Let’s break down the fraught history behind BMI.

BMI: The backstory

BMI (first called the Quetelet Index) was invented by a Belgian mathematician (you read that right, not a doctor) named Lambert Adolphe Jacques Quetelet in the early 19th century. He set out to find the “average man” by studying the height and weight of (mostly) European men. His work excluded women and people of color. 

BMI, a calculation of weight (in kilograms) divided by height in (meters squared), was later picked up by health insurers and medical providers in the U.S. They used various BMI categories (underweight, normal weight, overweight, obese, and morbidly obese) to determine insurability and individual health. 

Is this starting to raise some red flags for you?

OK, but does it work?

The short answer is no, it does not work and there are a few reasons why.

1. BMI was originally created to indicate population health, not to determine individual health.

Quetelet was a statistician. His intention was to collect large amounts of data to uncover population-level trends, not to assess an individual’s health or risk factors. 

2. These categories are problematic for individuals who were left out of the original studies

Given the fact that so many groups were excluded from the development of BMI in the first place, it doesn’t make much sense to apply it to them retrospectively. Further, BMI suggests that there is an ideal height/weight ratio. This is simply not true.

3. BMI equates muscle, fat, and bone

The body is made up of (among other things): bones, muscles, and fat. BMI groups all these categories together into one, treating bone, muscle, and fat the same. Not only that, but which out of these three parts of the body weighs the most? Bone. The least? Fat.

So is there a better way to calculate health?

There are alternative calculations of health informed by weight, but the issue at play here goes far beyond the biased history of BMI or its misguided application to individuals, because even weight itself is not a strong indicator of health. Research has shown that simply changing one’s body weight is not a reliable measure of improvement in one’s health. 

If you’re looking to feel stronger and healthier, there are things you can do, like starting a health promoting behavior. 

Here are a few examples of health promoting behaviors

• Setting a goal to drink more water
• Figuring out what type of exercise you enjoy and doing it consistently
• Finding a mindfulness practice that helps you tune into your inner needs
• Intuitive eating: listening to your body’s requests for nourishing food

Setting goals like these – that are based on how you feel, how your body functions, and what you personally need to be living in a healthier body – is more reliably associated with improvement in overall health. 

Providers that rely too heavily on BMI might be missing the whole picture of your health. If you’re concerned that your provider isn’t understanding the whole picture of your health, seek out a HAES (Health At Every Size) aligned healthcare provider. There are therapists, body image coaches, doctors, nurses, and dietitians who are all trained in HEAS. You deserve to feel seen and cared for by your provider, regardless of your BMI or the size of your body. 

Reviewed by the Ovia Health Clinical Team

Read more

• Body image and bouncing forward with Taylor Bjorgum
• Accepting and taking care of your body as a new parent

Sources

• Brazier, Yvette. “How Useful Is Body Mass Index?” Medical News Today. MediLexicon International. September 6, 2021. https://www.medicalnewstoday.com/articles/255712.    
• Jackson-Gibson, Adele. “The Racist and Problematic Origins of the Body Mass Index.” Good Housekeeping. Good Housekeeping. November 1, 2021. https://www.goodhousekeeping.com/health/diet-nutrition/a35047103/bmi-racist-history/. 
• “Adult BMI Calculator.” Centers for Disease Control and Prevention. Centers for Disease Control and Prevention. January 21, 2022. https://www.cdc.gov/healthyweight/assessing/bmi/adult_bmi/english_bmi_calculator/bmi_calculator.html. 
• “About Adult BMI.” Centers for Disease Control and Prevention. Centers for Disease Control and Prevention. August 27, 2021. https://www.cdc.gov/healthyweight/assessing/bmi/adult_bmi/index.html. 
• The MNT Editorial Team. “BMI calculations and charts.” Medical News Today. Medical News Today. May 3, 2021. https://www.medicalnewstoday.com/articles/323586. 
• Devlin, Keith. “Top 10 Reasons Why the BMI Is Bogus.” NPR. NPR. July 4, 2009. https://www.npr.org/templates/story/story.php?storyId=106268439. 
• Eknoyan G. Adolphe Quetelet (1796-1874)–the average man and indices of obesity. Nephrol Dial Transplant. 2008 Jan;23(1):47-51. doi: 10.1093/ndt/gfm517. Epub 2007 Sep 22. PMID: 17890752.

