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BALANCING ACT:

Nutrition & Elimination

ELIMINATING FOR TWO

Many breastfeeding moms experiencing infant food allergy symptoms will begin systematically removing foods from their diet.  While navigating elimination diets, a common question that pops up is whether this will impact the nutrient density of breast milk as well as what this means for mom’s health.  Here, we dig into nutrient deficiencies seen during elimination diets and what that means for baby and mom. 

 

Changes Over Time

 

It is important to note that mother’s milk is a complex fluid that consists of almost 200 recognized constituents which are continuously changing based on baby’s needs [1]. Composition of milk changes from beginning of the feed to the end, diurnally, and with progression of lactation.  Most remarkable of this change in composition is seen in the first week of lactation as mom transitions from yellow colostrum, high in carotenoids, β-carotene, and lutein, to traditional milk [2].  Baby’s phase of development as well as mom’s nutrient intake, creates an ever-changing super-food. 

 

Calories

 

To ensure proper infant nutrition, the child must receive ample milk volume.  Think of it like your own diet: eating only one bite of an apple gives you much fewer nutrients than if you ate the entire thing.  Milk production is dependent on lactation performance as well as maternal calorie intake [1].  A well-nourished lactating mother needs an increased daily energy intake of ~500 kcal [3].  During elimination diets, mommies should focus on calorie-dense safe foods to support lactation.  Tracking calories can be a vital tool to ensure mom is consuming enough to support lactation. 

 

Nutrients

 

Interestingly, major ingredients of mother’s milk like calcium have been reported to be unaffected by the mother’s diet [4].  This means that if mom’s diet is lacking in specific nutrients that her body will pull it from her reserves in order to feed baby.  In the case of calcium, the typical daily loss through breast milk is 200-400mg.  If this demand is not met, the body will demineralize the maternal skeleton to make nutritionally complete breast milk [4].  In other words: your body sacrifices itself to best feed your infant.  Takes “sucking the life out of you” to a new level.  Alternative calcium sources include green leafy vegetables, sardines, fortified orange juice, chia seeds, and rhubarb.

 

Conversely, concentrations of fatty acids, fat-soluble and water-soluble vitamins are impacted by maternal diet.  More specifically, maternal intake of B vitamins (except folate), vitamin A, selenium, and iodine strongly affects breast milk concentrations [5].  Below are natural, top 12 infant food intolerance free ways mom can boost her intake of these nutrients.

 

B Vitamins: Millet, fish, seeds, avocado, banana, citrus, broccoli, spinach, oysters, clams, nutritional yeast, pork

 

Vitamin A: Carrots, fish, butternut squash, sweet potato, spinach, cantaloupe, red bell pepper, pink grapefruit, broccoli

 

Iodine: Seaweed, fish, oysters, shrimp, prunes, scallops, banana, strawberries, leafy vegetables, sweet potato

 

Supplementation

 

The amount of nutrient absorbed by the infant is further influenced by the “bioavailability” of that nutrient.  Bioavailability is the ability for a nutrient, vitamin, mineral, or similar to reach the circulatory system where the body can effectively utilize that molecule.  Nutrients found in breastmilk have an extremely high bioavailability rate [6].  Supplemental foods given to breastfed infants are shown to impact total nutrients absorbed.  For instance, infants consuming foods such as formulas or cereals generally decrease their intake of mother’s milk and thus decrease their nutrient and other specialized components intake because formula and cereal has less bioavailability [7].  Thus, the intake of supplementary foods adds nutrients in a less bioavailable form, decreasing the bioavailability of nutrients from the mother’s milk, and hence decreasing the intake of important factors from the mother’s milk [8].

 

Takeaways

 

Elimination diet mamas have to be cognizant of their calorie and nutrient intake.  By filling their plates with nutrient rich and calorie dense foods, they can effectively reduce deficiencies that will impact their production rates and nutritional value of their breast milk as well as their own bodies.  Healthy nutrient intake can be found and maintained through an elimination diet.  Schedule a one on one consult to develop an elimination and reintroduction strategy that fits your life and journey. 

Co-authored by: Neha Misra, Ph.D. & Trill Paullin, Ph.D.

 

References

  1. Eriksen, Kamilla G., et al. "Human milk composition and infant growth." Current opinion in clinical nutrition and metabolic care 21.3 (2018): 200-206.

  2. Sinanoglou, Vassilia J., et al. "Factors affecting human colostrum fatty acid profile: A case study." PLoS One 12.4 (2017): e0175817.

  3. Blincoe, Alana Juman. "The health benefits of breastfeeding for mothers." British Journal of Midwifery 13.6 (2005): 398-401.

  4. Kovacs, Christopher S. "Calcium and bone metabolism in pregnancy and lactation." The Journal of Clinical Endocrinology & Metabolism 86.6 (2001): 2344-2348.

  5. Allen, Lindsay H. "Multiple micronutrients in pregnancy and lactation: an overview." The American journal of clinical nutrition 81.5 (2005): 1206S-1212S.

  6. Zhu, Jing, and Kelly A. Dingess. "The functional power of the human milk proteome." Nutrients 11.8 (2019): 1834.

  7. Fairweather-Tait, Susan J., and Birgit Teucher. "Iron and calcium bioavailability of fortified foods and dietary supplements." Nutrition reviews 60.11 (2002): 360-367.

  8. Martin, Camilia R., Pei-Ra Ling, and George L. Blackburn. "Review of infant feeding: key features of breast milk and infant formula." Nutrients 8.5 (2016): 279.

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