9 September, 2021

The importance of mother's diet in the fourth trimester

After 9 months of life as one, your baby is now out of the womb and you might concentrate all your attention on your little human trying to adjust to life. You will be probably checking if he or she is breathing every 10 minutes, counting diapers and trying to get the hang of breastfeeding. And when you are not doing all these things, I am sure is because you are trying to get some sleep. But what about feeding yourself?

The first weeks postpartum is a time when you should take care of yourself to fully recover from pregnancy and giving birth and a well-balanced diet during this period is very important for your health. This post is entirely dedicated to new mothers and the postpartum period.

2021-5-28 Maël Birthday-35

What happens to your body

The postpartum period starts about an hour after the delivery of the placenta and includes the following weeks. This is a special phase in your life when you need to be gentle with yourself and allow your body to heal and recover from pregnancy and childbirth. If you take good care of yourself, most of the changes of pregnancy, labor, and delivery will fade and the body will revert to the non pregnant state.

Even during an uncomplicated pregnancy and delivery, significant changes happen in a woman’s body. This is especially true of the connective tissues, breasts and uterus, as well as the skin. Plus, after labor it may feel like you’ve run a marathon. Nutrition is one of the pillars of life you should concentrate on in order to speed recovery. 

Most important nutrients for postpartum women

Especially in the first weeks postpartum, women should try to avoid packaged, processed foods and drinks that are high in sugar, salt and saturated fat. Choosing fresh, whole foods rich in vitamins, minerals and fiber will help the body heal faster. I know this can be difficult if you are overtired and don’t have someone cooking for you so in that case it is a good idea to pack your freezer with homemade, balanced meals starting a few weeks before your delivery.

Recommendations for postpartum mothers are similar to those for the general population, but focus more heavily on certain nutrients. To begin with, at every meal try to fill half your plate with fruits and vegetables. The other half should include protein combined with whole grains such as brown rice, whole grain bread or pasta, or other unrefined cereals.

Then, make sure you get enough:

Protein. While your tissues are healing, they require a good amount of protein, especially the amino acids glycine and proline, to make collagen. Foods like beans, fish and seafood, lean meats, eggs and soy products are rich in protein, and including them in your meals will help your body recover from childbirth. If you are vegan, make sure you include the following foods in your diet as sources of proline and glycine: asparagus, mushrooms, cabbage, nuts and beans.

Iron. In the days after birth, iron is the one nutrient all women need. Some might need more or less depending on their blood loss during childbirth. Include sources of vegetables that are rich in iron and vitamin C in your diet such as pulses and green leafy veggies, as well as animal food sources packed in iron such as red meat, seafood. If you’re vegan or vegetarian you might consider iron supplements for some days or weeks. If you get a minimum of 18 mg of iron per day, your iron levels will be restored within a few days but as the following example shows, achieving this amount is quite difficult. By including the following foods in your day you will get about 12mg of iron:

  • 50g oats
  • 150g of chicken
  • 50g spinach
  • 28g of pumpkin seeds
  • 1 egg
  • 100g of tuna
  • 50g lentils
  • 50g of quinoa

Vitamin D. If you were taking Vitamin D supplements during pregnancy, keep going with those after birth since vitamin D supports the immune and nervous system and reduces risk of postpartum depression and anxiety. Besides supplements, make sure your diet includes fatty fish like salmon and tuna, or fortified food items like dairy, orange juice or eggs.

If you are breastfeeding (and especially if you are vegan) you should focus on:

Calcium. Changes in calcium metabolism occur during lactation to enable an adequate mineral transfer to the milk. These changes play a role in the decrease of bone mineral density during lactation which might influence the onset of postmenopausal osteoporosis. To prevent a loss of bone mineral density, you need 1,000 milligrams of calcium - about 3 servings of low-fat dairy- each day. If you are vegan or lactose intolerant, you might consider calcium carbonate supplements. These tend to be better than calcium citrate because they contain the highest amount of elemental calcium. One gram of calcium carbonate contains 400mg pure calcium. However, it is important to remember that our body cannot usually absorb more than 500 mg of calcium at a time so it is good to take the supplements spread out over the course of the day with our meals, but not with iron rich foods or iron supplements.

The omega-3 fatty acid DHA. The breastmilk profile is mostly stable no matter the mother eats but the concentration of DHA is one of those few nutrients that can change based on the mother’s intake. High DHA concentration in milk is critical for good brain and vision development in your baby. Since DHA is present only in animal food sources and algae, vegan moms should continue to take a DHA vegan supplement after pregnancy.

Vitamin B12. Such an important nutrient for red blood cell development and energy production, vitamin B12 is also present in animal food sources. The best sources are clams, tuna, liver, beef, and salmon. To guarantee a healthy brain growth and development for your baby, vegan mothers should continue taking B12 supplements during breastfeeding.

Don’t worry too much about weight loss

As a new mother and a new woman, your postpartum focus should be SELF-CARE. Let your body and mind adapt to your new life with patience and engage in practices like yoga that can help you relax. From a nutritional standpoint your focus is to replenish your energy and make sure you get all the nutrients you need to account for blood loss (in case there was any) and tissues healing. Do not let the idea of weight loss consume you in the first weeks!

This will look different for every woman but it will generally happen naturally if you make mindful choices and bring you caloric intake back to what it was before pregnancy. Only breastfeeding women will need 500-700 calories extra.

Already after delivery, 6-7 kilos are automatically lost from the weight of the baby and placenta. After that, you should not lose more than 0.5-1 kilogram per week.

My top postpartum tips:

  • Sleep as much as you can while baby sleeps
  • Do not be afraid to ask for help from your family or friends to cook for you and do house chores while you and your partner bond and take care of your baby
  • Just in case have your freezer packed with homemade meals
  • Don’t think about weight loss
  • Don’t panic….it’s just a phase!

Bibliography

  1. Olson CM. Tracking of food choices across the transition to motherhood. J Nutr Educ Behav. 2005;37:129-136.
  2. American Dietetic Association. Position of the American Dietetic Association: obesity, reproduction, and pregnancy outcomes. J Am Diet Assoc. 2009;109:918-927.
  3. US Department of Health and Human Services. Healthy  People 2020: Understanding and Improving Health. 3rd ed. Washington, DC: Government Printing Office.

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