 

An interview withTaylor Bjorgum

Taylor is a stay-at-home mom and lives in Minnesota with her husband, four kids, and a golden doodle. We talked to her about body image, what it means to be a plus size mom, and how other parents can reimagine the way they think and talk about their bodies.

Do you have any advice for someone preparing for postpartum or in the postpartum stage? What helps on the hard body image days?

Give yourself grace. Postpartum is wonderful, it’s unknown, it’s beautiful, and it’s really hard! No amount of creams or serums will make those stretch marks disappear. Loving yourself at every stage isn’t easy, somedays you won’t, and that’s okay. It’s nearly impossible, but try not to compare your journey with someone else’s. 

And do you have any strategies for what to do when those thoughts of comparison do creep up on you?

Usually comparison happens on social media, so I’ll take a step back and try to figure out why I’m feeling this way. We have to remember that majority of people only post or share the highlights, and we see very small glimpses into their lives. Someone might look like they have the perfect picture life, but you never really know what they’re going through. We’ve all had moments where we’ve faked that everything is okay when it definitely was not.

So I just try to remember that no one’s journey is the same. And if you find yourself comparing, stop following those people. Find people who you relate to, that bring you joy. When you’re struggling with comparison and having bad body image days, take a moment to be kind to yourself. You’re doing the best you can.

I try to remind myself all of the things I’m capable of doing and all the things my body is capable of doing. I sacrificed my body for 10 months, technically 40 months (4 babies) to grow little humans. That’s not easy, and pregnancy is not easy. This might sound cheesy but nourish your body with food, practice self-care, and tell yourself daily affirmations until you believe that your body is good at every stage. 

What does health at every size mean to you?

HAES to me is measuring one’s health beyond the scale. Your weight and outer appearance cannot determine your health. HAES to me is being able to go to the doctor for a broken arm or depression medication and actually being taken seriously. It means I’m not going to be misdiagnosed, ignored, or given weight loss advice when I didn’t ask for any.

What words are you saying no to?

There are so many I steer clear from: flattering, dieting, healthy/unhealthy, good/bad food, treats, rewards, earning food, or the saying “I feel fat.”

What do you think is missing from the conversation about plus-size pregnancy?

There is very limited representation in the plus size pregnancy world. “B” bellies and “apron” bellies are hardly ever shown. Some women don’t show until way later or they don’t show at all. I was so embarrassed by my apron belly for so long and had no one to relate to. Being plus size and pregnant isn’t a bad thing. 

There is a ton of misleading information about plus size pregnancies. You can have a textbook perfect pregnancy and delivery as a plus size person. Just because you’re fat does not mean you have to or will have a C-section. It also doesn’t mean you’ll have a big baby. 

How did the birth of your children change your feelings about your body?

Before my first child was born I was already plus/mid size. My expectations about my appearance weren’t realistic. I didn’t see or know anyone else who was plus size and pregnant. I expected to have the cute round belly bump and pregnancy bliss. Instead, I had an apron belly and was swollen majority of the time. I don’t have any pregnancy photos because I was so embarrassed about my appearance and I will always regret that. 

I really started celebrating my body and rejecting diet culture when my son was 1.5 years old. (He’s currently 3.5). So, when I was pregnant for the last time recently (final baby is 7 months old), that was the pregnancy that changed everything for me. I really felt beautiful even when my body was changing. I embraced my pregnant body one final time. My biggest regret was waiting until that pregnancy to shift my thinking. I regret not taking pictures, and I regret not doing things because I was so embarrassed about my appearance. I wish I would have celebrated each time and embraced my body instead of hating it.

Does your rejection of diet culture impact the way you’re raising your children? If so, how?

Yes, greatly! I do not talk about diets, unhealthy/healthy foods, treats, etc. My kids try lots of things unprompted. They listen to their bodies when they’re hungry they’ll eat, if they’re not they won’t eat. They don’t have to earn treats or clean plates. My kids haven’t shown any signs of restricting or bingeing. I have seen articles that say girls on average will start their first diet by age eight and I’ll do everything in my power to prevent my daughter and kids from being that statistic.

