The Breastfeeding Diet

After giving birth you may think about going on a diet or cutting calories in order to lose the baby weight.  If you are breastfeeding it’s really important not to try to lose the weight too quickly otherwise you may compromise the quality and quantity of your breast milk.  Once breastfeeding, some women drop the weight very quickly and others hold on to the weight and have trouble dropping the rest until they stop breastfeeding.  Either way, know that your diet right now is very important so if you are not able to maintain a good diet with adequate calories then breastfeeding may not be right for you.

During the 2nd and 3rd trimesters of pregnancy you needed extra calories.  But guess what, while breastfeeding you have to keep those extra calories up or have even more!  Approximately an extra 500 calories are needed while breastfeeding.  And those calories shouldn’t come from junk (a little is ok).  You want to make the quality of your diet as good as possible.

Guess what?  You can now say hello to: sushi, deli meats, unpasteurized cheeses, runny yolks and sprouts!

Things to Keep in Mind While Breastfeeding

• Continue taking your prenatal vitamin!
• Key nutrients are: protein, calcium, zinc, folic acid, and vitamins E and B6.
• Hydration is very important – make sure to have a large glass of water whenever you are nursing.
• Limit caffeine and alcohol
• Fish recommendations remain the same from pregnancy
• Sugar substitute recommendations are the same from pregnancy

For Baby: The only supplement your baby needs while breastfeeding is 400IU of vitamin D.  This is essential since the mother’s milk does not provide enough vitamin D.

Many women miss alcohol during their pregnancy, so it’s ok to have some while you are breastfeeding.  Try to have the drink right after your nurse.  I really enjoy a glass of wine now and then.  Right now I feed Hannah around 7pm and she goes to bed by 8pm.  We have dinner once we put her down for the night and it works perfectly to have a glass of wine with dinner since I just fed her.  It’s a great way to relax and unwind (not every night though!).  If you still feel the effects of the alcohol then it’s best not to nurse and instead pump and dump the milk.

Next Post: Breastfeeding Diet Breakdown

To Breastfeed or Not

As a new mom I’ve learned how much pressure new moms feel to breastfeed.  As a dietitian breastfeeding was something I always wanted to do since I know how great it is for mom and baby.  However, it does not always go as smoothly as everyone hopes.  Luckily, Hannah is a good eater and we haven’t had any issues thus far.

The pros of breastfeeding for baby:

• optimal nutrition
• it’s easy for the baby to digest
• strong immune component for baby
• reduced risk of respiratory infection, gastrointestinal infections, asthma, obesity, type 1 and 2 diabetes, heart disease, hypertension, hypercholesteremia and childhood lukemia
• reduced rates of SIDS (sudden infant death syndrome)
• promotes bonding with mother
• reduced rates of allergies and intolerances
• helps promote proper jaw and teeth development
• may increase intelligence and school performance through adolescence

The pros of breastfeeding for mom:

• it’s free and doesn’t involve any preparation
• promotes strong bond with baby
• helps shrink uterus
• helps mom return to pre-pregnancy size sooner
• reduces postpartum bleeding
• decreased risk for: type 2 diabetes, breast cancer, ovarian cancer and postpartum depression
• improved bone density

Even though there are so many benefits of breastfeeding it does not mean that formula is bad!  You have to make the right choice for your own lifestyle, comfort level and medical situation.  Some women just don’t produce enough milk.  Some babies are not able to latch on properly.  Some women are not around their babies enough to do so and pumping may not be realistic.  Whatever your reason is, it’s important not to feel guilty if you are not able to breastfeed.

Since I have returned to work part-time I pump enough milk to provide Hannah with breast milk even when I’m not home.  I also give her bottles when we’re out in public which makes me more comfortable.  Again you have to do what is right for YOU!  This has been working really well for us and I hope to continue doing this till she is at least 6 months and I’ll evaluate at that point whether I want to continue or not.

Coming up in my next post:  The breastfeeding diet!

I’ll leave you with a couple photos from our recent trip to Bermuda.

I’m Back with a Baby!

Sorry I’ve been MIA this past month – things have been quite busy!

