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After your baby is born, the journey of the first 1000 days continues. If you’ve been following me for a while or have read some of my other posts you will know i’m passionate about this period in your little ones development and often talk about critical nutrients.
Birth to weaning
After your baby is born you will either breastfeed or formula feed them in order to meet their nutritional requirements for growth and development.
There is much evidence to show that breastmilk is the optimal first food, particularly as its composition changes on an hourly basis to meet the changing needs of your baby. However, I’m not going to make you feel guilty if you aren’t breastfeeding as I believe that ‘fed is best’. Please skip ahead to the part that’s relevant for you.
We know that breastmilk contains all the nutrition babies need up until 6 months. It also contains powerful antibodies that help fight illness and build immunity as well as probiotics for a healthy digestive system (2).
Research shows breastfeeding could protect babies against pneumonia, respiratory infections, episodes of diarrhoea and Sudden Infant Death Syndrome (SIDS) (2).
Breastfed babies will need a vitamin D supplement as unfortunately, this is one vitamin that breastmilk is lacking. They need 8.5-10mcg vitamin D as a supplement irrespective of whether you yourself take a supplement too.
Your diet affects your breast milk
If you are breastfeeding, the quality of your milk is determined by the food you eat and drink.
This is a message I’m passionate about sharing as it’s a bit of a bugbear of mine that healthcare professionals don’t advertise the fact that the quality of your diet matters, probably because they are keen to get you feeding in the first place!
But your diet does matter. Firstly it’s worth saying that breast-is-best even with a crappy diet!
Your body will take the nutrients from your own stores to optimise breastmilk, leaving you, unfortunately, depleted!
But you have got to have good stores of nutrients in the first place otherwise your baby’s breastmilk will be deficient too.
For example selenium and iodine are two micronutrients that are often low in women’s diets anyway but are essential for both your thyroid function and also your baby’s. You need even more while you are breastfeeding.
When your stores are insufficient, your body will take the little you have to enrich breast milk as best it can, but it still might not be enough. By eating foods high in selenium and iodine you can change the micronutrient profile of breast milk.
Selenium is found in: brazil nuts, fish, sunflower seeds, meat, fish and wholemeal or wholegrain versions of bread, flour, pasta and rice
Iodine is found in: fish and shell fish, seaweed (although it varies depending on the type so isn’t a reliable source), dairy foods like milk, yoghurt and cheese and some grains.
Likewise, omega 3 levels of breastmilk are influenced by your diet, if you eat oily fish your breastmilk will be richer. If you are vegetarian or vegan you should eat omega 3 rich nuts, seeds and beans for the same reason.
In addition vitamin D will pass into breast milk but that assumes you have adequate stores to start with, most of us don’t and that is why both mum’s and babies are advised to take vitamin D supplements.
Now you know how you can improve breastmilk if you optimise your diet I’m sure you’ll be wanting to make a few changes. Here’s how:
A healthy breastfeeding diet involves:
Eating at least 5 portions of fruit or vegetables per day – go for a rainbow and more veggies than fruit – that way you’ll get a wider range of nutrients.
Eat wholegrain starchy carbohydrates at every meal and snack – wholemeal bread, wholegrain cereals, pasta, rice and potatoes
Eat 3 portions of calcium rich foods each day including dairy products such as milk, cheese and yoghurt or choose non-dairy alternatives such as tofu, chia seeds, canned fish with small edible bones, bean s, lentils and other pulses, almonds.
Eat protein foods at each meal, these include meat, fish, beans, lentils, eggs, seeds, nuts and vegetarian alternatives like quorn, soya and tofu.
Cook with rapeseed or olive oils and use an olive based spread rather than sunflower spread or butter.
Drink plenty of fluid. Aim for around 2 litres per day. This includes water, squash and hot drinks.
Eat 1-2 portions of oily fish per week, it’s great for healthy fats and omega 3 but while breastfeeding avoid having more than 2 portions of oily fish per week. Oily fish includes sardines, salmon, trout and mackerel.
Eat a variety of different foods.
I can’t stress this last point enough. Variety is so important as it’s the mixture of different foods that provide us with the wide array of vitamins and minerals that we need and when you are breastfeeding this directly translates to the nutrients you’ll be giving your baby (13).
If you want some suggestions of healthy foods for breastfeeding – and those you can eat with one hand enter your details in the box below and I’ll send you some ideas for breakfasts, main meals and snacks.
Foods to avoid
Make sure to watch your intake of caffeine as this can pass through your breastmilk to your baby and keep them awake. The maximum amount of caffeine per day is 200mg. Instant coffee has 100mg of caffeine, filter coffee 140mg, cola 40mg and tea 75mg. Energy drinks can contain from 60mg-180mg per can.
The latest advice is that an occasional alcoholic drink is unlikely to harm your baby (14). However, anything you eat and drink can find its way to breastmilk, including alcohol. Regular or binge drinking is not advised when breastfeeding (14).