I will speak for majority of millennials here — we grew up with diet culture impacting our lives from a very early age. Most of my friends and myself grew up with eating disorders and/or disordered eating. I missed out on so much growing up due to diet culture and body image. At my smallest, I was treating my body extremely poorly. I would burn over 2,000 calories a day and barely eat 1,000. I would workout until I puked. Diet culture ruined my childhood, and I don’t want that for my children. It’s hard to find others in my age group who weren’t negatively affected by diet culture.

What makes you feel beautiful and/or powerful?

My body is not perfect, or society’s definition of perfect, but it was my children’s home before they entered the world. To me that makes me feel beautiful. I honestly feel the most beautiful by being my authentic self — whether that’s no makeup and lounge wear or getting a little dressed up with makeup and hair done. 

My first born was actually stillborn, so his birth story and surviving that time in my life makes me feel very powerful. I gave birth to my daughter a month after my stillborn son’s first birthday. That day was tough but I did it, and while grieving him.

I feel powerful when I say no to getting weighed at the doctor when it’s not necessary. I feel powerful when I’m wearing something that is out of my comfort zone (like a swimsuit in public with no cover up).

What would you say to someone struggling to find their stretch marks, cellulite, or body beautiful or worthy?

There are going to be tough body image days, especially when your body doesn’t feel like your own. But you created life! Your body stretched and changed to grow another human. You aren’t the same person you were before your kid(s) and that’s okay! Our bodies are meant to change. It took almost ten months to grow a baby, we shouldn’t expect it to “snap back” like nothing happened. You are amazing, and your body is incredible just the way it is.

Pamela DeGregorio Women’s Health Writer at Ovia Health

Alyson Roux worked for a decade in the arts and entertainment industry, when, spurred by her own health challenges, she chose to return to her science roots to help others live as healthily as possible, reconnect with nourishment, and grow to have a positive relationship with food. I spoke with the L.A.-based nutritionist about nutrition and self-care postpartum, how to ensure that you meet your nutritional needs when you’re busy caring for a new baby, and how to make a meal when you don’t even have time to shower.

I’ve been thinking a lot about how nutrition fits into self-care postpartum. Certainly, at least in theory, during the postpartum period new moms and birthing parents absolutely do need to focus on self-care, and yet, in practice, it’s so easy for that to not be a priority. You just had a baby! Your world is rocked! You’re not only caring for a brand new little human, but many folks are also going back to work very quickly, don’t have a support system around them, and may not be getting tons of sleep or be eating at all hours. What can you recommend for new parents who want to focus on nutrition but also need to keep it simple? 

What we call a gentle “rule of three’s” can really let people off the hook in terms of “Am I balancing my plate? Am I meeting my nutritional needs?” It means aiming for three meals a day. It seems so simple, but it can be so hard when your world is rocked. It’s not like, “Are you meeting your macronutrient distribution properly?” Let that go. Just make sure there’s a protein, a carb, and a fat at each meal. And don’t necessarily really have any vigilance over the ratio of those things. 

And, ideally, you get at least two of those groups at snacks, if not three. So, for example, I love Persian cucumbers because you don’t have to peel them. So if you’re gonna grab some Persian cucumbers, can you dip them in some hummus, just to get some protein and fat in there? 

So, for macronutrients, just gently thinking about three meals a day. Many of which can be premade, preordered, delivered – whatever works!

It’s also important for individuals to develop healthy behaviors for their own quality of life. If an individual is breastfeeding and their behaviors are therefore impacting another being, it becomes even more important to make sure that you’re getting the nutrients you need to keep your energy up. 

And so there are gentle ways to do this – what we refer to in the intuitive eating world as “gentle nutrition.” It’s essentially really similar to a standard Mediterranean style diet, where you eat plenty of whole grains, lean protein – that can be beans, nuts, poultry, seafood, and if it agrees with your beliefs, incorporating other meats with a frequency that is supportive for health – plenty of vegetables of every color that are appealing to you, fruit. And water, which is crucial! 

