Postpartum nutrition plays an important role in optimizing recovery from pregnancy and childbirth as well as helping to decrease the risk of maternal mental health disorders.

A staggering number of women face perinatal mood and anxiety disorders in the months and years after childbirth, many who are unable to connect to the help and support they need for recovery.

It is estimated that up to 1 in 5 women will suffer from maternal mental health disorders, such as depression or anxiety, during or post-pregnancy. In fact, maternal mental health disorders, like postpartum depression, are the most common complication of childbirth. This can emerge as either a new problem or a recurrence of a pre-existing mental health condition.

How Does Postpartum Depression Happen

Maternal mental health concerns, like postpartum depression, often develop due to a variety of many different factors, including physical components (things related to our body), and environmental stressors (experiences that affect us).

Risk of maternal mental health issues may be influenced by:

• A woman’s family history of mental illness

• Previous mental illness

• Difficult or traumatic childbirth experiences

• Recent exposure to psychological stressors

• Lacking family or economic support

• Physical and mental stressors from pregnancy, childbirth, and caring for a new baby

• Hormonal Imbalances

• Genetic Predisposition

• Lack of postpartum support

• Inadequate nutrition, lacking nutrients or a poor quality diet

• Living in poverty

• Limited access to adequate healthcare

There is no single factor associated with maternal mental health disorders that can be pinpointed as the cause of this maternal mental illness. Postpartum depression is often the result of many different issues that combine to create the perfect storm.

It’s important to realize that many of the components that contribute to postpartum depression are not necessarily things we can control or prevent, like our genetics or how we bring our babies into the world, whether by cesarean or vaginal delivery.

However, there are other aspects of our wellness that we do have some degree of control over, like how we care for and feed our bodies. This is where nutrition can come into the picture as a vehicle to help support ourselves during a vulnerable time of transition into motherhood.

How is Postpartum Depression Treated

Because postpartum depression, like all mental illnesses, is influenced by many different factors, treatment options should also be comprehensive.

Every woman and her postpartum experience are unique, and what might help one mother overcome postpartum depression may be different for another mother. The most important thing is to have the support of both professionals and loved ones. Mental illness is real and the consequences can be devastating if left untreated, especially for a mother and her baby.

Some of the common forms of treatment that might be used for postpartum depression include:

• Psychotherapy (such as cognitive behavioral therapy or dialectical behavioral therapy)

• Medication

• Support Groups

• Peer and Partner Support

• Nutrition Therapy and Counseling

• Complementary and alternative therapies

For many new mothers who might be struggling with postpartum depression, a combination of treatment approaches can be effective for conquering this mental illness.

How Nutrition Can Improve Maternal Mental Health

Postpartum Depression Nutrition Connection

The role of nutrition in maternal mental health may not be as well understood as other facets of wellness, but more research is highlighting the importance of an optimal diet, especially during the critical months and years after pregnancy and childbirth.

Studies have found a connection between nutrition and perinatal depression, or maternal depression that can occur during pregnancy and up to 1 year postpartum.

Specific nutrients are needed in greater quantities during pregnancy and postpartum, and deficiencies in these nutrients may increase the risk of postpartum depression. Nutrition plays an important role with hormonal regulation, gut health, immunity, and neuroendocrine functioning.

Some of the nutrients that may be connected with postpartum depression include:

• Trace Minerals, including Selenium, Zinc, and Iron

• Vitamin D

• B-Vitamins, including B-6, B-12 and folate

• Essentially fatty-acids, including EPA/DHA

When these nutrient stores are depleted during pregnancy and not adequately replenished in the postpartum period, this can be a trigger for poor functioning of many systems in the body and increase risk of mood disorders, like postpartum depression.

While postpartum depression and other maternal mental health disorders can’t necessarily be prevented, there are many things that can be done to help decrease your overall risk of experiencing these conditions.

Optimizing your postpartum nutrition through your diet can be one effective way to help decrease your risk of experiencing postpartum depression that may be related to nutrient deficiencies. A comprehensive postpartum care plan can support overall health in a way that promotes physical, emotional, and mental recovery and healing.

