Nutritional Programs for Lactation





  • Nutrient Program for Lactation (Range—RDAs to Optimum)






  • Breastfeeding is an important part of the pregnancy and birth process and the best way to nourish the new infant. It is also helpful for the mother to balance her pregnancy. Nursing not only is a calorie and fluid outlet, helping mother reattain her pre-pregnancy weight, it is often vital to her emotional and psychological well-being and to the bonding with the new baby. In addition, the hormone released during breastfeeding, oxytocin, helps contract the uterus back to normal size and health.


    Nutritional requirements are much the same as during pregnancy, with even higher requirements for many nutrients and reduced needs for a few. After all, we are feeding a growing baby. An infant requires about 2–3 ounces of milk per pound of weight, so a newborn of seven pounds needs about 18 ounces of milk daily; as he or she grows, more milk is required. Each ounce of milk has about 20 calories, so mother is giving out 300–400 calories a day initially, and more as the baby grows. She needs 200–500 more calories per day than even during pregnancy and 500–1,000 more than before it, depending on her weight. Some mothers will consume fewer calories after birth in order to lose weight, but this is not wise. Too great a reduction in calories can diminish milk production (as can resuming cigarette smoking). Mother should naturally lose weight during breastfeeding, and as she reduces her level of nursing, she may also lessen her calorie intake.


    Water is the main ingredient of mother’s milk, so adequate fluid intake is essential. At least three quarts of liquid are recommended daily, including water, juices, and milk. Mother’s diet should also be high in nutrients, mainly from eating those good, wholesome foods. High protein levels are still required, though a little less is needed than during pregnancy; calcium, magnesium, and iron requirements are also similar. Vitamins C and A, zinc, and iodine are needed in higher levels. Folic acid requirements decrease by 25 percent as the mother’s blood volume decreases. Extra B vitamins may be helpful (for stress and fatigue related to sleep deprivation), as breast milk is fairly low in them, but high-dosage B vitamin pills are best avoided during lactation. Specifically, high amounts of vitamin B6 can reduce milk production.


    Good nourishment is essential to prevent depletion of mother and to provide the right nutrients for baby. Remember, the food that mother eats provides the nutrients in her milk and thus the infant’s nutrition. Many of the nutrient-rich foods suggested for pregnancy should be consumed—dairy products, eggs, fish, other animal foods, whole grains, vegetables, especially leafy greens, and vitamin C fruits. Standard food-group orientation suggests more portions of most everything. The summary of food group needs for nonpregnant, pregnant, and nursing women shown here is adapted from Mowry’s Basic Nutrition and Diet Therapy by Sue Rodwell Williams.




    General Pregnancy Nutritional Plan








    Servings per Day

















































    Nonpregnant

    Pregnant

    Nursing

    Milk foods—low-fat milk (avoid skim), 2 3–4 5–6
    cheese, yogurt, butter (1 serving = 1
    cup milk or yogurt, or 3–4 oz. cheese)
    Cereal grains (1 serving = about 13 4–55
    cup grain or 1 slice of bread)
    Vegetables—raw yellow or dark green1 22
    (1 serving = 1 cup)
    Other vegetables (1 cup)1 22
    Vitamin C foods—citrus, berries,1 22
    peppers, tomato (1 serving = 1 cup)
    Eggs (1 serving = 1 egg)1 1–21–2
    Meats—fish, poultry, or lean red1 1–22–3
    (1 serving = 3–4 oz.)
    Legumes (1 serving = 6 oz.)1 1–21–2





    For vegetarian women, it is wise to eat the recommended amount of the dairy products and eggs to meet protein and calcium needs, as well as to eat more whole grains and legumes. If milk consumption is minimized, more tofu, legumes, nuts and seeds, and leafy greens and some calcium supplement are recommended. More care in balancing the diet is usually necessary whenever the diet limits specific food groups. Additional protein powder or supplemental amino acids (free form), as powder or capsules (750–1,500 mg. daily) may be useful if the protein intake is not sufficient.


    For healthy breastfeeding, mother’s comfort is important. To maintain good milk production, use both breasts regularly and relax before and after nursing. Remember, good fluid and nutrient intake is essential for successful nursing and thus to the growth and development of the baby. Many women tell me that using olive or coconut oil on their nipples keeps their skin healthier and aids nursing. (See earlier Infancy program for further discussion of nursing.)


    The nutrient program shown in the table gives the range of values from the minimum requirements to the optimum amounts for the needs of lactation. Refer to the table in the previous section on Pregnancy for comparison with the nutrient needs listed here. The following program refers to the combined intake of diet and nutritional supplements. Chloride, fluoride, phosphorus, potassium, and sodium are not usually supplemented unless shown by testing to be needed.




    Nutrient Program for Lactation
    (Range — RDAs to Optimum)









































































    Calories* 2,600–3,500
    Fiber15–30 g.
    Protein*65–90 g.

    Vitamin A*7,000–10,000 IUs Calcium*1,200–1,600 mg.
    Beta-carotene5,000–15,000 IUs Chloride+2–4 g.
    Vitamin D400–600 IUs Chromium200–400 mcg.
    Vitamin E*60–400 IUs Copper2–3 mg.
    Vitamin K100–400 mcg. Fluoride+1.5–3.5 mg.
    Thiamine (B1)1.6–25.0 mg. Iodine*200–400 mcg.
    Riboflavin (B2)1.7–25.0 mg. Iron*50–100 mg.
    Niacin (B3)18–100 mg. Magnesium*450–1,000 mg.
    Pantothenic acid (B5)7–250 mg. Manganese2.5–15 mg.
    Pyridoxine (B6)2.5–100 mg. Molybdenum150–500 mcg.
    Cobalamin (B12)4–200 mcg. Phosphorus*+1,200–1,600 mg.
    Folic acid*600–1,000 mcg. Potassium+2–5 g.
    Biotin200–500 mcg. Selenium150–300 mcg.
    Choline100–250 mg. Sodium+2.5–4.0 g.
    Inositol100–250 mg. Zinc*25–40 mg.
    PABA25–100 mg.
    Vitamin C*100–2,000 mg.
    Bioflavonoids125–250 mg.






    *These nutrients are needed in higher than usual amounts during lactation.

    +These nutrients are required in the diet, although they are not usually supplemented.

    Elson M. Haas MD Written by Elson M. Haas MD

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