Maternal energy needs

• • First 6 moths: Additional 500 kcal/ day
  • Afterwards: Additional 400 kcal/ day for milk production
  • DRI: Additional 330 kcal/ day in first 6 months + 400 kcal/ day afterwards
• • Energy deficient --> Reduce volume of milk produced
  • Consider mother’s overall nutritional status when assessing adequacy of energy intake
• Calcium

  • For strong bones & teeth
  • 1000 – 1300 mg
• Iodine

  • Higher RDA (290 mcg vs 220 mcg)
  • For Thyroid hormone synthesis, fetal Skeletal, Central nervous system
• Vitamin D

  • For absorption of calcium
• Iron

  • Lower RDA (9 mg vs 27 mg)
  • Low in breast milk + Pulled from maternal store
• Choline

  • Higher RDA (550 mg vs 450 mg)
  • Brain development & cognition
• Protein

  • 1.05 g/ kg/ day
  • Preserve their own muscle mass
• Vitamin B12

  • Higher RDA (2.8 mcg vs 2.6 mcg)
  • Help body release energy, Nervous system
• DHA

  • For baby’s nervous system development
  • Vary based on maternal DHA level
• Moderate malnutrition has minimal impact on quantity & quality of milk
• Vegetarian Diet (YES)

  • w/ adequate nourishment of the mother and the child
  • Result: Milk low in vit B12 --> vit B12 supplement/ plant foods with bioavailable B12 (e.g. yeast, seaweed)
• Alcohol (YES)

  • Occasional use in limited amount (> 0.5 g/ kg)
  • Pass into breastmilk + Significantly decrease oxytocin level --> Wait for alcohol to clear her system before nursing
• Coffee (YES)

  • Moderate intake (2-3 cups coffee)
  • Passes into breastmilk in small amount (~ 1% caffeine consumed; Peak 1 hour after consumption)
  • If infant appear to be more fussy/ being wakeful --> Decrease intake
• Exercise (YES)

  • Diet + Exercise: Help lose weight
  • Safe to begin exercising a few days postpartum (if healthy pregnancy & normal vaginal delivery)
  • Result: Increase lactate in breastmilk; Influence the milk’s taste
  • Breastfeed before exercise
• Marijuana (NO)

  • Harmful effect:

  • Structural change in brain cells of newborn animal

  • Impair DNA & RNA formation

  • 8 fold accumulation of THC (Active ingredient) in breast milk > compared to maternal plasma

  • Provide +ve urine tests in infant’s urine up to 2 – 3 weeks after exposure thru milk
• Cigarettes (NO)

  • Increase risk of otitis media, exacerbations of asthma, respiratory infections, gastrointestinal dysregulation
  • Not ideal to smoke and breastfeed, but worse to smoke and not breastfeed
• Cigarettes (NO)

  Con:

  • Nicotine passed through breast milk
  • Risk factor for low milk supply & poor weight gain
• Cigarettes (NO)

  • Pros: Better in terms of general health, respiratory illness, risk of sudden infant death