Foods to Avoid during Breastfeeding

Lots of women are concerned about eating the wrong thing when they're breastfeeding. Especially when they hear that certain foods can cause their baby to respond in a way that makes them appear fussy or uncomfortable. 

I was appalled to see a popular website put out a list of foods that a woman should avoid during breastfeeding. The list went as far as to say that certain spices can cause your baby to be gassy and certain fruits can cause diaper rash. As if breastfeeding isn't stressful enough! Now you have to worry about eating things you enjoy or thought were good for you and your baby!? There is no actual scientific evidence that backs up these claims, so don't let popular media stress you out. One of the many reasons women stop breastfeeding is because they are told that they need to follow restrictive guidelines for what they can eat and drink. I get it! Your body has not been your own for 9 months, you've followed all the rules of pregnancy and now you're ready to get your freedom back. Fear not! The real rules (the ones that ARE based on actual science and research) are not as restrictive as you might think. 

Here's what you need to know about "the rules" while you're providing breastmilk for your little one. 

Alcohol

Your breastmilk is just like your blood. Things move in and out - alcohol does not get trapped in your breastmilk. So, basically, if you're drunk, then your breastmilk has a pretty high content of alcohol in it. Once you sober up, the alcohol content of your breastmilk has also decreased. Ideally, breastfeed shortly before having a drink so you can give your blood alcohol level a chance to come down before nursing again. If you get a little carried away, feed your baby some stored breastmilk instead. Your blood alcohol level will parallel with the alcohol content of your breastmilk, so, if you really over did it, it might be a good idea to have a stash of frozen pumped breastmilk on hand to feed your baby. Having a couple of drinks is not a good reason to resort to formula, which can cause your milk supply to decrease and may cause other problems for your baby. The biggest risk of occasional drinking is not that you are feeding tainted milk to your baby, it is your parenting skills and ability to respond and make good decisions. So, if you plan to indulge, make sure you have sober back up to take care of your little one while your judgement and level of awareness may be impaired. Make no mistake, I am talking about occasional light-moderate drinking with the above recommendations - regular and heavy drinking is a much different story and should be discussed with your doctor. 

Fish

The United States Food and Drug Administration (FDA) and Environmental Protection Agency (EPA) recommend that pregnant and breastfeeding women should avoid eating any shark, swordfish, king mackerel, or tilefish. These fish have high levels of mercury. Don't make the mistake of avoiding fish altogether! There are great benefits in the omega 3 fats that come from fish that can help your baby's brain and eye development! Breastfeeding mothers can eat up to 12 ounces a week (2 average servings) of fish and shellfish that have lower concentrations of mercury. This includes shrimp, canned light tuna, salmon, pollock, and catfish. Albacore (white) tuna has more mercury than canned light tuna, and should be limited to 6 ounces (one average meal) per week. Salmon is a great option for low mercury and high omega 3 content!

Caffeine

Most breastfeeding women can drink a moderate amount of caffeine without it affecting their infant. The American Academy of Pediatrics defines a moderate intake of caffeine as two to three cups of a caffeinated beverage per day. However, some young infants are sensitive to caffeine and become irritable or have difficulty sleeping, even with small amounts of caffeine. An infant's sensitivity to caffeine usually lessens over time. 

Spices, Flavor and Citrus

You may have heard babies can become fussy with "gassy" foods, citrus, garlic, chocolate or ethnic flavors. The reality is, fussiness and gassiness are a totally normal part of the newborn period. It is unlikely that these behaviors are related to your food intake. Even when a baby does react to a food in the mother's diet, the specific food that causes a reaction will vary from baby to baby... so just because your neighbor claims that her baby cries more when she eats a certain food, doesn't mean that all babies (or your baby!) will have an issue with it. A true allergy will usually produce a skin rash or you may notice blood in your baby's stools. This usually occurs between two and six weeks of age, but may occur as early as day of life one. Elimination diets do exist and will include avoiding common allergen foods such as cow's milk, nuts and soy. If your baby has any of these symptoms, talk to your doctor and a Registered Dietitian. 

Just remember, you can't always believe what you read online! Make sure you're getting your information from a reliable source, especially if it's something that can be deal breaker for breastfeeding! 

References:

Academy of Breastfeeding Medicine. ABM Clinical Protocol #24: Allergic Proctocolitis in the Exclusively Breastfed Infant. 2011. Available at: http://www.bfmed.org/Media/Files/Protocols/Protocol24_English_120211.pdf. Accessed 11/7/12.

Lieberman T. Best for Babes. Booby Traps Series: Six breastfeeding myths you might hear at the doctor's office. Posted 9/18/12. Available at http://www.bestforbabes.org/booby-traps-series-six-breastfeeding-myths-you-might-hear-at-the-doctors-office. Accessed 11/7/12.

Rigg, D. Best for Babes. Can I drink on New Years Eve? Posted 12/31/08. Available at: https://www.bestforbabes.org/can-i-drink-on-new-years-eve. Accessed 11/7/12. 

