Postpartum Nutrition Care for Mothers

 

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I often give advice to new mother to remember in taking good care of themselves first before they care for their newborn. I know that the maternal instinct is to focus all your energy on your baby, but the truth is mother’s health comes first. Your baby will gets plenty of love from you and everyone else. Whereas, you, will feel neglected at times, and can easily lead to the postpartum blues or worse case scenario– postpartum depression. If you are not physically or emotionally healthy, your baby will be affected physically and emotionally as well. Therefore, ask for help, rest and sleep when your baby is sleeping, and utilize your friends to bring you food. Yes, you’ll hear that over and over again.

So, let’s focus on good nutrition care after your delivery, whether you’ve decided to breastfeed or using formula. Remember that if you choose to breastfeed, your caloric requirement will increase on an average of 500 calories per day and more if you are feeding multiples.

HYDRATION
Fluids, fluids and more fluids. Even though when you are experiencing edema (swelling), it is still important to keep hydrating yourself to pull the fluids back into cells and excrete through urine. It is extremely important to get adequate fluids intake especially when you are breastfeeding.  Always keep a 16 oz glass fluids nearby and drink before, during and after feeding.  This could be water, milk, juice, or soups.

HIGH IRON
This is particularly important with the amount of blood loss occurs during delivery, this apply to both natural or cesarean birth. You need to make sure to replenish your iron stores if not, you’ll tend to become weaker due to anemia. Make sure to keep up with good iron intake during this period. Iron sources can comes from meat products, vegetables, fortified grains and beans.  Although, do try to avoid eating foods that inhibit iron absorption together. This is due to the phytates compound (an antioxidant) in food such as whole grains, legumes, nuts, coffee and tea binds to the iron content and reduces its availability for absorption.  So, it is recommended to continue taking your prenatal vitamins post delivery as well.

GOOD PROTEIN
Protein is crucial for strength and recovery especially if you had a cesarean birth. Even though is very common, it is still consider a major abdominal surgery that brings trauma to your body and organs. Protein is needed to heal wounds, re-build muscle and aid in recovery.  Protein also helps you to reach your higher calorie requirement during breastfeeding period.  How much do you need ? It depends on your weight,  it is recommended about 1.1-1.2 g of protein intake per kilogram of your body weight or 0.5-0.55 g per pound of body weight.  For example, a 145 pounds women would need 73-80 gm protein during breastfeeding period.

REMEMBER CALCIUM
The requirement for calcium remains the same as during pregnancy, 1,000 mg daily for women ages 19-50. If you are teen mother, your requirement is 1,300 mg daily. There’s some research indicates of bone loss during lactating period but quickly restore during the weaning period. So, be sure to get adequate calcium intake to support good bone health for both mom and baby. Most women doesn’t consume adequate calcium through foods, therefore, it is recommended to continue your calcium supplement while you are lactating unless you are meticulous and knows you get enough calcium through foods, then supplementation is unnecessary.  Make sure that you choose the products that is made from “calcium citrate”, the best form of calcium that are easily absorbable in our body.

VITAMIN A & C
Vitamin A & C are the essential vitamins for wound healing because they are the building blocks for collagen and cell formations.  If you had a C-section, epiosiotomy or a vaginal tear during vaginal birth, then you better pay attention on getting adequate Vitamin A & C to help with tissue repair and shorten your recovery time.  If you are not sure what kind of foods has Vitamin A or C, think red, orange and yellow colored foods such as pumpkin, sweet potatoes, orange, bell peppers, tomatoes, papaya, strawberries etc.

GOOD FATS
There’s two types of fat: Saturated Fats (bad fats) and Unsaturated fats (good fats).  We need to focus on good type of fats as they are a major source of calories in helping body meeting the caloric intake to help with milk productions. This doesn’t mean you need to go on a high-fat diet, please don’t do that! Research shows that a high-fat maternal diet actually increases the risk of their baby to become obesity later in life. So, eat and choose your fat intake wisely.  Recommended to have a minimum of 3-4 servings of unsaturated fat daily.  What’s a serving of good fat ? 1 teaspoon cooking oil (olive, canola, safflower),  1 Tablespoon salad dressing, 1/8 avocado and 10 small olives.

