nipples may lead to reduced frequency of feeding. Avoidance of specific foods by the mother seldom benefits the baby Combined estrogen and progestin pills may reduce milk volume and the duration of breastfeeding; progestin-only pills have not been found to have this effect.2

Physical Examination

Rapid weight loss often occurs over the first month post partum without restricting food intake, regardless of breastfeeding status. Engorged breasts and cracked nipples signal a need for support with breastfeeding.

Basic Guidance
All Women
  • Encourage a healthful diet based on the Dietary Guidelines (see “Basic Dietary Guidance," Tab 2, page 27).

  • Assist the mother or primary meal preparer with strategies for a healthful diet for the family.

  • Clarify that (further) weight loss will occur only if energy intake is less than energy expenditure (plus the energy content of the milk produced).

  • Discourage the use of harmful substances.

  • Encourage physical activity.

Breastfeeding Women
  • Encourage generous intake of milk products, fluids, and foods rich in vitamin A. (See box "Special Recommendations for Lactating Women," page 73.)

  • Explain that most women who breastfeed can eat more calories than they could before pregnancy without gaining weight.

  • Answer questions concerning breastfeeding.

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