Nutrition and Exercise

Stress Relief and Sleep

Stress and a lack of sleep can affect a breastfeeding woman’s overall mental state and well-being leading to decreased milk supply and thus not reaching her infant feeding goals. 

Weight Loss 

Mothers may feel anxious or pressured to return to their pre-pregnancy weight. It is important to offer reassurance that with a balanced diet and breastfeeding they will naturally begin to lose the weight gained during pregnancy.

• During pregnancy, 4–11 pounds (2-5 kg) of body fat is stored which supplies a portion of the energy needed for lactation after an infant's birth.
• Most lactating women gradually lose weight at a rate of about 1-2 pounds per month after postpartum diuresis and more slowly after 6 months.
• Liquid, fad or rapid weight loss diets and weight-reducing medications are not recommended while breastfeeding. Lactating women should be recommended to eat to hunger and drink to thirst.
• Weight loss of up to 4.5 pounds per month is not likely to affect milk volume. 
• Intake of less than 1,800 kcal per day is not recommended for fully lactating women.
• An infant's weight gain should be monitored if rapid weight loss occurs in the breastfeeding mother.

• A well-balanced diet consisting of fruits, vegetables, whole grains and protein-rich foods is recommended.
• Consume fish according to FDA and EPA fish advisory. 
• Follow MyPlate for Pregnant and Breastfeeding Women recommendations 
• For vegans, advise on their intake of B12, either through supplemented plant products or through a vitamin B12 supplement
• Vitamin D at 600 IU per day for women. 
• Breastfeeding women consuming unbalanced diets may benefit from daily prenatal vitamin and mineral supplement
• The AAP recommends Vitamin D supplementation of all infants beginning in the first week of life with 400 IU per day

Stress Relief and Sleep

Encourage breastfeeding women to practice stress relieving techniques such as:

• Exercise including walking, running, biking, hiking, yoga, dance or other physical activity that she enjoys.
• Deep breathing, meditation or prayer.
• Reading, journaling or drawing.
• Watching a movie or TV show or listening to calming music.
• Confide in a friend, family member or health professional if something is bothering her.

Getting enough sleep can be difficult for the breastfeeding woman but sharing the following tips may help her:

• Sleep when her infant sleeps.
• Seek or accept help from family, friends or others that can take care of her infant between feedings.
• Limit screen time an hour or two before bedtime to prevent overstimulation.
• Avoid caffeine before bedtime.
• Limit exercise before bedtime.
• Take a warm shower or bath before bedtime.    

Physical Activity 

Regular exercise, including vigorous exercise appears to be compatible with production of an adequate volume of milk.

• Exercise increases prolactin release, stimulating milk production and increasing the potential for leaking to occur.
• Sweat can make skin taste salty, possibly resulting in breast rejection; if this occurs, the breastfeeding woman can shower before nursing.
• Encourage breastfeeding women to drink lots of water to replace fluids lost during exercise. 
• Breastfeeding mothers should wear a supportive bra during all exercise.

Clinical Guidelines

• Taylor, S. N. (2018). ABM Clinical Protocol #29: Iron, Zinc, and Vitamin D Supplementation During Breastfeeding. Breastfeeding Medicine, 13(6), 398–404. 

References

1. Andreas, N. J., Hyde, M. J., Gale, C., Parkinson, J. R., Jeffries, S., Holmes, E., & Modi, N. (2014). Effect of maternal body mass index on hormones in breast milk: a systematic review. PloS One, 9(12), e115043. 
2. Dozier, A. M., Nelson, A., & Brownell, E. (2012). The Relationship between Life Stress and Breastfeeding Outcomes among Low-Income Mothers. Advances In Preventive Medicine, 2012, 902487. 
3. Dugat, V. M., Chertok, I., & Haile, Z. T. (2019). Association Between Stressful Life Events and Exclusive Breastfeeding Among Mothers in the United States. Breastfeeding Medicine, 14(7), 475–481.