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Lola&Lykke Experts Answer: Top Nutrition Tips For C-section Recovery

* Written by Marika Luukkonen, MHS, Registered Dietician

Without a doubt, it is a wondrous thing for a new baby to arrive into the world, but it often takes a while for the mother to recover, both mentally and physically. Whether the birth was vaginal or a C-section, recovery is a process that takes time.

Every postpartum recovery period is unique. The way the mother gave birth also impacts recovery and postpartum needs. From a mental recovery perspective, it makes a difference whether the C-section was planned or unexpected. A well-constructed diet can make the physical recovery process smoother, but it also offers benefits to psychological and emotional wellbeing.

So how should you eat while recovering from a C-section?

What to eat right after a C-section

A C-section is a significant operation that inevitably comes with major challenges to the mum’s body. After the operation, you may feel slightly disoriented and woozy. Some mums also experience nausea. If the C-section was pre-planned, you should not eat for at least 6 to 8 hours before the operation (1). The long fasting and blood loss can cause nausea. To ease recovery after the birth, it is important not to prolong the fasting. A liquid diet is recommended for 8 to 24 hours after the surgery, after which a normal diet can be resumed (2). A liquid diet is not recommended for any longer than this as it makes it more difficult to take in enough energy and nutrients.

The mum should also ensure they are getting enough energy from food to support the start of milk production and breastfeeding. The invasive operation and the healing of the incision also require extra energy, so the main focus in boosting recovery is to ensure you are getting enough energy from your diet. This can be achieved by enjoying plenty of high-energy but nutritious foods, such as smoothies or dairy or plant-based non-dairy products (3).

Immediately after the operation, the bowel is often unable to function normally, so bloating and unusual gut symptoms are common (4). These changes can be very painful at the beginning and the first time in the toilet after giving birth can be challenging.

Here are some tips to ease constipation during the first few days after the C-section (3,5):

- Drink plenty of fluids. You should aim to drink at least 2 liters of water every day.

- Get plenty of fibre, which you can obtain from whole wheat products, vegetables, fruit, and berries. You can also try a fibre supplement. Oat porridge and yoghurts topped with bran are great examples of how to add good fibres to your diet.

- Try eating plums and figs, which contain plenty of fibre and can help to get the bowels moving. You can also put 6 or 7 plums in water and drink the water in the morning.

    Meal prepping to survive the first days with a newborn

    The time mums are required to stay at the hospital can vary and you might get to go home with the baby sooner than you thought. Recovering from the surgery and learning to live with your new family member can be quite exhausting. The recovery process can be painful and uncomfortable, which can make everyday tasks a struggle. In this situation, eating and cooking might be the last things you want to focus on.

    Often mums put their babies' needs before their own, which is completely understandable. However, taking care of yourself and your diet are extremely important so that you can recover from the C-section and have enough energy to take care of the baby. When you return home, help from your partner, family members, or close friends can be invaluable to ensure you eat properly.

    A handy way to prepare in advance is to fill the freezer with plenty of nutritious foods. You can also fill the cupboards with convenient food products that are quick to prepare when you feel hungry. Great examples are whole wheat pasta and rice, tomato sauces, pulses, canned foods, and porridge, nuts, and dried fruit.

    You will need more energy and nutrients after a C-section

    When you get home after a C-section, it is very important to eat well. The C-section incision requires energy, proteins, carbohydrates, fat, vitamins, and minerals to heal (6). The incision secretions, tissue repair, and new tissue formation increase your nutritional needs. At the same time, mums often start to breastfeed, which further increases the need for a well-balanced diet (6,7).

    Increase meals per day

    It is common for the time between meals to widen unintentionally, so eating more often may be beneficial. To ensure that you are taking in sufficient energy after a C-section, it is important to eat regularly, approximately every 3 hours. Eating snacks in between main meals can also help to ensure you are getting enough nutrients. Eating should not cause extra stress or pressure, so never feel guilty about using pre-prepared meals and frozen vegetables. In some cases it is far better to eat a ready meal than to skip a meal. Ready meals can be further enhanced by adding more vegetables or healthy fats to them in the form of nuts or oil-based salad dressings.

    Increase protein intake

    C-section incision healing can temporarily increase protein requirements (8). Protein plays an important role in healing and tissue repair. The precise need for protein can vary and, in addition to healing and breastfeeding, the mum’s weight and age are important factors. Where necessary, a registered dietician can help to evaluate your personal protein requirements. You should avoid adding too much protein to your diet to avoid over-simplifying your diet, and because the extra protein is stored in your body as fat and can also cause extra stress to your kidneys (9).

    It is recommended that you get your protein from different sources. Great ways to obtain protein include meat, fish, chicken, eggs, and dairy products, as well as pulses, soy, peas, beans, wheat products, nuts, and seeds (8). If you do not eat meat, it is important to combine different plant-based sources in your meals to get different types of amino acids to help build up the protein, such as by eating both pulses and wheat.

    Include fat from different sources

    After giving birth, it is recommended that you include different kinds of sources of fat in your diet. If you are breastfeeding and producing a lot of milk, it is even more important to ensure you are getting enough good fats, as the mum’s fatty acids directly affect the breast milk (7). Excellent sources of fats are fish, vegetable oils (excluding coconut and palm oil), avocado, nuts, and seeds.

