Staying Healthy When Breastfeeding During Fasting

During fasting, nursing mothers have to stay healthy in order to produce quality and substantial breast milk. The volume of breast milk produced by mothers are influenced by stimulation as well as the quality and quantity of nutrients consumed by mothers. The more often the child breastfeeds, it will give good stimulation in breast milk production. In addition to those two factors, the mother’s psychological condition greatly affects the quantity of breast milk. Mothers who receive support from family and their surrounding will be able to breastfeed their children and meet their needs.

Nursing mothers should always be in a good psychological condition and receive adequate support from their surroundings, particularly their spouses and family. The importance of nutritional intake lies in the fluid intake, among others. Mothers who are dehydrated will affect the volume of breast milk produced. When fasting, nursing mothers are prone to dehydration. Therefore, mothers have to maintain fluid intake by drinking enough water at iftar time and at sahur.

Nursing mothers are also advised not to do activities that increase the risk of dehydration, such as activities in hot outdoor places. It is recommended to do wudu often or wash your skin with clean water to relieve possible dehydration. If possible, before entering the month of Ramadan, nursing mothers are advised to prepare a stock of breast milk so they can meet the needs of their babies when fasting, which is when the volume of breast milk may reduce due to mild dehydration.

Fluid and Food Intake for Nursing Mothers

Pay attention to fluid intake at iftar time and sahur, do not let nursing mothers become dehydrated. Check out these tips below to ensure adequate fluids for breastfeeding mothers when fasting:

• Try to meet the needs (1.5 -2 liters/day, depending on body weight) throughout the night until sahur
• Avoid drinking tea, coffee or other drinks that cause diuresis (urinating more)
• Avoid hot sunlight and excessive activities in open spaces
• Ensure protein, vegetables, and fruit intake are fulfilled when having meals at iftar time and sahur

Meanwhile for food intake, nursing mothers need more energy than before pregnancy. Every nursing mother needs an additional 660 kcal/day of her total energy. These total calories can be met from a variety of foods. For example:

• 1 serving of rice = 100 gram, contains 175 kcal
• 1 medium-sized chicken, contains 50 kcal

The food consumed must also be complete, with balanced composition of carbohydrates, proteins and fats. Nursing mothers can use the balanced nutritional composition guideline issued by the ministry of health, namely My Dining Plate, especially in the first 6 months, as babies depend on breast milk in this period. Below is the general guideline for nursing mothers in consuming food:

• Ensure adequate sources of animal protein, red meat 2-3 times and nuts of any kind that are processed without being fried
• At every meal, it is advisable that in the same plate, the half is filled with sources of carbohydrates and protein (with good fats). It is recommended to have more of carbohydrates sources than the protein. The other half of the plate should be filed with vegetables and fruit, with more vegetables than fruit.
• Meanwhile, foods that nursing mothers should avoid are excessive simple carbohydrate intake, such as sugar, syrup, candy, chocolate, and so on, sweet cakes with high calories, and saturated fat usually obtained from fried foods or fritters.

It is recommended that nursing mothers consult with a clinical nutrition specialist or a nutritionist to understand the amount of intake that should be eaten and how to regulate the right diet.

Nursing Mothers Lose Weight When Fasting

Losing weight can be cause by losing fluids during fasting. It is important to monitor body weight after finishing breaking the fast (before sleep) and before breaking the fast to monitor the amount of lost fluids. If you lose body weight because of the loss of fluids due to minimal dehydration, your weight will return when breaking the fast because the body will be well hydrated. However, if the fluid loss are not recovered, it usually indicates weight loss. Weight loss is not a problem as long as nursing mothers have a good diet. If the weight loss is caused by lack of nutrient intake, this is not a good sign, especially if the cause is illness.

Do’s and Don’ts at Sahur and Breaking The Fast 

Each person’s nutrient needs are different, it is best to understand your own needs and add 600 kcal/day during sahur or breaking time. Below is a summary of dos and don’ts for nursing mothers during sahur and breaking time.

Do's

• Consuming foods with blanaced nutritional compositions, which is quality animal protein, such as eggs, fish, chicken, red meat 2-3 times a week.
• Salmon and tuna can only be consumed 2-3 times/week because naturally these fish contain mercury
• Consume anchovies and mackerel are also good because they contain Omega 3
• Consume 3-5 servings of portion and 3 servings of fruits
• Ensure adequate fluid intake throughout breaking until sahur
• Get enough sleep and rest

Don’ts

• Eating foods with saturated fats, for example fried foods and fritters
• Adding too much salt in every food
• Consuming processed food (corned beef, sausage, etc.), sugar and syrup.
• Consuming high-calorie sweet foods (cakes, cookies), coffee, and tea at sahur
• Doing outdoor activities with high sun exposure

Fasting while breastfeeding is not a simple matter. If necessary, nursing mothers may consult with clinical nutrition specialist to help provide input regarding proper and nutrient-rich food intake.

Reference:

1. World Health Organization (WHO) Regional Office for the Eastern Mediterranean. Stay healthy during Ramadan. (https://www.emro.who.int/noncommunicable-diseases/campaigns/stay-healthy-during-ramadan.html). Diakses pada 13 Agustus 2024.
2. Haratipour H, Sohrabi MB, Ghasemi E, Karimi A, Zolfaghari P, Yahyaei E. Impact of maternal fasting during Ramadan on growth parameters of exclusively breastfed infants in Shahroud, 2012. J Fasting Health. 2013;1(2):66-69. (https://applications.emro.who.int/imemrf/J_Fasting_Health/J_Fasting_Health_2013_1_2_66_69.pdf). Diakses pada 13 Agustus 2024.
3. Mubeen SM, Mansoor S, Hussain A, Qadir S. Perceptions and practices of fasting in Ramadan during pregnancy in Pakistan. Iranian J Nursing Midwifery Res. 2012;17(7):467-471. (https://applications.emro.who.int/imemrf/Iran_J_Nurs_Midwifery_Res/Iran_J_Nurs_Midwifery_Res_2012_17_7_467_471.pdf). Diakses pada 13 Agustus 2024.