NUTRITION DURING

LACTATION
Nutrition Department

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Breastfeeding : A Learned Behavior

Physiological process virtually

all mothers are capable of doing
Is a learned behavior not all
mother decide to do
Mothers partner also plays an
important role

Advantages
Nutritionally superior to any
alternatives
Bacteriologically safe & always fresh
Contains various antiinfectious
factors & immune cells
The least allergenic to any infant
food

 Breast-fed babies are less likely to be

overfed
Promotes good jaw & tooth development
Cost less
Promotes close mother-child contact
More convenient once the process is
established

American Academy of Pediatrics (AAP)

& American Dietetic Association (ADA)

Exclusive breastfeeding for 6

months, and breastfeeding with
complementary foods for at least
12 months as an optimal feeding
pattern for infants

American Academy of Pediatrics

(AAP)
Females infected with the human
immunodeficiency virus (HIV) should
be counseled not to beast-feed
Females who are at risk for being
infected with the virus should be
educated about the risk of infecting
their infant with HIV through breast
milk

The Baby Friendly Hospital Initiative

Global effort to the incidence &

duration of breast-feeding
To become baby friendly, a
hospital must agree to implement
the Ten steps to Successful
Breast-feeding

Ten steps to successful breastfeeding

Have a written breast-feeding policy
that is routinely communicated to all
health care staff
Train all health care staff in the skills
necessary to implement this policy
Inform all pregnant females about the
benefits and management of breastfeeding

 Help the mother initiate breast-feeding

within a half hour of birth
Show mothers how to breast-feed and
how to maintain lactation, even if they
are separated from their infant
Give new born infants no food or drink
other than breast milk unless medically
indicated

Practice rooming-in
Encourage breast-feeding on demand
Give no artificial teats or pacifiers
Foster the establishment of breast
feeding support groups, and refer
mothers to them on discharge from the
hospital or clinic

Nutritional requirements
Lactation is nutritionally demanding
Increased intake of most nutrient is
advised
Milk production is most affected by the
frequency of suckling
Milk composition varies according to
mothers diet, but in general the effect
is to reduce quantity, not quality

Energy
Production 100 ml of milk need 85
kcal expenditure
1st 6 mo of lactation 750 ml/day
(550 1200 ml/day)
RDA : + 330 kcal (1st 6 mo)
+ 400 kcal (2nd 6 mo)

 2nd 6 mo
- production 600 ml/day
E req
- consuming solid food
Energy intake at least 1800 kcal/day
Inadeq maternal fluid intake affects milk
volume

 After birth women are in a hurry to

lose weight
In general lose - 1 kg / mo during
the 1st 4 6 mo of lactation
Exercise >> lactic acid of breast milk
influence milk taste

Breastfeeding and maternal weight loss

(Dewey et al. Am J Clin Nutr 1993;58:162-6)

Fat
20 35% of total calories
Presence of long-chain PUFA
crucial for fetal & infant retina &
brain development
AI n-6 PUFA : 13g/day
AI n-3 PUFA : 1.3 g/day

Human Milk Composition

Influences of maternal diet
a. CHO, protein & minerals not influenced by maternal diet
b. Fat and vitamins influenced by maternal diet

Human Milk Composition

Influences of maternal nutritional status

- milk composition remains relatively constant unless malnutrition

is severe
- the volume of milk produced may with malnutrition

Water
Drink a glass of milk, juice or
water at each meal and each time
the infant nurses

Nutrient supplements

Most women can obtain all the

nutrients from a well balanced diet
Some may need iron to refill
their depleted iron stores

Particular foods
Foods with strong or spicy flavors (e.g.
garlic) may alter the flavor of breast
milk
Infants who develop symptoms of food
allergy more comfortable if the
mothers diet exclude the most
common offenders (cows milk, eggs,
peanuts)

Increased Requirements

Practices incompatible with

lactation

Alcohol
- easily enters breast milk
Smoking
- transfer nicotine
Medicinal drugs
Environmental contaminants
Caffeine