Q: I am breast feeding my baby for the last 4 months but I am on a restricted diet as I have been diagnosed to be pre-diabetic and have high cholesterol (232) and triglyceride too. So I have stopped taking fatty foods, or any milk products except for a glass of soy milk and oats cereal and otherwise my diet is 2 chapatis with vegetables and daal for lunch and dinner and for snacks some energy bars or 2-3 servings of fruit. Apart from this I am taking the prenatals and fish oil capsule(for baby and also for my cholesterol) as recommended by my doctor. Can you tell me if this is okay as far as I am feeding my baby. Also I go for a 30 minutes walk everyday. Can you tell me if this diet is OK or is my baby being deprived of some essential nutrients? Should I include some fatty foods in my diet?

A:The aim of the diet during breast feeding is to provide sufficient nutrients for you to remain well nourished and to assist in gradual weight loss if needed whilst providing an adequate supply of quality breast milk for your baby, and to control the babys hunger. HIGH 1. Complex Carbohydrate: Foods, such as whole-wheat bread, whole grain cereals, rice and pasta. Breast feeding places a great demand on mothers blood sugar supply and if the diet is not adequate in complex carbohydrate foods, sugar cravings and extreme hunger may occur. Eat every two to three hours to maintain a good blood sugar supply and control hunger. Fresh fruit for between meal snacks are acceptable. 2. Fluids: Drink more than 8 glasses of fluid daily, spread over waking hours and through the night when night-feeding. Drink at least one glass of water each time baby has a feed. Fluid is the most critical factor in ensuring an adequate volume of breast milk for baby. Limit fruit juices, low calorie and normal soft drinks and cordials, caffeine beverages and alcohol. 3. Calcium: This must be high to provide sufficient amount in the breast milk without compromising your calcium reserves. A consistent intake is more important than maintaining an unnaturally high intake of calcium-rich foods. Drink 600ml (2 - 2 1/2 cups) milk or its equivalent in dairy foods daily. 4. Protein rich foods. Protein needs to be increased to the equivalent of 30-60g meat, chicken, fish or 1/2 to 1 cup beans or 30g cheese or 1 egg daily. 5. Zinc - Zinc levels are believed to decrease in breast milk at around six months. Supplementation of zinc may be recommended at this time to ensure adequate levels if dietary intake is inadequate. Check with your doctor about this. 6. Iron- Iron levels are thought to decrease in breast milk at around four months of age. Supplementation of iron at this time may be recommended if dietary intake is inadequate but it shouldn't make up for poor eating habits. Strive to eat an iron rich diet. 7. Essential fatty acids - EFAs are important for the babys visual and brain development. Sources include oily fish (salmon, tuna, mackerel, sardines), wheat germ and nut oils. LOW 1. Fats since these contribute excess calories and do not assist in weight control. Even though excessive fats are discouraged, it is important that you eat some fat. Fat is a necessity that your infant needs in order to grow. A complete lack of fat could hinder your child’s development. 2. Any foods, which by elimination and challenge appear to provoke symptoms in baby (such as hives or digestive upsets) when included in mothers diet. 3. Alcohol. Alcohol passes through to the breast milk. It is dehydrating to the mother and may reduce milk production and may have harmful effects on the baby. Youd be wise to cut back or avoid caffeine and alcohol. If you're really craving a drink, try a non-alcoholic alternative. You'll be able to figure out if your child is sensitive to something you eat or drink, because shell show her discomfort by being fussy after feeds, crying inconsolably, or sleeping very little. Sample meal plan Two glasses of water on rising. Breakfast 1. 1 1/2 to 2 cups rolled oats porridge made on low fat/skimmed milk or 1.5 to 2 cups high fibre cereal or 3-4 slices whole meal or grain bread 2. 1 egg, boiled, poached or scrambled or 1 slice cheese or 1/2cup baked beans. 3. One fresh fruit or 1 cup fruit salad. One to two glasses water. Morning tea 1. 1-2 khakras/idlis. 2. Small glass skimmed milk. One to two glasses water. Lunch 1. 2-3 chappati without oil/ghee + 1 small bowl rice 2. 2 pieces fish/chicken/1 bowl dahi, made with less oil 3. Plenty of fresh salad + 1 bowl cooked vegetables 4. 1 bowl dal OR Pulses 5. One piece fresh fruit. One to two glasses water. Between lunch and dinner 1. One vegetable sandwich with plenty of vegetables + 1 glass buttermilk. One to two glasses water. Dinner 1. 90-150g lean meat, chicken or vegetarian meat substitute- soya with low preparation or 180-300g grilled or poached fish or 2 egg white omelette 2. Steamed or mashed potato or 1 cup rice or pasta or 2 phulkas 3. Plenty of lightly cooked vegetables or salad. 4. One piece fresh fruit or 1 cup fruit salad. One to two glasses water. Before Sleeping Small glass skimmed milk or a milk pudding or dahi. Count on taking 10 months to a year to return to your pre-pregnancy weight. And dont even think about trying to lose weight until at least six weeks after your baby is born. Limiting what you eat in the early weeks of lactation may reduce your milk supply. Moderate exercise is good for both you and your baby. Schedule exercise to suit your nursing schedule so you have the best chance for uninterrupted exercise.