Source: theradmom.com
The evidence of breast-feeding’s many health benefits—for both mothers and babies—is plentiful and has stood as the backbone of current recommendations from numerous studies. In fact, mothers are encouraged to breastfeed their babies exclusively for first six months and continue until up to two years. complementary feeding will be begin at six months onwards. The Malaysian Breastfeeding Policy also follows these requirements.
The Benefits
There are lots of benefits for the mothers and the infants if they chose to continue breastfeeding exclusively. Since the prevalence of Gestational Diabetes Mellitus (diabetes during pregnancy) is increasing in numbers, this group of mothers receive the most benefit. For instance, the GDM mothers will have an improvement in glucose metabolism if they continue breastfeeding for the first three months. This is due to the increased insulin sensitivity (due to increasing prolactin production and decreasing estradiol levels), and improved β-cell function.
Mothers who breastfeed will lose weight more rapidly compared to the mothers who don’t. According to a report published by the United Nations and World Health Organization, exclusively breastfed infants consumed an average of 807g of milk per day during the first six months postpartum. This translates into a maternal energy expenditure of 675 calories per day. Mothers of partially breastfed infants burned 460 calories per day. Part of the energy needed to make milk comes from the mother’s own fat reserves. Women who gained an appropriate amount of weight during pregnancy should consume an extra 505 calories per day (Table 1). A weight loss of about 0.5kg a week is safe and shouldn’t impact your milk supply. Furthermore, breastfeeding decreases the risk of ovarian and breast cancers, cardiovascular diseases, diabetes, and rheumatoid arthritis.
Breastfed infants are leaner, thanks to the dynamic composition of the breast milk. On the other hand, formula fed infants tend to be obese since they produce more insulin that will lead to hyperinsulinemia. This condition retards the process of lypolisis (fat break down) and enhances fat deposition. The incidence of chronic disease such as diabetes, obesity and hypercholesterolemia in later life are also reduced in breastfed babies.
Nutrition During Lactation
Breastfeeding mothers tend to have higher requirements for energy, thiamin, riboflavin, niacin, folate, vitamins B12, C, A, and D, calcium, phosphorus, magnesium, zinc, copper and selenium. Lactational capacity (the ability to produce milk) usually exceeds the production (volume produced by the mother) and increased demand by the infant will be met by increased supply, irrespective of maternal energy intake.
General recommendations for healthy eating (Table 2) are also applicable to lactating mothers. It is advisable to take small and frequent meals, drinking plenty of fluids such as water, milk, fruit juice also helps. Long chain polyunsaturated fatty acids (LCP) contained in breast milk plays a vital role in infant’s brain and retinal development. To ensure good intake of LCPs, mothers are encouraged to include fish in their diet, at least twice a week.
Alcohol and caffeine are substances that easily pass into the breast milk. High intakes of either should be avoided during lactation.
Table 1
| Nutrient | Normal | Pregnant | Lactation |
| Energy (Kcal) | 2000 | 2000-2470 | 2500 |
| Protein (g) | 55 | 62.5 | 75 |
| Calcium(mg) | 800 | 1000 | 1000 |
| Vit. A (mcg) | 500 | 800 | 850 |
| Vit.C (mg) | 70 | 80 | 95 |
| Thiamin, B1 (mg | 1.1 | 1.4 | 1.5 |
| Riboflavin,B2 (mg) | 1.1 | 1.4 | 1.6 |
| Niacin,B6 (mg) | 14 | 18 | 17 |
| Folate(mcg) | 400 | 600 | 500 |
Table 2
| Food Groups | Functions | Sources | Servings/day |
| Carbohydrates | |||
| Cereals, starchy veges | – good source of complex carbohydrate – Also provides vitamins, minerals, fibre and some proteins – Low fat |
Rice, oats, barley, wheat | 9-11 |
| Fruits | – good source of vitamins and minerals – Source of fiber |
Banana, apple, orange, papaya, | 2 |
| Protein | |||
| Fish, poultry, meat and legumes | – Good sources of protein – Rich in B vitamins, Iron and Zinc – Legumes: rich source of vit B, magnesium and fiber |
Beef, lamb, chicken, sardine, tuna, mackerel | 2-3 |
| Milk and dairy products | – source of Calcium – important source of protein – source of vitamins |
Low fat milk, cheese, yogurt | 1-2 |
| Vegetables | – good source of vitamins and minerals – Source of fiber |
Mustard greens, kale, broccoli, asparagus, peas | 2-3 |
| Fats | – energy source for body – focus on unsaturated fatty acids, reduce intake of saturated ones |
Palm oil, butter, margarine, mayonaise | 1-2 |
| Omega3 and Omega 6 Fatty Acids – Long chain Polyunsaturated Fatty Acids – Essential for brain, growth and development of infant |
Deep sea cold water fishes such as tuna, sardine, mackarel, salmon | ||
| Vitamins and Minerals | – needed for normal daily function – can be obtained from fruit, veges and proteins |
Fruits, vegetables, lean proteins | – |
Encik Mohd Fauzee bin Mohd Zaki is a dietitian working in Temerloh, Pahang.
[This article belongs to The Malaysian Medical Gazette. Any republication (online or offline) without written permission from The Malaysian Medical Gazette is prohibited.]
References:
- Manual of Dietetic Practice (4th edition)
- www.eatright.org