On Friday May 21st at 5:40 in the morning I gave birth to my beautiful daughter Hannah at 7lbs 4oz.  She is amazing and makes us so incredibly happy.  But at the same time, I’ve never felt busier and more tired in my life!  You’ll have to bear with me as I slowly ease my way back into blogging.  Free time is very hard to come by these days – and I haven’t mastered typing and holding a baby at the same time.   The little free time I do have has been spent going for walks, attending mommy groups, and attempting to cook or clean!  Meals have been super simple.  One thing I will cover in the coming weeks will be how to maximize the little free time you have and still manage to eat healthy when you don’t think you can!

Here’s a photo of us from when she was a few days old:

This photo is from when she was 9 days old:

And I’ll leave you with a photo of me the day before I gave birth, make-up free heading to the hospital:

Thanks for being patient!

Food Safety During Pregnancy

Well today’s my due date!  Which means this will likely be the last pregnancy post.  Don’t worry I’ll still give you information on pre- and post-natal nutrition and throw in some baby nutrition information as well in the future!

Source

Today I want to talk about Food Safety during Pregnancy.  Pregnant women are more susceptible to illness because their immune systems are weakened.  These are the foods pregnant women are advised to avoid eating:

• Sushi or Raw Fish
• Sprouts
• Raw Eggs
• Unpasteurized Dairy
• Deli Meats and Refrigerated Smoked Seafood (lox, nova, kippered)
• Refrigerated Pates or Meat Spreads

In addition to avoiding these mentioned foods, you want to make sure you are handling food safely.

The FDA has great information on their website, and I will summarize the main points here.

1. Clean: Wash your hands often.  Keep kitchen utensils and supplies clean at all times.  Wash your fruits and vegetables.
2. Separate: Always keep raw food separate from cooked food.  Use a separate cutting board and plates for anything with cooked food versus raw food.
3. Cook: Cook foods to their proper temperature.  Keep foods out of the danger temperature zone of 40-140 degrees F and throw away any food that has been left out for 2 hours or more!
4. Chill: Keep your refrigerator at 40 degrees F or below and your freezer at 0 degrees F.  Follow use by dates on packaging, and consume leftovers in a couple days.

My Pregnancy Summary

Overall I have had a great pregnancy, but it’s not over yet!  I know a lot of women have trouble late in their pregnancy due to swelling, back pain, lack of sleep, having to use the bathroom all of the time, and other complains.  But I really haven’t experienced these problems!  I have no swelling, I sleep 7-8 hours each night and use the bathroom maybe one time.  I have had some days where I’m very tired, but that I can handle!

My doctor instructed me to be as active as possible to try to get the baby moving, so I’m following her orders 🙂  Yesterday I walked a total of 6 miles and the day before 5 miles.  I just put on my sneakers and go!  I gave up wearing cute shoes for walking a couple months ago, and only wear sneakers because comfort is definitely the most important thing at this point.  At the end of the day my bones ache (they’re stretching!), but the doctor said that’s normal.  I’m also keeping up with my prenatal yoga (1-2 times/week), which I believe has helped me avoid back pain during my pregnancy.   And I’m still doing some light weights at this point, but much less than I was previously doing.

My husband and I are ready for this baby to come and hope she shows her face soon so that I can avoid being induced!  As much as I have enjoyed my pregnancy, I’m ready for the next phase…to meet her!

Pregnancy Food Cravings

One of the first questions my clients and friends ask me is if I’d had any food cravings during my pregnancy, and surprisingly the answer is: NO! While there have been times that I’m in the mood for dessert or french fries, they haven’t been real cravings because I can live without them (and usually do).

Most pregnant women do have some types of cravings, but why?

• Research is inconclusive as to why pregnancy food cravings occur.
• Some believe that it’s your body telling you that you need a nutrient.  For example if you are craving a burger, maybe your body needs iron or protein.  However, studies have not proven this.
• Many professionals say it’s those pregnancy hormones once again that lead to the cravings.

When to be concerned?

• There’s a condition called Pica, which is a craving for non-food items (clay, dirt, paper, paint chips, raw flour, etc).
• If you are experiencing this make sure to talk to your doctor.

How to manage cravings:

• Allow yourself a little slack, and give in when you know absolutely nothing else will suffice.  Just make sure to eat balanced meals in addition to your cravings so that you don’t replace healthy foods (ie fruits and vegetables) for junk food all the time!
• Keep your portions small.  If you want ice cream, get it, but get the small!
• If you want a burger and fries, split it with someone and get a salad to start.  Like I did here.