Managing your weight and breastfeeding
Breastfeeding can help you lose weight as you can burn up to 500 extra calories per day (generally between 200-500kcals per day burned from feeding) (15). Breastfeeding mums may, therefore, need an extra 400-500 calories per day when feeding regularly. It’s best to get these calories from the foods listed above. Eating more food than this is likely to lead to weight gain.
Even if you eat a poor diet you can still successfully breastfeed. Your own nutritional stores will be drawn upon to enhance the quality of your breast milk so your baby will get what he or she needs. The immunity that you pass on is not affected by your diet and you really give this to your baby in any other way. Don’t forget breast milk varies in between feeds depending upon what your baby needs at that time.
If you are formula feeding, choose a ‘first’ milk. These are actually suitable right up to your baby’s second birthday, there is no need to switch them on to the second, follow-on or even cows milk if you don’t want to.
Formula milks are manufactured to be as nutritionally close to breastmilk as possible. They have added vitamins and minerals and so providing your little one has more than 500ml (20oz) per day there’s no need for a supplement as well.
Follow your babies lead when bottle feeding, feed them when they seem hungry and don’t worry if they don’t finish the bottle. Paced bottle feeding is a technique that allows your baby to only take the milk that they need and encourages them to stop when they are full.
Feeding your baby is an excellent opportunity for bonding, and bonding is one of the critical factors in the first 1000 days. Enjoy holding your baby and always making sure they can see your face and make eye contact. Give your baby plenty of time to feed (11) allowing them to set their own pace.
How much to feed
Babies need around 150ml formula per kg of weight.
A newborn weighing 4kg will need 150 x 4kg = 600ml.
Initially, they will manage just 75-100ml (3-4oz) per feed and need feeding frequently but as they grow they will be able to take larger volumes.
An average 3 month old weighs 6.5kg and so 150ml x 6.5kg = 975ml.
By now most babies demand larger volumes of around 200ml (7-8oz) so 5 milk feeds a day.
By 7-9 months this can decrease to 500ml daily because of weaning and reduce further to 300-400ml by 10-12 months.
Do they need additional vitamins too?
Usually not as formula already has the vitamins added, however, if your baby is taking less than 500ml (20oz) of formula per day you will need to give them a vitamin A, C and D supplement too. Choose one that is 8.5-10mcg vitamin D per dose.
My favourite is Nature & Nurture as it contains the exact dose for all three vitamins is a very small half ml drop.
This is when you combine both breast and bottle feeding and it can be really handy if you want someone else to be able to help out with feeding. You might be going back to work or want to leave your baby with granny so you can have a night out with your partner.
It can sometimes take a while for your baby to get used to bottle feeding if they’ve been exclusively breastfed (17).
If you are expressing, they may notice a difference in temperature of the milk, and if it’s formula you are using sometimes they notice a difference in taste.
Other times it’s the teat of the bottle that can be the issue.
Effectively it’s a new set of skills your baby has to learn and babies will always prefer what’s easiest and most natural to them. They will get there in the end though, I’ve helped many mums with this including one who had to stop breastfeeding quite quickly due to breast cancer.
Here are my top tips:
Breastfeeding and bottle feeding require two different sucking techniques and so it can be confusing for your baby when moving from one to the other give them lots of opportunities to practice and if you can make a certain feed each day a bottle feed they’ll have regular opportunities to learn and know what to expect.
Offer your baby the bottle when they’re not too hungry but not too full. A hungry baby might get frustrated and cross and a full baby won’t be interested enough
Choose a time of day when your baby is alert and not too tired, the middle of the night feed may be the one you are aspiring to (so dad can help out and you can get some sleep) but it’s best to learn when your baby is most alert.
Some babies won’t take a bottle from Mum (as you’re the boob lady!) but are more accepting of the bottle from Dad or another family member.
Sometimes distraction is needed too, particularly if you need to give up a breastfeed quickly like for returning to work or medical reasons.
Finally, don’t force the issue, persevere gently and regularly and your baby will get there in the end.
Sometimes when your baby starts taking formula, your breastmilk supply might reduce. This is simply because your baby is not demanding it as much. You can keep up your supply with regular pumping.
There is some evidence that suggests it’s not a good idea to start combi feeding in the first few weeks as breastfeeding isn’t quite established and mums who tend to introduce formula early tend to give up breastfeeding sooner.
Try paced feeding with your breastfed baby as this is more similar to breastfeeding than traditional bottle feeding. you can read more about it here.
If your baby is coming up for 6 months
There’s no need to introduce a bottle, your baby can drink expressed breast milk or formula from a cup. Go for a free flow lidded beaker like the Tommee Tippee first cup and avoid cups with teats as these are just bottles in disguise.
It’s also best to avoid the non-spill cups with valves as these require an unnatural sucking action and its thought may also be linked to delayed speech development.
At around 6 months breast and formula milk will no longer be enough to meet your baby’s nutritional requirements and it’s now that you’ll need to start introducing food.
There are critical nutrients that your baby needs that must come from food, I often hear ‘food before one is just for fun’ and that’s not true. Read this next instalment of food and feeding in the first 1000 days to find out why.