How to provide nutritional support to breastfeeding mothers

Between supplements and dietary recommendations, here are some ways that you can provide nutritional support to breastfeeding mothers. New mothers may have a lot of questions when it comes to breastfeeding, so as a registered dietitian, you can both educate and guide your clients through this transitional period. 

Breastfeeding is highly recommended for both mom and baby, as breast milk is the best source of nutrition for most infants, including premature and sick newborns [9]. In addition to meeting an infant’s nutritional needs, breast milk can also help protect against certain illnesses and diseases like asthma, type 1 diabetes, SIDS, and GI infections [9].

But how does nutrition play a role in breastfeeding, and what dietary changes should mothers consider?

Before discussing how you, as a nutrition professional, can offer nutritional support to breastfeeding mothers, let’s first understand the nutritional benefits of breast milk and how diet plays a role.

Nutritional benefits of breast milk

Protein

Whey and casein are two types of proteins that are found in breast milk. While both proteins serve a purpose, there are a few important types of whey protein found in breast milk that are important for babies.

• Lactoferrin: Lactoferrin is a type of whey protein that stops the growth of iron dependent organisms from growing within the gastrointestinal tract [2]. Some examples of these iron dependent organisms are yeast and coliform bacteria.
• Secretory lgA: Secretory lgA is an antibody that protects the baby from virus and bacteria that both the baby, mother, and even other members of the family are exposed or infected with [2]. In addition to being antiviral, it can also protect against infection from E. coli and can possibly prevent the formation of allergies [2].
• Lysozyme: Lysozyme is an enzyme that protects the baby from bacteria such as E.Coli and Salmonella. It can also promote the proliferation of intestinal flora and act as an anti-inflammatory [2].

High-fat content

While fats are an important calorie source for a growing infant, they also provide fat-soluble vitamins and support brain, retina, and nervous system development [3]. The fats in your clients’ breast milk may also play a role in controlling their baby's appetite.

Colostrum

Colostrum is the milk that is produced during the first few days postpartum. This type of breast milk is thicker in consistency, rich in vitamins A, E, K, and protein, and has extremely high amounts of antibodies and white blood cells to help protect newborns against illness [6].

Since newborns are at risk for necrotizing enterocolitis (a disease that can lead to an erosion of the intestine), colostrum helps protect against this by coating the infant’s gastrointestinal tract and preventing any bacteria from coming through [6]. It also acts as a natural laxative to kickstart normal digestion and excretion within newborns.

Does diet impact the quality of breast milk?

Unlike standardized formula, the contents of breast milk can vary from person to person depending on factors like environment, genetics, infant sex, and illness [1]. But does dietary intake also have a direct effect on breast milk quality?

Research says yes! It’s been found that DHA, an important building block for a baby’s brain health, was in higher concentrations in breast milk produced by women who ate diets rich in protein and healthful fats and lower in carbohydrates [1].

Additionally, research suggests that women who ate diets higher in zinc, selenium, iron, and vitamins C, E, B1, and B2 produce breast milk containing more of these nutrients [1]. Since these nutrients are vital to a newborn’s health and wellbeing, it’s important to make sure that your clients are consuming the right foods to improve their breast milk quality.

Dietary recommendations for breastfeeding mothers

To provide newborns with the most nutrition possible, the World Health Organization, the American Academy of Pediatrics, and the European Society for Pediatric Gastroenterology, Hepatology and Nutrition all recommend breastfeeding infants for at least their first 6 months [4]. However, this is just a recommendation; if your client isn’t able to breastfeed for this long, you can still support them in other ways while providing positive encouragement.

Additionally, leading experts recommend that the average breastfeeding woman should consume an extra 330-440 calories per day in addition to her pre-pregnancy needs (which are based on age, height, weight, and activity levels) [7].

To deliver nutritional support to breastfeeding mothers and help your client meet her caloric and nutritional needs, you can suggest a well-balanced diet (rich in high-quality protein sources, fruits, vegetables, healthful fats, and whole grains) and create a personalized meal plan to ensure she meets these requirements. However, there are certain foods your clients should avoid while breastfeeding, so here are a few to keep in mind when creating their meal plans.

• Seafood high in mercury: All fish contains some mercury, which can accumulate in the body and be passed from mom to baby. For this reason, it’s recommended for breastfeeding women to avoid high-mercury content fish such as swordfish, bigeye tuna, king mackerel, and marlin. However, if your client wants to consume seafood, it should be limited to 8-12 ounces per week [7].
  
