Book review: Eat Well, Lose Weight while Breastfeeding.

Eat Well, Lose Weight, While Breastfeeding (Ballantine Books, 2006), by Eileen Behan, R.D. is an updated version of her 1992 book of the same name. 

While there are a number of features to appreciate about this book, my favorite is Behan's low key and reassuring approach to balancing new motherhood with weight loss.  While she acknowledges the pressure many women feel to "bounce back" quickly to an idea shape after having a baby, she states, "while you are breastfeeding, your primary job is to take care of yourself and your baby."

This book has some wonderful practical advice, including meal plans, nutritional information for nursing mothers, and exercise information.  The final chapter provides advice on eating well after weaning. 

She also does a good job taking on the "500 extra calories per day" guideline for nursing mothers, pointing out that for some women this is far too many calories.  She dispels the myths that there is a long list of foods which need to be avoided during breastfeeding, and that a nursing mother must force herself to drink water.  She encourages mothers not to focus on what they shouldn't eat, but "instead, emphasize all the good foods you can have."  She comments on low carb diets while breastfeeding, sugar substitutes, and fish safety. 

When discussing the research on weight loss and breastfeeding, Behan presents only studies which showed minimal or no effect of breastfeeding on weight.  I'm not sure if this was intended as an exhaustive review of the literature on this subject, but there are certainly studies which do show an effect which could have been presented. 

I was disappointed by several statements she made about breastfeeding duration.  One statement, "most doctors currently recommend that mothers not introduce solid foods to their babies for at least four months," should at least have been followed by the AAP recommendation that solid foods not be introduced until babies are six months old.  She also states that one way to view breastfeeding is that "the first nine months are for building the baby, the next nine are for breastfeeding her," though the AAP recommends breastfeeding "for at least the first year of life."  In another section, she states that having a cesarean section birth "will not impact the timing of you milk coming in," though numerous studies (one here) have demonstrated an association between c-sections and delayed onset of mature milk.

Behan warns mothers that lactic acid increases in breastmilk after a nursing mother exercises, which can cause babies to reject the milk.  A number of studies have found that this is only a concern if the mother engages in "exhaustive" exercise (and very few nursing mothers have the energy or motivation to exercise to that point), and sometimes even then there is no effect.  I'm always concerned when I hear this issue raised to nursing mothers, since exercise in the postpartum period is so beneficial for our physical and mental health, and so hard to find time to do.

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