Differentiated feeding during lactation

Breast milk must guarantee adequate nutrition for the baby, as a continuation of intrauterine nutrition, constituting the best food for the first six months of the baby's life. During lactation, the mammary glands have a relative metabolic autonomy, which guarantees the adequate composition of the milk, unless the mothers are extremely malnourished.

Milk production depends on the individual metabolism, age, previous weight and nutritional status of the mother. To achieve good nutritional status during lactation, the woman has to increase nutrient intake. At each postnatal visit both mother and child should be examined, and advice on healthy eating should be provided.

Maternal needs may vary throughout lactation, and nutritional deficiencies may become apparent in the mother, impacting her own health and that of the infant.

Breastfeeding

It is a form of feeding that constitutes an incomparable way of providing the ideal sustenance for the growth and correct development of the baby. It begins at birth, with milk produced in the mother's womb and should be extended as an exclusive form of feeding during the first six months of life; from that date and up to two years of age, it is recommended, as a complement to breastfeeding, to offer the baby other foods appropriate for his age. Breastfeeding can be extended until the mother or the baby decides to do so, without any time limit.

Advantages of breastfeeding for the baby

• It provides the nutrients and fluids best suited to the baby's nutritional needs.
• Reduces the risk of gastrointestinal diseases (colic, diarrhea and gastroenteritis) and respiratory infections (colds, bronchitis, otitis and pneumonia).
• Reduces the occurrence of allergic disorders, such as asthma and atopic dermatitis.
• Reduces the risk of childhood obesity.
• It favors the emotional bond established between mother and child, affecting the development of intelligence, self-esteem and interpersonal relationships.

Advantages of breastfeeding for the mother

• Contributes to the return of the uterus to normal size.
• Reduces the risk of postpartum depression syndrome.
• It can favor gradual weight loss after pregnancy.
• May reduce the risk of developing uterine and breast cancer.

Physiological changes in the mother during lactation

• Weight reduction occurs due to expulsion of the fetus, loss of amniotic fluid and placenta.
• Increased levels of prolactin, a peptide hormone that stimulates milk production in the mammary glands.
• They decrease the levels of progesterone, a steroid hormone involved in the female menstrual cycle, pregnancy and embryogenesis.
• Decrease levels of estrogens, sex steroid hormones produced by the ovaries and placenta during pregnancy.
• Lactic secretion begins 48 hours after delivery, increasing nutritional requirements.
• In response to the stimulation of the nipple by the baby's suckling, oxytocin is released, a hormone that acts as a neuromodulator of social and sentimental behaviors, thus facilitating lactation.
• The pre-pregnancy blood volume is restored.
• Extracellular fluid levels, which had been retained during the gestation process, are reduced.
• Fat deposits used for milk production are mobilized.

Influence of the mother's diet during the breastfeeding period

During lactation, maternal nutritional needs increase, in order to supply the metabolic effort required in the synthesis of fats, proteins, vitamins and minerals contained in breast milk, to guarantee the nutritional demands of the child.

The nutritional content of the diet directly influences the quantity and quality of the milk produced, and the health of the mother and child; the milk produced by a malnourished mother is obtained from her own reserves, causing her state of health to deteriorate.

The quantities and qualities of some nutrients contained in breast milk may vary depending on the mother's diet, as is the case, for example, in the following cases:

• Increases in neuronal development in small children during the first year of life are associated with the inclusion in mothers' diets of omega-3 and omega-6 fatty acids contained in olive oil, fatty fish and nuts.

• Reduced levels of some minerals in breast milk, such as selenium and iodine, are caused by deficiencies of meat, fish and cereals in mothers' diets.

• Reductions in protein levels in breast milk are associated with nutritional problems of the mother.

Women who have been overweight or obese prior to pregnancy have lower prolactin levels in the postpartum period, manifesting lower levels in the initial production of breast milk, as well as greater difficulties in maintaining lactation, so it is very important to control the woman's weight before, during and after pregnancy, so that she can successfully breastfeed.

Principles to be taken into account for proper nutrition during breastfeeding

• A diet of five or six meals well distributed throughout the day should be established, guaranteeing a complete breakfast.
• Dairy products should be included in at least four servings a day to guarantee calcium intake.
• Complex carbohydrates should be included in four of the six meals.
• Olive oil, or seed oils such as sunflower, corn and soybean oil should be included in the diet. Avoid consumption of palm and coconut oils as well as animal fats and trans fats.
• Vegetables and fruits should be present in five of the six proposed meals, to ensure an adequate intake of vitamins, minerals and dietary fiber.
• Animal proteins should be included in two meals a day, preferably chicken and turkey, eggs and fish such as sardines, tuna, trout and salmon.
• During lactation, restrictive diets that limit the consumption of nutrients or energy for the purpose of reducing body weight cannot be practiced.
• Two to three liters of water should be drunk daily. It is recommended to drink at least one glass of water after each feeding.
• Also, salt consumption should be reduced, because less liquid is retained, which reduces edema, mainly in the feet.
• A doctor should be consulted before taking any medication, in order to foresee the possible harmful effects on the newborn.
• Do not consume toxic substances such as drugs, alcohol and tobacco.