Introduction

When you are breastfeeding your baby, you may wonder about what foods and drinks are best for you and whether what you eat may affect your breast milk and your baby.

Bear in mind that women who are breastfeeding do not need to consume special foods or excessive amounts of fluid to successfully lactate or to increase their milk production.

One of the wonders of breast milk is that it can meet your baby’s nutritional needs even when you are not eating perfectly. However, that does not mean that you will not suffer.

When you do not get the nutrients you need from your diet, your body draws on its nutrient reserves, which can eventually become depleted. Also, you need energy and stamina to meet the physical demands of caring for a new baby.

What Food To Eat While Breastfeeding ?

If you are already eating well when you were pregnant, you probably do not need to make any major changes on what you eat or drink when you are breastfeeding, although there are a few important considerations to keep in mind.

The amount you need to eat depends on your pre-pregnancy weight, and how much weight you gained during pregnancy, as well as how active you are.

In general, most women who are breastfeeding need about 500 calories more than women who are not – that is a total of 2,500 kilocalories (kcal) per day.  You do not need to eat any special or different foods.

However, you should try to follow a healthy and balanced diet, which includes a variety of foods from the food groups in the Malaysian Food Pyramid.

Include a variety of healthy foods

Variety and balance are crucial to a healthy diet. Eating a mixture of food containing :

• carbohydrates,

• protein, and

• fat..

..at meal times keeps you feeling full longer and supplies the nutrients your body needs.

Eating a variety of foods while breastfeeding will change the flavour of your breast milk.

In fact, some experts believe that babies enjoy a variety of flavours in their breast milk, and this may help him accept different foods once he starts eating solids.

Malaysian Food Pyramid

Food Groups

Level 1 (lowest level)	Rice Noodle Bread Cereals and Cereal Products Tubers	This is the food group that you should eat adequately to provide all your energy needs. It includes healthy foods like ; cereals rice pasta. Complex carbohydrates like ; whole grains cereals legumes tubers… ..not only provide more nutrition than processed starches and sugars, but they also provide longer-lasting energy and dietary fibre. Since your energy needs increase by 500 kcal a day when you are breastfeeding, you probably need to eat an additional 1-2 servings from this food group.
Level 2	Fruit and Vegetables	Fruits and vegetables give us fibre and important vitamins and minerals. Every day, you should take at least ; 2 servings of fruit, and 3 servings of vegetables. Include green leafy vegetables in your daily diet. Because they are low in fat and calories, fruit and vegetables can be taken as healthy snacks between meals.
Level 3	(i) Fish Meat Poultry Egg Legumes Nuts	These foods are good sources of ; protein vitamin (fish and eggs are rich sources of vitamin A), and minerals, such as : iron zinc magnesium B vitamins. During breastfeeding you need additional protein for the body to manufacture breast milk, which is rich in protein and important for baby’s growth. Eating an additional serving of fish, chicken as well as legumes and milk will help to achieve this.
	(ii) Milk and milk products	This group includes : milk (all types EXCEPT sweetened condensed milk) yoghurt cheese They are THE BEST SOURCE of calcium and rich in protein and vitamin. Milk is a good source of vitamin A. Since your need for calcium is very high (1000 mg/day), you need 3 servings of milk or milk products in your diet.
Level 4 (highest level)	Fat Oil Sugar Salt	Try to limit foods that are high in fat and oil (fried foods), as these foods are very high in energy. Since sugar provide mainly energy and very little of other nutrients, sweet foods and beverages should also be REDUCED. Cutting down on salty foods is also part of a healthy diet. REMEMBER, sauces such as soya sauce, tomato sauce, are also high in salt.

Chart of Daily Food Group Servings For Breastfeeding Mothers

Food Group	Serving per day	Serving Size
Rice Noodle Bread Cereals Tubers	8	Rice : 1 cup (2 scoops) Rice porridge : 2 cups Bread : 2 pieces Breakfast cereal : 1 cup
Vegetables	3	Green leafy veggies : 1 cup (raw veggies) Root veggies (carrot) : ½ cup Fruit veggies (tomato) : 2 medium-sized tomatoes
Fruit	2	Guava : ½ whole Watermelon : 1 slice Orange : 1 medium-sized
Fish Poultry Eggs	4	Chicken : 1 piece of medium-sized drumstick Beef : 2 slices (matchbox-sized) Eggs : 2 eggs
Legumes	1	Beans and legumes : 1 cup (cooked) Tauhu : 2 pieces
Milk and milk products	3	Milk : 1 glass Yoghurt : 1 cup Cheese : 1 slice

What Foods To Avoid ?

While breastfeeding, you can eat practically anything you like, in moderation.

However, do remember that traces of food and drink can sometimes get into breast milk, and this may cause your baby to become irritable or have an allergic reaction.

If your baby becomes ;

• fussy,
• develops a rash,
• diarrhoea, or
• experiences congestion..

..soon after breastfeeding, consult your doctor. These signs could indicate a food allergy.

