Nutrition and Breastfeeding Articles

​Dairy products contain 10 essential nutrients; calcium, potassium, phosphorus, magnesium, carbohydrate, protein, vitamin A, riboflavin, vitamin B12 and zinc, important for healthy immune and blood systems, eyesight, muscle and nerve function, healthy bones, skin, energy, growth and repair of your body. If your child cannot have dairy, whether it be due to an allergy, intolerance or dislike, it is important to find alternatives that provide these nutrients.
 
Soy milk has the most similar nutritional profile to cow’s milk and is considered the best choice if your child cannot have dairy, unless they have a soy allergy. Soy milk is also high in protein. Look for soy milks with added calcium, Vitamin A, B1, B2, and B12. When opting for a milk alternative, always look for brands that contain 120mg/100mL of calcium.
 
If your child cannot have dairy and soy, other options are:
-        Oat; contains protein, fibre and is high in carbohydrates. Choose those fortified with calcium.
-        Almond milk; low in protein and carbohydrates. Again choose unsweetened brands with added calcium.
-        Coconut: High in saturated fat, and low in most nutrients e.g. protein, carbohydrates, vitamins and minerals.
-        Check out our article comparing plant vs dairy milks: https://www.nicolebando.com/articles/which-milk-a-review-of-plant-vs-dairy-milks
 
For dairy-free brands, see our article; https://www.nicolebando.com/articles/dairy-free-andor-soy-free-foods-supermarket-brands-to-look-for.
See here for information on how much dairy kids need.
 
Full cream or low fat milk?
The latest evidence suggests that full cream milk is recommended from the age of 12 months onwards, even into your adult years, unless you have high cholesterol, and then reduced fat is recommended.
 
Infants (0-12 months of age) should only be given breastmilk or infant formula. Cow’s milk as a drink is not suitable for infants under 12 months of age. Cow’s milk may be consumed as part of a meal, e.g. in cereal. 

By Emma McShane, Dietitian, November 2022 (Edited by Nicole Bando, APD, IBCLC)

By Emma McShane & Nicole Bando 

Nutrition whilst breastfeeding is vital to optimise the health of both mother and baby. New motherhood is a very busy time, and many women put their own health last.  A woman’s remarkable body will produce the live, biodynamic, complete food that is breastmilk that evolves with her baby’s growing needs. Milk production is robust and will only be affected in very extreme circumstances. The average woman produces 750mls of breastmilk per day, from 1-6 months. Fat stores accumulated during pregnancy are used to fuel milk production when baby arrives, though this does not cover all of the energy needed to produce breastmilk. Some elements of breastmilk are impacted by a woman’s diet and those that follow a vegetarian or vegan diet, are at greater risk of vitamin and mineral deficiencies.
 
DID YOU KNOW?

• Adequate nutrition can help with coping with a new baby and the adjustment to motherhood, mood, and energy levels. Restrictive eating during breastfeeding can impact mood, milk supply, overall coping, and bone health.

• Certain nutrients in breastmilk, such as lactose and protein are fairly constant, however the fat content of breastmilk changes according to how empty the breast is. The types of fatty acids and quantities of iodine and Vitamin B12 are also affected by the mother’s diet.

• A mother’s varied diet exposes baby to different flavours and tastes, which will help baby to accept a wider range of solid foods, including fruit and vegetables.

• Regular nutritious meals and snacks are important to nourish both mother, and baby. There is no need to aim for dietary perfection.

 
ENERGY:
An extra 2000kJ per day is needed for a breastfeeding mother, though this can change depending on individual needs. This is equivalent to a serving of spaghetti Bolognese with cheese (1 cup pasta and ½ cup sauce), or a bowl of porridge with apple, yoghurt, and nuts (½ cup uncooked oats, made with 1 cup of milk, 1 apple and a handful of nuts) or a combination of snacks throughout the day, such as yoghurt (¾ cup), popcorn (small packet/1 cup), crumpets, and peanut butter (1 crumpet with 1 tb of nut butter). Studies show that not eating enough can directly impact milk supply and composition, so a wholesome diet is vital to fuel both mother and baby.
 
FLUID:
Breastmilk production requires fluid, so a breastfeeding woman requires more fluid than usual. The amount depends on various factors such as weather conditions, activity levels, and the food eaten. Be guided by your body, and ensure you’re drinking water consistently throughout the day.
 
CAFFEINE:
Caffeine transfers directly into breastmilk, so avoid large quantities of caffeinated drinks when breastfeeding. 1% of caffeine enters breastmilk and peaks an hour after consumption. A newborn baby can take up to 160 hours to process caffeine, however by 6 months that drops to 2-3 hours, so an older baby is able to better tolerate caffeine. A morning latte or a few cups of tea across the day might not cause any issue, but observe baby; a mother may consider changing to a decaffeinated tea or coffee if she notices that her baby is very wakeful after her morning coffee. A moderate amount of caffeine a day, such as two cups of coffee (latte or espresso), three cups of instant coffee or four cups of tea is usually fine. Remember that sources of caffeine include: cola, chocolate, tea, guarana, and energy drinks.
 
Caffeine can also affect the let-down (the milk ejection reflex) and worsen nipple vasospasm (occurs when blood vessels tighten and spasm, causing nipple pain).
 
