Expert: Sally Wendkos Olds - 11/5/2008

Question
Hello,
I am writing a piece about weight loss--or the lack of it--while breastfeeding
and I'd love to pick your brain. Possible?
Thanks!
Hope

Answer
Dear Hope,

I'm attaching an excerpt from the new (not yet published) 4th edition of THE COMPLETE BOOK OF BREASTFEEDING (see below) about weight loss. Feel free to quote anything here (with attribution of course!), and if you have any questions, email me directly at WendkosOlds@alumni.upenn.edu.

Good luck with your story!

Regards,

Sally

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Sally Wendkos Olds
Author, THE COMPLETE BOOK OF BREASTFEEDING: Eiger & Olds, 3rd edition 1999, published by Workman Publishing & Bantam Books, and available in most public libraries, bookstores & La Leche League chapters. Now in revision for a fourth edition, with pediatrician Laura M. Marks, M.D.
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Losing Weight: How Much, How Soon?
Breastfeeding does not make women gain weight. In fact, it uses up calories and therefore helps to get rid of extra weight. Nature’s way of providing the extra calories needed for milk production is to store up fat during pregnancy. Then lactation helps to use up these fat stores. As a nursing mother, you’re more likely to lose the fat you gained (especially the lower-body fat) during your pregnancy than is the woman who does not nurse her baby. If you nurse your baby exclusively for the first four months, you’ll probably lose more weight than if you combine breast milk and formula.
  According to one study, four out of five nursing women who don’t restrict their diets lose up to one and a half pounds a month for the first four to six months after delivery, with a smaller loss afterward. Another study found that six months after delivery, breastfeeding women are, on average, closer to their prepregnancy weight than are formula-feeding mothers.
  After six months, the more frequently you nurse and the more time you spend breastfeeding, the more weight you’re likely to lose. However, some women who are less active after childbirth and eat more (thinking they have to, to make milk) do gain weight. Follow this rule: “Eat when you’re hungry and stop when you’re full. And build exercise into your schedule.”
  Every woman is different, and some nursing mothers retain at least some of the weight they gained during pregnancy longer than others do. What, then, to do about it?

Strenuous Dieting Is Not the Answer
First of all, wait a couple of months after your baby’s birth before trying to shed pounds. Then, for as long as you’re breastfeeding, don’t diet strenuously. Don’t follow a liquid diet, take any weight-loss drugs or herbal supplements, eliminate any specific food groups, or cut your calories below the recommended amount for your height and build.
Here’s why: Your body needs enough nutrients to produce milk. If you cut down too drastically on what you eat, you’ll be robbing yourself. Your body will maintain the quality of your milk at your expense by cutting into your lean tissues (your muscles) and your bones. You could lose muscle tone and bone density, and become anemic.

You Can Lose Weight Without Strenuous Dieting
A modest weight loss won’t affect your production of milk, and you’ll serve yourself and your baby best by slowly dropping any excess weight left over from your pregnancy. If by two months postpartum, you have not been losing weight gradually while nursing, the two effective ways to do this are by exercising regularly (more about this later in this chapter) and by cutting down without cutting out. Some weight loss programs (like Weight Watchers) have developed well-balanced plans with a variety of foods, specifically for nursing mothers.
In devising your own plan you can:
• Substitute skim milk and nonfat yogurt for whole milk products.
• Broil, boil, roast, or bake meats and potatoes instead of frying them.
• Eat more fish and poultry and less red meat.
• Eat smaller amounts of fatty meats and fish.
• Snack on raw vegetables and fruits instead of potato chips and cookies.
• Eat fresh fruits rather than sweetened canned ones.
• Go lightly on high-calorie fruits like avocados and cherries.
• Eliminate or eat very little of high-fat cheeses, rich sauces, fatty salad dressings, sugared soft drinks, sugary cereals, cookies, cakes, pastries, and candy.
* Although a mother’s intake of moderate amounts of artificial sweeteners doesn’t seem to affect her nursing baby adversely, there’s no good evidence that these products help people to lose weight, and you’re probably better off minimizing your intake of them.
• Read the food labels (see the box on page tk).