Nutrition Concerns During Pregnancy and Postpartum

Pregnancy, childbirth, postpartum healing and breast milk production all put additional demands on a woman's body, and therefore nutrient deficiencies arise more easily during this time.

A woman’s body can be depleted of essential nutrients as it works to ensure that her baby’s needs are adequately met.

In addition, nutrient needs are higher for postpartum moms for tissue and muscle repair, especially for mothers recovering from cesarean births. The surgical incisions involved with cesarean birth and any tears or lacerations incurred from vaginal birth are wounds that require significant more energy and nutrition to heal from.

Other stressors that may cause nutrient-deficiencies in a pregnant or postpartum mom might include:

1. Having a history of chronic dieting, malnutrition, or an eating disorder, such as anorexia, bulimia, orthorexia, or binge eating disorder

2. Long-term use of certain medications before, during and after pregnancy

3. Stressors associated with motherhood

4. Excessive exercise

5. Inadequate nutrient-intake or sub-optimal diet

6. Rapid postpartum weight loss

7. A pregnancy or postpartum eating disorder

Typically, prenatal nutrition is overemphasized during pregnancy, and for good reason. Pregnancy can be a motivating time to care for your body and pay special attention to how you are eating with a baby growing inside you.

Postpartum women also have increased nutrient demands, especially for healing, recovery, and to support breastfeeding. Yet postpartum is one of the most challenging times to have an optimal diet because of that new mom life. Between the demands of caring for a newborn and adjusting to the many transitions after childbirth, it is hard to make time to feed your body appropriately.

Nutrition all too easy falls to the wayside during postpartum, but this window of time is vital for replenishing nutrient stores that may have been depleted from pregnancy and childbirth.

Imagine it like training for a marathon. Athletes understand that the post-race recovery is just as critical as the time, energy and effort spent into running the race itself. If you don’t put the effort into caring for your body after running a marathon, your recovery and health would inevitably suffer. Pregnancy and postpartum are a lot like this. It’s easy to focus on the pregnancy itself, and once baby has come, to neglect the care and support needed to help a mother adequately recover from her 9-month marathon.

The additional nutrient demands in postpartum can quickly compound if a new mom is not being proactive and intentional about feeding her body well. It’s like trying to drive a car with an empty gas tank - eventually you’re going to suffer a breakdown.

For some mothers, postnatal depletion might trigger postpartum depression or other maternal mental illness. Other mothers might struggle to thrive physically or feel run-down. Motherhood is physically demanding, among other things, and nutrient deficiencies can trigger a host of complications that make it harder to function optimally.

Combating Postpartum Depletion With Nutrition

What postpartum eating plan should you follow after pregnancy and childbirth?

The good news is there are simple ways to support your body’s increased nutrient needs during pregnancy and postpartum. Being intentional about eating well can help your body replenish nutrient stores that may have been depleted during your motherhood journey.

Feeding your body optimally is not about restricting any foods or dieting but intentionally nourishing your body with foods that keep you replenished and that will help your body heal and recover.

Eating adequately and including nutrient-dense foods in your daily meals and snacks will help increase your intake of nutrients that are typically depleted during pregnancy, childbirth, and lactation.

Here are some steps you can take to optimize your nutrition to minimize risks of postpartum depression that may be associated with depleted nutrient stores:

Focus on the Quality of Your Diet

This is not about trying to perfect the way you eat or not having flexibility and balance with food. This is about aiming for variety and including foods in your diet that can support the increased nutrient needs that come during pregnancy and postpartum.

When it comes to your postpartum nutrition, think about foods you can include to support your physical and mental health, not hyperfocusing or worrying about what you need to eliminate or exclude. Sometimes, you will need to make food choices based on convenience, because that is real life in new motherhood. That is OKAY. Do the best you can, and remember that it’s more important for you to be eating consistently and sufficiently rather than experiencing added stress about the quality of your food.

Aiming for nutrient-dense foods can be a way to get essential nutrients that are more easily depleted.

