Posted

Nourishing Your Fourth Trimester

The days and weeks after birth are such a sacred time of bonding between mother and baby. The postpartum period, also known as the 4th trimester, is the 12-week period that begins after the birth of your baby. When pregnant, it’s common to focus most of your attention to planning the birth and organising the nursey, however what doesn’t get enough attention is planning the postpartum period and considering how you are going to support your recovery and wellbeing as you make the transition to ‘mother’, for the first, second, third or fourth time!

In traditional cultures, families and villages took care of the mother after birth. It was customary for family members to help the mother for a period of time, often 40 days or longer. In Chinese culture, they call it “Zuo yuezi” which translates to “sitting out the month”. Family members took over household chores including cleaning and cooking and prepared nourishing traditional meals to boost circulation within the body, replenish nutrient stores and enrich breastmilk. This allowed the mother to recover, rest and bond with her baby. In our modern culture, this practice is often not observed and self-care, including specific postpartum nutrition strategies, are not given much attention or thought between the chaos of nappy changes and feeds. You might be surprised to know that nutrient needs in the postpartum period are actually higher than in pregnancy, especially if you’re breast feeding.

When considering the best ways to support and nourish yourself during this time, it helps to consider what your body went through over the last 9 months of growing a baby and during the birthing process. This includes, but is definitely not limited to:

  • The physical repair and healing of body tissues
  • Blood loss during birth
  • Demands of breast feeding
  • Disruptions to sleep
  • Hormonal changes
  • Mentally adjusting to looking after a little human

One way you can focus on self-care is by having an easy to follow postpartum nutrition strategy in place before giving birth. The key principles of postpartum nutrition should focus on:

  1. Providing adequate macronutrients: Ensuring you are consuming the right balance of protein, carbohydrates and fats is crucial to making enough breast milk and providing nutrients that your baby needs, without depleting yourself of what YOU need!
  2. Replenishing nutrient stores: Research on the link between nutrient depletion during pregnancy and postpartum depression (PPD) has shown that nutrient depletion can affect the production of key mood-regulating neurotransmitters, like serotonin. Additionally, lower levels of folate, vitamin D, iron, selenium, zinc, fats, and fatty acids have all been associated with a higher risk of postpartum depression. It’s important to be including foods rich in these nutrients.

Some guidelines for what to include are listed below:

1. Warm & digestible foods:

Giving birth is an outward motion, and postpartum is an inwards motion. Traditional Chinese Medicine refers to these as yin and yang. Birth is described as very yang, and the postpartum period welcome more yin. To balance both yin and yang, warm foods and liquids ensure ‘chi’ known as ‘energy’ flows freely through the body providing circulation and a sense of well-being to the mother.

Soups, stews & curries

The focus should be on warming and easy to digest soups, hearty stews and curries. By slow cooking fattier and tougher cuts of meat, these foods supply collagen-building amino acids glycine, proline, and hydroxyproline, which are key to supporting tissue healing. Where possible, use bone broth as a base for your meals. We love the brand GevityRx or Nutraorganics. Try our Slow Cooked Lamb Shanks with Vegies and Sweet Potato Mash or Slow Cooked Satay Chicken.

Cooked vegetables

Soft-cooked vegetables also offer a broad range of vitamins, minerals and complex carbohydrates. Roast a tray of vegetables and add them to lunch bowls or add them to slow cooker meals. Vegetable based broth and soups are perfect too. Use warming spices such as cinnamon, cumin, ginger and turmeric where possible.

Smoothies

Smoothies are a great option as you can sneak in so many nutrients and consume them one handed. Add avocado, nut/seed butters and hemp or chia seeds for good fats. For a breast feeding safe protein powder, we love using Nutraorganics Thriving Protein. Smoothies are best consumed at room temperature, or at least not super icy to aid in digestion.

Preparing grains

When cooking grains, such as oats, rice, quinoa or buckwheat, soak them in 1 tablespoon of apple cider vinegar and filtered water over night, then rinse and cook as per usual. Soaking grains before cooking can help neutralise the phytic acid, removing barriers to proper absorption of important minerals within the grains.

2. Nutrient dense, energy rich foods:

Just as your baby’s nutrition is important, so is your own diet. The focus should be on ensuring your overall energy intake is high enough to support the needs of yourself and your baby, especially when breast feeding. Include fats from quality proteins such as eggs, grass-fed beef, seafood, avocados, nuts, seeds and cold-pressed oils to help baby’s brain development and keep your own baby brain at bay. We love using ghee or coconut oil to fry eggs, olive and macadamia oil through salads and coconut cream and milk through soups and curries.

Some key nutrients to focus on include:

Iron

Iron rich, high protein foods will help to restore iron lost through pregnancy and birth and assist with overall energy levels. One tip for increasing the iron content of meals is to use organ meats. Ask your butcher for carnivore mince, which is a combination of beef mince mixed with liver. Chicken livers contain 11mg of iron (per 100g) compared to beef mince alone which as 3.5mg of iron (per 100g). Using this mince to cook with is an affordable and palatable way to include organ meats into your diet.

Calcium

Calcium is an important mineral during pregnancy and lactation as it contributes to baby’s bone development. The average calcium transfer to the fetus during pregnancy is 50mg per day during the second trimester and 250mg per day during the third and 250mg to 300mg during lactation. Given this loss, the recommended daily intake during breast feeding increases to 1300mg per day.