It can be so hard when you suddenly have someone you need to care for all the time, to get that adequate nutrition, but this sort of an approach to eating should give you those nutrients you need. 

I love the simplicity of these concepts – both the rule of three’s and the gentle nutrition approach to eating – and I wonder about other practical ways of approaching meals and eating that can be incorporated into those early postpartum days, when even just eating three meals can feel so challenging. You mentioned having food delivered. Obviously these days there are a lot of meal delivery kit subscription services and entirely premade meals that people can order. Arranging for a meal train – when friends and family organize meal deliveries to your home – is also an option. I know my husband and I were lucky enough to have family members occasionally bring us food after the birth of both of our children, and we also froze a ton of meals ourselves ahead of time – a lot of veggie soups, casseroles, pasta bakes with protein, that sort of thing. But once we got through that stockpile of frozen food, we were sometimes faced with the choice of, well, should I use what very little free time I have to shower, or should I skip that and prepare a fresh meal? Are there any other habits or shortcuts that can be helpful for new parents to ensure that they’re eating well? 

If you do have a social or family network, you can arrange for a meal train, which can be really helpful. If you don’t, we are very fortunate to live in a world where we can get almost anything delivered to our door. There are so many meal kit services that call for pretty easy assembly. And there are so many prepared meal delivery services too. When you think about the cost of the ingredients, I don’t know how some of these services are making money. So being able to get food delivered through a meal delivery service can be really helpful. I would encourage, especially in the first few weeks, if you’re not going to do a meal train or if you don’t have people that can help provide you with food, to just get at a minimum two meals a day through some kind of prepared food delivery service. And I’m not just talking about Postmates or another grocery delivery service! Actually, I mean, like, get six meals dropped off at your doorstep on Monday, and then get some more dropped off later that week. 

And make sure that you have foods on hand that are easily accessible. For breakfast, maybe yogurt with granola. Have lots of fruit around. Maybe beans dips. Get a rotisserie chicken and do a quick chicken salad. Use canned wild salmon. Have frozen meals that are really easy to heat up and are made of ingredients that you like. 

A lot of new parents can get into a frozen meal rut though, and that can be potentially remedied on a budget by making sure you get bags of baby greens and spices that you like – you can throw the baby greens and spices into the reheated frozen meal to freshen things up. Even Trader Joe’s now has precut vegetables that are not very expensive, so those can be easily thrown into a meal. 

It can also be really helpful to think about assembly versus cooking. So finding things that you can use to literally assemble a meal, where stuff is essentially premade and you just assemble it. Again, a rotisserie chicken is so great. Frozen brown rice that’s been already cooked is also available at many grocery stores. One of my favorite meals is rotisserie chicken, brown rice, some baby greens, and then I just do a scoop of sauerkraut on there, and it’s just so easy and yummy. 

A lot of these tips seem like they’re a great fit for people who are limited in time, as most new parents find themselves to be. But what about people for people who hear about a meal delivery service and feel that’s just too cost-prohibitive? Essentially, I wonder what would you recommend for people who feel not just limited by time, but also limited by cost?

Definitely cooking things in bulk and freezing them is a really helpful tool. Soups, stews, all of those things can freeze really well. If you’re buying certain grains in bulk – like rice, farro, or quinoa – just rinse them really well before using them, because it makes them more digestible. It’s also really important that you’re getting enough protein. So if buying a pre-made rotisserie chicken is out of the question, cooking a lot of chicken breasts or beans is great. 

Know that you can probably safely freeze that sort of thing for at least a month, sometimes up to three months. Just make sure you put the date on there and make sure it’s packaged in a way that makes it easy to reheat. And never put hot food in a plastic container! Let it cool in a glass or stainless steel or ceramic container. Especially during the perinatal period, trying to reduce any kind of exposure of something heated in a plastic container is good for health.

And if you’re going to be eating simply – like grains, proteins, baby carrots – whatever your simple system becomes, make sure that you find condiments that you love that you’re using. That is so key. It can really make a huge difference in being able to have a pleasurable eating experience. 

