The Breastfeeding Mother’s Diet
By Erika Landau, M.D., and Abigail Brenner, M.D.,

As in pregnancy, a breastfeeding mother’s diet should be healthy and balanced. There is simply no need to “eat for two” (or more). The nursing mother needs an extra 500 calories a day, so this is definitely not the time to diet. Good nutrition will result in breast milk that will help the baby grow well. The mother should continue taking prenatal vitamins, because these nutrients will pass to the baby.

While you’re breastfeeding, it is advised not to eat raw fish, raw meat, deli meat, or unpasteurized dairy products. Some fish contain high amounts of methyl mercury. Steer clear of swordfish, shark, king mackerel, or tilefish. Tuna is okay (not solid albacore), as is shrimp, salmon (wild, if possible), or catfish once or twice a week.

Baby Steps: For daily updates on the safety of fish, visit www.epa.gov/waterscience/fish.

Everything the mother eats or drinks goes through the breast milk. Therefore, if the baby seems physically uncomfortable, it may be caused by something that the mother ate the day before. Eliminating the potentially upsetting food for a week usually takes care of it, then you may restart it after that, watching again for any discomfort. Every newborn is different and will react uniquely to different foods or spices.

Breast milk contains many different substances: lactose, milk fat, proteins, minerals, antiinflammatory substances, enzymes that aid in the baby’s digestion, and immunoglobulins that protect the baby against some infections. However, it is lower in fluoride as well as in vitamins D and K.

Although breastfeeding is considered the best nutrition for an infant, breast milk unfortunately doesn’t provide enough vitamin D-a vitamin essential for the development of strong bones and fighting a disease called rickets. If you’re breastfeeding, you can start giving vitamin D in the first month. In the United States, formulas have enough vitamin D added.

The sun helps the body make vitamin D naturally. But because of the risks of being in the sun (skin cancer), most of us use sunscreen. The sunscreen prevents vitamin D from being made in the body. Moreover, it’s not recommended for young infants to be out in direct sun.

All breastfed babies should be given vitamin D, which comes in the form of a solution and is given with a dropper directly into the baby’s mouth. Try to give it between feedings, just in case the baby doesn’t like it and spits it up. It won’t interfere with the rest of the feedings. Make sure you follow the instructions. It’s not a prescription vitamin. Your doctor will tell you when to change the vitamin as the baby grows.

Definition: Rickets is a disease of the bones when they aren’t mineralized and become soft. As a result, bones can easily break, or serious malformations can result. It happens because there is not enough vitamin D, calcium, and phosphate in the body. This is either because of poor diet (for example, breastfed babies who don’t get vitamin D, or because of certain diseases such as kidney and liver diseases, and celiac disease, among others). There are still many countries, unfortunately, where rickets is common.

If the mother is on any medication, she may continue taking it, in most cases. Always ask your obstetrician or pediatrician before starting or stopping a new medication. Smoking or drug use should be stopped while breastfeeding. Alcohol in moderation, such as one or two alcoholic drinks per week (with a lower alcohol level) may not be harmful. It takes 30-90 minutes for the alcohol level to peak and up to 13-16 hours to be eliminated completely. The stronger the alcohol level, the more time it takes to clear.

The breastfeeding mother needs to eat well and keep well hydrated with lots of water.

The above is an excerpt from the book The Essential Guide to Baby’s First Year by Erika Landau, M.D., and Abigail Brenner, M.D. The above excerpt is a digitally scanned reproduction of text from print. Although this excerpt has been proofread, occasional errors may appear due to the scanning process. Please refer to the finished book for accuracy.

Copyright © 2011 Erika Landau, M.D., and Abigail Brenner, M.D., authors of The Essential Guide to Baby’s First Year.