    Food to help normalise bowel function during C-section recovery

    It may take a while for normal bowel movements to return after a C-section. Getting enough fibre is key to a healthy gut. Great sources of fibre include whole wheat products such as porridge, bran, muesli and cereal, pasta and rice, and bread (5). In addition to whole wheat products, you can also get fibre from berries, fruit, root and other vegetables, pulses, nuts, and seeds.

    Whether you are in the hospital or at home, you can ease constipation with dried plums, figs, and brans (5). If you opt for using fibre supplements, it is best to start cautiously, as in the beginning they can cause temporary stomach aches and wind (5). With brans, you can start adding 1 to 2 teaspoons to foods and then slowly increase your intake up to 3 to 6 tablespoons a day. Brans can be soaked in water or added to any food containing liquids.

    The normal recommended intake of fiber for women is 25 to 35 grams per day (10). For treatment of constipation, this can be increased (5). Here is an example of how to get your daily fiber:

    - Bowl of oat porridge (4 g)
    - Two pieces of fruit, e.g. an apple and an orange (6 to 10 g)
    - 1 tbsp of sunflower seeds (1 g)
    - 100 g of mixed vegetables (3 g)
    - 275 g of boiled whole grain rice (5 g)
    - 3 pieces of whole-grain bread (6 to 15 g)
    - 1 tbsp of bran (1 to 1.5 g)

      It is important to stay well-hydrated, both for your gut health and breastfeeding. Adding extra fiber to your diet also increases the number of fluids required for normal bowel movements (5). Breastfeeding increases fluid requirements as much as is lost through milk expression (11). However, your body will continue to regulate your overall fluid balance no matter how much you take in, and will therefore not produce any extra milk just because you are getting more fluids. It is best to drink water, but fat-free dairy and juices with low sugar content are also good options.

      Vitamins and minerals for C-section recovery

      The key vitamins and minerals to enhance C-section recovery are vitamins C, A, and E, as well as iron, copper, magnesium, and zinc (12). Blood loss is common during a C-section and the postpartum bleeding can be heavier due to weaker contractions (13). These increase the need for extra iron. A C-section also makes you more susceptible to infections, which these vitamins and minerals can help both prevent and treat (4,13).

      You can get different vitamins and minerals by ensuring you eat plenty of different kinds of vegetables, fruit, berries, wheat products, dairy, fish, meat, and eggs. Below I have provided more detail on each of these key vitamins and minerals for C-section recovery.

      Vitamin C (12,14,15)

      - Great sources include vegetables, fruit, and berries. For example, papaya, kiwi, oranges, cloudberries, blackcurrants, and different colour bell peppers are rich in vitamin C.
      - Vitamin C gets destroyed by heat, so it is best to eat these foods fresh.
      - As the intake of vitamin C increases, the absorption decreases, so extra supplements are not necessary.
      - Enhances iron absorption.

      Vitamin A (12,15)

      - Great sources include fish, eggs, fortified spreads, and dairy products that contain fat.
      - Carotenoids i.e. vitamin A precursors can be obtained from yellow, red, and orange vegetables, berries, and fruit.

      Vitamin E (15)

      - Great sources include vegetable oils, nuts, and seeds.
      - Fat enhances vitamin E absorption.

      Iron (16)

      - Great sources include liver, blood, and meat products, wheat products, pulses, lentils, soy, seeds, and nuts.
      - Heme iron from animal products absorbs better than non-heme iron from vegetarian sources.
      - Phytates (found mostly in wheat products), calcium (found mostly in dairy), soy protein, and phenol substances (e.g. from coffee, tea, and cocoa) decrease iron absorption, whereas vitamin C increases it.

      Copper (12)

      - Main sources include wheat products, vegetables, and dairy products.

      Zinc (17,18)

      - Great sources include whole wheat, meat, offal, fish, crustaceans, eggs, and dairy products.
      - Zinc is not very abundant in vegetable-based foods, but some vegan sources include wheat germs and gran, pumpkin and sunflower seeds, whole grains, and pulses.

      Magnesium (12,19)

      - Key sources are wheat products, vegetables, potatoes, fruit, berries, dairy products, and coffee.
      - The surplus intake is lost through urine, so extra supplements are not necessary.
      - The effect of magnesium supplements on muscle cramps has not been backed up by reliable studies.

      If you are breastfeeding, it is also good to take note of your intake of vitamin D, calcium, folate, and iodine (7). A certified dietician can help you assess your personal needs if you feel unsure.

      Allow your body to recover and eat intuitively

      Keep in mind that every C-section recovery journey is individual and takes time. Try not to compare your healing to that of others, but rather try to focus on your own and your family’s wellbeing.

      When you are recovering from an operation and from birth itself, and you are in the midst of a new life with your baby, it is important to savour all moments of enjoyment and happiness. Food can be an excellent way to add some joy to your everyday life. Sometimes a takeaway pizza enjoyed with your loved ones is just the thing your body and mind need. Remember to allow yourself to enjoy food amidst all the exhaustion and stress of this busy time in your life.

      Source materials

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