Protocol development in integrative medicine is not typically a simple process. Individuals require individualized care, and what works for one patient may not work for another.

To establish these protocols, we first developed a Rating Scale that could be used to discern the rigor of evidence supporting a specific nutrient’s therapeutic effect.

The following protocols were developed using only A through D-quality evidence.

Class
Qualifying studies
Minimum requirements
A
Systematic review or meta-analysis of human trials
 
B
RDBPC human trials
2+ studies and/or 1 study with 50 + subjects
C
RDBPC human trials
1 study
D
Non-RDBPC human or In-vivo animal trials
 

Introduction

Whole person care is a person-centered approach to medicine. It goes beyond treating symptoms or isolated conditions, focusing on the interconnectedness of bodily systems and addressing a wide range of factors. These include biological makeup, behavioral habits, environmental factors, and a patient’s personal beliefs, values, and goals. By tailoring care to align with these unique aspects, healthcare providers can create highly personalized treatment plans that address not only physical health but also emotional and mental well-being.

This template, developed in partnership with OvationLab, aims to provide healthcare providers with practical suggestions for labs, supplements, and lifestyle strategies, helping them design personalized, whole person care plans for patients looking to support the physical and emotional components of the postpartum transition into motherhood.

Advanced lab testing is primarily indicated to monitor specific conditions that arose during pregnancy or to monitor the mother’s recovery. Standard clinical guidelines recommend postpartum testing for thyroid function in women with thyroid disease or repeat glucose tolerance testing for women who developed gestational diabetes at 6–12 weeks postpartum. (Alexander 2017)(Carter 2017)

Ongoing research also explores the utility of functional gut microbiome analysis and omega-3 index tests to provide qualitative and quantitative data on microbial and nutritional markers of maternal and infant health and development. (Mutic 2017)(von Schacky 2020)(Li 2024)(Munhoz 2025)

Evidence-based supplements, personalized for each woman under the guidance of a healthcare provider, support increased postpartum and lactating nutritional demands that diet alone may not meet and may assist with common postpartum experiences like fatigue and poor sleep.

Lifestyle modifications form the foundation of a holistic postpartum recovery plan. Diet, exercise, stress management, and restful sleep promote recovery, support breastfeeding, prevent long-term health issues, and enhance mental well-being. Healthcare providers should collaborate with women to identify and develop strategies for overcoming common barriers to maintaining a healthy lifestyle during the fourth trimester. (Makama 2021)(Lim 2024)

Labs

Quest Diagnostics Glucose Tolerance Test

Quest Diagnostics Glucose Tolerance Test in the Fullscript catalog

Quest Diagnostics Thyroid Panel with TSH

Quest Diagnostics Thyroid Panel with TSH in the Fullscript catalog

Diagnostic Solutions Laboratory GI-MAP® (GI Microbial Assay Plus)

Diagnostic Solutions Laboratory GI-MAP® (GI Microbial Assay Plus) in the Fullscript catalog

Quest Diagnostics OmegaCheck®

Quest Diagnostics OmegaCheck® in the Fullscript catalog

Ingredients

Prenatal Multivitamin

Dosing: Choose a reputable brand and follow label instructions unless advised otherwise by a healthcare provider. (Adams 2021)(Adams 2022)

Supporting evidence:

  • Micronutrient requirements are higher during lactation than during pregnancy, and maternal diet and supplementation influence the concentrations of most vitamins and minerals in breast milk. (Allen 2025) 
  • A longitudinal study of 793 pregnant women revealed widespread vitamin deficiencies (particularly iron, folate, and vitamins C, E, and D) during pregnancy that persisted into the postpartum period. (Aparicio 2020) 
  • Prenatal multivitamins, formulated to meet the increased nutritional needs of pregnancy and breastfeeding, can help prevent common nutritional inadequacies, such as iron, magnesium, and choline, during this critical time for the mother’s recovery and infant’s growth. (Jun 2020)(Ball 2022)
  • In a double-blind RCT of 1,729 women from the United Kingdom, Singapore, and New Zealand, those who continued vitamin supplementation from preconception through postpartum had higher plasma concentrations of riboflavin and vitamins B6, B12, and D at six months postdelivery. (Godfrey 2023)
Prenatal Multivitamins in the Fullscript catalog

Docosahexaenoic Acid (DHA)

Dosing: At least 200 mg per day; higher doses may be required to achieve optimal DHA levels in breast milk and maternal red blood cells, especially in women with lower baseline DHA levels (Stoutjesdijk 2018)(Jackson 2021)

Supporting evidence:

