Date 17.10.2023

An Expert Guide to the Postnatal Period

An Expert Guide to the Postnatal Period

During pregnancy, there is a huge focus on what food you should be eating, and this is often neglected in the postnatal period. Postnatal nutrition plays a large role in optimising recovery from pregnancy and childbirth, both physically and mentally. A mothers mental health is incredibly important after birth and the correct nutrients can help to support this. New mothers are often zapped of energy and need to recuperate, which is incredibly difficult when you have a newborn who is completely dependent on you. To say ‘it takes a village’ is an understatement and having help during the fourth trimester is incredibly important. 

Nourishing your body with a healthy diet during the postnatal period can help increase energy levels, have better recovery from birth, decrease risk of postnatal depression, support weight management and is especially important for breastfeeding mothers. So, what should you be eating? And how do our hormones affect our mental health after birth? 

 

Jade Ellis is a Nutritional Therapist, specifically focusing on supporting mothers in the prenatal, pregnancy and postpartum stages.

 

 

Jade see's clients in her clinic both online and in-person to support them on their journey to healthy pregnancy and beyond

 

 

 How Do Our Hormones Affect Our Mental Health Post-Birth?

Brain heath is not linear, it is something that humans have to work at throughout life. It ebbs and flows at different points; depending on stress, different situations and the pressures of daily life. Becoming a mother is the biggest change anyone can go through. It is no wonder that when combined with the trauma which can often accompany birth, women struggle throughout this time. There are many challenges that arise in the postnatal period; from lack of support, to sleep deprivation, figuring out feeding, and a change in hormones.

The emotional rollercoaster that surfaces in the postnatal period is completely normal and happens to many new mothers. There are big hormonal shifts happening in your body. After the birth of the placenta, the oestrogen and progesterone hormones, which have been high throughout pregnancy, take a huge dip. The big drop in hormones contributes to the postnatal ‘crash’ and can cause mothers to feel low and experience the ‘baby blues’ (mood swings, anxiety, sadness, irritability) which usually resolves within a week or so of giving birth. When nutrient stores are depleted during pregnancy and not adequately replenished in the postnatal period, this can be a trigger for poor functioning of many systems in the body and increase risk of mood disorders, like postnatal depression (PND). 

These feelings are completely normal and felt by many women after birth. However, this can potentially turn into PND which has similar symptoms, but takes longer to resolve and is often more intense feelings. When you have postnatal depression, you may feel increasingly depressed and low. Looking after yourself or your baby may become too much. It's important to seek help as soon as possible if you think you might be depressed, as your symptoms could last months or get worse and have a significant impact on you, your baby and your family. PND is a common problem, affecting more than 1 in every 10 women within a year of giving birth. 

There are some aspects that make us more susceptible to PND, such as genetics, previous mental illness, traumatic birth, hormonal imbalances, lack of support. Most of these things are out of our control. However, there are parts of our mental health which we can control, and a large one is the way we nourish and take care of our bodies. Nutrition can become a helping hand in the introduction to motherhood. 

What Nutrients And Foods Are Beneficial For The Postnatal Period? 

It can be difficult to eat a healthy, nutritious diet after giving birth, as new mothers may lack the energy, brain power or feel they have no time to eat nutritious foods. Sleep deprivation can often cause a craving for sugar; which may seem to help at first, but can cause further issues with energy levels, fatigue and low mood. The brain needs nutrient dense foods, which give the body the building blocks to produce neurotransmitters, as well as a sustainable source of energy. 

Research shows that a breastfeeding mother needs an extra 300-500 calories a day, from food that is rich in the right macro and micronutrients to nourish both mother and baby. Staying hydrated whilst breastfeeding is also very important, as you will notice your thirst and hunger increase. Below we will explore the key nutrients during the postnatal period for optimal recovery and mental health. Getting nutrients from food is preferred for the most health benefit, however a supplement can be a great assurance. It can be extremely helpful to work with a registered nutritionist to ensure you are getting enough calories and the correct nutrients during your healing period. 

Key Nutrients For Mental Health During The Postnatal Period

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. 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. WHO and the Food and Agriculture Organisation 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.

Iron rich foods: 

  • Red meat 
  • Poultry 
  • Fish 
  • Beans
  • Dried fruit 
  • Dark leafy green vegetables 
  • Nuts 

How Can You Help Iron To Be Better Absorbed By Your Body? 

  • 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 contain polyphenols and tannins which make it harder for your body to absorb iron from food.

