Maternal Diet During Breastfeeding
It often happens that breastfeeding mothers consume too much food, eating "for two." They may not worry about the fact that they are gaining a lot of weight, which later is not so easy to lose. Therefore, it's important to remember that during breastfeeding, a mother’s daily caloric needs increase by only about 500 kcal, which is equivalent, for example, to an extra liter of fruit juice.
What should a breastfeeding mother eat?
Generally, all food products are suitable, provided—highlighting this important point—that the baby tolerates them well. However, this is often not the case, as signs of intolerance include symptoms such as stomach pain, colic, vomiting, or rash in the infant. The mother’s diet should include easily digestible, natural, minimally processed foods free from artificial substances such as dyes, thickeners, flavorings, and stabilizers. Particularly recommended foods include dairy products, cereals, and fresh fruits and vegetables. Conversely, a breastfeeding mother should avoid fatty dishes and fats “hidden” in processed meats and sweets.
Mother should also avoid excessive consumption of cow’s milk and other liquids, as this does not influence the amount of milk produced. Milk production depends mainly on the baby's sucking activity— the more frequently and vigorously the baby suckles, the more milk the mammary glands produce. Overconsumption of liquids by the mother beyond her body's needs does not increase milk supply; instead, it can break down the protective antibodies in her milk, potentially leading to intolerance or allergic reactions in the baby.
Alcohol, strong coffee, tea, drugs, and tobacco are strictly contraindicated.
Medications and Breastfeeding
General rule is that if the medication can be safely discontinued for breastfeeding, it should always be done to prevent its transfer through milk and potential harm to the baby. If the mother must take medication for a short period, breastfeeding should be paused, but milk production should be maintained through regular hand or pump expression. During this time, the baby can be fed with formula.
Most natural method of breastfeeding is “on demand,” meaning the baby signals hunger by crying. After finishing one breast and completely draining it, the baby should be offered the other breast. Whether the baby suckles or not will be decided by the baby itself.
Duration of a single feeding is individually regulated by the baby, but it is generally considered to be about 10-20 minutes. During the first 5 minutes, the newborn consumes roughly 80% of the milk, which is mostly water and lactose, with less fat. This amount satisfies the baby’s thirst. The subsequent smaller portions contain more nutrients and energy to fulfill hunger. The baby naturally regulates the feeding phases, suckling as long or as often as needed. Therefore, there is no need to give additional drinks, such as tea, to a breastfed infant.
Mothers often wonder if their baby is adequately fed. It’s helpful to know that a well-fed infant will sleep for 3–4 hours between feedings, wet at least 6 diapers a day, and pass several to a dozen soft stools daily. Weighing the baby before and after feeding is not a reliable indicator of milk intake.
During the first weeks of life, it’s common for the baby to sometimes not suckle during a feeding. Giving formula during these times may quickly lead to reduced milk secretion and cessation of breastfeeding.
Signs of successful breastfeeding include a slight tingling sensation in mother’s breasts during feeding, full breasts before and empties afterward, and the sound of the baby swallowing during suckling. Initially, most newborns demand to breastfeed multiple times—up to 10–12 times per day—and later, the frequency decreases. Night feedings, though initially inconvenient, are very important for proper milk production. At night, the milk composition differs, containing higher amounts of fat.
Common Problems
Milk stasis occurs when milk drainage from the breasts is impaired, leading to accumulation in the gland. The breast becomes swollen, painful, the skin tense and shiny, and milk may not flow easily. In such cases, it is advisable to nurse more frequently, especially on the affected side, and to use warm compresses before feeding and gentle milk expression. After feeding, cold compresses can be applied.
Breastfeeding should not be discontinued in the case of mastitis; on the contrary, opening the blocked duct is essential because it shortens the infection duration. Besides attaching the baby to the breast, manual or electric pump expression can be helpful. If the mother’s temperature does not exceed 38°C, she can continue breastfeeding. Elevated body temperature does not negatively affect the quality of the milk, as the milk still provides immunity antibodies against microorganisms, which the child absorbs.
Breastfeeding twins should not be an issue for a healthy, well-nourished woman. Similarly, mothers of triplets can successfully breastfeed their babies, although sometimes supplementation with other food is necessary.
If cracking or irritation of the nipples occurs, it is recommended to temporarily stop breastfeeding the baby for one or two days. Additionally, a soothing ointment prescribed by a doctor should be applied to the affected nipple.
After about 5 minutes of continuous, vigorous suckling, the newborn usually empties the breast, leaving only a small amount of milk. If the baby falls asleep after a few minutes of suckling, it can be assumed that it is not hungry. However, this must be confirmed by the baby’s proper weight gain.
There is no situation in which the mother has no milk. If temporarily the milk volume decreases, it is crucial—very importantly—to support and encourage the mother psychologically and to verify the breastfeeding technique. Also, increasing the frequency of applying the baby to the breast is the strongest stimulus to stimulate lactation. Natural remedies commonly used to boost milk production include herbs such as dill, anise, and black cumin.
Sometimes, in the first few days after delivery, there can be an overproduction of milk. In such cases, it is best to nurse the baby frequently and express the excess milk manually or with a pump. Sometimes, milk stagnation can inhibit lactation and locally cause inflammation of the mammary gland. Excess milk can be frozen in sterile containers and used in emergencies, such as when the mother falls ill.
Spitting up small amounts of milk usually only requires improving the nursing technique and is not a sign of disease—only a temporary weakness of the muscle called the esophageal sphincter.
Vomiting, which involves throwing up large amounts of over-digested food, is always a medical symptom requiring treatment.
A healthy newborn has a slightly more protruding belly than the chest but should be soft. During bloating, the abdomen becomes ballooned and hard, and the baby is very restless, passing too little gas; constipation or diarrhea can also occur. The cause may be due to improper nursing technique, digestive disturbances, or overfeeding. Recurrent bloating, with proper feeding, requires medical consultation.
Pregnancy is not a contraindication to breastfeeding. The process of nursing does not adversely affect the baby or the fetus. Small amounts of the hormone oxytocin, released during breastfeeding, have a contractional effect on the uterine muscle, which is not dangerous in a normal pregnancy. If pregnancy is at risk, after medical consultation, the number of feedings should be limited.
If the mother has excess milk or there are temporary contraindications for breastfeeding the baby, the expressed milk can be frozen at an appropriate temperature until the baby is ready to consume it.
Let us remember that the success of proper lactation highly depends on the mother's positive mental attitude and conviction about the benefits of natural breastfeeding, despite temporary difficulties. Support from the whole family is essential in this process.
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