User's comments:
I haven't got a picture, but I would like to be assessed regarding my diet. My weight is 54kg and my height is 1.56. Currently, I am a breastfeeding mother. In the last months, we have stopped the consumption of red meats and eventually we stopped eating chicken and any cooked meat, like ham and sausages. We only eat fish, fresh and canned. Instead of a big dinner, we eat a big lunch. This is a day in our meals:
Breakfast
Porridge (50g oats, 100ml semi-skimmed milk), 2 slices of wholemeal bread, one fruit and fruit infusion
OR Scrambled eggs with mushrooms or sweetcorn and 2 slices of wholemeal bread and rooibos tea and a fruit
OR Smoothie (3 fruits, milk and probiotic yoghurt), 2 slices of wholemeal bread
Mid-morning snack
A probiotic yoghurt and a banana
Lunch
A type of pulse cooked with onion, garlic, tomato etc: chick peas, kidney beans, lentils, exotic bean mix etc. (basically we cover all the beans that we can get).
Brown rice or quinoa or wholemeal pita bread or wholemeal pasta.
A salad or a vegetable stirfry. We aim to use only olive oil in small quantities. When we eat fish, we cook it with vegetables, like curly kale, tomato, broccoli, green beans, garden peas etc.
Couple of dates.
Mid-afternoon snack
A bowl of muesli, no added nasties, and 2 fruits
OR popcorn and fruit
OR smoothie of 3 fruits
Dinner
Slice of wholemeal bread with pickle or peanut butter
Slice of organic cheddar
Big bowl of salad with at least 5 different vegetables
Sometimes a cup of vegetable creamed soup
A fruit
I drink at least 3 litres of water a day.
Expert's comments:
Congratulations on a very balanced, healthy eating plan.
Lactation is nutritionally demanding and increased intakes of most nutrients are advised. Individual adjustments in energy intakes and energy expenditure must be balanced to meet each woman’s specific needs during this time. Adequacy of energy intake should be made within the context of the mother’s overall nutritional status, weight changes and the adequacy of the infant’s growth.
I would like to make a few comments with regards to your diet and breastfeeding:
Breastfeeding moms have increased energy and protein requirements. The energy needs for lactating women are estimated at 600 calories per day for the first 6 months and 400 calories during the second 6 months – more than the energy recommendations for non-lactating women. With regards to protein, requirements are approximately 70g per day as opposed to 46g per day in non-lactating women. You have an appropriate weight for your height (BMI – 22kg/m2), so make sure you're not restricting your food intake to lose more weight at this stage.
Vitamin and mineral intakes that have been documented as being low in lactating women include folate, thiamin (vitamin B1), vitamin A, calcium, iron and zinc. I am uncertain why you chose to eliminate red meat and chicken from your diet, as apart from excellent protein foods, lean red meat (lamb without the fat, lean beef, game meat, ostrich), followed by poultry is still the best source of haem iron (iron which has higher bioavailability to the body than non-haem iron from plant sources). I have included a table with good food sources for each of the vitamins and minerals below:
Vitamin/ mineral & dietary reference intakes (DRIs)
Milk & dairy products (cheese, yoghurt), pilchards, sardines, canned salmon (eat with the bones), tofu, soya products, broccoli, carrots, green beans, oranges
Vitamin C-rich foods or juices aid iron absorption when taken as part of or immediately after a meal which contains food high in iron. Examples include citrus fruit (oranges, naartjies, grapefruit); guava, strawberries and other berries, paw paw, pineapple, kiwi fruit, mangos; fresh fruit salad, spanspek/sweet melon; fruit juice of any of the fruit mentioned previously; tomatoes, red, green or yellow peppers, potatoes, broccoli, Brussels sprouts, cauliflower, cabbage and asparagus.
You could look at your overall calcium intake as this is an essential nutrient for bone mineralisation and metabolism, preventing osteoporosis. Recently, it has also been implicated as playing a role in weight maintenance. We absorb calcium optimally only until the age of 30-35 years, so the best time to build strong bones is in your teens and twenties. It is, however, possible to help maintain bone mass throughout your life by keeping up your calcium intake and exercising (weight-bearing exercise). The average lactating woman has increased calcium requirements and needs around 1000mg of calcium every day. I would suggest you ensure that you are consuming adequate amounts of calcium from both the diet and a calcium supplement (providing at least 800mg elemental calcium, vitamin D and magnesium for absorption). Approximately 4 servings of dairy should help you meet your calcium intake as well as ensuring appropriate calorie, protein and vitamin D intake. Below is a table with the approximate calcium content (mg) per 100g of foods:
* If fortified with calcium, will contain more per 100g
We know that breast-milk composition of certain nutrients varies according to the mother’s diet, e.g. the fatty-acid composition of a mother’s milk reflects her dietary intake; milk concentrations of selenium, iodine, and some water-soluble B vitamins vary according to the maternal diet. Fish is an excellent source of the essential fat, omega 3. Our bodies are unable to produce the fatty acid, hence the need to obtain it from dietary means. This important nutrient has been shown to help prevent heart disease, high blood pressure and inflammatory conditions as well as being necessary for brain development and visual acuity in infants. As a lactating mother, you should attempt to eat fish 2-3 times per week as well as other sources. Congratulations on getting this right. Be aware that large doses of omega 3 supplements (not that obtained from food) may have a blood-thinning effect.
While breastfeeding, foods should not be eliminated unless you have a specific food allergy or your child has clinically demonstrated a reaction to a certain food that may be passed on through your breast milk. If you suspect a food allergy, please consult with an allergy specialist or a dietician with an interest in food allergy in order to do a food elimination and challenge test to confirm the exact food(s) that may be causing a reaction. New research indicates that unnecessary elimination of foods from a mother’s diet while breastfeeding (and an infant’s diet once solid foods have been introduced at around 6 months) may in fact induce food intolerance rather than oral tolerance to that food.
With regards to fluids, there is no evidence that increasing fluid intake will increase milk production. However, fluid demands do increase during breastfeeding, so you should drink fluids to thirst and aim to keep your urine a pale yellow colour. It is often helpful to have something to drink either while you nurse, or just afterwards. The current recommendation for water for lactation women is approximately 3 litres for the first 6 months, which is what you are drinking – well done!
Your intake of fruit, vegetables and fibre seems sufficient.
Here are 12 easy guidelines to achieving a balanced approach:
Enjoy a variety of foods
Eat 3 balanced meals daily with 2 healthy snacks in between meals.
Be active, by doing mild exercise.
Make starchy foods the basis of most meals – try to make them fibre-rich.
Eat plenty of vegetables and fruit every day – aim for 5-a-day (2 fruits and 3 vegetables).
Eat legumes – canned/dry beans, peas, lentils and soya regularly.
Chicken, fish, lean meat, milk or eggs can be eaten daily.
Eat fats sparingly.
Use salt sparingly.
Drink lots of clean, safe water – 3 litres a day.
If you drink alcohol, drink sensibly and in moderation – small amounts of alcohol taken with a meal will not affect milk supply.
Use foods and drinks containing sugar sparingly and not between meals, but rather as part of a meal or snack.
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