The top 5 nutrients for postnatal recovery.

Within this article we are going to explore the 5 most important nutrients for mothers in the postnatal period.

Mothers who have just given birth need good nutrition to support their healing and recovery.  For breastfeeding mothers it is important to consume nutrients needed for energy levels and also to make enough calories are consumed, due to burning plenty more calories when breastfeeding. Listed below are the 5 most important nutrients to make sure you are getting enough of during postnatal recovery period, also know as ‘the fourth trimester.’

1. Iron

Iron is often low in pregnancy and post-birth it can continue due to blood loss during delivery. After birth some women may experience anaemia (low iron stores). Mothers with low iron stores during delivery and after childbirth may experience fatigue and potentially feel depressed (1).

During childbirth women can loose blood and then afterwards experience bleeding (lochia). If you're breastfeeding, your iron stores supply your baby with iron for their proper development and thyroid function. Supplementing iron and making sure to consume plenty of iron rich foods will help immensely. Foods such as red meat, poultry, fish, beans, nuts, dried fruit, dark green vegetables. WHO and the Food and Agriculture Organization of the United Nations recommended nutrient intake for iron in lactating women ranges from 10 to 30 mg per day, depending on the bioavailability of dietary iron (2).

How can you help iron to be better absorbed in your body?

• Consume vitamin C rich foods. Haem iron (animal foods) is more easily absorbed than non-haem sources (plant based foods). Consuming vitamin C rich foods such as oranges, peppers, kiwi fruit, lemon, strawberries, grapefruit, tomatoes, broccoli, cauliflower, cabbage can help non-heam sources absorb much better.

• Avoid drinking coffee and tea with meals. Coffee and tea contains polyphenols which make it harder for your body to absorb iron from food.

2. Vitamin D

Research suggests that vitamin D deficiency may lead to a higher risk of postnatal depression (PND) and mood disorders after birth. Vitamin D may play a significant role in the recovery of women with PND (3).

Vitamin D supports the immune system, brain, and reduces risk of mood disorders, depression and anxiety. The best dietary sources are egg yolks, fatty fish (tuna, salmon), liver, fortified dairy and orange juice. The NHS recommends that everyone should take a supplement in the autumn/winter months as the sun is the best and most absorbed form of vitamin D. If you're breastfeeding, you should consider taking a vitamin D supplement, containing 10mcg (4).

3. Omega 3 fatty acids - EPA & DHA

Most people in the Western world do not get enough omega-3 fatty acids in their diet, EPA & DHA. They are found in oily fish (sardines, anchovies, mackerel, salmon, herring). If you are vegan, vegetarian or dislike fish you can take an algae supplement instead, which is how the fish obtain the fatty acids - through consuming the algae.

EPA & DHA supports brain function, mood disorders, heart health and bone health. Many new mothers can experience postnatal depression and research has found that supplementing with omega-3 fatty acids rich in EPA during pregnancy or postpartum reduces some symptoms associated with depression. DHA supplementation to healthy pregnant women can also reduce the risk of PND (5). Some studies have also found that your omega 3 levels during pregnancy could be a risk factor for PND (6). Many prenatal vitamins already contain around 200-300 mg of DHA, so it's important to check this prior to adding additional omega-3 supplements. Around 450mg of EPA and DHA is approximately the equivalent of eating one or two portions of oily fish a week (7).

4. Iodine

The majority of us tend to fall short of this very important trace mineral. Iodine is an essential nutrient needed in small amounts for the body to make thyroid hormones, triiodothyronine and thyroxine. These hormones play a vital role in the early growth and development stages of most organs, especially the brain (8). Women who are pregnant or breastfeeding need extra iodine, which puts them at greater risk of deficiency. During pregnancy and postpartum, the World Health Organisation (WHO) recommends iodine intake be increased to at least 200 mg/day.

Iodine is found in seaweed (kombu, nori, arame and wakame), fish, shellfish, dairy products, eggs, beef liver, chicken, iodized table salt. People who follow a vegan diet, or those who eat minimal eggs, dairy or seafood can be more prone to deficiencies.

5. Choline

Choline is a very important and essential nutrient for memory and brain development. Choline is required to produce an important neurotransmitter acetylcholine, needed for memory, mood, muscle control and other brain and nervous system functions. The need for choline increases in pregnancy and for breastfeeding mothers. Choline, like vitamin D and docosahexaenoic acid (DHA), can be synthesized in the body but not in amounts sufficient to meet metabolic demands. Supplementing the maternal diet with additional choline has been shown to improve offspring cognition, neurodevelopment, placental functioning and to protect against neural and metabolic insults (9).

An adequate choline intake is 450 mg daily during pregnancy and 550 mg daily while breastfeeding. Breastfeeding mothers need extra choline to meet the demands of their bodies and those of their growing baby (10). The best food sources of choline are eggs, organ meats like liver, eggs, salmon, brussel sprouts, beans and lentils.

References

1. https://pubmed.ncbi.nlm.nih.gov/29363366/

2. https://www.ncbi.nlm.nih.gov/books/NBK379991/

3. https://pubmed.ncbi.nlm.nih.gov/29393662/

4. https://www.nhs.uk/start4life/baby/feeding-your-baby/breastfeeding/healthy-diet/vitamins-for-mum-and-baby/

5. https://pubmed.ncbi.nlm.nih.gov/29860183/

6. https://www.nature.com/articles/s41398-020-00886-3

7. https://www.getthedose.com/blog/omega-3-for-pregnancy

8. https://pubmed.ncbi.nlm.nih.gov/17701774/

9. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6722688/

10. https://ods.od.nih.gov/factsheets/Choline-HealthProfessional/