Nutrition Issues During Lactation

Abstract

Breastfeeding is the gold standard and strongly recommended method of feeding infants. The World Health Organization recommends human milk as the exclusive nutrient source for the first 6 months of life, with introduction of solids at this time, and continued breastfeeding until at least 12 months postpartum. It will come as a surprise to many readers that the energy and nutrient needs of lactating women adhering to these optimal infant feeding guidelines will exceed those of pregnancy. During the first 4-6 months of life, an infant will double its birth weight accumulated during the entire 9 months of pregnancy. The nutrient output via breast milk to support this growth is tremendous. Early postpartum, weight is an issue for many women, as they are anxious to return to their pre-pregnancy body size. For many, weight management will be difficult given personal circumstances and multiple demands on their time. Given the elevated nutrient requirements of lactation, women will need to plan meals with care to maximum nutrient intake while limiting energy dense foods. The purpose of this chapter is to provide an overview of the energy demands of lactation as well as a select list of nutrients known to be sometimes provided in short supply for reproductive age women in developed countries. The specific nutrients to be examined include calcium, vitamin D, folate, vitamin B12, and iron. As energy balance is a current area of concern for many lactating women, and their health care providers, we will also review the literature in relation to dieting and exercise during lactation. Finally, we will close by talking about long-chain polyunsaturated fatty acids (LC-PUFAs), variability in breast milk content, and the implications of maternal LC-PUFAs supplementation on infant outcomes.