Case study: new mother losing too much weight
Suzie is not getting enough calories to maintain her weight and produce enough breast milk for her baby.
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Name Suzie
Age 26
Problem
Suzie is very busy with her young baby and finds it hard to sit down for a meal. Yesterday Suzie ate cornflakes with semi-skimmed milk for breakfast, half of a cheese and pickle sandwich and orange juice for lunch, and some chicken breast with a baked potato and diet cola for her dinner. She likes ice cream at night if she has time between feeds.
Suzie says she is now hungrier than she was during her pregnancy, but cannot find time to eat. She knows she is not drinking enough as her mouth is dry. She is afraid that she is not producing enough milk because her baby always appears hungry and is not as chubby as her friend's bottle-fed baby. Her mother told her not to eat vegetables and chocolate because they would upset the baby and produce wind.
Lifestyle
Suzie had a healthy 3.7kg (8lb 2oz) baby boy, now six weeks old and weighing 5kg (11lb). This was her first pregnancy. She has lost 9kg (20lb) since giving birth and currently weighs 63.5kg (140lb). She is 1.7m (5ft 6in) tall and weighed 59kg (130lb) before she was pregnant.
Advice
Suzie is not getting enough calories to maintain her weight and produce enough breast milk for her baby. Her requirements when she is breast-feeding are increased by about 550 calories per day. She specifically needs more protein, vitamins A, B12, and folate, calcium, and zinc.
To increase her intake of calories, Suzie should follow the recommended servings from the main food groups and eat a number of servings towards the higher end of the range given for each food group.
Since she lacks the time to prepare and eat balanced meals, she should buy healthy ready meals that can be cooked quickly in the microwave. Suzie can also increase her intake of whole grains by eating microwaved instant porridge with semi-skimmed milk and a sliced banana or berries for her breakfast. She can add some carrot sticks and a glass of milk to her sandwich at lunch, and include a piece of wholemeal bread and fresh fruit salad with her dinner. These are healthy additions that are quick and easy to prepare.
Semi-skimmed milk or low-fat yogurt and iron-rich dried fruit can be added as snacks. She should also take a multivitamin. To increase her fluid intake, she should drink more of the nutritious fluids (up to 3 litres/5 ¼ pints every day), such as milk, 100 per cent fruit juices, and water with meals and snacks. To make this easy, Suzie should keep a large bottle of still water and a glass to hand at all times.
Lisa Hark, PhD RD & Dr Darwin Deen
Posted 14.02.2011
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