Postpartum Considerations: Nutrition, Movement, & Body Image
The period of raising an infant is so rewarding– many days all you want to do is stare at your little one and think how amazing it is to say you created this beautiful human being. Yet how you take care of yourself can reflect on your ability to be the best guardian possible. As a new mama, properly nourishing your body, hydrating, incorporating movement that feels good to you, getting proper sleep, and taking steps to manage your stress are important to keep you physically and mentally healthy. In this blog I’ve broken down some nutrition, hydration, movement, and positive body acceptance considerations to help fuel the postpartum mama, with a specific focus on breastfeeding needs. Whether you are a new mother, partner, grandparent, or friend supporting your friend, this blog is for you!
Nutrient needs after birth
Starting the day of your baby’s birth, a mom’s body requires fuel, rest, and recovery. Labor and delivery is a natural process the body prepares itself for, yet everyone’s story looks a bit different. Either way it's taxing and the body is ready for some immediate food and fluids. Research is sparse on food and hydration needs during L & D, but some recommendations compare the needs during this process to that of running a marathon. Consider having a meal as soon as possible, or when your healthcare provider gives the okay, to fuel yourself and, if you plan to breastfeed, your growing baby. Nutrient-dense, calorie-rich snacks are another option to meet your needs until this meal is available, such as crackers or fruit and peanut butter, cheese and deli meat roll ups, granola bars, trail mix, and nutrition shakes. Lean on your support system to help you with what you’ll need the day of. Know that you’ll likely be sleep deprived (to put this into perspective, my spouse and I were awake for at least 20 hours) and this may throw your appetite off, but remember that you need to replace all the energy you spent in delivering your new bundle of joy plus energy for raising them.
Lactation nutrition requirements
Calories and macronutrients
If you plan to breastfeed, your nutritional needs remain elevated like at the end of pregnancy. Without breastfeeding your energy requirements essentially drop back to baseline overtime. For breastfeeding mamas the standard recommendation for calorie increases is 450-500 calories per day above baseline, derived from the mean value of breastmilk produced per day by lactating moms and calories in 100 mL of breastmilk (about 67 calories, or 28 calories/ fl oz). This is equivalent to a peanut butter and jelly sandwich, adding 2 extra snacks of 1-3 items, consuming a small fourth meal, or adding 8-12 oz of a caloric drink, like juice or milk, to 3 meals per day.
As calorie needs increase while breastfeeding, this means all macronutrient values should increase. I recommend aiming for the breakdown of at least half of your daily calories coming from carbohydrates, with the inclusion of whole grain, fiber-rich sources, and the other half should be split evenly between fats and proteins. For a generally healthy female, aiming for 1.1g protein/kg of body weight per day (approx. 60g/d), increased from the baseline needs of 0.8g/kg (46g/d) is recommended. Being physically active will increase one’s protein needs (in general overall calorie needs), with values of 1.2 - 2.2g/kg of body weight being appropriate. (Note that this is such a wide range to reflect the different types of exercise, i.e. cardio vs strength training, and variations in intensity, duration, and frequency.)
Micronutrients
Like during pregnancy, in breastfeeding individuals their micronutrient levels also increase. Incorporating a prenatal and consuming a wide variety of dairy products, grains, starchy and non-starchy veggies, fruits, nuts and seeds and other fat-rich foods, and proteins from animal and plant sources will support a lactating female to meet these increases. In one of my past blogs, The Do’s and Don'ts of Prenatal Nutrition, I broke down some nutrients of emphasis while pregnant and their corresponding recommended daily allowance (RDAs) values. The National Institute of Medicine also has a good chart in their report Nutrition Recommendations in Pregnancy and Lactation.
Hydration
Like during pregnancy your hydration needs will remain elevated while breastfeeding. You can go by the tip of “drink when thirsty”, but as a mom focusing on a newborn and sometimes your needs get pushed to the backburner I recommend being intentional with getting in enough fluids. Aim for 10-12 or more cups of fluids per day, mainly from water with the addition of sparkling water, milk, 100% juice sources, coffee and tea (but limit caffeinated beverages to 200-300 mg/d), and electrolyte-rich sources. Personally I drank a lot of milk, chocolate milk, and nutrition shakes the first month postpartum to help meet the calorie demands of breastfeeding.
Weight, body changes, and body acceptance
Remember that as a mom you’ve just grown another human being and are now raising an infant, so it takes some time to physically feel like yourself again. Within the first couple of days you will see shifts in your weight and appearance as you no longer are carrying a baby, the placenta has also been delivered, your uterus starts to shrink back to normal size, and fluid shifts will occur. Through the first six weeks most women will see their weight start dropping towards their pre-pregnancy weight, with many experiencing losses of half of their pregnancy weight, and then will slowly decrease back to their old weight by 6 to 12 months. Yet this varies greatly where many females don’t see this trend. Some determinants that may affect weight after pregnancy include age, gender, stress level, nutrition habits, sleep, exercise, medications, and whether or not you are lactating. Not everyone’s body shifts in the same way post-pregnancy. If you’re feeling pressure to lose the baby weight, I can totally sympathize with you as the media portrays women going back to their baby weight and that everyone’s journey should be the same. For you and your baby it’s important to meet your elevated food and hydration demands to keep your energy and milk supply up rather than striving to lose weight through restrictive patterns.
Some tips if you are struggling with postpartum negative body image:
Remember your body has just grown another human being! You are amazing!
Consider that your anatomy has stretched and twisted over 9 months, so give your body grace if it does not feel or look the same
Incorporate movement that feels good to you, makes you feel energized, and maybe something you can bond over with your little one rather than for the purpose of weight loss
Know that it’s okay to grieve an old pre-pregnancy body, name that, and work on applying gratitude to what your current body does for you
Take steps to show yourself body acceptance: integrate hobbies and make time for play, wear clothing that fits you rather than you trying to fit the clothing, nourish your body with nutritious and delicious foods, move your body in ways that you enjoy vs feeling like a have to, and develop a support system that loves you for you
Exercise
The recommendations to reintroduce exercise vary depending on your labor and delivery type, or any complications that may have occurred. With these recommendations, it’s important to communicate with your health care team first as you have questions and pursue a new exercise routine. For healthy pregnancies with no post-labor complications, it's appropriate to introduce light exercise like walking, stretching and gentle yoga a few days later. Reintroducing moderate to intense forms of exercise, such as running, brisk walking, or weight lifting should wait 6-8 weeks until having the postnatal check up. If you’ve had a c-section or any complications your time to reincorporate a past exercise routine may look different. Take exercise one step at a time. Be gentle with yourself if exercise feels different compared to pre-pregnancy– remember that you’re raising an infant, likely sleep deprived, and hormone changes can affect muscles, fat distribution, and joint stability.
Some ideas for gentle exercise: push the stroller for one nap per day, go to the park and enjoy the swing set or give your infant the chance to watch the older kids run around (for older babies), stretching, yoga, and postnatal classes.
Have further questions after viewing this blog? Reach out to us for support and we can help you get started in meeting your nutrition and health goals in any stage of life.
Resources:
https://www.nichd.nih.gov/health/topics/breastfeeding/conditioninfo/calories#f3
https://evidencebasedbirth.com/evidence-eating-drinking-labor/
https://www.acog.org/womens-health/faqs/breastfeeding-your-baby
https://pmc.ncbi.nlm.nih.gov/articles/PMC5104202/
https://www.ncbi.nlm.nih.gov/books/NBK555904/