WHOLE GRAINS
Whole grains foods provide good fiber, vitamins and minerals for your body after childbirth and to give you the foundation of energy usage and to produce good quality breast milk. Eat a variety of whole grains daily, at least 8-10 servings per day.

FRUITS & VEGETABLES
Constipation is a common problem during pregnancy and postpartum. With the increase iron and calcium intake, this can make constipation worse. Making sure to eat a variety of fruits and vegetables to help keeping constipation at bay.  Fruits & Vegetables also provides abundance of vitamins, minerals and anti-oxidants that are good for your during your recovery period.  Eat a least 3-5 servings of fruits and vegetables daily.

FUN FACTS:
Did you know that in Chinese culture, there’s this so called “confinement month” or  “sitting the month” (坐月子). All mother is required to be resting, house bound for 30 – 40 days and she will have a lot of help during that month from her mother, in-laws or a confinement lady to help her with cooking, house chores, taking care of the baby (that’s the good part), and some activities of daily living that are strictly forbidden (not so cool part). I will discuss the “confinement month” in another article if you are interested in reading.

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What Not to Eat During Pregnancy

Congratulations on your pregnancy!

“Now what can I eat?” you ask.

There are a lot of things you have to be careful about, especially since the food you eat directly affects the outcome of your pregnancy. My advice is to think to yourself, “Would I feed a baby that?” If the answer is “no,” then don’t eat it while you are pregnant.

Let’s review the “Don’t” List:

Stop Smoking / Using Illicit Drugs
This seems like a no-brainer, but you’ll be surprised how many babies have mothers who are smokers and drug users. If you can’t quit these activities, knowing you are pregnant, it’s time to seek professional help. You are exposing your unborn baby to toxic chemicals and restricting their intake of valuable nutrients needed for fetal development.

Say “No” to Alcohol
Alcohol is rapidly absorbed in the bloodstream and can cross the placenta to affect the baby. Baby’s liver is not capable of breaking down alcohol, increasing the risk for a miscarriage, preterm labor, and fetal alcohol syndrome (FAS), an alcohol spectrum disorder that can lead to growth problems, developmental delays, learning disabilities, and deformed facial features.  The research on occasional, light alcohol intake (one to two drinks per week) during pregnancy remains very limited. Though no serious side effects have been reported, it’s always good to play it safe. Alcohol  used for culinary purposes (cooking wine or sherry, shaoxing wine, or rice wine) is relatively safe at this time.

Avoid Raw / Undercooked Fish and Raw Shellfish
It’s advised to avoid all raw seafood products, if possible, due to potential viruses, parasites, and bacteria that can lead to food poisoning. This includes sushi, raw oysters, and all other undercooked seafood or shellfish. There’s some controversy about eating sushi during pregnancy as most Japanese women still eat it during their pregnancy and no adverse side effects have been reported. However, eating any raw food products always poses a risk, and therefore you should be extra cautious during pregnancy.

Avoid High Mercury Fish
Mercury can cause birth defects and the larger the fish (especially the predatory type), the higher mercury levels it contains. If you regularly consume fish with high mercury level, excess mercury will accumulate in your blood stream and cross over to your baby, causing damage to their brain and nervous system. Fish high in mercury include swordfish, tilefish from the Gulf of Mexico, king mackerel, and shark. It’s still safe to eat other types of fish such as salmon, sardines, trout, cod, pollack, Atlantic or Pacific mackerel and catfish. Tuna should only be eaten in moderation, about three ounces per week.

Stay Away from Cold Cuts
Deli meats have long been known to be contaminated with a bacteria called Listeria. Listeria has been linked to miscarriage and can cause serious blood poisoning and infection. Since Listeria can cross the placenta, it will threaten the safety of your baby. The bacteria can be killed through heat, so if you still want to eat deli meat during pregnancy, be sure to heat the meat until it’s steaming.

