A subscriber to my newsletter, Jenine wrote to me
and asked if I had any nutritional advice for “athletic mothers who are
breast-feeding”? Is there anything more beyond the advice to eat healthy?
Breastfeeding itself certainly requires extra energy, that is, providing liquid
food for someone else means you need to eat and drink more. Approximately 2900
kJs (700 Cals) are needed to produce a litre of breast milk. That has to come
partly from Mum’s diet and partly from the 3-5kg of extra body fat laid down
during pregnancy. Some women lose the extra body fat quickly, some slowly, but
keeping active will certainly help.
Vitamin D
During the winter
especially, lactating Mum’s may need some extra vitamin D as a supplement, through
vitamin D fortified foods or mushrooms exposed to light. Vitamin D is needed to
assist calcium absorption from the gut. Nowadays many women are assessed for
vitamin D levels during pregnancy because of a rise in infant rickets in modern
societies. Women who are dark skinned, indoors during the middle of the day or
live further from the equator will be most at risk.
Although the baby sucks
260 mg of calcium out of Mum each day, much of it coming from Mum’s bones,
taking extra calcium does not stop this bone loss, with the losses being
replaced after weaning. (I didn’t know that until I just read it in a textbook).
For this reason breastfeeding Mum’s don’t need to fret about taking more
calcium than usual (assuming they eat calcium-rich foods like cheese, yogurt,
milk, soft bones of fish, calcium-fortified soy drinks).
Most other nutrients are
required in greater amounts but this is usually covered by the extra appetite
from being active and producing milk.
Eat well, eat a bit more & keep active
Anyway, there is nothing
unique in the advice for very active breast-feeding Mums, except to eat well
and eat more. Remember that in the olden days you may have had a “day off” for
the birth, then you were back out gathering and cooking so lactation was always
associated with being active. If you do find weight loss after birth to be a
bit too rapid, then nourishing drinks (eg Sustagen), smoothies with extra skim
milk powder added or including more oil (eg olive oil) in your diet will pump
up the kJs/Cals.
Breastfeeding & baby’s weight
Jenine then further asked
if childhood obesity and breast-feeding were linked. She had heard that obesity
can begin through mother’s milk. I assumed that she was referring to a
preventative, not causative, role. My local legend, Professor Wendy Oddy,
University of Western Australia, wrote a review of all the information on this
very topic. In one sentence, breast-fed kids have a lower risk of being
overweight as they grow up. The “why” is interesting.
1. Breast-fed kids drink
until they are done. Mouth off breast signals to Mum that they have had enough
(infant-regulated). Bottle-fed babies may be encouraged to finish the bottle
(parent-regulated).
2. Bottle-fed babies grow
at a faster rate, effecting adipokines, which in turn affect insulin
sensitivity and create a chronic sub-inflammatory state playing a role in heart
disease and diabetes development.
3. The Growth
Acceleration Hypothesis states that rapid early weight gain may program the
body for later obesity, high blood cholesterol, high blood pressure and insulin
resistance (which means high blood glucose levels). Breast-fed babes seem to
gain weight slower in later infancy, suggesting that breastfeeding for a year
or so could protect baby from later flab and disease.
4. The Early Protein Hypothesis view is that the higher protein content of formula could be responsible for an
increased infant growth rate and excessive production of permanent fat cells.
Breastfeeding protects against fatness with lower blood insulin, less fat
storage and preventing fat cell development.
What does it all mean?
Breast milk has all that a
newborn requires and it is smart to exclusively breast feed for the first six
months and continue breast feeding for the following six months while
introducing solids. Baby learns to feed on demand and stop when content,
normalising both appetite and growth. The pay-off seems to be a healthier and
leaner child down the track. Good news. If only it could make them immune from
drug dealers, charlatans, television viewing, advertising and religious fundamentalism
too.
Reference: Oddy WH.
Infant feeding and obesity risk in the child. Breastfeeding Review 2012; 20 (2): 7-12
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