When you are craving something salty try:

• Pretzels (instead of chips) or pita chips with hummus
• Whole grain crackers or rice cakes with low fat cheese and sliced tomato
• Low fat popcorn
• 1 ounce of salted nuts
• Low fat tortilla chips dipped in salsa and/or guacamole
• Soy Crisps
• Lightly salted edamame
• Vegetables and low fat ranch dip

When you’re craving something sweet try:

• Fat free yogurt with 1/4 cup granola
• Kashi TLC Granola Bar
• Fresh fruit
• Dried fruit (watch portions!)
• Frozen grapes or bananas (very refreshing in the summer!)
• Smoothie: skim milk, fat free yogurt, frozen fruit and flaxseed
• Peanut Butter & Banana Sandwich
• Chocolate Covered Strawberries: melt 1 Tablespoon Chocolate Chips in the microwave and dip strawberries
• Fat free pudding
• Chocolate Milk or Hot Chocolate (made with skim milk)
• 1 Graham cracker sheet topped with low fat ricotta, a drizzle of honey and cinnamon
• Luna, Balance, Clif or Zone Bar
• Fat free or low fat frozen yogurt/ice cream (portion it out from the big containers!)

When it comes to actual meals: burgers, pizza, lasagna, etc.  I say make your own!  You can easily save a lot of calories and fat.  If you’re too tired, not in the mood, or just don’t have the time watch your portions!

There are two main concerns with pregnant women giving into food cravings all the time.  The first is that they may gain too much weight which isn’t healthy for mom or baby.  And secondly is that the less healthy foods will replace healthy ones and the women might not get all the proper nutrients she needs.

Have you had intense pregnancy cravings?

Pregnancy Iron Needs

As a woman your iron needs are higher than men’s naturally (hello menstruation!).  But during pregnancy your needs increase even more.  Iron is a part of hemoglobin.  Hemoglobin carries oxygen to the cells in your body.  During pregnancy, hemoglobin not only has to supply your own cells but it has to supply your baby’s cells as well!  The extra iron is needed for:

• production of red blood cells
• to build a strong immune system
• for energy production
• for the development of your baby’s brain and nervous system

There are two types of iron: heme and non-heme.  Heme iron comes from animals (eggs, red meat, seafood and poultry) and is absorbed at a much higher rate than non-heme iron which comes from plants (leafy greens, beans, and fortified grains).

To increase iron absorption never take it with regular or decaf coffee or tea!  Try pairing iron with vitamin C (orange juice, bell peppers, strawberries) to increase absorption.

So how much do you need?

• When not pregnant (18-50 yrs) you need 18mg
• When pregnant you need 27mg
• For comparison men need 8mg

Iron deficiency anemia is very common during pregnancy.  It’s important to have good iron stores before pregnancy  to reduce the risk of developing it.

My Pregnancy Update

38 weeks and counting!  Still going strong and feeling well.  In terms of iron for my pregnancy, my prenatal vitamins provide 30mg.  So I’m covered in my pill.  However, I think it’s important to eat a varied diet and I have eaten more red meat during pregnancy than before.  Part of that is because I’m eating less fish when out at restaurants!  I also consume leafy greens and beans on a regular basis.

Pregnancy: Protein Needs

Protein is a vital nutrient during pregnancy.  Why you may ask?  Well here are some reasons:

• Protein is involved with the development of new cells, enzymes, and hormones.
• Protein helps your baby develop properly.  Including: hair, fingernails, skin, and organs!
• Protein is crucial to keeping a proper fluid balance in your body.

So how much does a pregnant woman need?

• 1st trimester your needs are the same as someone who is not pregnant: 0.36 grams/pound of body weight (pre-pregnancy weight).  A woman who weighs 135 pounds requires 49 grams of protein.
• 2nd & 3rd trimester your needs increase to: 0.5 grams/pound of pre-pregnancy body weight plus 25 grams. The same 135 pound woman now requires 93 grams of protein.

What are good sources of protein?

• Poultry, Meat and Fish
• Eggs
• Dairy Products: milk, yogurt and cheese
• Nuts and Seeds
• Soy Protein
• Lentils/Beans
• Whole Grains

If you are a vegetarian or vegan, make sure that you are consuming complementary proteins.  To learn more about complete proteins and incomplete proteins read these posts.

