By Elisa Bell, MPH, RD, LD, WIMI-CP
Introduction
We are thrilled to feature Elisa on our blog to share her expert tips on postpartum nutrition. At Mamas in Motion Physical Therapy and Wellness, we know that proper nutrition plays a vital role in postpartum recovery, especially for pelvic floor health. A balanced diet not only supports healing but also helps maintain energy levels, manage inflammation, and rebuild strength—all crucial for a strong and functional pelvic floor.
Elisa Bell, MPH, RD, LD, WIMI-CP is a clinical dietitian with almost a decade of clinical
experience. She owns a private practice, Well Woman Studio, based in Louisville, KY. Her mission at WWS is to provide science-backed education along with individualized nutrition and functional medicine protocols to women who are experiencing hormonal changes, GI dysfunction, or recovering from disordered eating. Her own postpartum experiences were very different, the second postpartum being much smoother which she personally attributes to improved nutrition before and after birth. This blog post will delve into 5 of her practical tips for improved postpartum nutrition.
Why Care About Postpartum Nutrition?
Despite the joy of welcoming a newborn, the postpartum months are not easy on a birthing
person’s body. Whether it’s your first baby or your fourth, focusing on adequate nutrition during recovery has numerous benefits, including:
faster healing of tissues
improved mood
decreased risk of postpartum depression
improved milk supply
higher energy levels
decreased risk of prolonged postpartum anemia
decreased risk of infection
decreased risk of future thyroid dysfunction
increased nutrient stores for potential future pregnancies
What Are Basic Postpartum Nutrient Needs?
The nutrient needs of postpartum shift over multiple phases of healing and recovery, lasting up to one to two years or as long as the mother continues to breastfeed. The phases of recovery
include an acute healing phase, early postpartum, the first four months, and up to one year and beyond.
The acute healing phase encompasses the first two weeks immediately after birth. This acute
phase is the most nutrient intensive time of postpartum recovery, and needs are even higher than during pregnancy. Throughout this acute healing phase the uterus contracts and returns to its typical size, organs shift, lochia begins (postpartum bleeding), perineal tears or C-section incisions begin to heal, and there is a huge hormonal shift. The birthing person may also be recovering from a long labor and/or abdominal surgery. The birthing person should be encouraged to rest, hydrate, and eat often. This is a time to eat abundantly, include nutrient
dense foods, and continue any prenatal vitamins.
The early postpartum phase refers to the first six to eight weeks after birth. Nutrient needs
remain high as healing continues, physical activity begins to increase, and as lactation
continues. Lochia is likely to continue throughout much of this time (average is twenty-four to thirty-six days, but can be longer). If the birthing parent is breastfeeding, they continue to establish a nursing relationship with their baby and milk supply continues to increase. The pelvic floor and abdominal tissues continue to heal throughout this time. Baby blues should be subsiding as the parents increase their confidence caring for their baby. Sleep is likely not great and physical activity remains limited to walking. Nutrient needs remain high as healing continues, physical activity begins to increase, and as lactation continues.
Around four months the parent is likely returning to work, may be going through a sleep
regression, movement and exercise is likely increased. And if a parent is exclusively or partially breastfeeding, nutrient needs remain increased to support lactation. It is important to note that a nursing mother’s body will preferentially give nutrition to the nursing child and take from the mother’s nutrient stores.
Healing and recovery continues to 12 months and beyond.
Around the one year mark, the baby is now eating solids consistently, the pelvic floor is likely back to normal function, and physical activity may be back to the pre-pregnancy level. Around 12 months the thyroid may still be fluctuating. Consider thyroid testing if there is not noticeable hair regrowth or if there is increased anxiety, depression, tiredness, etc.
How much do energy needs go up postpartum?
Energy needs increase by around 500kcal/day for postpartum women who are exclusively
breastfeeding. Energy needs likely remain high until around six months, or until the birthing
parent ceases breastfeeding. There is a lack of clear data on when energy needs start to go
down. There also are no recommendations for non-nursing postpartum women. More research is needed in this area.
Nutrients that are important during postpartum:
“Blood Building" nutrients: B12, iron, retinol, folate
Iodine: breast and thyroid health
Selenium: thyroid & liver
Collagen, glycine: tissue repair
B vitamins: energy, adrenal system, mental health
DHA: brain and tissue repair
Electrolytes: cellular function, blood pressure
Zinc: immune function, thyroid health
And more!
Foods to prioritize according to traditional postpartum cultural practices:
Broths and stews made with meat, bones, organ meats (contain lots of iron)
Foods rich in protein and fat (believed to strengthen milk production and promote tissue healing)
Warming foods like broths, teas, etc.
Ample fluids
Liberal salt and spices
Cooked vegetables preferred over raw or cold ones
Well-cooked starches (vary by culture)
Foods rich in iodine like seaweed, seafood, eggs, and dairy
Nutrient Dense Choices for Postpartum Meals:
Food rich in Iron and B12:
Red meat, organ meats, oysters
Cooking with “hidden liver”- meatloaf, chili, etc
Foods high in Collagen:
Bone broth, soups, slow cooked meats
Pot roast, pulled pork, whole chicken with the skin, whole fish, organ meats
Foods high in DHA, Choline, and Iodine:
Fish and seafood
Eggs
Grass-fed beef
Vitamins and Supplements that are recommended:
It is recommended to take the following vitamins or supplements for at least 6 months
postpartum, or as long as the birthing person continues to breastfeed.
