Body image is among the greatest concerns of women during the first year after childbirth. The desire to lose weight and tone muscles in the postpartum period is common concern after child birth in today's society. Weight reduction can be difficult for anyone at anytime, but a mother who is trying to return to her pre-pregnancy weight is also challenged with additional stresses of increased child care commitments, less rest and sleep, household responsibilities, and, possibly, returning to work outside the home. A woman trying to be successful at weight management while breastfeeding will need the support of her family, friends, employer, and medical caregiver.

This article provides preliminary recommendations for diet and exercise programming for breastfeeding women who have the desire and, in consultation with their health care provider, have determined that weight management is necessary.

Lactation places significant energy demands upon the mother, causing the additional expenditure of more that 500 calories per day. The recommended diet is at least 1,800 calories per day, the minimum recommended intake for lactating women. The food eaten should consists largely of complex carbohydrates, low in fat and sugar, and contains the necessary meat and dairy products to meet minimum safe nutritional intake guidelines (United States Department of Agriculture [USDA], 1995). No effort should be made to deliberately restrict total calorie intake, and women should feel free to eat to satiety when they are hungry but to refrain from becoming overly full.

There is a need to make use of dietary exchange list to simplify meal planning and facilitates eating and recording food intake. The exchange list represented below consists of six groups of foods classed together because of similar calorie content and percentage of carbohydrates, protein, and fat. The numbers and types of exchanges eaten should be recorded after each meal in a daily food log to keep a written track of the daily food intake. The strength of this type of dietary recommendation, which uses exchange lists, is that it allows the woman to plan and prepare her own menus based on the type of foods she and her family prefer.

The diet should be composed of approximately 60% of carbohydrate (