Now That I’m No Longer Pregnant (But Nursing), Can I …

There were several activities that you had to graciously bow out of while
pregnant. And now that you are no longer carrying a baby in your belly,
you are probably wondering whether you can resume your usual
activities. Read on.

Drink Alcohol?

Good news, mama: you can now enjoy a glass of wine here and there
without the added stress of how it may affect your baby as it develops in
the womb! However, you cannot drink to the same extent as a woman
who is not breastfeeding. The conservative recommendation is to
completely abstain from alcohol until you are no longer breastfeeding.
That said, a couple of glasses of wine per week are A-okay—just be sure
to exercise caution.

If you choose to have a drink, do so right after a feed,
so that about 4 hours pass before the next feeding and your body
metabolizes the alcohol (the alcohol content of your breast milk is
similar to that of your blood). More hours are needed if you have more
then one drink, so it may be a good idea to limit yourself to just one, or
alternatively, plan—pump before drinking and store the milk in
advance so that you’re not faced with the dilemma of a hungry, crying
baby and only alcoholic milk to feed it. Additionally, you can screen your
milk for alcohol before breastfeeding with a simple test (such as
Milkscreen, a home test for the presence of alcohol in breast milk) that
will tell you whether there’s any residual alcohol left in your milk,
because to date no level of alcohol in breast milk has been determined
safe for a baby.

Research on the long-term effects of alcohol consumption during the
breastfeeding period is still limited, but the current data show that in the
short term, alcohol inhibits lactation and the milk ejection regex, which
may somewhat reduce your milk supply—something to keep in mind,
especially if your milk supply is already on the low side. While long-term
consequences are unknown, so far occasional drinking while
breastfeeding has not been convincingly shown to adversely affect
nursing infants. The bottom line: remember that moderation is key, and
check your milk for alcohol before a feeding. It’s always better to be safe
then sorry—and keep some pumped breast milk stored, in case you test
positive and the baby is hungry.

HOW MUCH IS ONE DRINK?
“One drink” is not necessarily the amount you pour into your glass.
It is defined as:
• 340 g (12 ounces) of 5% beer, or
• 141.75 g (5 ounces) of 11% wine, or
• 42.53 g (1.5 ounces) of 40% liquor
Use a measuring cup because eyeballing it isn’t very accurate.

Drink Coffee?

Just like during pregnancy, moderation is key; drinking up to 2 or 3 cups a day is one for your baby. Also, keep in mind that foods other than coffee can contain caffeine (soda, tea, chocolate, chewing gum, and others), so be sure to read food labels to avoid excessive intake.

Eat High-Mercury Fish?

Similar to when you were pregnant, try your best to steer clear of all
high-mercury sh. If you eat these, the methylmercury and other
pollutants and heavy metals present in these sh will get into your milk
and will thus be passed on to your baby, increasing the risk of
neurodevelopmental issues. Studies have shown delays in the age of
walking and talking, as well as lower mental and psychomotor
development index scores, in infants exposed to mercury, lead, and
methylmercury in breast milk.

Raw Fish and Shellfish, Sprouts, Juice, and Everything Else?

Unlike during pregnancy, your immune system is no longer suppressed, so you can return to many of the food habits you’ve been avoiding. Sushi is now ne to consume, as long as it doesn’t contain any high-mercury sh. Also, everything else that you may have been consuming before getting pregnant—such as raw juice, raw shellfish, deli meats, raw sprouts, and other raw or unpasteurized foods—are now ne to eat. That said, you should continue to exercise regular safe food handling techniques to lower any risk of food poisoning.

Special Medical Considerations

There are certain conditions that women may have when entering
pregnancy or that can develop during a pregnancy that may require
special medical and dietary attention. When expecting, women may
experience high blood pressure, preeclampsia, and gestational diabetes,
all of which may require special nutritional interventions to help
decrease the risks associated with these conditions. Additionally,
increased nutritional requirements are suggested for women expecting
twins. In this appendix, I give an overview of the most common
conditions that can occur during pregnancy and provide nutritional
advice that can help reduce your risk of complications or support your
pregnancy with multiples.

Gestational High Blood Pressure and
Preeclampsia

More common in overweight and obese mothers, gestational hypertension (high blood pressure during pregnancy) affects about 6 to 17 percent of first-time mothers and 2 to 5 percent of non-first-time mothers.

About half of all women with gestational hypertension diagnosed before 30 weeks of gestation go on to develop preeclampsia, a more severe form of hypertension that is associated with increased risk of preterm delivery, low birth weight, and neonatal and maternal death, and a greater risk that the mother will develop cardiovascular disease later in life. When you have preeclampsia, your placenta is not working as well as it should, so it is delivering less oxygen and nutrients to your baby, meaning that baby may have less-than-optimal growth while in your belly and may not reach its full developmental potential.

Risk factors for preeclampsia include having had preeclampsia in a previous pregnancy, being younger than 20 or older than 40 at the time of pregnancy, having a BMI in the obese range (30 and above), having insulin resistance, or diabetes, carrying twins, and having certain genetic factors.

The good news is that there are ways to both reduce your chances of developing preeclampsia and prevent complications in case you have already developed it. First, it is very important not to gain excessive weight during your pregnancy, as obesity and excessive weight gain are some of the biggest risk factors for developing preeclampsia. In the same vein, you should avoid consuming excess calories, calorie-rich foods, and foods high in added sugars.

A study examining women’s intake of calories, sucrose, and polyunsaturated fatty acids in the second trimester found that those who consumed any of the three in excess had a higher risk of developing preeclampsia compared to those who had moderate intakes. A recent study of first-time mothers in Norway at risk for preeclampsia showed that a high intake of vegetables, plant foods, and vegetable oils decreased the risk, whereas greater consumption of processed meats, sweet drinks, and salty snacks increased the risk. Also, a review of numerous studies found that calcium supplementation reduced the risk of preeclampsia by approximately half. Further, this reduced the risk of preterm birth and death (especially in high-risk women with previously low calcium intake).

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