Prenatal vitamin
DHA (or consuming 12oz sea food per week)
Vitamin D (at least 6400 IU/day for breastfeeding women to ensure adequate transfer to
breastmilk)
Iodine (290mcg/day, if not consuming seafood and if not present in prenatal vitamin)
Iron (as needed per labs)
B12 (as needed per labs)
Probiotics (as needed, recommended if given antibiotics during labor)
5 Practical Nutrition Tips for Postpartum
Continue your Prenatal Vitamin: Nutritional needs postpartum surpass nutrient requirements during pregnancy. In addition to more energy intake, a simple way to support postpartum recovery and rebuild nutrient stores is to continue taking a prenatal vitamin. The recommended duration is at least 6 months postpartum, or as long as the person continues to breastfeed. Other supplements to consider adding to support recovery include DHA, Vitamin D, Iodine, iron, and B12.
Have a Nutrition Plan: Setting up a meal train- or enlisting a friend or family member to do this for you—is a great way to ensure food availability for the first weeks after giving birth. Be sure to specify any dietary requirements, and if you are comfortable, giving specific requests or recipes is a great way to ensure you get what you want. Consider the first four to eight weeks while you are planning for your postpartum time.
Ideas for Nutrition Planning: Snack cart/basket for during nursing sessions; Postpartum doula that helps provide meals; Meal delivery service (Door Dash, etc.); Grocery delivery; Pre-prepped recipe kits delivered for partner or family members to help cook with less mess or trouble (Hello Fresh, etc.); Create a meal freezer stash; Give recipes out at your baby shower/have people sign up for a meal train at the party; or host a friend food prep party several weeks before your due date
Eat regularly and adequately: Eating regularly throughout the day is important to promote blood sugar regulation and hormonal balance. The goal should be to eat every 3-4 hours. If you’re likely to forget, set timers or have a snack stash in multiple rooms. I also recommend a large water bottle with a straw so you can hydrate easily without multiple refills. Eating adequately refers to taking in enough calories throughout the day. Healing is an energy intensive process. Your body needs enough calories and enough macronutrients to rebuild and repair tissues. You also need enough intake to fuel producing breastmilk if you choose to nurse.
Quick note on macronutrients: they are all needed! You need carbohydrates, protein, and fat to heal and recover. I recommend around a third to half of your plate at mealtimes to be carbohydrates, around a third of your plate is protein, and the other third should be fruits and vegetables. A source of fat during mealtimes is also important. Aim for 20-30 grams of protein during mealtimes. Snacks should contain at least 2 food groups, and around 10-15 grams of protein if able to help with blood sugar balance and satiety.
Add nutrient dense foods: Adding in nutrient dense foods is a huge boost to your nutrient status and recovery process. Nutrient-dense foods are rich in vitamins, minerals and other nutrients that are considered important to our health. Animal foods are considered nutrient dense as they provide protein, fat, and high amount of vitamins and minerals. Examples of nutrient dense foods to include: seafood, meat, eggs, full fat dairy, nuts, seeds, avocados, olive oil, olives, leafy greens like kale, seaweed, berries, and potatoes.
Take it slow and steady: Let’s go ahead and ditch the phrase “bounce back”. Healing after birth, becoming a mother, learning to care for a new baby, adding to your family… this a tremendous life shift. Postpartum recovery is a slow and steady process that takes time and nurturing. Bodies change. That is a constant for every woman who chooses to become a mother, her body will change. And this change is to be expected. There is no “going back” to the pre-mother body, because it is forever changed. And I think that needs to be normalized.
Nutrition as Self-Care
Consider nutrition an act of self-care during the postpartum period. Make a plan for your
nutrition, eat often and eat enough, add nutrient dense foods, and treat your body with kindness and patience. If you need guidance or have questions, I encourage you to book a nutrition session or package at Well Woman Studio for individualized recommendations. An investment in your nutrition is an investment in your future health.
We hope you find these tips from Elisa helpful as you navigate your postpartum journey. For more expert guidance on nutrition, visit Well Woman Studio or follow Elisa on Instagram: @wellwomanstudio.
To learn how Mamas in Motion Physical Therapy and Wellness can support your pelvic floor and overall postpartum recovery, follow us on Instagram: @mamas.in.motion.pt or email us to chat: hello@mamasinmotionllc.com . Together, let’s prioritize your health and wellness every step of the way!
Citations:
12 of the most nutrient-dense foods you can eat (no date) Healthline. Available at:
August 2024).
How can I eat more nutrient-dense foods? (2023) www.heart.org. Available at:
more-nutrient-dense-foods (Accessed: 30 August 2024).
Nichols, L. Chapter 12: The Fourth Trimester. In: Real Food for pregnancy: The science and
wisdom of optimal prenatal nutrition. 2018: 217-255.
Nichols, L. Postpartum Recovery and Nutrient Repletion. Presentation presented virtually for
Women’s Health Nutrition Academy; March 28, 2019.
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