The role of nutrition in postpartum recovery

The postpartum period, sometimes dubbed the ‘fourth trimester’, is a time of significant physical and emotional adjustment and nutrition can play a crucial role in this recovery process – supporting healing, hormone regulation and overall wellbeing. So ideally what should you be eating in the weeks immediately after giving birth and why? This article explores why postpartum recovery matters and includes key foods to consider eating after giving birth as well as practical tips for postnatal wellbeing.

Many women talk about having a whole new found level of respect and admiration for what their body is capable of after pregnancy and childbirth. And they should. It is remarkable. Think about it: you carried a growing foetus, a baby, for the best part of a year and then went through the demanding (for some, traumatic) process of labour and delivery. Little wonder then that in the postpartum period (the time immediately after the birth which lasts around six to eight weeks) you are likely to feel exhausted, hormonal, and possibly overwhelmed – both emotionally and physically. This is the time your body and brain need supporting, nurturing and, quite literally, nourishing. And whilst food is not the only thing you need, it should play an integral part in that postpartum recovery process as you care for your new baby.

Why nutrition matters for postpartum recovery

Most women are highly conscious of having a nutritious diet when they are pregnant but after nine months of disciplined eating, understandably they might want a bit more food freedom and flexibility following the birth. Not least because they are likely to be too drained and distracted to worry about serving up perfectly nutritious meals.

Unsurprisingly, perhaps, a UK study found that nearly three quarters of postpartum women were not meeting the 5 a day recommendation of fruit and vegetables and over 40% skipped breakfast or lunch every day. Fatigue, lack of time and feeling stressed were given as the most common reasons for not eating as healthily as they might. The study found that women’s diets were also lacking in fibre, iron and vitamin D and that breastfeeding mums were found to have lower intakes of calcium and zinc.¹ Whilst the demands of your baby need to be prioritised it is important not to lose sight of the fact your body is doing a lot of repair work and also needs nurturing. It's important to support your wellbeing in order to:

Heal tissue and muscle
Replenish nutrients lost during pregnancy and labour
Support hormone regulation
Support a healthy immune system
Support milk production, if breastfeeding

Key foods and nutrients for postpartum recovery

A postpartum diet doesn’t look too different to a generally healthy eating plan - it should include a variety of vegetables and fruits (kale, broccoli, berries, citrus fruits); protein (meat, eggs, pulses, nuts and seeds); wholegrains (oats, brown rice, whole-wheat bread or pasta, quinoa) and healthy fats (such as those found in oily fish, avocados and oils such as olive oil) - but there are certain key food groups, vitamins and minerals and other dietary factors that should be prioritised when you have had just a baby including:

Protein – protein is essential for tissue repair, hormone balance, immune health and helping to provide more sustained levels of energy by balancing blood sugar. Good food sources: include eggs, chicken, fish, tofu, lentils, chickpeas, nuts and nut butters, seeds such as chia seeds and Greek yogurt. Aim to include protein with all meals (including snacks – say, mixed nuts and dried fruit; hummus and vegetables; apple or pear slices (skin on) spread with nut butter; or roasted chickpeas).

Fibre - Constipation may have been a side effect of your pregnancy, but it is also common after the birth, particularly if you have had stitches or are experiencing pain and are worried about how ‘straining’ could exacerbate this. You can help to get your bowels moving more efficiently by eating fibre-rich foods such as kiwi fruits (research shows these are can help keep you regular)²; prunes; porridge with fruit and nuts; potatoes with their skin on; whole-wheat pasta; brown rice; vegetables such as cauliflower, broccoli and cabbage and pulses. Drinking plenty of fluids should also help alleviate constipation, as can gentle exercise like walking which can stimulate your bowel to move.

Hydration - It’s important to stay hydrated postpartum particularly if you are breastfeeding (breast milk is made up of around 87% water and your body needs plenty of fluid to create it). Advice from the European Food Safety Authority (EFSA) is that women who are not breastfeeding should get around 2 litres of fluid daily (typically, around eight glasses) and breastfeeding women should drink around 10-12 glasses a day. However, this doesn’t have to be just plain water and can include herbal teas, other unsweetened drinks like juice, milk and even water-rich foods such as watermelon, cucumber, tomatoes, celery and natural yogurt, soups or poached white fish – all of which can all contribute to your daily fluid intake. Getting enough fluids can help support your general wellbeing during the postpartum phase.