Depending on the person, using nutrient-dense foods like nut butters can be great too. For a while, the advice was to not have peanuts while pregnant, which we found out was actually maybe causing more health problems! And having inexpensive nutrient-dense protein sources – beans, nuts, canned salmon, yogurt, oats – is also absolutely fair game. 

Even new parents with limited time and operating on a budget can get the nutrients they need and find pleasure in eating – and, really, everyone deserves that. 

Choose healthy, energy-dense foods to keep up with an increase in appetite

You might have noticed that you feel quite hungry when you’re breastfeeding. Roughly 300 to 500 additional calories per day are recommended while breastfeeding. The exact amount you need depends on how much milk you are producing and how active you are. This increase in food quantity is important, but it’s also important to plan meals to include the quality nutrients you may be missing out on. 

Add more nutrients

Luckily, a vegetarian diet can support your nutritional needs, as long as you are enjoying a variety of different vegetables, fruits, whole grains and proteins. However, particularly for those who are not consuming any animal protein at all, there are a few vitamins and minerals to pay extra attention to:

Calcium (1,000 mg/day)

Calcium exists in dairy, dark leafy greens, tofu, orange juice, sesame seeds, and fortified alternative milks

B12 (2.8 mcg/day)

You can find this in dairy products, fortified cereals, fortified plant milks and fortified soy foods. Nutritional yeast also packs a punch of B12.

Zinc (12 mg/day)

Zinc is in beans, nuts, whole grains, fortified cereals, and nutritional yeast

Omega-3 fatty acids (1.3 gm/day)

This exists in fish, fortified eggs, seeds (like chia, ground flax, and hemp) and walnuts.

Iodine (290 mcg/day)

Seaweed, fish and eggs are good sources of Iodine. Some dairy may also contain helpful amounts. While table salt often has added iodine, specialty salts (sea salt, Himalayan salt) and the salt in most processed foods do not have added iodine.

If you are a vegetarian mom and you are not sure if your diet is complete, talk with your doctor or a registered dietitian.. They can offer support and guidance as you decide what works best. If you are concerned with your nutrient intake, talk with your provider about whether or not you need to be supplementing beyond a typical postpartum vitamin.

Reviewed by the Ovia Health Clinical Team

Read more

• Nourishing foods to support breastfeeding
• The self-care you need when breastfeeding

Sources

• Kolasa K, Firnhaber G, Haven K. Diet for a Healthy Lactating Woman. Clin Obstet Gynecol. 2015 Dec;58(4):893-901.
• The Risk of Breastfeeding on a Plant-Based Diet, Arthur I. Eidelman Breastfeeding Medicine 2023 18:1, 1-2
• Naina Dwivedi, Abbas Ali Mahdi, Sujata Deo, Assessment of endocrine disrupting chemicals in breast milk: Association with dietary habits and duration of lactation, Environmental Research, Volume 221, 2023,
• Maternal Diet and Breastfeeding, CDC, Feb 9th, 2024 https://www.cdc.gov/breastfeeding-special-circumstances/hcp/diet-micronutrients/maternal-diet.html

Recipe for success

You can cut down on indecision when dinner time comes around by making a meal plan before you head out to do the grocery shopping. Recipes that will keep well as leftovers are key to saving time during the busy week. Meals that require little prep (and cleanup) time are also a bonus.

• Stir-fry: This is a dish you can switch up the ingredients to as often as you want, so it doesn’t start to feel repetitive. Alternate protein, vegetables, and sauces for this versatile meal to keep it feeling fresh. Chances are, Baby will take interest in the bright colors a stir-fry offers, making them more likely to try that first bite.
• Chili: Are you a “set it and forget it” type? If so, nothing beats a good chili in the slow-cooker. Toss in some tomatoes, black beans, sweet peppers, and corn so Baby will get some veggies with their dinner. Unless you know for sure that Baby has a taste for spicy foods, if you’re using a seasoning packet, you may want to opt for mild.
• Chicken dinner: A classic, comfort meal that’s sure to please. Serve this one with sweet potatoes and Baby’s favorite vegetable on the side. If you’re using a packaged gravy, choose one that’s labeled “low-sodium.”
• Burritos: For the more adventurous young eater, burritos are a great way to expand their palate. These can be fixed with meat, vegetables, or even just beans and cheese. Serve with diced tomatoes and avocado for some extra nutritional punch.
• Whole-grain pasta with turkey meatballs: Despite (or maybe because of) the fact that it takes the better part of the evening to clean up, spaghetti tends to be a huge hit with toddlers. Making a healthy switch to whole-grain pasta, and turkey meatballs for a lean protein alternative, can cut down on any fears you might have that Baby isn’t getting all the nutrients they needs, especially if they is in a phase of picking at their food. At least that way, you’ll know that each of the tiny bites they takes are full of healthy, wholesome goodness. Oh, and wipes for their face and hands are the perfect accessory for this meal.