When putting together your meals and snacks, aim for a combination of nutrient-dense foods such as:

• Protein, for rebuilding tissues and muscles in the body, to stabilize blood sugar and support wound healing. Foods high in protein include grass-fed beef, poultry, collagen, seafood, eggs, milk, yogurt, cheese, cottage cheese, legumes, nuts and seeds.

• Complex Carbohydrates to provide your body with energy, promote healthy digestion and regularity, and protect lean muscle mass in the body. Foods that offer your body complex carbohydrates include whole grains, like quinoa, oats, and brown rice. Fruits, non-starchy and starchy vegetables, and legumes are also great sources of complex carbohydrates.

• Healthy fats and essential fatty acids are crucial for nutrient absorption, supporting brain health, stabilizing hormones, and balancing blood sugar. Foods that provide healthy and essential fats include extra virgin olive oil and olives, nuts and seeds, avocado, eggs, coconut, grass-fed butter, and fatty fish like salmon.

In the chaos that often comes with new motherhood, you might find it challenging to remember to eat. Try not to go more than 3-4 hours without having a balanced meal or snack to prevent dips in your blood sugar and to stabilize your energy levels.

Going long periods without eating during the day can exacerbate physical and mental health challenges, making it more difficult for you to get adequate nutrition for your postpartum recovery. Set reminders on your phone if needed to give you the gentle nudge needed to feed yourself enough throughout the day.

Include Nutrient-Dense Foods to Improve Postpartum Nutrition

As mentioned earlier, there are certain nutrients that your body may need more of to help replenish nutrient stores that may have been depleted during pregnancy, childbirth and breastfeeding (if you are nursing).

This includes trace minerals, B-vitamins, Vitamin D, and essential fatty acids.

Including foods in your postpartum diet that naturally offer these nutrients can help replenish your nutrient stores, as well as decrease your risk factors of postpartum depression that may be associated with poor nutrition.

Aim to include some of these nutrient-dense foods that can provide your body with crucial nutrients needed to support your physical recovery and mental health:

• B-vitamins: These nutrients, including folate, B-6, and B-12, are crucial to many functions in the body, including energy and metabolism. B-vitamins in the diet all directly impact breast milk concentration. Mothers who follow a vegetarian/vegan diet may need additional supplementation to ensure they are getting adequate amounts of B-vitamins, particularly B-12. Foods to eat include: dark green leafy greens, eggs, nuts, whole grains and red meat.

• Choline: Choline nutrient needs are at an all time high while breastfeeding to support ongoing brain development for a nursing baby. Foods to eat include: eggs (pasture-raised eggs are preferred) and liver. Other plant based sources include cruciferous vegetables, legumes, pinto beans, nuts, quinoa, yogurt and the supplement, lethicin.

• Calcium: During pregnancy and while breastfeeding, a mother’s body will draw calcium from her own bones to support her baby. For this reason, getting adequate calcium is essential to preventing calcium store losses that can contribute to osteopenia or osteoporosis. Foods to eat include: Dairy-rich foods, include yogurt, cheese, milk, and cottage cheese, legumes, seeds, and non-dairy milk/yogurt (that are fortified).

• Iron: Iron-deficiency anemia can be a risk factor for postpartum depression, and many postpartum women struggle to replenish their iron stores. Research has specifically found that there is a strong association of iron-deficiency with depression, stress, and cognitive function in the postpartum period. Your iron needs are higher while breastfeeding and when resuming menstruation. In addition, if you’ve lost a significant amount of blood during childbirth, this can also contribute to depleted iron stores. Foods to eat include: Beef, liver, dark poultry meat, lamb, shrimp, dark leafy greens (like spinach), lentils, nuts, and whole grains.