ALCOHOL
The safest option while pregnant and breastfeeding is to avoid alcohol altogether, as it can reduce breastmilk production and impact baby’s growth and development. Alcohol is present in breastmilk in the same levels as the bloodstream and it takes approximately 2-3 hours for the mother’s body to clear the alcohol in one standard drink. This time increases with each drink consumed. So if choosing to consume alcohol, wait around 2 hours before breastfeeding. Any milk expressed before the 2-hour window will need to be discarded, as it is not safe for the baby to consume. If there are times where a mother plans on drinking more than one standard alcoholic drink, plan ahead and express some breast milk beforehand to feed baby during this time. Below are two links to resources for further information:

• NHMRC Infant Feeding Guidelines
• Feed Safe App

MIXED FEEDING:
Any amount of breastfeeding increases a woman’s dietary requirements, however given the wide variation in breast milk production when mixed feeding, it can be difficult to estimate. A woman should use her appetite as a guide and may require additional foods from the core groups. A dietitian can help to guide this.

DO CERTAIN FOODS INCREASE BREASTMILK PRODUCTION?
Oats: Many women wonder if oats or lactation cookies help with milk supply, however, there is no clear evidence to support this.
Fenugreek: There is poor quality and limited evidence to suggest that fenugreek increases milk supply.
Breastfeeding with good attachment, flexibly and frequently is the best way to protect milk supply.

IMPORTANT NUTRIENTS:

As part of planning for a glowing pregnancy, have you considered your diet? It's true that supplementation with key nutrients is important, but a nutritionally complete diet during pregnancy and breastfeeding helps to lay the vital foundations for a healthy mother, foetus and eventually, a thriving family. This is important to reduce the risks of chronic disease later in life, in both the mother and child.

New research is emerging that nutrition plays an important role in the pre- conception period and can also affect fertility. Despite having more information at our fingertips than ever before, as a population our diet has never been worse. We are constantly bombarded with myriad information about nutrition and it is little wonder that we are confused about what to eat.

The latest data from the Australian Health Survey shows that less than 7% of Australians are eating enough vegetables and that a significant portion of our daily calories (35%) comes from discretionary items. These are foods that are not essential to a healthy diet and are high in refined sugar, fat and alcohol. Yet, we have heard the argument that the Australian Dietary Guidelines (ADG’s) don’t work, and this is simply because we are not following them. The ADG’s aren’t designed to be a ‘one-size-fits-all’ approach. They are evidence-based and provide us with a brilliant framework for living a healthy lifestyle without the merry-go-round of fad diets, or the latest buzz in superfoods. Perhaps they just need to sound a little more glamorous.

All foods are fabulous in their own right and there are many ways that the guidelines can be tailored by a dietitian to fit in with a range of lifestyles, cultures, taste preferences and life stages to suit the individual; sounds a little bespoke, doesn’t it?
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Boosting vegetable intake by 1-2 serves (half to one cup) per day has many health benefits and can be done relatively easily. For example: 

• Add canned legumes to salads, soups and slow-cooked meals during winter. Legumes are super food powerhouses, replete with fibre, iron and protein. They are low in fat, have a low glycaemic index and on top of these great benefits, are cheap.
• Try one new recipe a week and add in an extra vegetable that isn’t on the list of ingredients. 
• Snack on cut-up vegetables and dips such as hummus or tzatziki (food safety is an important consideration in pregnancy, avoid dips containing raw egg). 
• Try avocado with tomato on wholegrain toast for breakfast, for a brilliant source of mono- unsaturated fatty acids, lycopene, vitamin C, fibre and beta-carotene. Boost iron and folate with a scattering of basil leaves. 
• Add a handful of spinach or rocket to any meal for a boost of folate, iron, vitamin C and fibre 
• Avoid pre-cut vegetables and ensure all fresh produce is washed to avoid listeriosis

To plan for a healthy pregnancy and make sense of the nutrition information, come and visit me at NEST Elsternwick for personalised advice on how to make the best start for you and your family.

​Happy Winter everyone...with June 1st upon us, what do you need to know about oats – steel cut vs rolled vs instant or quick? All oats have the same nutritional profile, they are rich in fibre, beta-glucan (helps to keep cholesterol in check). They are often marketed to increase breast milk supply, however there is no evidence to support this claim, though oats are a great source of energy for breastfeeding women, therefore great to include as part of a balanced diet.

1. Steel cut oats are the least processed, they are unrolled then cut into pieces, they take the longest to cook; 20 minutes once simmering. Fashionable in recent years, there is negligible difference to rolled oats nutritionally, though they cost a lot more. They have a slightly lower glycaemic index than rolled oats.
2. Rolled oats have been steamed, rolled and dried. They take approximately 5 minutes to cook once bought to a simmer. They have a low glycaemic index, so will keep you full longer.
3. Quick oats have been rolled, steamed and ground into smaller pieces. They have just as much nutrition as their less processed relatives, but your digestive system doesn’t have to work as hard; so they may not keep you feeling as full for as long, meaning the glycaemic index is higher.
4. Instant oats: another step along the processing chain, these have been cut further and have additives, such as sugar, emulsifiers, milk products and sweeteners. They are lower in fibre and higher in sugar.

The bottom line? If choosing microwave oats, opt for a plain or high fibre option (e.g. Uncle Toby’s Original sachets, Carman’s Natural 5 Grain & Super Seed ). Steel oats are of negligible added benefit, so my advice is if you have time, choose plain rolled oats. Whichever oats you choose, add your own toppings such as fruit, yoghurt, nuts and seeds to sustain you for longer.