To make sure you are getting in enough protein daily, try to include some sort of protein with each meal and snack.  If you think you may be running short read labels and use the internet to evaluate how much you are consuming on a given day.  Here’s how I’ve been managing my protein needs:

Breakfast

• Greek Yogurt: provides ~18 grams per 6 oz cup
• Cottage Cheese: provides ~12 grams per 1/2 cup
• Skim Milk: 8 grams per cup
• Peanut Butter: 8 grams per 2 TB
• Eggs: 7 grams for each egg

Lunch/Dinner

• Chicken/Fish/Meat: ~21 grams for 3 ounces
• Cheese: 7 grams for 1 ounce
• Chickpeas: 6 grams per 1/2 cup
• Lentils:  9 grams per 1/2 cup
• Veggie Burger: 10-15 grams per patty (this can range quite a bit!)
• A lot of the time I have cottage cheese or yogurt with my lunch for protein.

Snacks

• Almonds: 6 grams per ounce
• Babybel light cheese: 6 grams per round
• Soy Crisps: 14 grams per bag
• Edamame: 9 grams per 1/2 cup shelled
• Kashi TLC granola bars: 6 grams
• I also consume the breakfast proteins as my snacks.

Pregnancy Update:

Today is 37 weeks!  That means I’m technically full-term so if the baby came she wouldn’t be considered a premie and she would most likely thrive.  I’m still feeling great.  Here’s a photo from last Saturday when I was 36 weeks.  A friend said it looks like I swallowed a basketball – I think he’s right 🙂

Do you find it hard to reach your protein needs?

Calcium During Pregnancy

During pregnancy, there are many important nutritional needs, but one I like to focus on is calcium.

Why is calcium so important during pregnancy?

• Your baby needs calcium to grow bones and teeth!
• Calcium helps other parts of the baby develop such as his/her heart, nerves and muscles.
• Calcium is also important for the baby to develop normal heart rhythms and the ability to form blood clots.
• If you don’t consume enough, the baby will take it from your own bones!

How much do you Need?

• The recommendation is the same as pre-pregnancy, if you are over 18 years of age you need 1,000 mg/day.
• If you are under 18 years of age you need 1,300 mg/day.

Some Tips on Getting Enough Calcium

• Try tallying up how much you consume on a daily basis.  Read the label on your prenatal supplement, there’s usually a couple hundred milligrams in there.  Add up all the dairy (but read labels b/c they vary quite a bit!), fortified drinks (orange, soy milk, etc), canned salmon with bones and sardines, protein bars and other fortified foods (ie luna bars contain 350 mg calcium).  Leafy greens and almonds contain calcium too.
• If you fall short of 1,000 mg, consider taking a supplement or examine more ways to get calcium through food.  Remember vitamin D helps aid in the absorption, so look for a supplement that is USP certified and contains vitamin D.
• Your body can only absorb 500 mg at a time, so don’t take a supplement with a dairy meal (for example breakfast if you’re eating milk or yogurt).
• Try taking your calcium supplement separate from your prenatal vitamin b/c some of the minerals may fight for absorption.

How do I get my calcium?

• My prenatal vitamins have 400 mg of calcium in them, however, the calcium pills are separate.  I try to take the vitamins in the morning and then the calcium with lunch or dinner.
• Everyday I aim to have a greek yogurt (200 mg), 1 glass of skim or soy milk (~300 mg), and 1 oz low fat cheese (200 mg).   Some days it may be slightly different.  I occasionally have luna bars for a snack (which may replace one of my dairy servings) and other days I may have a yogurt and 2 servings of cheese.   Then there are some days I just fall short – usually on the weekends since my meals are not as structured.
• I do consume leafy greens and almonds almost daily so I probably get at least 100 mg more each day through those foods, however, I would rather go over 1,000 mg than be under, so I just use those as an added benefit and don’t count them.  1 ounce of almonds has 75 mg of calcium and 1/2 cup cooked spinach has 136 mg (but the oxalates to decrease absorption rates).
• What I make sure to do is at the end of the day I tally what I have consumed and if it’s low I will take an extra calcium supplement  to make sure I make my quota.
• The last thing I want is my baby taking calcium from my bones!

How do you get enough calcium?

Pregnancy: Fake Sugar or Real Sugar?

My husband and I took an impromptu trip to Vermont this weekend to enjoy the beautiful weather.  As a result this post is up today instead of Friday.  Here’s a photo of me in front of the Equinox pond in Manchester, VT.  We went on some really nice walks/easy hikes; the weather was close to 80 degrees!

