5.2.2  Counselling on postnatal nutrition

After delivery, women’s routine food intake should be increased to cover the energy cost of breastfeeding and for her to recover her normal energy and health. She should eat about 10% more than before she was pregnant if she is not moving around much or doing her usual work, and about 20% more if she is physically active. In practical terms, she is advised to take at least one or two additional meals every day. Nutritional counselling should include:

• Advising the mother to eat a variety of high protein, high energy foods (as much as the family can afford), such as meat, milk, fish, oils, nuts, seeds, cereals, beans and cheese, to keep her healthy and strong. Your nutritional advice should depend on what is available at home and on what they eat as their staple diet. The most important thing is to tell them that she needs to eat more than usual.
• Exploring whether there are important cultural taboos about eating foods which are really nutritionally healthy. For example, in some cultures it is considered bad to eat high-protein foods, spicy foods, or cold foods after a birth. Respectfully advise against these taboos and tell the woman that there is no nutritious food item that needs to be restricted.
• Talk to family members, particularly the partner and/or the mother-in-law, and encourage them to help ensure the woman eats enough of a wide variety of foods and avoids hard physical work.

Advise the mother to take micronutrient supplementation regularly to prevent deficiency disorders and anaemia, as we describe next.