breastfeeding / calories

[Evita]

This is a question for a friend of mine who's just about to give birth. I've breastfed my daughter for 14 months and she always asks for my 'advice' but on this one I just don't know. It's about how many extra calories you need to eat a day to successfully breast feed and do yourself no harm. I should say that she has a bit of an eating problem and is very underweight but has gone through the pregnancy relatively ok. She really wants to breastfeed but I'm a bit worried she barely eats enough to survive herself let alone feed a baby too. If she did mixed feeding would that help?

I read on a La Leche League advice board that you shouldn't have less than 1800 calories a day.

I was told 500 extra calories a day

There is no good up to date evidence on the calories needed to bf - all the decent research indicates you can bf successfully without anything extra, though if you have been seriously undernourished for a very long time (as your friend may be?) you may find bf affects you and takes more out of you...this website may help answer some questions (click on the link Maternal Nutrition) and we have discussed this several times on these boards, too.

Tiktok, the link you've mentioned argues that women who suffer from malnutrition can still b/f successfully - but as I'm lucky enough to live in the developed world, I'm curious about the other end of the equation. Does a nursing mother need to up her food intake for her own health? Especially in the early days with what seemed like endless feeding, I craved sugary food. I really felt I needed the energy hit - and I often didn't have the time between feeding/winding/nappy changing to do anything more than grab a biscuit. It's wonderful that your body still makes great milk even if you aren't taking any more calories, but does this leave you nutritionally compromised?

I have a very thin friend (no eating disorder BTW, just very skinny - 5'8" and just over nine stone when nine months pg!) who breastfed three children long term and never used a drop of formula with any of them. You may well not need any 'extra' calories at all. As Tiktok says, metabolism and breastfeeding isn't that well understood, but studies do show that generally women don't need any extra calories because their own metabolisms adjust (ie slows) while breastfeeding. Indeed good studies show that you can diet (ie normal diet, not starvation) to lose weight while breastfeeding with no problems with infant growth or maternal health. The idea that breastfeeding is this dangerous thing for your health unless you take lots of care of yourself is a myth.

The evidence is that women don't get nutritionally compromised - in fact there is evidence that breastfeeding actually helps build bone strength long term and of course, reduces the risk of breast cancer. You may fancy a biscuit but you don't 'need' it, sadly

I know the evidence is against it, but my experience isn't. I found a marked difference in ds' weight gain while I was breastfeeding if I "forced" myself to eat (it really did feel like forcing because I wasn't hungry and I'm a small eater normally) biscuits and a large lunch (roughly the 500 calories a day extra that Lisa78 mentioned). For me it made the difference between success and failure in breastfeeding.

Perhaps I'm just weird.

GeorginaA, I don't doubt your experience but a study with a sample of one person only doesn't show anything

The studies that have been done in developed countries show that eating less does not affect the weight gain of the baby. The studies done to look at the opposite - whether feeding the mother more makes a difference in the baby's weight gain - have been done in the developing world (though I can't see why this would make a difference) and again there was no difference in the babies' weights.

Of course, like any study, individual responses will vary, but by looking at large numbers, you can decide whether it is cause and effect, or just chance that weight appeared to differ when the mother's diet changed.

The experience of being hungrier when in the early weeks of bf is very common, though the hunger tends to come in pangs (like suddenly being thirsty which is also common in the early weeks of bf). So many women report this, though I don't know if it has been studied and recorded. It may be nothing to do with bf, but to do with the extra energy needed in being a mother.

There is no evidence that an extra amount of food is needed routinely, either to protect the mother's health or to protect bf.

Oh I don't doubt I'm just weird, tiktok I like to mention it though as something people can try if they find they're struggling. Whether it's received wisdom or not, I was so grateful to the midwife who suggested it to me at the time when I really thought I was going to have to supplement.

Thanks for all these responses. I'll pass the information onto my friend who knows I'm asking here for her by the way.

I think I'm more worried about her health than the babies. I'm sure women can breast feed pretty well even at a low physical ebb. I had a dire stomach bug for 3 weeks when my daughter was 6 months old and barely ate or drank a thing but her feeding was fine. I, however, felt absolutely exhausted. Is there any hard evidence that it can seriously damage a breastfeeding mother? My friend's eating problem has been serious enough in the past to see her in hospital for it and she's struggled through pregnancy barely eating more than she does normally which is shockingly little. She knows all this and is desperate to do the best thing for her baby but also really struggles with her own problems. She's on her own and I really worry for her.

The bottom line is that breastfeeding won't harm her at all. Many studies show metabolism appears to slow anyway so the body doesn't use more calories than before. But I think she will need support after the baby arrives - does she get any?

She does see a councillor regularly, every week I think. But you know what it's like when you've got a new baby for the first time, especially if you're in a flat on your own.

When I was first breast feeding, weight fell off me no matter how much I ate. I've never been particularly heavy anyway but it was a shock. In my friend's case, if weight falls off, there'll be nothing left! Also she had some problems with her heart at one point due to emaciation. Oh, it's all worrying when I think about it. On the other hand she can be remarkably tough.

Just bringing this to the top again in case anyone else has any suggestions. Am getting really worried now, my friend's just given birth 2 weeks early and has started breast feeding but has a bad anaemia and is being kept in hospital. I hope someone there can advise her as to diet etc. but just in case anyone else knows anything, thought I'd post this again.

Evita, if your friend is chronically badly nourished and underfed with long-term untreated anaemia then she may have difficulty breastfeeding solely for the recommended 6 mths, and because her own nutrition is so far out on the end of the spectrum she may also find her own health is affected - but the answer is not to stop bf (unless she wants to) but to address these underlying issues. The anaemia will no doubt be addressed in hospital and the desire to do the best for her baby may be a turning point in getting the right help for other diet-related problems.

Oh dear. I've been eating like a horse since dd born, all with the excuse that dd needs a well nourished mother (not sure whether doughnuts count, though.
Still, I did use the "eating for 10" excuse when pregnant. Any excuse....
Lost 2 and a half stone in about 3 weeks immediately after the birth. But then was huge and for some reason completely lost appetite in the early weeks of motherhood.

I lost a lot of weight after my daughter was born and during breast feeding but I did eat a bit more than normal too.

Tiktok, thanks for your advice. I'd really love to think this could be a turning point for my friend, but I also hoped the pregnancy would be too and it hasn't, not really. Actually what I'd really like to know is how will her body be affected if she fully breast feeds? Is her heart going to keep up with it? In terms of the hospital care, I'm actually amazed how little interest they're taking in her general health. They're sending her home today or tomorrow as her anaemia's much better but it seems obvious to me that she should receive some more advice and councilling. There just doesn't seem to be anyone around to help her.

Tiktok, I hear what you say re research, but I nearly fainted a few times when ds newborn after feeding him without eating anything first/during - maybe only affects people prone to fainting when blood sugar low? Happened once or twice when pregnant too. But frightened me as not good when on your own with baby. Have to say am now sick of biscuits though (easy to grab when ds yelling for feed).

Evansmum, I believe you!! Mums who are diabetic do need to take care when bf because of the effect on sugar levels, so it would make sense for someone with your condition to be affected too.

This isn't the same as overall nutritional status, though, which is only affected adversely if it is already severely compromised (like Evita's friend).