The six weeks after childbirth, known as the post-partum period, is a vulnerable time for women and their infants. The impacts of the ongoing pandemic have only heightened concerns that new mothers in South Africa are able to access the care and resources they need as they step into motherhood. It’s not unusual for the need for post-partum follow-ups to extend for four to six months, especially in cases where there are physical and emotional issues and health complications. In South Africa, primary health care provides free services to pregnant and lactating mothers, as well as children under six years. Given the severe economic impact of the global pandemic, this access to post-partum care has become particularly important to the country’s new mothers.
As with pregnancy, nutrition is a particular focus of post-partum care. New mothers need the support to recover from the rigours of pregnancy and childbirth so that they can cope well with the different challenges presented by infant care. Exclusive breastfeeding, which means providing only breastmilk to the exclusion of water, tea, juice or food, from birth for the first six months of life, is crucial and requires ongoing support within the family and through community and healthcare connections.
According to ADSA (The Association for Dietetics in South Africa) spokesperson, Professor Lisanne du Plessis breastfeeding is not only the best source of food for babies; it is also a major cost saver for food-insecure families and a major immune support for vulnerable children. Therefore, we have to make sure during this COVID-19 time that our new moms are healthy and well-nourished. She says, “Mothers should try and eat a healthy balance of fresh, whole foods including carbohydrates from unrefined, whole grain starches; proteins from meat, eggs, fish, chicken, beans and legumes; healthy fats; fruit and vegetables as well as dairy thatsupplies vitamins and minerals. They should try to avoid fast foods and other ultra-processed foods that are high in salt, sugar, preservatives, and unhealthy fats. It is interesting to note that breastfeeding moms need around 500 additional calories daily, which equates to an extra snack such as a wholewheat bread sandwich with cheese or peanut butter; one to two glasses of milk, and an extra vegetable plus a fruit. What is most important is a focus on fresh and whole foods. New moms who are battling currently with household food insecurity need to raise this issue with their primary health care providers and get connected to a community-based or non-profit initiative which supports families through food parcel or other food security programmes.
When it comes to nutrition, post-partum care and breastfeeding, some of the same pregnancy restrictions should continue. Prof du Plessis says, “Limit coffee drinking to just one cup a day, avoid other drinks and snacks that contain caffeine, and keep avoiding cigarettes and alcohol.”
An issue for many new moms is managing the weight they gained through pregnancy. Another Registered Dietitian and ADSA spokesperson, Cath Day says, “Don’t rush it. Don’t worry about how much you weigh for at least the first six weeks after the birth of your baby. During this time, concentrate on eating fresh and minimally processed food. Focus on your support system and on getting enough rest. Once you have healed from childbirth and established a good breastmilk supply, you can begin to think about getting your body back. Go slow, do what you can, and be kind to yourself. If you are not back to your pre-pregnancy weight by six months, then you can start looking at your diet and exercise regime. Remember, it took you 9 months to gain the extra weight, so give yourself enough time.”
As disruptive as the pandemic has been, and how it has shaped many women’s experience of pregnancy, childbirth, and new motherhood, what’s important to remember is that COVID-19 has not changed the essentials of bringing a new life into the world. Moms need the same as they always have. They need support and encouragement from their families and friends. They need access to good, fresh foods. They need easy access to quality healthcare and professional support when needed. Day says, “There is currently no evidence to suggest that pregnant women and new mothers need to adapt their nutrition specifically in response to COVID-19. Pregnant mothers and new mothers should concentrate on eating a healthy and well-balanced diet made up of minimally processed and fresh foods such as wholegrains, legumes, nuts and seeds, plenty of fruit and vegetables, lean proteins, and plant-based oils. Combat stress with a healthy, balanced diet along with enough sleep and exercise. Consider stress management techniques such as walking, deep breathing, meditation, yoga or Pilates. It is really important that if mothers require nutrition and food support, there are various government, non-government and community-based programmes providing food parcels and other social relief.”
Prof du Plessis adds: “Although everyone is encouraged to stay at home with COVID-19 regulations in place, it is important that new mothers continue to go for their check-ups and take their babies for routine immunizations and follow-up clinic visits, according to the schedule in the Road to Health booklet. During these visits, mothers should ask questions about their health and their children’s growth, health, and nutrition. They should also request breastfeeding support if they are experiencing challenges to their goal of breastfeeding exclusively for the first six months. The pandemic has not changed the essentials of life, and post-partum maternal and infant health remains a high priority in our country.”