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Dear Doctors: I’m breastfeeding my 4-month-old son, and I’ve lost some weight. I’m naturally thin, but my sister thinks my baby is not getting the nutrients he needs. The pediatrician says my son is doing great, but I’m worried. Do I need to switch to formula?
Dear Reader: When a new mom is in good health and eating a balanced and well-rounded diet, her breast milk has everything that a baby needs to grow and thrive. Breast milk not only contains fat, protein and carbohydrates, but it provides the infant with vitamins and minerals, as well as water for hydration. It’s also a source of a range of important bioactive compounds that help to train and strengthen the baby’s developing immune system and aid in brain development. Breast milk is easily digested and absorbed, both significant factors for an infant’s brand-new digestive system. And the act of breastfeeding can be an important part of building a bond between mother and infant.
Your pediatrician says your baby is doing well and meeting the general growth guidelines for his age. That means your breast milk is doing its job. Unless your pediatrician suggests it, there’s no need to switch to formula. The recommendation from the American Academy of Pediatrics is, when possible, to exclusively breastfeed until the baby is 4 to 6 months old. At that point, switch to a mix of breastfeeding and appropriate solid foods.
When it comes to your own weight loss while breastfeeding, it’s not unusual. Women who breastfeed burn an additional 500 to 700 calories per day, which can lead to weight loss. Since you are already thin and are continuing to lose weight, be sure to adjust your diet to make up for the calories your body is using to produce milk. (When you begin to add solid foods to your son’s diet when he’s 6 months old, you can adjust your own diet to reflect the decreasing amount of breast milk that you’re producing.) Making up for the calories that you’re expending will help with your energy levels and with continued milk production.
As you focus on calorie-rich foods and meals, be sure to stay within the parameters of a healthy diet. Your baby is eating what you’re eating. Include plenty of high-quality protein, fresh fruits and vegetables, leafy greens and healthful oils. Choose high-value snacks like nuts, seeds, yogurt and nut butters. Occasional “cheats” are fine, but try not to make highly processed foods a regular part of your diet. And don’t forget to stay hydrated. If you maintain an increased caloric intake and still continue to lose weight while you’re breastfeeding, you need to check in with your obstetrician.
A new baby to care for is already a challenge. Having a family member offer opinions that adversely affect your comfort and confidence isn’t helpful. You might consider bringing your sister along to your baby’s next visit to the pediatrician. You can broach the question of your weight and the baby’s nutritional needs, and hopefully the doctor can ease both of your minds.
Eve Glazier, M.D., MBA, is an internist and associate professor of medicine at UCLA Health. Elizabeth Ko, M.D., is an internist and assistant professor of medicine at UCLA Health. Send your questions to firstname.lastname@example.org, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10880 Wilshire Blvd., Suite 1450, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.