Dietary Changes (with the link to our NEW lactation calorie counter!)
Weight Loss Medications and Breastfeeding
Dietary Changes
Increase Whole Foods: Focus on a diet rich in whole foods like fruits, vegetables, lean proteins/ plant proteins, whole grains, and healthy fats (unsaturated plant oils). These foods are nutritious and can help you feel full longer. Companies that promote cleanses, weight loss shakes, supplements, severe caloric restriction, etc. are not regulated by the FDA and are generally not recommended due to the variable added ingredients. Many products available are aimed to make weight loss seem simple and fast, but are not always healthy nor are they necessary.
Stay Hydrated: In addition to supporting the fluid needs during lactation, staying hydrated can also help with weight loss. Replacing high-calorie drinks like soda, juice, or sweetened coffee with water reduces overall liquid calorie intake. Additionally, drinking water before meals can decrease appetite, potentially leading to reduced calorie intake. These small changes can contribute to weight loss, especially if you don't compensate by eating more calories elsewhere.
Moderate Calorie Reduction: It is important to consume enough calories to maintain your milk supply and energy levels. For breastfeeding, an average of 250-500 extra calories needs to be added to your basal metabolic rate when determining a daily caloric goal. The basal metabolic rate is the amount of energy expended per day for basic bodily functions (like your heart beating and digestion). Activity level is also a factor in determining what your daily caloric goal should be. The IRC team could not find a calorie calculator that considered the calories your body burns to make milk that is specific to infant age and milk production…so we made our own!
Free apps available for tracking calories include, nutritionix, MyFitnessPal, and Lose It! – With all of these apps, you will be able to customize your specific caloric goals based on your energy from the InfantRisk Calorie Calculator for breastfeeding moms.
Frequent, Smaller Meals: Eating smaller, balanced meals more frequently throughout the day can help maintain energy levels and prevent overeating.
Limit Processed Foods and Sugars: Reduce the intake of ultra-processed foods, sugary snacks, and beverages. These are high in added sugars, sodium, and fat, and are less satisfying. They can contribute to weight gain and provide less nutritional value.
Include Fiber-Rich Foods: Foods that are high in fiber, like fruits, vegetables, legumes (beans), and whole grains, can help you feel full and satisfied. These foods are also good for healthy intestinal flora, and have been shown to improve mental and overall health.
Incorporate Healthy Fats: Include sources of healthy fats like avocados, nuts, seeds, and olive oil. These are essential for your health and can be beneficial for weight loss when consumed in moderation.
Consult a Professional: It's advisable to consult with a healthcare provider or a registered dietitian before starting any weight loss plan, especially while breastfeeding. Many health insurance plans include nutrition consults (sometimes at no cost)! Look at your benefits to see if that is an option for you.
Remember to drink plenty of water throughout the day and adjust portion sizes as needed to meet your specific caloric needs and hunger levels.
Exercise
Considerations: Some women find that exercising immediately after breastfeeding or pumping is more comfortable, as breasts are less full. A supportive bra is essential to be comfortable, especially if your breasts are fuller due to breastfeeding. Bras that are too tight can contribute to mastitis or clogged ducts.
Start Slowly: If you're new to exercise or resuming postpartum, begin with low-impact activities like walking or gentle yoga when you feel ready. Moderate and intense exercises should never be started until you are cleared by your OBGYN. This typically occurs around 6-12 weeks after delivery, depending on your recovery. Walking 10,000 steps per day has been shown to aid in weight loss. This can be enhanced if 3,500 of those steps are done with moderate intensity. Start with a small goal and gradually increase as your time and energy allow. Along with moderate cardio activities, including strength training can increase muscle mass, which can boost metabolism and aid in weight loss. Aim to work up to 150 minutes of moderate-intensity aerobic activity per week, as recommended by the CDC. Keep in mind that every activity counts! You don't have to spend hours at the gym to make progress. Simply increasing your physical activity will result in greater caloric burn (dance parties in the living room, stroller walks to the park, bike rides, swimming, hiking, etc. Keep it simple and FUN!)
Include Pelvic Floor Exercises: It is important to strengthen the pelvic floor muscles after pregnancy. If you have incontinence, low back pain, pelvic pain, or bulging/coning in your abdomen, it is advised that you see a pelvic floor physical therapist before starting any exercise program. There are many free exercise plans for postpartum mothers available aimed to help with pelvic floor and diastasis recti after childbirth.
Weight Loss Medications and Breastfeeding:
Oral weight loss medications are generally not compatible with breastfeeding due to the likelihood that some will enter milk and cause appetite suppression in infants along with other possible side effects depending on the medication. There is a lot of hype right now about injectable GLP1 drugs for weight loss (Wegovy, Ozempic and Mounjaro, etc.) that are gaining attention in the breastfeeding population. The InfantRisk Center is currently studying these medications in breast milk to determine their safety. While we do not believe that these medications will enter the milk, we do have concerns about their use in lactation. These medications work by decreasing appetite and slowing down the digestion process. Patients that use these medications typically experience nausea, vomiting, and diarrhea which could lead to dehydration and decreased milk supply in lactating women. Due to decreased appetite, a caloric deficit is achieved resulting in weight loss. If a mother is exclusively breastfeeding, there is concern that breast milk produced while taking these medications could be less nutrient dense which could negatively impact infant growth. This is problematic in the first year postpartum while breastfeeding. After one year of age, and assuming your baby is getting nutrition for other sources, the risk is lower. If you are using one of these medications, we highly recommend that you take a high-quality prenatal vitamin. This website can help you determine your individual daily vitamin needs.