UpToDate. Maternal health and nutrition during breastfeeding. Updated 9/18/12. Available at: http://www.uptodate.com/contents/maternal-health-and-nutrition-during-breastfeeding-beyond-the-basics. Accessed 11/7/12. 

Things to consider before becoming pregnant ...

I often get asked by women that are just starting to try to conceive if they should be taking a prenatal vitamin. The answer is ABSOLUTELY! Any female of child bearing age should be aware of vitamin and mineral intake since crucial increases in your needs occur before you might even know you're pregnant! It's definitely a good idea to start a prenatal vitamin now.

Iron and folate become critically important during your fifth week of pregnancy (that's just 1 week after your missed period!) Folate, which is important for preventing defects of the brain and spinal cord, increases to a recommended intake of 600 micrograms per day. Iron becomes important because as your uterus expands, blood vessels are forming to nourish your baby. Iron is necessary in this process and daily needs increase to 27 micrograms per day while you're pregnant.

Before the positive pregnancy test, a regular prenatal vitamin is fine as long as it includes the right amounts of those two nutrients. Including 1000 mg of calcium is also beneficial - most women aren't getting enough calcium anyway, and building up your reserves prior to pregnancy will definitely give you an advantage.

If you want to to stick to the same vitamin before and during pregnancy, then you need to look past the first five weeks. DHA, and now new research for lutein, become important at week 6 when the baby's brain and eyes begin to develop. Prenatal vitamins with DHA and lutein usually require taking 2 pills and very few prenatal vitamins include lutein. Of course, it is always an option to find DHA and lutein separately in a different supplement to take in addition to your basic prenatal vitamin. If you choose not to take supplemental lutein, then it is extremely important to start adding some good sources of it into your diet, such as dark green veggies.

Beyond the prenatal vitamin, some things to consider before becoming pregnant ...

Make sure to achieve/maintain a healthy body weight and get into a regular exercise regimen. It's not recommended to start a new workout program after becoming pregnant, so it's important to have a routine established prior to conception... start now! There are so many benefits to staying active during pregnancy. Also, one of the main complaints during pregnancy is fatigue, so if caffeine is a main staple in your diet, start cutting back now. That way, you aren't dealing with caffeine withdrawal when you have to kick the habit for the baby on top of being tired in general from pregnancy! Cutting back on alcohol is a good idea at this point as well - a drink here and there is no biggie, but definitely try to keep it under 3 drinks if you're feeling social.

Take advantage of this time to get into the best shape of your life. If all goes as you're hoping, your body won't be the only one that depends on your health!

Pre-pregnancy Weight

We now know more than ever that your nutrition and weight status prior to becoming pregnant can affect both your health and the health of your future baby. It is a common misunderstanding that a baby is only affected by a mother’s habits during pregnancy. Your pre-pregnancy weight matters!

Fat actually plays a big part in fertility as well. Too little or too much of it can affect your chances of getting pregnant. Beyond affecting your ability to conceive, an unhealthy pre-pregnancy weight can increase the chance of complications during your pregnancy.  

Overweight, obese, and severely obese women have more complications than normal weight women including diabetes that develops during pregnancy, pregnancy induced high blood pressure, and cesarean delivery. Women who are heavier prior to pregnancy are at a higher risk for having a high-birth-weight infant and an infant with low Apgar scores (Apgar scores measure the health of the infant immediately after birth). A recent study in the journal Pediatrics, also found that among preterm infants, children of mothers who were obese prior to pregnancy had double the risk of brain development and learning issues at age two than those of mothers that were normal weight prior to pregnancy.

Although much less common, underweight prior to pregnancy also comes with risks. Underweight women are more likely than those of normal weight to have a preterm delivery or a low-birth-weight infant, putting the baby at risk for a variety of conditions at birth.

Calculate your BMI (body mass index) to determine your weight status on the BMI calculator.

If your BMI is below 18.5 or above 29 and you’re thinking about becoming pregnant, it’s time to start making some changes!

If you’re underweight…

Quality is much more important than quantity. Focus on concentrated calories. Foods high in fat have more calories than high carb or high protein foods, but the goal is not to increase weight by eating excessive unhealthy foods. Seek out healthy fats such as nuts, healthy oils, or avocado. Continue to eat your vegetables even though they aren’t a high calorie food, try cooking green veggies with olive oil and slivered almonds or crushed walnuts to increase the energy density.

If you’re overweight…

It’s all about staying satisfied! Make sure you start your day off with breakfast. Even if you’re not hungry when you wake up, try to have at least have a piece of fruit to get your body working! Throughout the day focus on low calorie foods that are high in nutrients such as vitamins, minerals and fiber. Water, fruits, vegetables, lean protein and low-fat dairy in addition to portion controlled healthy fats can keep you satisfied throughout the day without packing on the pounds!

Regardless of the weight status you achieve before becoming pregnant, making changes toward a healthier weight can improve your general well being and help you to be the healthiest soon-to-be mom you can be.