• Fatty Acids and DHA: The amount of fatty acids in your diet will directly impact the fat composition of your breast milk. Sufficient amounts of fatty acids support brain-development for your breastfeeding baby via your breastmilk. Essential fatty acids are also critical for supporting your own brain health and overall mood. Studies have found that a low intake of omega-3 fatty acids, such as DHA, are associated with an increased risk of maternal mental health conditions, including postpartum depression. Foods to eat include: Seafood (especially salmon and fattier fish), eggs, grass-fed beef, and grass-fed dairy (like butter). Plant sources have form of omega-3's called ALA, and this can be found in nuts, like walnuts, or seeds, like flaxseeds, chia, etc. However, plant sources don't convert as well in the body, so animal based sources are preferred.

• Vitamin D: Studies have found an association between lower vitamin D status and increased risk of depressive symptoms during and after pregnancy. Nursing mothers also have increased Vitamin D needs while breastfeeding in order to provide adequate vitamin D via her breast milk. Vitamin D is also essential to support calcium absorption in the body. Foods to eat include: Fortified dairy foods, egg yolks, fatty fish (like salmon and tuna), fortified orange juice, and supplementation.

• Probiotics: Recent studies have investigated the link between the gut and the brain, otherwise known as the “gut-brain axis”. Studies have found that probiotics may be beneficial for mental health. By including fermented foods in your diet, you can naturally boost your intake of probiotics, which can support both digestive and mental health. Foods to eat include: yogurt, kefir, fermented vegetables (like kimchi or sauerkraut), kombucha, or a probiotic supplement.

These foods and nutrients described above are not only important for replenishing your postpartum body and aiding your recovery from childbirth but for enriching your breastmilk as well (should you decide to breastfeed your baby).

What to Eat After Cesarean Delivery

Some factors can affect your appetite or make it difficult to eat, including cesarean surgeries or certain medications. If you are finding it challenging to feed your body, take it slow at meal times and feed yourself what you are able to. Smaller, more frequent meals can help you get the nutrition you need.

Because a cesarean delivery is a major abdominal surgery, it’s important to feed your body well to help promote incision healing and overall recovery.

Opt for foods that are softer and easier to digest in the days and weeks following your surgery and as things normalize for your digestive tract.

Softer, nutrient-dense postpartum snacks that are easier to digestive post cesarean delivery and that promote healing may include:

• Whole fat greek yogurt

• Smoothies made with fruit, nut butter, milk, and protein powder

• Sweet potatoes with grass-fed butter

• Overnight oats with nuts or seeds

• An egg scramble with soft cooked veggies and cheese

• Soups or stews with slow-cooked meats and bone broth

As your bowels regulate and digestion normalizes, you can slowly begin to transition to foods that are higher in fiber to help promote regularity.

Your doctor may recommend stool softeners post delivery to help ease bowel movements.

Getting Adequate Fluids, Staying Hydrated

Hydration is crucial for promoting digestive regulation, as well as maintaining and replenishing electrolytes.

Many women experience postpartum night sweats in the days and weeks after delivering their babies, which is often the body’s way of releasing extra fluid that helped support your body and baby during pregnancy. With sweating and extra fluid loss during childbirth, adequate hydration is necessary for replenishing fluid and electrolyte levels.

Drinking to thirst can help support adequate hydration. Try keeping a water bottle next to places you frequently sit for easy access, especially next to places where you might hold and/or nurse your baby.

Remember that you can incorporate other fluids to support hydration, including herbal tea, milk, juices, and coconut water.

Special Considerations for Postpartum Nutrition Breastfeeding Moms

If you are currently breastfeeding, keep in mind that lactation does create additional nutrient demands on your body. In fact, breastfeeding is more nutrient and energy taxing on your body than pregnancy, requiring an average of 500 calories more per day than when you were pregnant. Because of this, it’s not usual to feel an increase in your appetite as your body works to provide breastmilk and nourishment for your baby.

As best as you possibly can, aim to eat and drink to hunger and fullness. Your eating and drinking patterns may mimic the frequency with which you feed your baby, and that is OKAY. You can trust your body to help you navigate the transition from pregnancy to postpartum and breastfeeding.

To support satiety, make sure you’re including a variety of complex carbohydrates, healthy fats, and protein at each meal and snack. Eating more frequently during the day can also help meet your increased appetite needs to support the process of lactation and a healthy milk supply for your baby.