  
• Excess caffeine: Like mercury, caffeine can also pass through the breast milk to the baby, so it’s recommended that mothers limit their consumption to 300 milligrams of caffeine per day (about 2-3 cups of coffee) [7]. However, younger infants digest the caffeine more slowly, so new mothers may want to further limit their caffeine during the first few months.
  
  
• Alcohol: The alcohol content from one drink can be passed to the baby through breast milk for up to 2-3 hours after a drink is consumed [8]. This length of time can increase up to 8 hours the more drinks a woman has. As such, it is recommended that, while breastfeeding, a woman limits her alcohol intake to no more than one drink per day [8].

Is supplementation necessary?

While your breastfeeding clients can get many vital nutrients from a healthful, well-balanced diet, they may not get all of them on a regular basis. That’s where supplements come into play. Think of supplements as an insurance policy rather than a replacement for food, since they fill in the gaps and make up for shortfalls in a diet [5]. Here are some supplements for you to consider to enhance the health of both mom and baby.

• Vitamin D. This nutrient provides support for growing bones and teeth, and prevents diseases such as rickets. Since breast milk is not naturally high in vitamin D, and it can only be obtained through sunshine and a few foods, supplementation may be necessary [5].
• Iron. Iron supports proper neurological development during infancy and prevents anemia in both mom and baby. Since this nutrient is found in many animal products, you may want to consider iron supplementation if your client is vegetarian or vegan [5].
• Folic acid. This nutrient plays a vital role in the development of a baby’s brain and spinal cord, as well as promotes growth of new cells and DNA [5]. While you can obtain folic acid from certain foods (like dark leafy greens, beans, and whole grains), supplementation may be necessary for your client to meet her and her baby’s needs.
• Omega-3. This fatty acid promotes healthy brain, eye, and heart development as well as supports memory, learning, and attention span in growing babies [5]. You can obtain this nutrient through fatty fish, nuts, seeds, and plant oils, but you may want to consider supplementation if your client is vegetarian or vegan.

Summary

As a registered dietitian, you can provide nutritional support to breastfeeding mothers through supplements and dietary recommendations. These, along with personalized meal plans, can boost the quality of the mother’s breast milk, support a newborn’s health, and provide a deeper insight into your clients’ wellbeing.

We are always working toward bringing you the best nutrition content, so we welcome any suggestions or comments you might have! Feel free to write to us at info@nutrium.com.

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References:

1. Bravi, F., Wiens, F., Decarli, A., Dal Pont, A., Agostoni, C., & Ferraroni, M. (2016). Impact of maternal nutrition on breast-milk composition: A systematic review. The American Journal of Clinical Nutrition, 104(3), 646–662. https://doi.org/10.3945/ajcn.115.120881
2. What's in breast milk? American Pregnancy Association. (2021, December 9). Retrieved January 6, 2022, from https://americanpregnancy.org/healthy-pregnancy/first-year-of-life/whats-in-breastmilk/
3. Koletzko, B. (2016). Human milk lipids. Annals of Nutrition and Metabolism, 69(Suppl. 2), 27–40. https://doi.org/10.1159/000452819
4. Verduci, E., Giannì, M. L., Vizzari, G., Vizzuso, S., Cerasani, J., Mosca, F., & Zuccotti, G. V. (2021). The Triad mother-breast milk-infant as predictor of Future Health: A Narrative Review. Nutrients, 13(2), 486. https://doi.org/10.3390/nu13020486
5. Breastfeeding nutrition. American Pregnancy Association. (2021, December 9). Retrieved January 6, 2022, from https://americanpregnancy.org/healthy-pregnancy/breastfeeding/nutrition-during-breastfeeding/
6. AG, M. (2021, November 24). Breast milk composition: What's In your breast milk? Medela. Retrieved January 6, 2022, from https://www.medela.com/breastfeeding/mums-journey/breast-milk-composition
7. Centers for Disease Control and Prevention. (2021, September 2). Maternal diet. Centers for Disease Control and Prevention. Retrieved January 6, 2022, from https://www.cdc.gov/breastfeeding/breastfeeding-special-circumstances/diet-and-micronutrients/maternal-diet.html
8. Centers for Disease Control and Prevention. (2021, February 9). Alcohol. Centers for Disease Control and Prevention. Retrieved January 6, 2022, from https://www.cdc.gov/breastfeeding/breastfeeding-special-circumstances/vaccinations-medications-drugs/alcohol.html
9. https://www.cdc.gov/breastfeeding/faq/index.html