by Stephanie Greunke

If you need immediate help, the National Suicide Prevention Hotline is a free and confidential network of more than 140 crisis centers nationwide. It is available 24/7 to contact in a crisis at 1-800-273-8255. You can call for yourself or someone you care about.

For additional help, call Postpartum Support International’s warmline at 800-944-4773. You’ll get a return call within several hours. You can also visit their website Click here to connect with your closest coordinator to get info, support, resources, and referrals to providers trained to treat PPD in your area.

I know that postpartum can be a challenging time, and I want to help you navigate this sometimes bewildering season. Last week I shared the first two nutritional considerations in my 4R approach for optimizing postpartum nutrition. Click to read more about the benefits of using food to help reduce inflammation and regulate blood sugar.

This week I’ll share the last two areas to consider, which are replenishing nutrient stores and repopulating the gut.

3. Replenish nutrient stores.


It’s well-known that mothers need to increase their calories during pregnancy. As you know, pregnant mamas are “eating for two” and are generally advised to increase intake by about 340 calories per day in the second trimester and 450 calories per day in the third trimester. However, there’s an unfortunate disconnect between what’s needed during the third trimester and what’s needed postpartum.

If you are breastfeeding, you actually need more calories postpartum than you did during pregnancy—about 500 extra calories/day while exclusively nursing! This accounts for an increase in metabolic rate and an increased need for certain vitamins, which are transported into your breastmilk.

Calorie and nutrient needs are also increased for tissue healing and repair, especially if you are recovering from a surgical birth. Tissue/wound healing is an energy-demanding process, something that is often overlooked. Seeing at the cesarean rate in the US is over 30%, this needs to be considered to help women successfully recover from any nutrient losses or deficiencies as a result of pregnancy, childbirth, and nursing.

Focus on nutrient-dense foods, such as meat, fish, vegetables, fruits, and healthy fat at most meals. This will promote the intake of nutrients often depleted during pregnancy. If you are nursing, this will increase the concentration of certain nutrients in your diet that are passed into your breastmilk. If you are deficient in certain nutrients, this affects the concentrations in your breastmilk. However, with a healthy diet rich in these nutrients and possibly supplementation (such as continuing on a prenatal vitamin, fish oil, and vitamin D), this can be corrected.

While grass-fed beef, wild-caught fish, pastured pork, and organic fruits and vegetables are ideal, this may not be feasible for everyone. Families can purchase high-quality protein when it’s on sale, purchase it in bulk at a discount (such as a cow-share), or choose to purchase only organic fruits and vegetables from the Dirty Dozen list, to reduce exposure to pesticides. 

4. Restore the gut.

We used to think of the body as separate systems. We’re now beginning to understand that our body is deeply interconnected. The health of our gut can impact our mental health through the gut-brain axis and immune system health, since upward of 80% of our body’s immune system is in the gut.

Researchers refer to this as GALT (gut-associated lymphatic tissue). If food is not broken down properly or is foreign to the body (such as highly refined, processed foods), this can cause an inflammatory response, impacting how the entire body functions—including the brain. Additionally, bacteria in our gut can secrete chemicals and neurotransmitters, such as dopamine, serotonin, and GABA, which play a role in mood disorders like depression and anxiety.

Consume a diet rich in prebiotics and probiotics. Prebiotics include soluble fiber, resistant starch, and non-starch polysaccharides. Foods rich in prebiotics include garlic, onions, Jerusalem artichokes, leeks, asparagus, cooked and cooled potatoes, and green (unripe) bananas. Prebiotics feed your beneficial bacteria and have been associated with overall health and well-being.

Fermented foods such as sauerkraut and kombucha contain probiotics which also optimize the health of your gut.

Including a probiotic supplement with strains that have been specifically studied to reduce inflammation, such as L.paracasei, L.plantarum, and P. pentosaceus as well as strains that may have mood-enhancing properties, such as Lactobacillus casei ShirotaLactobacillus helveticus R0052 and Bifidobacterium longum R0175 can also be beneficial.

*Individuals with GI conditions, such as bacterial overgrowth, or those who need to follow a low-FODMAP diet will want to consider working with a functional medicine practitioner. These individuals may not tolerate large amounts of fibrous vegetables, fermented foods, and certain probiotics.

Read our post from Dr. Ruscio, gut health expert, for more information on what you can do to increase gut health in all stages of motherhood.


To recap, here are the 4Rs one more time:

  1. Reduce inflammation
  2. Regulate blood sugar
  3. Replenish nutrient stores
  4. Restore the gut.

I know that you have a lot on your plate, mama, but consider the importance of your diet in managing your mood. I know change is not easy, especially in the midst of postpartum anxiety or depression. Although changing aspects of your lifestyle may not be the complete solution to your struggles, it can play a part.  With the proper help, you will get better! Postpartum Support International is one of my favorite organizations for postpartum support. They wisely state, “You are not alone. You are not to blame. With help you will be well.” I believe that for you, mama!

All photos are by Sarah Steffens. Click to find the recipes crafted specifically for nourishing postpartum mamas!

Stephanie Greunke is a registered dietitian with a master’s degree in nutrition who specializes in women’s health. She is a certified personal trainer and prenatal and postnatal corrective exercise specialist. Stephanie has guided and supported women locally and globally through her web-based private practice,, and continues to do so in her role as program manager with Whole Mamas.