When putting together your meals and snacks, keep this framework in mind to help you:

• Do you have a good balance of macronutrients at your meals (including carbohydrates, proteins, and fats?)

• Are you pairing carbohydrates with enough protein?

• Are you eating enough healthy fats, including animal fats?

This can help support adequate nutrition intake, especially while breastfeeding.

Dedicate Time to Meal Planning and Preparing Ahead

There’s no question that caring for a new baby makes it harder to find time for cooking and meal planning. Set aside a brief amount of time each week to plan out some healthy meals and postpartum food for yourself that you can quickly put together.

Automate and delegate what you can when it comes to meal planning and preparing food in motherhood to make things easier for yourself while caring for your baby. This might include:

• Ordering groceries online and having them delivered

• Using a meal-kit service temporarily for easier postpartum meals

• Asking for help from loved ones for shopping, cooking and preparing snacks

• Batch cooking and doubling recipes when you do cook to have extra on hand for postpartum freezer meals that you can eat later

• Utilizing a slow cooker and/or instant pot to help simplify cooking

• Using simple postpartum recipes that can help you put together easy and nutritious meals and snacks

Spending a short time planning meals and snacks for yourself will help you be more intentional about how you are feeding yourself. You will be more likely to reach for nutrient dense foods that support your mental health and physical recovery if you have them readily available.

Stock your pantry, fridge and freezer with postpartum foods that are easy to eat with one-hand, like fresh fruits, trail mix, hard-boiled eggs, string cheese, yogurt, and veggies that you can dip in guacamole or hummus packs.

Use Quality Postpartum Supplements

Supplements can be a great way to fill in the gaps when it comes to increased postpartum vitamins and minerals nutrient needs. Be sure to continue taking your prenatal vitamin after you have your baby, even if you are not breastfeeding.

Your prenatal vitamin can help you replenish nutrient stores while postpartum, especially micronutrient needs. As a general rule, you should continue taking your prenatal for at least 6 months postpartum or as long as you are breastfeeding.

Remember that while nursing, nutrients from your body and your diet are passing directly into your breast milk for your baby. If your body is deficient in certain nutrients, this can impact the overall quality of your breast milk.

Optimizing the quality of your diet along with continuing your prenatal can help improve the concentrations of nutrients that are passing to your baby through breast milk.

Because the supplement market is not well-regulated, you want to be sure you are using high-quality, professional grade supplements that are tested by a third party.

Look for a prenatal supplement that offers bioavailable and active forms of nutrients, including:

• Methylfolate (bioactive form of folate)

• Vitamin B6 (pyridoxal-5”-phosphate)

• Methylcobalamin (bioactive form of B12)

• Vitamin D

• Choline

• EPA/DHA (Essential Fatty Acids): Studies have found that dietary supplementation with omega-3 fatty acids during pregnancy or postpartum reduces some symptoms associated with depression

• Calcium

• Trace minerals, such as selenium, iodine, zinc

• Vitamin B12 (methylcobalamin or adenosylcobalamin)

Other postpartum supplements that may aid your physical recovery and promote improved mental health include probiotics and collagen/gelatin.

These prenatal supplements are a high-quality option recommended for pregnancy, postpartum and lactating moms that offers comprehensive nutritional support.

As with all supplements, please check with your health provider before taking anything.

Keep in mind that supplements are not a one-size-fits-all approach.

Be sure to consult with your prenatal registered dietitian and healthcare provider to determine what supplements might be most appropriate for you during your pregnancy and in postpartum.

A postpartum nutrition dietitian can help you determine if there are specific nutrients that you’re not adequately getting from your diet and if it would be appropriate to supplement.

Remember that supplements should be used to support a healthy diet, not replace it.

If your diet is lacking in certain foods and nutrients, you may need to supplement to ensure that you are getting adequate nutrition to support your pregnancy and postpartum recovery.

