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Determine possible causes of excessive postpartum weight loss, weight gain, or lack of any weight loss (see box); and check on the infant's growth.
Counsel the woman about strategies to adjust her energy and nutrient intakes, alter her level of physical activity, or both.
Recommend a low-dose multivitamin/mineral supplement (this can be the same as the prenatal supplement) if the mother has been curbing energy intake excessively and is unlikely to increase her nutrient intake.
Restrictive Food Practices During Lactation
If a breastfeeding mother is restricting her food intake to prevent colic, allergic reactions, or other problems in her infant, tell her that the evidence does not support routine elimination of milk or other basic foods to prevent these problems. If symptoms are serious, it may be advisable to demonstrate objectively whether food avoidance will help, as outlined below.
Remove the suspected food allergen from the mother's diet. (This may require diet counseling.)
Determine if the infant becomes asymptomatic.
If yes, conduct an oral challenge under careful medical supervision to determine whether the symptoms recur.
Treat provoked reactions appropriately.
If the mother must eliminate a basic food from her diet for weeks to months, provide for diet counseling to promote adequate nutrient intake.