Breastfeeding: Eating for Two

Why am I so hungry all the time?

Now that you’re producing breast milk you will likely notice an increase in your appetite. In the first 4-6 months of life, most babies double their birth weight, which means your body is using a lot of energy producing milk during this time. Feeling hungry is your body’s way of asking you to replenish those nutrients more often! In fact, it is recommended nursing moms increase their daily calorie intake by about 500 calories per day during the first 6 months postpartum, and 400 calories per day during the next 6 months.

How many calories per day should I be eating?

Calorie needs will depend on your age, size, activity level, fat stores, and how often you’re breastfeeding. According to the US Department of Agriculture’s (USDA’s) 2020-2025 Dietary Guidelines for Americans, most women between the ages of 19-30 require 1,800-2,400 calories per day and women between the ages of 31-60 require 1,600-2,200 calories per day before pregnancy and lactation. This means you will want to add an additional 500 calories per day to this requirement for adequate nutrition to support lactation in those first 6 months postpartum.

To determine your caloric needs, I highly recommend entering your data into a calculator that accounts for all of your individual factors including whether or not you are pregnant or breastfeeding, like this one here: USDA Calorie Calculator. If you have dietary restrictions or any additional questions or concerns, you should contact your healthcare provider for further guidance.

What should I include in my diet?

Eating a healthy, well balanced diet with nutrient dense foods will provide you with essential nutrients as your body heals from pregnancy and childbirth as well as provide the foundation for an abundant milk supply.

Examples of nutrient dense foods:

• Fruits
• Vegetables
• Whole grains
• Low fat dairy products
• Protein sources: seafood, lean meats, poultry, beans, peas, lentils, unsalted nuts, and eggs

Foods to limit:

• Foods higher in saturated fats (i.e. butter, cakes, biscuits, fatty cuts of meat, bacon, sausage, cheese, icecream, etc)
• Foods and beverages higher in added sugars
• Sodium

Should I continue to take vitamin supplements?

The quick answer; most likely!

Your baby is going to be completely dependent on you for their micronutrients while breastfeeding which means you need to make sure you are sufficient in these nutrients. Ideally, you would be getting all of your vitamins and minerals from food sources, but in reality, most diets alone will not be sufficient to ensure adequate nutrition while breastfeeding.

Most women decide to continue taking their prenatal vitamins, such as this one from Mommy's Bliss. It’s important to note nutrient needs change from pregnancy to lactation. For example, folate needs decrease postpartum, so your prenatal vitamin may exceed your folate requirements. Another important difference to consider is choline and iodine needs which increase while breastfeeding. See the table above for specifics regarding nutrients and recommended daily allowances for lactating women from the Institute of Medicine.

Exclusive breastfeeding is a risk factor for Vitamin D deficiency for mom, resulting in Vitamin D deficiency in human milk, and Vitamin D deficiency in baby. Vitamin D is a crucial nutrient for your infant’s bone health and immunity, so additional vitamin D supplementation is recommended for both mom and baby. Experts recommend the breastfeeding mother take 6400IU of Vitamin D supplementation daily to meet both mom and baby’s Vitamin D requirements. One alternative option is to continue taking your prenatal or postnatal vitamins which should contain 600IU of Vitamin D and supplement your baby with Vitamin D drops administered on your nipple while breastfeeding or the bottle nipple.

Please talk with your healthcare provider to discuss if your prenatal vitamin is sufficient to continue taking while breastfeeding or if a different vitamin might be better.

How much water should I drink?

Most breastfeeding mothers agree they feel VERY thirsty once they start nursing or pumping. There are a couple reasons why this is the case: 1) you release a hormone called oxytocin when your milk comes out of your breast which causes the sensation of thirst and 2) breastmilk is 87% water. Therefore, you need to replenish all of the water your body is using to produce breast milk each day.

Breastfeeding moms should consume 16 cups of water per day (~128oz) which can be in the form of drinking water, fruit, vegetables, soup, and other beverages. For most women, drinking to thirst and comfort is sufficient.

Babies, on the other hand, receive all of the hydration they need through breastfeeding or formula and do not need to be supplemented with water. In fact, babies don’t need water until they are 6 months old and even then they should just practice drinking sips of water.

Special considerations: Are there specific foods I should be cautious about?

Caffeine: Small amounts of caffeine do transfer into breast milk. The average range that is considered safe for breastfeeding mothers is between 200-300mg of caffeine per day (approximately 2-3 cups of coffee). With excessive caffeine intake, irritability, jitteriness, poor sleep, and fussiness in the infant have been reported. Monitor your child for these changes and decrease your caffeine intake if you notice a change in their behavior.

Alcohol: The safest option is to abstain from alcohol while breastfeeding. However, having one standard drink per day (as long as your healthcare provider is okay with it) is not known to be harmful to infants. Waiting two hours to metabolize the alcohol out of your bloodstream, and therefore out of your milk, prior to feeding your baby is safest. Drinking in excess may impair your judgment and your ability to safely care for your baby.

Conclusion

When you start your breastfeeding journey chances are you will feel VERY hungry and thirsty, which is absolutely normal! Remember your body is using a lot of energy when you’re breastfeeding around the clock, so select nutrient dense foods that fill you up and stay hydrated! Since most diets do not meet all of our micronutrient needs it’s a good idea to talk with your doctor about which vitamin(s) to take to ensure you and your baby are getting all the nutrients you need. If you like to drink caffeine or alcohol, do so in moderation monitoring your baby for any behavioral changes. Lastly, it’s important to respect your body’s cues by eating to hunger and drinking to thirst!