Expert: Sally Wendkos Olds - 5/16/2006

Question
HELP!!! I can't stop gaining weight and I m breastfeeding so I don't want to diet. I haven't had a period since delivery

Answer
Dear Chontea,

First, congratulations for giving your baby the best start in life by breastfeeding. You're right not to diet strenuously while you're nursing -- but there are steps you can take to watch your weight.

I'm enclosing an excerpt from my book (see below), which I hope will be helpful. You say you have not had a period since delivery, but I don't know how long ago that was. Some women don't begin to ovulate or menstruate for several months after their babies are completely weaned; others ovulate even while they're fully lactating and before they get their period. If you are asking whether you could conceive another baby, it's hard to tell. This is another topic I deal with in the book. Basically, if you definitely do NOT want to have another baby right away, you need to use some kind of birth control. The only time you're 98% protected is if your baby is under 6 months old, you're nursing frequently around the clock, and the baby is getting no other food.

Good luck!

Sally

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.


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  LOSING WEIGHT:  HOW, HOW MUCH, HOW SOON?
There's a paradox about nursing and women's weight. 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. Therefore, as a nursing mother, you are 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.
  According to one recent study, four out of five nursing women who do not restrict their diets lose up to 1 1/2 pounds a month for the first four to six months after delivery, with a smaller loss afterwards. 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 total time you spend breastfeeding, the more weight you are likely to lose. However, some women who decrease their physical activity and think they must eat more to make milk do gain weight. This can be minimized by this rule: "Eat when you're hungry and stop when you're full." Meanwhile, watch for gradual weight loss.
  In sum, every woman is different, and some nursing mothers retain at least some of the weight they gained during pregnancy longer than others do. The question then is what to do about it.

STRENUOUS DIETING IS NOT THE ANSWER
While you're breastfeeding, you should not be dieting strenuously. You should not be following a liquid diet, taking any weight-loss drugs, or cutting your calories below the recommended amount for your height and build. Here's why:
  *  First, your body needs to have 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), your bones. This means that you could lose muscle tone and bone density, and become anemic.
  * Then, if you become very undernourished, you'll produce less milk, so you'll be robbing your baby of her essential nutrients.
  
YOU CAN LOSE WEIGHT WITHOUT STRENUOUS DIETING
A modest weight loss will not affect your production of milk, and you will serve yourself and your baby best by gradually dropping any excess weight left over from your pregnancy. If you are not 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. For example, 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;
  * eat more bread, pasta, and rice, seasoned with spices or fruits rather than with butter, margarine, or oil;
  * 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;
  * read the food labels (see Box 7-6).
  
  BOX 7-6
  WHAT THE LABELS USUALLY MEAN
The following descriptions give information for a single serving:
Calorie free = no more than 5 calories
Sugar free = less than 1/2 gram of sugar
Salt free = fewer than 5 milligrams (mg) of sodium
Low sodium = no more than 140 mg of sodium
Fat free = less than 1/2 gram of fat
Low fat = no more than 3 grams of fat
Light = 1/3 fewer calories than, or half the fat in,
   the regular version or a similar food
  END OF BOX
  
MONITOR YOUR WEIGHT
A safe rule of thumb is to plan to lose no more than two pounds per month while you're nursing. Thus, 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. After all, 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 may happen without any special effort on your part -- many nursing mothers who eat to appetite 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 1 in 5 nursing mothers do 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. Then 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 extremely 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. One new mother we know had put on thirty excess pounds before she got pregnant and then gained another fifty pounds during her pregnancy. With the help of her doctor, she worked out a calorie-restricted but balanced diet and over a period of eight months lost sixty-five pounds, or two pounds a week, while continuing to breastfeed successfully. In this case both mother and baby did well. However, most women are not carrying this much excess weight, and such a large weight loss should not be undertaken unless it is medically indicated for your health.
   

A NEW LOOK AT YOUR BODY
As we said, some women do lose the weight they gained during pregnancy very soon after their babies are born and remain quite slender throughout lactation and afterwards. You don't have to be plump to be a good milk producer. However, as we also said, 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 American 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 will 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 and 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. Meanwhile, you can enjoy your baby, enjoy your food, and enjoy your life.