Don’t Skimp on Feeding Your Body Well

There is a tremendous amount of pressure of moms to lose weight postpartum and “bounce-back” to their pre-baby bodies. Some moms may turn to dieting as a way of creating some sense of normalcy in the chaotic transition of motherhood and rediscovering a new identity as a mom. It’s not uncommon to seek out some kind of postpartum diet plan that promises to deliver weight loss goals.

In talking about this, it’s important to acknowledge how difficult it might be to accept where you’re at in your body. Your postpartum body may feel foreign to you, and the changes you’ve experienced through your pregnancy might leave you uncomfortable in your own skin, or desperate to change. Postpartum diets can be alluring, in that they seem to offer a tangible solution to the things you are experiencing in your body.

However, dieting in postpartum is connected with poor body image, increased mental health issues, and eating disorders. New moms who are restricting their intake or not allowing themselves to eat enough are creating more nutrient deficiencies that can trigger a host of problems. Postpartum recovery goes easier when feeding your body optimal nutrition. Commit to self-kindness by treating your body with the respect it deserves.

Remember that your body created and birthed life into the world. This is a miraculous feat that requires adequate nourishment to help you heal and recovery.

Food can be your medicine during this critical postpartum period, as well as something that brings you pleasure and joy.

Honor Your Body With Intuitive Eating Postpartum

At the end of the day, you are and always will be the best expert of your body. Your body is the best guide of what you need to eat and the quantities of food that will adequately and sufficiently satisfy you.

You might feel at odds with your body through the many transitions you’ve endured through pregnancy and postpartum. However, the more you can align yourself with your body by listening to and honoring what your body needs, the better things will go for you: physically, mentally, and emotionally.

This is also important for helping you establish a positive relationship with food and your body, which is fundamental for thriving through motherhood. When you trust, honor, and respect your body, you will also set a powerful example for your own children to model and example one day.

If you are struggling with how to best feed yourself during the postpartum period or continually feel a pull toward dieting and restricting your food intake, consider learning more about Intuitive Eating. This approach to eating puts YOU in the driver’s seat as the best expert of your body and helps you learn how to tune in to your body’s innate wisdom for eating.

Studies have found that following a more intuitive eating approach to food consumption may encourage adequate postpartum intake without the required weighing, measuring, recording and assessing dietary intake that is required of traditional weight loss programs.

Intuitive eating could offer an alternative approach that may be less arduous for new mothers. This is crucial for supporting your overall mental health. If you feel at war with food and/or your body, this can worsen any maternal mental health issues you may be facing.

Work With a Prenatal and Postpartum Registered Dietitian Nutritionist

If you’re overwhelmed with how to optimize your nutrition during pregnancy and postpartum or have struggled with feeding yourself well, know that you don’t have to do this alone. Having some professional guidance along your journey can help you feel more confident in how you are feeding yourself and support a healthy pregnancy and postpartum recovery.

If you are a postpartum mom recovering from an eating disorder, consider joining Lift the Shame, a free online eating disorder support group specifically for moms who are healing from food and body image issues.

Your body has worked hard to grow your baby and bring it into the world. Take care of yourself and treat your body kindly so that you can recover well and thrive through motherhood.

Get Help for Postpartum Depression

It’s important to understand that postpartum depression is a severe mental illness that often requires comprehensive help and professional treatment for recovery. Supplements and dietary changes alone are not cures for postpartum depression and maternal mental illness, but rather, should be an integral part of treatment and recovery.

If you are experiencing symptoms of postpartum depression, please talk to your doctor and connect with professional resources for help, recovery, and a comprehensive treatment plan.

Consider working with a mental health professional to help support your overall mental health.

Remember that you are not alone and that there is hope for healing. If you are unsure of depressive symptoms or if something doesn’t feel right to you, please don’t wait to talk to someone and ask for help. There is no criteria needed for getting help and support.

To learn more about postpartum care for mom and resources for postpartum depression, please check out Postpartum Support International.

***If you are thinking about hurting yourself or your baby or in the case of a mental health emergency, please get help immediately by going to a hospital emergency room, calling 9-1-1, or contacting your obstetrician/primary care provider.