To capture how incredible the female body is, studies have shown that if a mother breastfeeds for up to 12 months, she is at risk of a 10% bone mineral density loss. This loss seems to be a natural part of lactation with all bone losses regained within 3–6 months after weaning, regardless of how much was lost, at a rate of 0.5–2% per month. During pregnancy, a woman’s body also physiologically compensates by increasing intestinal absorption of calcium, thereby decreasing renal calcium loss, and reabsorbing some calcium from the maternal skeleton. 

To keep on top of your calcium intake, rich sources of calcium to include are dairy foods, fish with edible bones (canned wild caught salmon and sardines in pure olive oil), tofu, tempeh, tahini and dark greens such as spinach and broccoli. Our Nutty Tempeh Stir Fry is rich in not only calcium but protein and iron. If you’re plant based, we also recommend trying our Broccoli & Artichoke Salad, also rich in folate and calcium.

Vitamin D

Similar to calcium, vitamin D is important for the development of your baby’s teeth and bones and is essential for maintaining good immune health, energy production, metabolic and cardiovascular function. Getting your levels tested prior to pregnancy and monitoring them in the postpartum period, especially throughout Winter, will help you understand your requirements and whether or not you need to supplement.

Vitamin D can be produced by the body in sufficient quantities when skin is exposed to the sun. If you’re pregnant in the Summer, it may be easier to ensure you get safe sun exposure daily, compared to Winter. Where possible, prioritise exposure of 10-15 minutes of natural sunlight per day on your belly and thighs without sun cream between the hours of 10am and 3pm. However, if you live in a cloudy or cold climate where it’s difficult to get regular exposure, you need to be proactive in your methods of obtaining vitamin D.

Few foods in the Western diet are good sources of vitamin D, however the best naturally occurring dietary sources are oily fish, cod liver oil (also rich in omega-3 and vitamin A), egg yolks and UV-exposed mushrooms. A handy tip is to expose mushrooms in the sun between the hours of 10am and 3pm for 30-60 minutes before cooking/consuming for a rich source of vitamin D. Try soaking your mushrooms and then cooking our Simple Beef Stroganoff or adding them to your omelettes.

Omega-3

Omega-3 fatty acids are an integral part of brain and nervous system cells. They have anti-inflammatory effects that may be protective against PPD and improve the production of serotonin, thereby providing mood regulation through balancing the feel-good chemicals in our brain. One study observed that women who developed PPD regained their blood DHA levels slower than those who did not develop PPD. Foods rich in omega-3 include salmon, sardines, mackerel, chia and hemp seeds, cod liver oil. A supplement may be beneficial if you are vegan or plant based.

Iodine

Iodine is an essential nutrient used in the body to produce thyroid hormones. During pregnancy and the postpartum period, thyroid activity and therefore iodine requirements are increased. Thyroid hormones are important for the regulation of growth and the healthy development of the nervous system, coordination, alertness, and our five senses. Nervous system tissue begins to develop as early as the second month of pregnancy. If women have too little iodine during pregnancy or infants have too little during early childhood, the damage may be irreversible. Research has shown that severe iodine deficiency can stunt children’s normal physical growth as well as harm normal mental development, resulting in lower intelligence quotients. Although breast milk contains iodine, concentrations can vary based on maternal iodine levels. If a pregnant or breastfeeding woman is deficient in iodine, the fetus or infant may be at risk for iodine deficiency and associated cognitive and psychomotor impairments.

Postpartum women require 270 micrograms per day. Naturally occurring sources of iodine include seaweed, kelp (or seaweed salt), dulse flakes, salmon, eggs and dairy products. To make sure you are obtaining adequate iodine you can include fish at one to two serves per week, consume moderate amounts of seaweed or kelp products or take a multivitamin or supplement that contains iodine. Here are some easy ways to include iodine rich food sources to help boost your iodine levels during the postpartum period:

3. Hydration:

When breastfeeding you need an extra litre of fluid every day to keep your body hydrated and your milk supply up. A rough aim is 3L per day. Choose filtered water (we love the water filters from https://www.waterscoaustralia.com.au), bone broth, coconut water and herbal teas.

Keep water stations around the house and always take a bottle when you’re out and about.

Remember, it’s not about getting it perfect every day but doing what you can to support your recovery while allowing yourself to be the best mother you can. You can’t pour from an empty cup. Surround yourself with a village you can trust, ask for help and remember you are never alone. There are many postpartum meal prep services that offer nourishing meals which may take the pressure off!

And don’t forget, even after you feel like you’ve finished your ‘postpartum period’ we believe postpartum is for life. How can we ever be quite the same after birthing a human into the world? Would you agree?

In your 4th trimester or know someone that is? Please book a complimentary 15-minute consultation to learn more about how we can assist you today.

References 

NSW Health 2018, Iodine Supplementation, Maternity, Child & Family, viewed 18 July 2023, <https://www.health.nsw.gov.au/kidsfamilies/MCFhealth/maternity/Pages/iodine-supplement.aspx>

Cochrane 2017, Iodine supplementation for women before, during or after pregnancy, Harding KB, Peña-Rosas J, Webster AC, Yap CMY, Payne BA, Ota E, De-Regil L, viewed 18 July 2023, <https://www.cochrane.org/CD011761/PREG_iodine-supplementation-women-during-or-after-pregnancy>

Hsu M-C, Tung, C-Y, Chen H-E. Omega-3 polyunsaturated fatty acid supplementation in prevention and treatment of maternal depression: Putative mechanism and recommendation. J Affect Discord. 2018;238:47-61. doi: 10.1016/j.jad.2018.05.018

Heringhausen J, Montgomery K-S. Continuing Education Module—Maternal Calcium Intake and Metabolism During Pregnancy and Lactation. J Perinat Educ. 2005;14(1):52-57. doi: 10.1624/105812405X23621

Leave a Reply