Vitamin D

Research suggests that vitamin D deficiency may lead to a higher risk of PND and mood disorders after birth. Vitamin D may play a significant role in the recovery of women with PND. Vitamin D supports the immune system, brain health, and reduces risk of mood disorders, depression and anxiety. 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. 

Vitamin D rich foods: 

  • Egg yolks 
  • Cod liver oil 
  • Fatty fish (tuna, salmon, sardines, mackerel)
  • Fortified dairy and orange juice 
  • Fortified plant milks 

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. Some studies have also found that your omega 3 levels during pregnancy could be a risk factor for PND. 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. If you are breastfeeding it is best to limit oily fish to twice per week due to the mercury levels. You should avoid fish high in mercury such as tuna, swordfish and marlin. 

Omega 3 rich foods: 

  • Oily fish - sardines, anchovies, mackerel, salmon, herring. 

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. 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. People who follow a vegan diet, or those who eat minimal eggs, dairy or seafood can be more prone to deficiencies. 

Iodine rich foods: 

  • Sea weed (kombu, nori, arame, wakame)
  • Fish 
  • Shellfish 
  • Dairy 
  • Eggs 
  • Beef liver 
  • Chicken 
  • Iodized table salt

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 synthesised 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.

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. 

Choline rich foods: 

  • Eggs
  • Organ meats like liver
  • Salmon
  • Brussel sprouts
  • Beans and lentils 

B-Vitamins, including B6

If you are taking a postnatal multivitamin, it should also contain the B-complex vitamins, however, there is one specific B vitamin which is extremely important - vitamin B6. This B vitamin is a cofactor (along with magnesium) in the production of serotonin and low levels have been implicated in PND. B vitamins have shown to be important in supporting the mother in ensuring she has enough energy to meet the demands of lactation. B vitamins help energy levels and fatigue, and are co-factors for essential enzymes. They have a direct impact on your energy levels, brain function, and cell metabolism. 

B vitamin rich foods:

  • Whole-grains
  • Peas
  • Fish
  • Eggs
  • Poultry
  • Dairy
  • Leafy greens
  • Legumes
  • Avocados 

Lifestyle Tips To Support Mental Health For The Postnatal Period 

Regular Exercise - Exercise during the postnatal period has been shown to decrease the risk of  PND, reduce stress, strengthen the abdominal muscles and boost energy. It can also support weight management and increase stamina, making it easier to take care of a newborn. Going for daily walks or joining a postnatal exercise class are important as you may meet other mothers who are going through a similar experience and have additional support. When you can start exercise depends on the type of birth you have had. Many women can resume vigorous exercise (running, dancing etc) after the 6 week check for natural births, and for caesarean sections it can be more, most commonly around 10-12 weeks. However this depends on the person and will be indicated in your after birth check with a health professional. 

Support - Feeling supported can help decrease levels of stress and anxiety. Due to this, having support around you could not be more important. Seeing friends and accepting help when you need it can help with your mental load, and help you to feel more positive in the postnatal period. 

Self Care - Looking after a baby all day is mentally and physically draining. It is easy to become disconnected with the person you used to be. It is important to still enjoy the activities that you used to; for example having a warm bath, reading a book, watching your favourite TV show. These small things will make you feel like yourself again and induce your relaxation hormones and reduce cortisol, your stress hormone. 

Sleep - Albeit, very difficult when taking care of a newborn! It is important to rest when you can, or ask for help and take a nap when possible. These pockets of rest can really help mental health and feeling like you can keep going. Having a consistent bedtime routine is also helpful, as well as avoiding screens (phone, tv) for around an hour before bedtime. The blue light from screens can block our sleep hormone, melatonin. 

Nutrition - Preparing healthy meals for the freezer before you give birth is very helpful, and you will definitely thank your past self! An alternative is getting a healthy meal plan delivered, or asking family and friends to help you cook. In the newborn days finding the time to cook is difficult, so having a plan for meals for the first few weeks is a great idea. 

Hydration - During pregnancy you should aim for 2 litres of water per day. If you are breastfeeding the need for hydration increases and you should aim for around 3 litres per day. The signs of dehydration include - dry skin, muscle cramps, fatigue, headaches, dry mouth and lips, dizziness, dark urine.

The postnatal period can be incredible but also very intense and demanding. Making sure you are eating nourishing and nutrient rich foods will give you the energy you need and support recovery. This will help you to feel more like yourself again, and you will be able to focus more on the joys of being a new mother.

 

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