Dinnertime tips

• Keep snacks and meals on a regular schedule, well-spaced so Baby isn’t full before dinner.
• Allow some time for them to explore the food before digging into what’s on their plate. It’s normal for toddlers to want to explore their food before taking a bite.
• Offer water with dinner as opposed to juice to limit their sugar intake and avoid having them fill up on liquids.

Jennifer Heinen, MS, RDN, LDN Founder, Nourish for Life

Gestational diabetes is a common complication of pregnancy, affecting up to 9.2% of women who are pregnant. Mothers who develop diabetes in pregnancy are seven times more likely to develop type 2 diabetes later in life, and have a 30% to 50% higher risk of diabetes in a later pregnancy. However, making lifestyle and dietary changes, as well as breastfeeding your baby, may significantly improve your health after giving birth. Let’s take a closer look at what the research tells us about reducing risk of developing diabetes after gestational diabetes.

• Weight loss: Maintaining a healthy weight is one of the primary strategies for preventing diabetes for women with a history of gestational diabetes. A prospective study showed that the risk of developing type 2 diabetes increases by 16% for every kilogram gained during pregnancy. To help you stay on track, consider keeping a food diary and planning meals at home. Be sure to talk with your doctor or dietitian about an eating plan and exercise regimen to lose weight healthily after having your baby.
• Diet: Healthy eating patterns can prevent gestational diabetes and the progression to type 2 diabetes. The Diabetes and Women’s Health Study showed that an eating plan high in fruits, vegetables, and whole grains, while consuming less red and processed meats, and sugar-sweetened beverages, is associated with lowered risk of gestational diabetes and subsequent diabetes. Focus on plant-based meals that are high in fiber to help you ward off complications in the future.
• Breastfeeding: Many women have been counseled on breastfeeding by their doctors, and for those with a history of gestational diabetes there are added health benefits. A study that looked at how lactation protects against diabetes after pregnancy showed a 40% decrease in the risk of long-term diabetes if breastfeeding was sustained longer than three months. Therefore, if you can continue breastfeeding, it may be worth a try for your long-term health.
• Exercise: Getting out and about, even if just for regular walks, can help you ward off diabetes. The Nurses’ Health Study II showed that for every 100 minutes per week of moderate-intensity physical activity, mothers with a history of gestational diabetes reduced their risk of advancing to type 2 diabetes by 9%, and those who increased their activity to 150 minutes per week saw a 47% reduction of risk! On the flip side, those that spent six to ten hours per week watching television were over 40% more likely to develop type 2 diabetes. Finding fun and exciting ways to add activity into your week, like walking, dancing, or hiking, will make you more likely to stick with a routine – and taking along your kiddo is encouraged!

Taking care of ourselves can be challenging after having a baby. We put our children first, as we should, but we must remember we are important too! Modeling healthy behaviors such as eating nutritious foods and staying active can help you achieve your health goals while showing our kids that caring about health is important. For more information talk with your doctor or dietitian about a personalized plan after gestational diabetes.

About the author: Jennifer is a dietitian passionate about connecting good nutrition with tasty food. She runs a private practice, Nourish for Life, where she works with new moms and parents of young children to help them eat well and have a healthy relationship with food. She is a mom of one tiny human and two fur-babies, and loves creating yummy new recipes in her free time.

