Kara Kaikini of Freeport is a lactation consultant. In addition, she is the OB Parent Education Program coordinator and breastfeeding support group facilitator at Maine Medical Center. She’s also the new mom of 3-month old Bode.
I caught up with Kara during the holidays to talk about what to eat while breastfeeding. I found her to be a font of practical wisdom on the topic of nursing your newborn.
Q: Things have changed a lot since I nursed my son 23 years ago. What is the most important thing for new moms to be aware of in terms of nutrition while nursing?
A: Try not to get too caught up in the “shoulds” or “should-nots” (there aren’t many) and just eat a healthy, varied diet. Fruits, vegetables, whole grains, omega 3’s, protein, complex carbs, and water are sufficient to meet most mothers’ and babies’ needs while nursing. If mom has special dietary needs (vegetarian, nursing multiples, etc.), she should discuss any extra considerations with her health care provider. In addition to staying in touch with knowledgeable resources (like a lactation consultant, your obstetrician or midwife) when questions arise, take care of yourself first and your baby will thrive.
Q: Are there certain foods new moms should avoid? For instance, I know that babies can’t have honey, but can nursing moms?
A: Yes, nursing moms can have honey. Botulism spores are killed in the mom’s digestive tract and don’t make it into her blood or milk. There are lots of old wives tales out there, but there is no list of foods that every nursing mother should avoid. New moms should continue to eat like they normally do. There is no scientific evidence that says spicy foods or foods that are likely to cause gas in mom (i.e., broccoli, cauliflower) will cause babies to be gassy, too. However, a small percentage of babies may show signs of an allergy to something in mom’s milk (blood or mucous in stools, inconsolable, rash, etc.), at which point mom may consider keeping a daily diary of her food intake and baby’s reactions. The most likely culprit would be cow’s milk proteins, but other common food allergens are peanuts, soy, wheat, corn and eggs. Some lists also include chocolate, citrus and tree nuts. It is important to remember that this is very uncommon and that most nursing moms and their babies don’t need to avoid anything in their diet.
Q: Are there certain foods that aid in lactation, either in the production of milk or in the letdown process?
A: Oatmeal has long been recommended for increasing milk production, though there is little scientific evidence to support it. At least it’s a nutritious food for mom, even if it doesn’t affect her milk supply.
Q: It seems that food sensitivities among children have skyrocketed. Is there anything a nursing mom can do to safeguard her infant against any particular food sensitivities?
A: They really have! I look forward to the day when we have more research on the topic of food sensitivities and allergies in children. Current research doesn’t suggest a benefit to nursing mothers from avoiding possible allergens, (unless either parent has a history of food allergies, in which case she’d want to keep this in mind), but keeping everything in moderation is always good advice.
Q: An old wives’ tale says that having a beer or a glass of wine aids in milk production? But is this really a good idea?
A: Everything a mother consumes passes into her blood through her digestive tract and therefore into her breast milk, including alcohol. The amount that passes is small, but it is still wise to limit alcohol consumption. It used to be recommended to “pump and dump” breast milk after consuming alcohol, but that was when it was believed that the alcohol got trapped in the breast milk. Now we understand that once the alcohol is out of mom’s blood, it is out of mom’s milk. So, mom is usually safe nursing baby, then having a drink (preferably with a meal), and is able to nurse again by the time baby is hungry next. Of course, there are several other considerations to keep in mind, including any medications mom is on, how much food she has consumed that day, health status of baby, etc. As far as alcohol helping with milk production, research actually has shown that alcohol can inhibit the “let down” reflex and that the baby actually takes in less milk the more alcohol the mother consumes.
Q: Should caffeine be avoided?
A: Moderate maternal caffeine consumption isn’t a problem for most babies. Some mothers report an increase in their baby’s fussiness after just one cup of coffee and some report it after seven cups of coffee, so it is important for mothers to monitor their own baby to determine how much caffeine they can comfortably consume.
Q: When I was nursing 20 years ago, the organic food movement was just blossoming. (Meryl Streep was up in arms about the pesticides in kids’ apple juice). So what’s the current thinking? Are pesticides in fish and on fruits/vegetables something new moms should be concerned about?
A: Mercury levels in fish is still a concern for nursing mothers, so avoiding fish like swordfish, shark, king mackerel and tilefish is a good idea. Pesticides and other pollutants can be found in human milk, so it is wise to choose organic produce options whenever possible. This can be concerning for some mothers, so it is important to remember that breastmilk is still superior to infant formula, which also contains pollutants and toxins.
Q: Do nursing moms need more calories? Should they be eating as if they were training for a marathon (lots of protein, balanced by good carbs)?
A: A nursing mom doesn’t need too many more calories than what she consumed pre-pregnancy. An extra 300-500 calories than what she consumed before pregnancy should be plenty. Listening to her own appetite is probably the easiest way to ensure she gets enough calories and remembering that the overall number of calories she needs also depends on how many calories she is burning each day, too. No special diet is necessary. A well-balanced diet, including plenty of water to match her thirst, is just right. If mother isn’t getting enough calories, her breastmilk and baby won’t suffer, but she may.
Q: Lastly, do you have a quick/easy recipe that you used while nursing and would be willing to share?
A: In the first week or so after I had my baby, I enjoyed a smoothie every day. This was one recipe that was extra delicious:
1?2 cup milk
1?2 cup yogurt (regular or frozen)
1?2 cup strawberries
1?2 cup blueberries
2 tablespoon peanut butter or almond butter
2 tablespoon flax seed (a great source of omega 3’s)
Happy New Year to all, but especially to new moms in 2012!