Before our walk, I knew I needed some extra fuel so I grabbed an apple and some water to get me through.  Here’s a photo that was taken when I didn’t realize with my fuel in hand:

Back to Pregnancy Nutrition.  Another decision you are faced with making during pregnancy is what kind of sugar you will use.  Artificial sweeteners: Sucralose (splenda) and Aspartame (equal) are approved during pregnancy but some people choose not to use them.  Saccharin (sweet ‘n low) is of concern since it does cross over the placenta.  On the other hand stevia has not been approved for pregnancy.

Coffee and Tea: If you are drinking coffee or tea, whether it is decaf or regular, what are you using to sweeten it if anything?  Personally, I chose to eliminate artificial sweeteners (I used them on occasion beforehand), I didn’t feel the need to add unknown things to my body.  When I have a decaf latte, I have it made with soy milk which is already sweetened or I get skim milk and sometimes I drink it as is or add one pack of real sugar.  With tea, I enjoy it plain, but that’s how I’ve always had it.

Diet Soda and Drinks: This will be your personal opinion if you want to include it or not.  Again for me, I gave up all diet sodas (not that I drank much before!).  Besides the artificial sweetener there are lots of other chemicals that you may want to think twice about putting in your body especially during this time.  If you really love your diet soda, just try to consume it in moderation.

Artificially Sweetened Yogurts & Other Foods: Read labels if you want to avoid artificial sweeteners, they are lurking in a lot of diet and light products.  For example the light yogurts are sweetened with them, and I would recommend switching to plain and sweetening it yourself with fruit and a little honey or jam if you need more sweetness.

Sugar: Regular sugar is fine during pregnancy, just keep in mind that the calories do add up.  Try to reduce sugar where you can.  Remember pregnancy is not a time to give in just because “you can.”  Trust me you will regret it afterwards if you do!

Bottom Line: Decide what you want to do and read labels carefully.  As I mentioned before Stevia is not yet approved during pregnancy, and it’s starting to pop up in a lot of products.

Have you given up artificial sweeteners during pregnancy?

Pregnancy: Morning Joe or No?

CAFFEINE! It’s something that the majority of our population relies on for staying alert and to keep going throughout the day.  Suddenly, you find out you’re pregnant: what to do?

Most experts say that 1 cup of coffee each day is ok – but drink responsibly!

Here are the risks:

• Caffeine slightly increases your blood pressure and heart rate.
• It is a stimulant and it can cross over the placenta to the baby.
• Some studies have shown that it can increase your baby’s heart rate and affect his/her breathing patterns.
• But do these things hurt that baby?  The answer is unclear.
• Some studies have linked high caffeine consumption with: higher risk of miscarriage, low birth weight, and other problems.

Bottom line limit your caffeine consumption to 200 mg/day.

Here are some examples:

• Tall Starbucks coffee: 250 mg
• Grande Starbucks iced coffee: 190 mg
• 8 oz generic brewed coffee: 95 mg
• Grande Starbucks cappuccino: 150 mg
• Grande Starbucks Tazo Green Tea Latte: 80 mg
• 8 oz brewed black tea: 47 mg
• 12 oz Mountain Dew: 71 mg
• 12 oz Diet Coke: 47 mg
• 12 oz Pepsi: 38 mg
• 12 oz Coke: 35 mg

Skip all Energy Drinks!  These are usually loaded with caffeine.  Also be mindful of chocolate which contains caffeine.

My recommendations:

• If you can’t live without your morning cup of joe, always choose the smallest size and only have one each day!
• If you can tolerate half caf/half decaf that’s a great option too.
• For those who can try switching over to decaf.
• When it comes to tea, stick with decaf if you are drinking a cup of coffee in the morning.  If you don’t drink coffee or are drinking decaf you can have a cup of caffeinated tea but be mindful of how much you sip throughout the day.

How I’ve Handled Caffeine:

• When we first started trying to get pregnant, I decided to cut back on my caffeine consumption (we make strong french press coffee).  So I made myself half caf/half decaf.
• Once I become pregnant the half caf/half decaf made me sort of nauseous and I had no taste for coffee!  I slowly gave it up.
• Now it doesn’t make me nauseous anymore, and I really enjoy coffee so I save it for when I’m really in the mood and get a decaf misto from Starbucks (if I’m really tired sometimes I tell them to use a little caffeinated coffee with most decaf).  Or I get a decaf latte to help fulfill my calcium needs for the day.

Did you give up caffeine during your pregnancy?