Say “Bye-Bye” to Soft Cheeses
Soft cheeses (especially imported ones) may also contain Listeria because of unpasteurized milk. Unless it’s clearly stated the cheese is made from pasteurized milk, it’s best to avoid it altogether. This includes: Brie, feta, Gorgonzola, Camembert, Chaource, Limburger, and Paglietta.

Be Mindful About Kelp Usage
Kelp is a type of seaweed that’s used in many Asian cultures for soups and stews. It is high in iron and very high in iodine. Routine consumption of kelp during pregnancy can lead to congenital hypothyroidism (a type of thyroid disease) that can contribute to cognitive delays and growth retardation. One to two tablespoons of kelp can contain as much as 1,500-2,000 micrograms (mcg) of iodine. The upper tolerable  limit set by the National Institute of Health is 1,100 mcg for adults. Nori, the most common seaweed wrap used in sushi, or seaweed sheet snacks are safer alternatives (e.g. the sheet snacks only contain about 280-300 mcg of iodine per pack).

Beware of Herbs and Dietary Supplements
Herbs are widely used to make tonics and teas and found in supplement form. The safety of herbal use during pregnancy still largely unknown. American Pregnancy Association has published a list of unsafe and likely unsafe herbs for pregnancy. They include: Rosemary (in medicinal doses), saw palmetto, goldenseal, blue cohosh, black cohosh, dong quai, ephedra, and yohimbe.

Don’t go Overboard with Caffeine
Caffeine has been associated with miscarriage, especially during the first trimester. So coffee and black tea drinkers take note and limit your daily intake to about 200 mg (about one cup). Also, beware of energy drinks and sodas that contain caffeine.

Preparing for a Healthy Pregnancy

Did you know a healthy pregnancy starts before conception?

When you and your partner begin planning for children, part of those plans should include a checklist to ensure both of you are in a good nutritional state. If you aren’t already doing so, eat a nutritionally balanced diet at least 6 months to 1 year before becoming pregnant. Maintaining a healthy weight (BMI between 19-25) and a balanced diet consisting of all food groups should provide you with the vitamins and minerals you need for a good reproductive system.

Some key preconception nutrients include:

FOLIC ACID
Folic acid or folate is a type of vitamin B (B9) used to create red blood cells and to help women sustain adequate blood volume throughout pregnancy. Women of childbearing age should consume at least 400mcg of folic acid daily as it helps reduce the risk of the baby developing neural tube defects (more commonly known as spina bifida), a birth defect that leaves the spinal cord unprotected due to incomplete closure. Folic acid also helps with DNA formation, cell growth, and overall baby development.

Good food sources: Spinach, asparagus, lentils, broccoli, bok choy, cauliflower, avocados, beans, nuts, and oranges.

ZINC
Zinc is one of many minerals the body uses to maintain male and female reproductive health by ensuring proper cell maturation (both eggs and sperm) and regulating hormones such as estrogen, progesterone, and testosterone. A diet low in zinc may hinder a woman’s chances of getting pregnant and/or increase the risk of miscarriage as the ovaries require large quantities of zinc to produce high quality eggs for fertilization. For men, low zinc levels directly affect the quality and production of sperm. A daily recommended allowance of zinc is 11mg for men and 8mg for women.

Good food sources: Oysters, lean beef, pork, chicken (dark meat), fortified cereals, beans, and nuts.

CALCIUM
Calcium is a major nutrient needed for the baby’s bone development. Since it might take several weeks to months to increase the body’s calcium concentration, it’s recommended a woman take at least 1,000mg of calcium a day, prior to conception. If a woman doesn’t consume enough calcium during pregnancy, her body will draw what’s needed from the bones, increasing the risk of osteoporosis.

Good food sources: Milk, dairy products like cheese and yogurt, soy milk and/or almond milk fortified with calcium, and tofu.