NUTRITIONAL AND FOOD REQUIREMENTS FOR LACTATING WOMEN

INTRODUCTION

The nutritional link between the mother & the child continues even after birth. The newborn baby depends for some period solely on breast milk for his existence.

A nursing mother produces 23 to 27 ounces of milk per day, containing 290 mg of calcium. This requires an extra energy expenditure of at least 600 calories per day. Good nutrition is therefore important for mother. The quantity of milk depends very much on the mother’s diet. Food absorbed by a nursing mother not only fulfills her own nutritional needs, which are greater during this period, but also enables her to produce milk.

 

NUTRITIONAL REQUIREMENTS

Nutritional needs exceed during lactation compared to pregnancy.  The RDA of a lactating mother is given in the following table:-

NUTRIENT NORMAL ADULT WOMAN LACTATING MOTHER

  0-6                        6-12 months

Energy Kcals
Sedentary 1875 +550 +400
Moderate 2225 +550 +400
Heavy 2925 +550 +400
Protein gram 50 +25 +18
Fat gram 20  45 45
Calcium mg 400 1000 1000
Iron mg 30 30 30
Retinol mcg 600 950 950
β-carotene mcg 2400 3800 3800
Thiamin mg
Sedentary 0.9 +0.3 +0.2
Moderate 1.1 +0.3 +0.2
Heavy 1.2 +0.3 +0.2
Riboflavin mg
Sedentary 1.1 +0.3 +0.2
Moderate 1.3 +0.3 +0.2
Heavy 1.5 +0.3 +0.2
Niacin mg
Sedentary 12 +4 +3
Moderate 14 +4 +3
Heavy 16 +4 +3
Folic acid mg 100 150 150
 Vit. C mcg 40 80 80
Vit.B12 mcg 1 1.5 1.5

PRINCIPLE OF DIET

High calorie, High protein, High fat, High CHO, High vitamins & minerals, High fiber, High fluid intake

DIETARY MANAGEMENT

ENERGY : The recommended energy increase is 550 kcal for first six months & 400 kcal during the next six months more than the usual adult allowance. The additional calories are required for the following:-

Milk content: -An average milk production for a lactating woman is 850 ml though some women may produce as much as 1000 ml. calorie value of human milk is 65 per 100 ml. Hence calorie value of 850 ml is 600 calories. Therefore, high calorie intake is essential during this period.

PROTEIN : Each 100 ml of human milk contains 1.2 g protein. Therefore, additional protein is required. If protein is lacking there will be a reduction in milk volume rather than in milk quality. At very low protein intakes the proportion of casein may be reduced.

FAT : High fat is required (25-30% of total calorie) in the diet to meet the increased demand during lactation.

CALCIUM : If the diet does not contain plenty of calcium, the body will use calcium from the bones to meet the increased needs. This may weaken the bones and increase the risk of developing osteoporosis later in life. 500 ml of milk & milk products should be given. Good sources of calcium includes: – Dairy products such as milk, cheese, yogurt, soymilk fortified with calcium.

IRON : Pregnancy uses up all the iron stores. So, during breastfeeding the lactating mother needs to rebuild the iron stores with iron rich foods such as-Red meat, chicken & fish, pulses & legumes, nuts & dried fruits, wholegrain bread & cereals, green leafy vegetables, egg yolk.

VITAMIN A : The quantity of vitamin A present in 850 ml of human milk is 392 mcg, so the ICMR recommends an additional allowance of 350 mcg. This can be achieved by including liver, fish liver oil, egg yolk, green leafy vegetables, carrots, pumpkin, mangoes, milk, butter, cheese, jack-fruit, guava, phalsa, jambu fruit.

Some suggested recipes for vitamin A – boiled egg, egg custard, coriander & mint chutney, carrot halwa, carrot salad, carrot juice, papaya, orange juice, tomato juice, mango juice, palak dal, palak paneer.

VITAMIN C : The additional needs during lactation are calculated on the basis of the vitamin C secreted in milk. Assuming a daily milk secretion of 700 ml milk with an ascorbic acid content of 3 mg per dl by well nourished women, the additional requirement during lactation will be 20 mg. Taking into consideration of the cooking losses (50% the committee recommends an additional intake of 40 mg per day during lactation).

FIBER : The benefit of High fiber – weight loss, lowers cholesterol, normal bowel movements.

FLUID : An increased intake of fluids is necessary for adequate milk production, since milk is a fluid tissue. Water & beverages such as juices, tea, coffee & milk add to the fluid necessary to produce milk.

DIETARY GUIDELINES

Ø Nutritional requirements are maximum during lactation compared to any other age group in a woman’s life hence the diet should be balanced & meet the requirement . Number of meals can be increased.

Ø Sucking is the best lactagogue. The diet can include lactogogue which stimulate the production of milk are- garlic, milk, almonds, lentil, garden cress seeds are considered to increase the milk production. Special foods like sonth laddu, gond laddu etc are given during lactation. This practice can be encouraged.

Ø Weight gain beyond the desirable body size should be avoided.

Ø It is better to control constipation by inclusion in the diet of raw & cooked fruits & vegetables, whole grains & an adequate amount of water than by use of laxatives.

Ø Use health drinks like proteinex mum, pro P&L.

SAMPLE MENU FOR LACTATION

Meal-time Menu Amount
Early morning Milk 1 cup
Biscuit 4 pc
Breakfast Stuffed sattu paratha 4 pc
Chutney(mint/coriander) 3-4 tsp
veg 1 katori
Banana milkshake 1 cup
Mid-morning Fruit juice 1 glass
Dried fruits 50 gm
Lunch Rice 100gm
Dal (lentil) 1&1/2 katori
Egg curry 2 pc
Spinach 1 katori
Chutney(onion/garlic) 3-4 tsp
Salad(tomato/cucumber/) 100gm
Mid-afternoon Badam kheer 1&1/2katori
Evening Chicken soup 1 bowl
Gud badam 50 gm
Dinner Roti / paratha 4 pc
Dal /rajma/soyabean 1&1/2 katori
Veg 1 katori
Bed time Milk with pro P&L 1 glass

 

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