We encourage you to embrace self-compassion during the postpartum period and prioritize the health of both you and your baby. Your body has accomplished a wonderful miracle and merits nurturing and respect.
Meal ideas:
Sample Regular Meal Plan (2000 calories):
Breakfast: Oatmeal (1 cup cooked) with 1/2 banana and a handful of almonds (1 oz) - 350 calories
Morning Snack: Greek yogurt (1 cup, non-fat) with honey (1 tbsp) - 150 calories
Lunch: Grilled chicken salad with mixed greens, cherry tomatoes, cucumber, and balsamic vinaigrette (2 tbsp) - 350 calories
Afternoon Snack: Apple slices (1 medium apple) with peanut butter (2 tbsp) - 250 calories
Dinner: Baked salmon (5 oz) with quinoa (3/4 cup cooked) and steamed broccoli (1 cup) - 500 calories
Evening Snack: Whole grain crackers (1 oz) with cheese (1.5 oz) - 250 calories
Sample Vegan Meal Plan (2000 calories):
Breakfast: Vegan smoothie: 1 banana, 1/2 cup of mixed berries, 1 tablespoon of chia seeds, 1 cup of spinach, and 1 cup of almond milk - 300 calories
Morning Snack: 1 medium apple and 2 tablespoons of almond butter - 250 calories
Lunch: Quinoa salad: 1 cup of cooked quinoa, 1/2 cup of black beans, 1/2 cup of diced tomatoes, 1/2 cup of corn, and 2 tablespoons of avocado dressing - 400 calories
Afternoon Snack: Hummus (1/4 cup) with carrot and cucumber sticks (1 cup) - 150 calories
Dinner: Stir-fry: 1.5 cups of cooked brown rice, 1 cup of mixed vegetables (bell peppers, broccoli, carrots), and tofu (6 oz) cooked in 1 tablespoon of olive oil and soy sauce - 600 calories
Evening Snack: Trail mix with nuts, seeds, and dried fruits - 300 calories
Sample Dairy and Gluten-Free Meal Plan (2000 calories):
Breakfast: Scrambled eggs (3) with spinach (1 cup) and bell peppers (1/2 cup) cooked in olive oil (1 tsp) - 300 calories
Morning Snack: Banana (1 medium) with almond butter (1.5 tbsp) - 225 calories
Lunch: Grilled chicken salad with mixed greens (2 cups), cherry tomatoes (1/2 cup), cucumber (1/2 cup), and balsamic vinaigrette (2 tbsp) - 350 calories
Afternoon Snack: Carrot sticks (1 cup) with hummus (3 tbsp) - 150 calories
Dinner: Baked salmon (5 oz) with quinoa (3/4 cup cooked) and steamed asparagus (1 cup) - 500 calories
Evening Snack: Rice cakes (2) with avocado (1/2) and a sprinkle of sea salt - 200 calories
Healthy snack ideas:
For a mom on the go, it's important to have nutrient-dense snacks that are easy to prepare and convenient to carry. An overall good practice when choosing pre-packaged snacks is to check the labels for added sugars. The smaller the number in the added sugar section, the better!
Here are some healthy snack ideas:
Fruit and Nut Butter: Apple slices or banana with a tablespoon of almond or peanut butter for a mix of healthy fats, protein, and fiber.
Trail Mix: A homemade mix of nuts, seeds, and dried fruits such as almonds, walnuts, pumpkin seeds, and raisins for a quick energy boost.
Veggie Sticks with Hummus: Carrot, cucumber, or bell pepper sticks with a small container of hummus for a crunchy snack with protein and fiber.
Boiled Eggs: Hard-boiled eggs are a convenient and portable source of high-quality protein and vitamins.
Energy Bites: Homemade energy bites made with oats, nut butter, honey, and flaxseeds for a balanced snack with healthy fats, protein, and fiber.
Cheese Sticks: Individually wrapped cheese sticks or small portions of cheese for a calcium-rich snack with protein.
Smoothie: A small smoothie made with fruits, spinach, and almond milk for a nutrient-packed snack on the go.
Protein Bars: Look for bars with minimal added sugars and a good balance of protein, fiber, and healthy fats. Brands like RXBAR, Larabar, and KIND have options that use whole food ingredients.
Roasted Chickpea Snacks: Brands like Biena and The Good Bean offer prepackaged roasted chickpeas in various flavors, providing a crunchy, protein-rich snack. You can also roast your own!
Popcorn: Single-serving bags of air-popped popcorn can be a satisfying, whole-grain snack. Look for options with minimal added ingredients.
Dried Fruit Packs: Individual packs of dried fruit like raisins, apricots, or apple rings can be a good source of fiber and energy. Just be mindful of portion sizes, as dried fruit is higher in sugar.
Vegetable Chips: Prepackaged veggie chips made from kale, sweet potatoes, or beets can be a convenient way to get some extra veggies in.
Rice Cake Packs: Mini rice cakes or rice cake thins can be a light, crunchy snack. Pair with a nut butter pack for added protein.
Nichole Campbell, MSN, APRN, NP-C
Kaytlin Krutsch, PharmD, BCPS
Christine D Garner, PhD, RD, CLC
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