If you suspect that something in your diet might be making your baby a little fussier than usual, avoid the food or drink for up to a week to see if it makes a difference in your baby’s behaviour.

If removing a certain food or drink from your diet has no impact on your baby’s fussiness, add it back to your diet and consider other possible causes instead.

If you are concerned about your baby’s behaviour, consult your doctor.

 

Drink Plenty of Water, Limit Caffeine and Alcohol

You only need to drink enough to satisfy your thirst while breastfeeding.

Drinking lots of water, or being thirsty, will not affect your milk supply.

There is no need to keep a record of how much water you drink. A good guideline to follow is to drink to satisfy thirst – that is, drink whenever you feel the need.

If your urine is clear or light yellow, it is a good sign that you are well-hydrated.

Coffee and Caffeine

Most experts recommend that breastfeeding mothers limit their consumption of caffeine to about 2 to 3 cups a day, this includes :

• coffee
• tea
• soft drinks
• chocolate
• coffee-flavoured ice cream.

A small amount of caffeine ends up in your breast milk, and it can accumulate in your baby’s system because he cannot easily break it down and excrete it.

This might agitate your baby or interfere with your baby’s sleep.

Alcohol

Drinking alcoholic drinks occasionally is unlikely to harm you or your baby. Remember, alcohol passes through your breast milk to your baby. Drinking more than two units a day while you are breastfeeding may reduce your milk supply, and even affect your baby’s development. Use of some alcohol in cooking is safe as the alcohol will evaporate during cooking.

 

Vegetarian Diet and Breastfeeding

If you are a vegetarian, most likely you already know the importance of choosing foods that will give you the nutrients you need. This is especially important during breastfeeding.

Choose Foods Rich In IRON, PROTEIN and CALCIUM

Good sources of IRON include :

• dried beans and peas

• lentils

• enriched cereals

• whole grain products

• dark leafy green vegetables

• dried fruits.

To help your body absorb iron, eat iron-rich foods in combination with foods high in vitamin C, such as :

• papayas,

• oranges,

• mangoes, or

• tomatoes.

For PROTEIN, consider ;

• eggs and dairy products, or

• plant sources, such as :

  • soy products and meat substitutes

  • legumes

  • lentils

  • nuts

  • seeds

  • whole grains.

Good sources of CALCIUM include :

• dairy products

• dark green vegetables.

Other options include calcium-enriched and -fortified products, such as :

• juices

• cereals

• soya milk

• tofu.

 

Consider Supplements

Your doctor will likely recommend that you take a daily vitamin B-12 supplement and, in some cases, a vitamin D supplement.

Vitamin B-12 is found almost exclusively in animal products, so it can be difficult to get enough in some vegetarian diets. Vitamin B-12 is essential for your baby’s brain development.

If you do not eat enough vitamin D-fortified foods — such as cow’s milk and some cereals — and you have limited sun exposure, you might need vitamin D supplements.

Weight Loss While Breastfeeding

You may have put on weight while you were pregnant. Some new mothers find it easy to lose weight, while others do not lose much. It all depends on your ;

• body

• food choices

• activity level

• metabolism.

Aim For Slow and Steady Weight Loss

DO NOT try to lose weight by dieting until at least two months after your baby is born.

A low-calorie diet in the first few months could ;

• drain-off your energy

• diminish your milk supply.

Losing about ½ kg to 1kg a week should not affect the amount or the quality of milk you make.

Eating healthily and doing some gentle exercise will help you get in shape.

This is better than very strict low-calorie diets when you are breastfeeding. You can increase your exercise six to eight weeks after giving birth.

Conclusion

Remember, there is no need to go on a special diet while breastfeeding. Simply focus on making healthy choices ? you and your baby will be healthy.

Reference

1. Amorim Adegboye AR, Linne YM, et al, 2007. Diet or exercise, or both, for weight reduction in women after childbirth. Cochrane Database of Systematic Reviews (3) : CD005627
2. AND. 2012. Which dietary factors would affect breast milk production (or breast milk supply, established lactation)? Evidence Summary. Evidence Analysis Library. Academy of Nutrition and Dietetics Committee on Drugs. 2001.
3. The transfer of Drugs and Other Chemicals in Human Milk. American Academy of Pediatrics. Pediatrics. 108(3) : 776-789
4. Dusdieker LB, Hemingway DL, Stumbo PJ. 1994. Is Milk production impaired by dieting during lactation? American Journal of Clinical Nutrition 59 : 833–40
5. LLLI. 2006. What effect does the mother’s consumption of caffeine have on the breastfeeding infant? La Leche League International.
6. Jones 2009. Alcohol and breastfeeding. Paisley : The Breastfeeding Network.
7. NICE. 2011. Food allergy in children and young people. National Institute for Health and Clinical Excellence, Clinical guideline, 116. London : NICE.
8. Malaysian Dietary Guidelines.  National Coordinating Committee on Food and Nutrition, Ministry of Health Malaysia, 2010.

Last review	:	29 January 2014
Writer	:	Mdm. Fatimah binti Salim