Sources

• Bao W, et al. “Long-term risk of type 2 diabetes mellitus in relation to BMI and weight change among women with a history of gestational diabetes mellitus: a prospective cohort study.” Diabetologia. 2015 Jun;58(6):1212-9. https://www.ncbi.nlm.nih.gov/pubmed/25796371.
• Bao W, et al. “Low Carbohydrate-Diet Scores and Long-term Risk of Type 2 Diabetes Among Women with a History of Gestational Diabetes Mellitus: A Prospective Cohort Study.” Diabetes Care 2016;39(1):43-49. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4686844/.
• Bao w, et al. “Physical activity and sedentary behaviors associated with risk of progression from gestational diabetes mellitus to type 2 diabetes mellitus: a prospective cohort study.” JAMA Intern Med. 2014 Jul;174(7):1047-55. https://www.ncbi.nlm.nih.gov/pubmed/24841449.
• Bellamy L, et al. “Type 2 diabetes mellitus after gestational diabetes: a systematic review and meta-analysis.” Lancet. 2009 May 23; 373(9677):1773-9. https://www.ncbi.nlm.nih.gov/pubmed/19465232.
• O’Reilly SL. “Prevention of Diabetes after Gestational Diabetes: Better Translation of Nutrition and Lifestyle Messages Needed.” Healthcare 2014 Nov 2;2(4):468-491. https://www.ncbi.nlm.nih.gov/pubmed/27429288.
• Ziegler AG, et al. Long-Term Protective Effect of Lactation on the Development of Type 2 Diabetes in Women with Recent Gestational Diabetes Mellitus. Diabetes. 2012 Dec; 61(12):3167-3171. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3501852/.
• “What is Gestational Diabetes?” American Diabetes Association. American Diabetes Association, November 21 2016. Retrieved June 17 2017. http://www.diabetes.org/diabetes-basics/gestational/what-is-gestational-diabetes.html?referrer=https://www.google.com/. 

Things to consider:

• Breastfeeding can be smooth sailing or require a ton of support. If you enjoy breastfeeding your baby, it can be easier to continue doing so and meet feeding goals. Seeking expert help can get you through early challenges!
• Both the World Health Organization and the American Academy of Pediatrics suggest that Baby should be nourished exclusively through breastfeeding for the first six months of their life.
• After the first six months, both organizations recommend starting to introduce solid foods, but as a supplement to breast milk, not a replacement. It’s still the easiest to digest and most nutritious source of food until age one.
• Longer amounts of paid family leave often translate into longer term breastfeeding rates. But a supportive work environment can also be a real win to making the logistics of breastfeeding continue to work. Be open with your employer about your feeding goals, and lean in to any state or federal protections you may have for pumping.
• General medical opinion says that while exclusively breastfeeding for the first 6 months is ideal, you should continue to feed Baby both solid food and breast milk for as long as the combination is right for both of you.
• Family and community support makes a world of difference. Sometimes finding support means reaching out in-person or on-line to find your people.
• You may know that breastmilk provides excellent nutrition for Baby as long as you offer it. But you may not know that health benefits for you increase the longer you choose to breastfeed. For example, for every year you breastfeed, the risk of breast cancer goes down 4.3%. 

And remember, if for whatever reason your feeding goals are different from what’s described above, any amount of time spent breastfeeding has a positive impact on your health, Baby’s health and their immune system! There isn’t one perfect way to feed your baby, and you know your family best.

Sources

• “Making the decision to breastfeed.” WomensHealth.gov. U.S. Department of Health and Human Services, January 23 2017. Retrieved October 25 2017. https://www.womenshealth.gov/breastfeeding/making-decision-breastfeed.
• “Up to what age can a baby stay well-nourished just by breastfeeding?” World Health Organization. World Health Organization, July 2015. Retrieved October 25 2017. http://www.who.int/features/qa/21/en/. 
• Stordal B. Breastfeeding reduces the risk of breast cancer: A call for action in high-income countries with low rates of breastfeeding. Cancer Med. 2023 Feb;12(4):4616-4625.
• Feldman-Winter, Lori “Breastfeeding: AAP Policy Explained.” Healthy Children American Academy of Pediatrics. 5/17/2024