Postpartum Health - The Nutrition Cliff No One Talks About (spoiler alert: stay on your prenatal)

Working with many women through their preconception, pregnancy and postpartum periods, a common thread I see in clinic is the tendency for new mothers to stop taking their prenatal multivitamins soon after giving birth. Once the ‘main event’ of pregnancy and birth has come to a close, many women disregard their nutrient intake, not realizing that in fact the demand for many of our key nutrients we focus on for pregnancy actually increase in the breastfeeding window. Iodine, zinc, choline, vitamin D and calcium requirements all increase in a breastfeeding woman, and without supplementation the daily amounts are very unlikely to be met by diet alone.

Iodine requirements during pregnancy are 150mcg daily, but during breastfeeding climb to 270mcg daily, according to the National Health and Medical Research Council (NHMRC 2025). That’s not far off double the original requirement, yet many mothers have ceased their prenatal vitamin during breastfeeding and are getting negligible amounts, if any, through food sources only. And this increase in daily iodine requirement is not just for the first few months of breastfeeding – I’m talking until weaning is well & truly complete. Iodine intake via mum, and the subsequent transfer through the breastmilk is responsible for the creation of baby’s thyroid hormones and for infant brain development – even mild to moderate iodine deficiency early in life has the potential to impair cognitive development in children (Brough L 2022). In fact, research consistently shows that optimal maternal iodine intake throughout both pregnancy & breastfeeding increases IQ scores of children when measured between 7-9 years of age (Qian et al 2005).

Choline is another nutrient that deserves a mention in the breastfeeding window. Choline requirements during breastfeeding are 550mg daily, 100mg more than what’s called for during pregnancy. Breastmilk transfer of choline is dependent on maternal choline intake, with research demonstrating that higher maternal choline consumption is linked to improved infant neurocognition, stress resilience and even metabolic profiles (Derbyshire 2025). Studies show a consistent positive correlation between maternal choline intake during breastfeeding and her child’s ability when it comes to attention span, memory and spatial learning – not just in the child’s infancy but well into their childhood years (Obeid et al 2022).

Even if you’re not breastfeeding, rebuilding maternal nutrient stores during the postpartum window is critical. Pregnancy itself places huge demands on maternal stores of zinc, iron, B12, vitamins A and D, choline and iodine, and these nutrients in particular are often depleted in a mother after birth. Without replenishing these stores, mothers are at an increased risk of postnatal mood changes, poorer recovery after birth and an elevated stress response in the coming months.

Suboptimal levels of choline and B12 in postpartum have a direct effect on maternal mood, with research showing that lower blood-levels of these B vitamins in mothers correlates with an increased risk of postpartum anxiety & depression (Herian et al 2025). When you add sleep deprivation into the mix and the subsequent stress on the body that lack of sleep causes, demand for optimal B vitamin intake shouldn’t be underestimated. B vitamins, particularly folate, B12 and B6 are key building blocks for our neurotransmitters such as dopamine, serotonin and GABA and the production of these brain-chemicals directly influences our mood – less anxiety, more motivation, increased stress resilience and fewer depressive symptoms – even if you’ve had a rubbish night (or many).

Zinc has also been well-researched in the interest of postnatal mood support, with studies demonstrating that postpartum zinc supplementation significantly reduces the risk of developing postpartum depression and increases production of GABA – our anti- anxiety neurotransmitter that allows us to feel calm and less anxious, as well as improving sleep quality (Aoki et al 2022, Feng et al 2024).

And hold on, let’s backtrack for a moment. In the early days after birth, whether baby was delivered via vaginal birth or Caesarean section, tissue repair and wound healing take priority for the mother as she recovers. Two of the most efficient nutrients when it comes to healing are zinc and vitamin C, with recent research highlighting the favourable role these two can play in early postpartum. A study carried out on women who received an episiotomy during labour had significantly better recovery time and wound improvement when given vitamin C post-birth, compared to women given placebo (Radnia et al 2025). Pre and postnatal zinc supplementation mitigates inflammation and oxidative stress associated with birth complications, highlighting its valuable role in early postpartum health (Berger et al 2025).

There’s something to be said too about continuing prenatal supplementation in the postpartum window in consideration of future planning. Many mothers will have subsequent pregnancies, and preconception care ideally begins 3 months, if not more, before another conception occurs. Maternal intake of folate, B12 and choline in the months prior to conception drastically reduces the risk of neural tube defects and supports healthy early foetal development. As mothers know, life doesn’t always allow for perfect planning, especially when you throw little people into the mix. So, covering off your preconception nutrients sooner rather than later and staying on your prenatal in the postpartum window can be a good insurance for future pregnancies, rebuilding depleted stores and setting up for the next little person to come along.