Iron - Now is the time to restore any iron lost during pregnancy and/or the birth - which may have resulted in significant blood loss. Good food sources include red meat, poultry, fish, lentils and beans, nuts, seeds, leafy green vegetables and fortified cereals. Ideally, eat iron rich foods with a source of vitamin C (say, a glass of orange juice) to help support its absorption.

Vitamin C - This antioxidant vitamin contributes to normal collagen formation and normal function of the immune system. Getting enough can may also support milk production if you are breastfeeding. Good food sources include citrus fruits, peppers, berries, potatoes and broccoli.

Omega 3 fatty acids - There are two main types of omega 3 fatty acids – DHA (Docosahexaenoic acid) and EPA (Eicosapentaenoic acid) – both of which can support your overall wellbeing during the postpartum period due to their role in reducing inflammation in the body. The anti-inflammatory actions of omega 3s may also help with postpartum hair changes triggered by hormonal shifts. Good sources of omega 3s include oily fish, avocados, eggs, flaxseeds and walnuts.

Calcium and Vitamin D - Vitamin D helps the body absorb calcium making these two nutrients important for maintaining bone health after pregnancy. Breastfeeding mums need enough vitamin D and calcium to enable their baby to absorb calcium and support healthy bones. Good sources of calcium include dairy foods (cheese, milk, yogurt); dairy alternatives (fortified plant milks and yogurts); nuts and leafy green vegetables. There are a few food sources of vitamin D such as oily fish and eggs but not many and vitamin D, often referred to as the ‘sunshine vitamin’ is primarily created on the skin on exposure to sunlight. Given that in the UK the sunlight between October and March is not strong enough to create enough vitamin D all adults, including pregnant and breastfeeding women, are advised to take a 10 mcg supplement daily³.

Magnesium – This is a particularly important nutrient during postpartum recovery as it contributes to the reduction of tiredness and fatigue. Not only is quality sleep important (and often lacking) for new Mums but breastfeeding is also known to place additional nutritional demands on the body, which may make it even more important for new mums to maintain good overall nutrient levels to support energy and rest.. Good food sources include nuts, seeds, leafy greens like spinach and bananas.

The best foods to eat after giving birth

Soups and bone broth (easy to prepare, nutrient dense and easy to digest)
Pulses such as lentils, chickpeas and kidney beans all good sources of fibre, vitamins, minerals and protein. Use in soups – such as a lentil soup or add to curries and chilli – all dishes which can be batch cooked and frozen before the baby arrives
Avocados, nuts and seeds -sources of healthy, nutritious fats which are readily available and don’t need special preparation
Leafy greens and other colourful vegetables such as broccoli, kale, spinach and peppers, carrots and sweet potatoes - key for vitamins and minerals, antioxidants and fibre. Either eat them on their own steamed, boiled or stir-fried or add to vegetable curries and pasta sauces which can be prepared and frozen before the baby is born
Eggs (good source of choline and omega 3 fatty acids). Eat them in whatever way you prefer – omelettes, scrambled or hard-boiled as a snack
Oily fish including salmon and mackerel - these omega-3 rich fish can be bought fresh, frozen, tinned and/or ready-cooked to be eaten cold
Fruits such as berries, kiwis, apples, pears, citrus fruit and bananas (good sources of vitamin C and other vitamins and minerals). These can be eaten as they are without special preparation, or you can freeze them for use in smoothies or cook them as stewed fruit and freeze them for use when needed
Wholegrains such as brown rice, quinoa, oats and whole-wheat pasta. These are a good source of fibre and vitamins and minerals. Oats can be simply prepared by soaking them overnight with apple juice or soy or other plant milk and rice and quinoa can be bought in sachets that just need to be heated in the microwave.

5 practical postpartum food tips for when you have just had a baby

Don’t skip meals. It can take time to adjust to the new routine of caring for a new-born and easy to forget to look after yourself but if you don’t eat regular meals, you can experience fluctuating blood sugar levels which can lead to low energy and low mood, making caring for your baby harder. Even if you don’t feel hungry, try to eat frequent small meals or snacks. Your postpartum body needs fuel.
Prepare food in advance. Batch cooking meals and storing them in the freezer before you have your baby can make it easier to have nutritious meals or foods to hand and which you just have to thaw out and/or heat up.
Keep a stock of snacks to hand. Choose ones that you can grab quickly and easily with one hand (i.e. when holding the baby or breastfeeding) such as apples; bananas; bowls of nuts, fruit and seeds or blueberries; a few squares of dark chocolate and/or healthy smoothies.
Ask for help. You might not be used to doing it and want to be seen to be functioning well as a new parent, but you have been through a lot. Most people are only too willing to be of assistance so lean on your partner, family and friends and let them feed – and water – you! If you are breastfeeding, for example, suggest someone brings you a large glass of water or herbal tea every few hours so you don’t have to consciously remember to stay hydrated.
Don’t be in a hurry to lose weight. Cutting out major food groups or drastically reducing your calorie intake immediately after the birth can counteract your healing and recovery, so focus on that rather than getting back into your pre-pregnancy clothes. Plus, if you are breastfeeding you need to increase the number of calories you are getting not decreasing them.