Monitor Your Weight
Plan to lose no more than two pounds per month while you’re nursing, unless you’re very overweight. In six months you’ll have lost twelve pounds, and by eight months you’ll have lost sixteen. This, in addition to the weight you lost with your baby’s birth, will probably bring you back down to or close to your prepregnancy weight. This amount of weight loss will not affect your baby’s growth and will not increase the concentration of environmental contaminants in your milk (see discussion on page tk). It took nine months to put on all those pounds, so it’s not unrealistic to expect it to take about the same amount of time to take them off.
  This gradual weight loss may happen without any special effort on your part—many nursing mothers who eat normally lose about one to one and a half pounds a month for the first four to six months after delivery without making any special effort to shed pounds. However, about one in five nursing mothers does not lose weight while breastfeeding. So the best approach seems to be to wait for two or three months after childbirth to see how your body responds.
  If you’re losing steadily, even if it’s only one pound a month, you don’t have to do anything special about your eating habits. If not, you can start to cut back gradually. By the time your baby is nine months old and is taking less milk in proportion to other foods in her diet, you can begin your plan to lose one to two pounds per week. Losing weight slowly by changing your eating and exercise habits is better than dropping weight quickly, since you’re more likely to keep the pounds off. A well-planned exercise schedule is important in your weight-loss program for a number of reasons, which we’ll talk about in more detail later in this chapter.

If You’re Considerably Overweight:  The advice against losing a great deal of weight during lactation does not necessarily hold for women who are very overweight. If you’re considerably overweight, you’ll have more problems nursing, and the more overweight you are, the more difficulty you’re likely to have, for several reasons. The areola of a very heavy woman is often so large that it’s hard for her baby to compress it enough to get a good milk supply. Also, heavier women have more trouble finding a comfortable position for nursing – and sometimes can’t see their babies at the breast well enough to see if they’re nursing correctly. Although a lactation consultant may be able to help with breastfeeding, it’s still a good idea – for both your and your baby’s health – to work out a weight loss program with your doctor and/or your nutritionist. While you’re on a major weight loss program, taking a vitamin supplement will help ensure that you have enough vitamin B6 in your body and in your milk.

A New Look at Your Body
Some women do lose the weight they gained during pregnancy very soon after their babies are born and remain quite slender throughout lactation and afterward. You don’t have to be plump to be a good milk producer. However, other women keep their more rounded contours for a longer time.
  You may need to think about your weight in a new way. When did you ever see a thin fertility symbol? Just as breastfed babies grow differently from formula-fed babies, the bodies of breastfeeding mothers tend to follow a different schedule from those of non-nursing mothers. A substantial weight gain during pregnancy helps to assure a healthy baby, and part of that weight seems to be nature’s way of providing energy for milk after your baby is born.
  If you’re a typical contemporary western woman, you’ll probably have no more than two or three children. Recognizing that during pregnancy and lactation your nutritional status has to support two lives—yours and your baby’s—and recognizing the very small proportion of time in relation to your total life span that you’ll spend breastfeeding, you need to ask yourself: “Can I stand being a few pounds heavier after the birth of each baby, with the assurance that after I’ve stopped nursing I’ll lose this extra weight?” Since you recognize the value of breastfeeding, you can probably answer this question with a ringing “yes!” You may want to talk this issue over with your husband or partner to help him understand and support you.
  If you want to feel beautiful now, go to your closest art museum and find paintings featuring breastfeeding mothers. Chances are that most of them will be ample in size—and you’ll have a lovely standard of maternal beauty to identify with. (While you're in the museum, you might welcome one bit of news from the Vatican: a church historian has called for the end of censorship of the Madonna's bare breasts in paintings depicting her breastfeeding the baby Jesus.) Meanwhile, enjoy your baby, enjoy your food, and enjoy your life.