In my early April article entitled, "Preparing for Another Child After Postpartum Depression or Anxiety", I shared an outline on how to prepare by each phase of the conception and birth process - pre-conception, during pregnancy and postpartum. And one of the postpartum strategies I recommended was to "Eat and rest well." Then I laughed at myself, realizing I made it sound a bit too easy. "But how?!" I could hear women screaming at the article. Today's interview is the first of a 2-part response. We'll get to sleep and rest in an upcoming post.
Today, we’re excited to share a recent interview with Registered Dietitian Nutritionist, Kelsey Higgins. She has been gracious enough to share her expertise regarding how to best maintain good nutrition in the immediate postpartum period. There is an undoubtable connection between mental health and good nutrition. As a psychiatrist that tries to prevent moms from developing or relapsing with postpartum mood or anxiety disorders, I am concerned for postpartum moms when I see their nutrition falling by the wayside. So, I sought out an expert.
Kelsey Higgins is a clinical dietitian at Northeast Georgia Health Systems in Gainesville, Georgia. In that role, she manages tube feedings in the Intensive Care Unit and provides services on the Oncology unit. At Fresh Start for the Mind in Suwanee, Georgia, she treats children, adolescents and adults for weight management. She also provides eating disorder nutrition counseling and teaches behavioral interventions relevant to the connection between depression and nutrition.
Allowances and Restrictions in the Postpartum Period
For my postpartum moms, one of the first questions on my mind was whether they need to follow any particular dietary plan or restrictions.
“The priority is having a well-balanced diet. You don’t have to be vegetarian or have to restrict carbs if you’re breastfeeding – or even if you’re not breastfeeding,” Kelsey explained.
She also suggested ongoing supplements. It is recommended that new moms remain on prenatal vitamins for the first 6 to 8 weeks postpartum, then switch to a multivitamin that contains 400 to 800 micrograms (mcg) of folic acid. Continue the recommended daily allowance of folic acid throughout your childbearing years since it is important for your overall health, and the neurological development of any baby you may conceive.
To keep up Vitamin D levels, she suggests 2-3 servings of low-fat dairy, daily. “Greek yogurt, 1% or skim milk, soy or almond milk, but you want to try to get to 3 a day.”
Kelsey also recommends the “MyPlate Method” to be sure your diet is balanced. That means each plate should follow this basic set-up:
50% percent of your plate (for each meal) should be filled with fruits and vegetables
25% of your plate should be healthy grains like brown rice, sweet potatoes, or even pasta
25% of your plate should be some type of lean protein (grilled chicken, lean ground beef, or fish)
Even though carbohydrate restriction wasn’t recommended, there were some restrictions suggested.
“You still need to be limiting your mercury intake - limiting your fish intake to 12 ounces per week while you’re breastfeeding. Avoid alcohol and limit it to 1 to 2 per week…avoid it completely at least 2 hours before breastfeeding. ‘Pump and dump’ is not a thing. It’s really not about the alcohol concentration in the milk, it’s the alcohol concentration in the blood that allows it to still pass to the baby,” she advised.
Good to know, right ladies?!
Dietary Needs and Weight Loss During Breastfeeding
“If you are breastfeeding, your calorie needs are a little bit higher than they are normally to maintain your milk supply – and to maintain adequate weight, because you don’t want to lose weight too quickly, it does affect your milk supply,” Kelsey says. “If you’re eating less than 1500 to 1800 calories a day, that’s kind of a trouble zone.”
Of course, these needs are also based on age, weight and height. In general, breastfeeding moms should increase caloric intake by 400 calories per day.
Now, we know many moms want to try to get back to their “pre-baby weight” as quickly as possible, but use caution! Kelsey recommended that we shouldn’t be aiming for weight loss in the first 6 weeks postpartum. However, after that time, and once your milk supply is established, weight loss should exceed no more than 1 lb per week.
“Also, you’ve got to think about with putting out so much milk, you’ve got to watch out for dehydration,” Kelsey advises. “Always drink a cup of water every time you nurse – aim for 12 cups a day of caffeine-free fluid - like water or low-fat milk.”
How do you know if you’re getting dehydrated? Kelsey recommends that you keep an eye on the color of your urine. “Straw-colored or lighter is good, but apple juice-colored or darker means you’re in trouble.”
Don’t wait on thirst as an indicator that you need to hydrate. If you’re feeling thirsty, you’re already late! Drink up!
Practical Meal Preparation in the Postpartum Period
After giving birth, the absolute last thing most women want to do is think about making meals. To avoid a lot of work in the kitchen, it may be a good idea to do meal preparation and freeze items before baby makes their arrival. If your partner’s not the cook of the family, this may be especially helpful.
“Have a meal prep weekend a week or so before you have the baby. If you have the space, you can cook a large volume of things like ground beef, you can shred chicken breast, cook those, and then you can freeze them in Tupperware or Ziploc bags and then pull them out and use them in low-impact dishes like casseroles you just put in the oven,” Kelsey says. She also suggests crock-pot meals, “there’s millions of recipes on the internet for women who are just on a normal diet after birth.”
Kelsey also suggests that having to eat “fresh foods” is a bit of a myth. She advises that to make things practical and easy after birth, eating frozen bagged vegetables or rice that can be microwaved is completely acceptable.
Don’t forget to have snacks as well. “While you’re nursing, having one-handed foods on hand like sandwiches, a protein drink, a piece of fruit…anything you don’t need silverware for,” would be great she suggests. “If you go to fast food places, there are healthier choices.”
And what about meal-delivery services? Kelsey suggests considering Good Measure Meals – a business associated with Open Hand, which is a non-profit organization that serves our homeless and underprivileged populations. Their meals are pre-made and only have to be microwaved. These meals can be delivered all around the Greater Atlanta-area. For 7 days, at 3 meals a day, the cost is $171 for one person. The neat thing is that clients can customize the calorie intake they want for each meal, based on what they need. But the really neat thing is that their work supports the community.
Kelsey strongly recommends checking in with your local dietitian for further information. Check with your insurance company to see which provider they cover. And don’t forget the lactation consultants at the hospitals - they are a wealth of knowledge. Be careful when you do random internet searches. Going to an expert is always best. But if you do find yourself having an internet search craving, Kelsey has one final suggestion, “add the word ‘dietitian’ to your search,” to increase the likelihood of finding reliable information.
Don't forget ladies, there is no way to have good mental and neurological health without strong nutrition. Treat yourselves well!
Questions? Comments? Please share your thoughts below. If you used creative and healthy eating tips throughout your postpartum period, let us know what you did! Husbands, partners, and other supportive family/friends are welcome to share, as well! Inspire someone!
Kelsey is a Registered Dietitian Nutritionist (RDN) and Licensed Dietitian (LD) in the state of Georgia. She received her Masters in Health Sciences and supervised practice hours through the Coordinated Program in Dietetics at Georgia State University in 2015. She completed her undergraduate degree in Nutrition at Tennessee Tech University in 2013. Kelsey offers individual and group services such as nutrition counseling, nutrition education, meal planning, and more. As an RDN, she utilizes mindful and intuitive eating techniques and practices evidenced-based medical nutrition therapy by teaching clients about the role nutrition plays in managing acute and chronic illness and disease. Kelsey is eager to help clients achieve their nutrition goals and make a positive impact on their well-being.