Postpartum nutrition when breastfeeding

A mother’s need for certain nutrients may increase when she is breastfeeding and she needs to be getting enough protein and healthy fat intake to ensure optimal milk quality and supply⁴. She will also need around 330-400 extra calories each day compared to non-breastfeeding new mums.⁵As a guide, a breastfeeding new mum should aim to:

Eat at least the recommended five portions of fruit and vegetables a day, ideally more. These can be fresh, frozen or tinned (in natural juice) but try to include as many different fruits and vegetables as you can.
Have regular amounts of dairy foods (milk, cheese and yogurt) or dairy alternatives such as fortified plants milks like almond or soy.
Aim to eat protein with every meal (including snacks). Good options are pulses, beans, lean meat, fish, eggs, nuts and nut butters and tofu.
Ideally make up the extra 330-400 calories a day needed when breastfeeding from healthy fats such as oily fish, avocados and nuts or seeds, rather than eating, say, a large slab of cake.
Try to have at least two portions of fish a week, one of which should be an oily fish such as salmon, mackerel or sardines. But have no more than one portion of swordfish or marlin weekly. These may contain mercury which can be transferred to the baby via breastmilk and potentially impact their wellbeing.⁶ You don’t need to limit how much white fish or canned tuna you eat whilst breastfeeding as long as it is part of a healthy, varied diet.
Include iodine-rich foods – many breastfeeding women are not getting enough of this trace mineral. Good dietary sources include seafood, seaweed, milk, yogurt and cheese.
Limit ultra-processed foods or ones that are high in sugar, fat and salt such as cakes, biscuits, pastries and crisps.
Cut down on caffeine – caffeine can pass from mother to baby in small amounts via breastmilk⁷and whilst this doesn’t appear to affect the baby adversely if the mum is getting low to moderate amounts, a high intake can lead to irritability, poor sleeping patterns and jitteriness in babies. For this reason, it is recommended that when you have no more than 200mg a day. This equates to around one or two mugs of coffee or tea (including green tea), one can of cola or energy drink or one 50g bar of plain dark chocolate.
Abstain, or limit, alcohol as it can pass into your breast milk and to your baby according to NHS information.⁸ It isn’t completely off the table, however, but if you do decide to drink be sensible and time it right. After one drink you should wait around four hours before breastfeeding or breast pumping to give your body time to metabolise the alcohol. Be aware that alcohol can potentially decrease your milk supply as well as impact on your mood, energy levels and sleep quality.

Foods and drinks to limit or avoid during postpartum recovery

Fewer foods and drinks are off the menu postpartum but avoid, or limit, these:

Alcohol – if you are not breastfeeding (see above) you can drink but try to limit it to a couple of small drinks. Alcohol is a well-documented depressant and can cause low blood sugar leading to energy and mood changes. Additionally, alcohol can disrupt restorative sleep, which may impact postpartum recovery and overall wellbeing.
Caffeine – is not off limits in the postpartum period and a regular caffeine jolt can make you feel temporarily more alert but be mindful that high caffeine intake can lead to anxiety, jitteriness and interfere with your sleep so it can be helpful to stop caffeine intake after around 4pm.
Fried/processed foods - foods that can be hard to digest and potentially ‘block you up’ and exacerbate constipation.
High sugar foods – these can cause a pretty immediate blood sugar spike followed by a crash which can then leave you feeling tired and a high sugar diet has also been shown to interfere with poor sleep quality⁹.

What you eat and drink is a hugely important part of the healing and recovery process after giving birth, but it should form part of a wider postpartum TLC plan. So whilst you try to get a good mix of the nutrients you need, also take every opportunity to rest when your baby sleeps; aim to get some gentle exercise when you feel up to it (such as a walk or gentle yoga stretches), enlist practical help from your partner and/or friends and family; be open about how you are feeling and continue talking to your GP or midwife if you have any concerns about your health or the health of your baby. Prioritising your health – both physical and mental – is crucial to your recovery and adjustment to new parenthood and caring for yourself should put you in a better position to care for your baby and experience the postpartum phase as positively as you can.