’s stores and also for breast milk production. A lactating woman must try to consume at least 500 ml of milk and its products. Her requirement goes up to 1200 mg of calcium in a day. Calcium-rich foods include milk and milk products, greens, ragi, jowar, sesame seeds, curry leaves, Bengal gram, Amaranth, Fenugreek leaves, etc.
A baby is born with enough iron stores and thus there are no additional requirements during lactation. The per-day requirement is 23 mg as compared to 27 mg during pregnancy, but an intake of iron-rich food is very important for maintaining the iron stores of the mother. Foods rich in Vitamin C must be taken to increase the absorption of iron in the body. Iron-rich foods include greens, ragi, jowar, watermelon, papaya, dry fruits, rice flakes, cauliflower greens, etc.
Galactagogues must be advised for women facing the problem of low milk production. These foods promote the flow of the mother’s milk by increasing the level of prolactin in the body. Lactogenic foods include fenugreek, barley, dark greens leafy vegetables, carrot, beetroot, yam, turmeric, nuts, green papaya, ginger, garlic, sesame seeds, and garden cress seeds.
A lactating mother must hydrate herself well and also consume enough fiber-rich foods to avoid constipation.
Content By: Ms. Shalini Arvind, Chief Dietitian, Fortis Hospitals, Bannerghatta Road, Bengaluru
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