  • Adequate DHA intake during pregnancy and lactation is important for brain development in children. DHA supplementation increases DHA levels in mothers, which is associated with benefits to children’s cognitive function, with some studies reporting improvements in cognitive measures by 6–11%. (Nevins 2021)(Muñoz 2024) 
  • An RCT involving 70 healthy lactating women in Germany evaluated the effects of supplementation with multiple micronutrients, lutein, and DHA compared to placebo. The primary endpoint was the change in human milk DHA content during 12 weeks of supplementation. Results showed a 30% increase in maternal milk DHA in the supplementation group compared to a decline in the placebo group. (Schaefer 2020)
  • A Cochrane review of eight RCTs involving 1,567 women found that attention scores were better at five years in the group of children whose mothers had received DHA supplementation. However, no significant difference was observed in children’s neurodevelopment, visual acuity, or growth at long-term follow-up beyond 24 months. (Delgado-Noguera 2015)
Docosahexaenoic Acid (DHA) in the Fullscript catalog

Pre/Probiotics

Dosing: 2 million–900 billion CFU per day; tailor dosage to individual needs and specific product formulation (Martín-Peláez 2022)

Supporting evidence:

  • A double-blind, randomized, placebo-controlled trial with 74 mother-infant pairs gave mothers in the intervention group 14.2 g of prebiotic powder (galactooligosaccharides (GOS) and fructooligosaccharides (FOS)) daily from <21 weeks’ gestation to six months postpartum. Results showed significant modifications in maternal and infant gut microbiota, including increased Bifidobacteria and changes in short-chain fatty acid concentrations, indicating potential benefits for maternal and infant gut health. (Jones 2024) 
  • A randomized clinical trial with 66 women administered a daily multi-strain probiotic (L. paraccasei DSM 24733, L. plantarum DSM 24730, L. acidophilus DSM 24735, L. delbrueckii subsp. bulgaricus DSM 24734, B. longum DSM 24736, B. breve DSM 24732, B. infantis DSM 24737, and S. thermophilus DSM 24731) or a placebo to expectant mothers from 36 weeks’ gestation to four weeks postpartum. Positive outcomes of probiotic supplementation included changes in breast milk cytokine profiles, increased fecal secretory immunoglobulin A (SIgA) in newborns, and reduced incidence of infantile colic and regurgitation. (Baldassarre 2016) 
  • A systematic review and meta-analysis of six RCTs found that probiotics significantly reduce bacterial counts in breast milk and the incidence of mastitis by nearly half. (Yu 2022)
  • A systematic review and meta-analysis of 100 studies focusing on the safety of probiotics and prebiotics during pregnancy and lactation found that these supplements are generally safe, with minimal adverse effects such as changes in stool consistency and vaginal discharge, but no serious health concerns for mothers or babies. (Sheyholislami 2021)

 

Pre/Probiotics in the Fullscript catalog

Magnesium

Dosing: 350 mg per day (may be included in prenatal multivitamins) (Adams 2021) 

Supporting evidence:

  • The recommended dietary allowance (RDA) for magnesium for lactating women aged 19–30 is 310 mg per day and 320 mg per day for those aged 31-50. (NIH 2022) 
  • Magnesium deficiency is prevalent among women of childbearing age in both developing and developed countries. (Dalton 2016)
  • A study that included 869 pregnant women found that 92.1% achieved normalized serum magnesium levels after four weeks of supplementing with a magnesium-vitamin B6 complex. (Orlova 2021)
  • Constipation, insomnia, and mood disturbances are common complaints among mothers in the postpartum period. (Turawa 2015)(Verma 2022) Studies have shown that supplemental magnesium can safely and effectively improve insomnia symptoms and stool consistency and frequency. (Djokic 2019)(Mori 2021)
Magnesium in the Fullscript catalog

Iron

Dosing: At least 10–30 mg per day; 30–60 mg per day may be recommended to support iron levels (WHO 2016)(Muñoz 2018)

Supporting evidence:

  • Postpartum anemia (defined as a hemoglobin level of < 10 g/dL at one week postpartum and < 12 g/dL at eight weeks postpartum) is common due to prepartum iron deficiency and childbirth-related blood loss. (Milman 2012)
  • Postpartum iron deficiency and anemia can significantly impact a mother’s emotional, cognitive, and physical functioning, making it more difficult for her to bond with and interact positively with her child. (WHO 2016)
  • Evidence suggests that continued surveillance and screening for iron deficiency anemia through at least six weeks postpartum is beneficial. (Elmore 2022)
Iron in the Fullscript catalog

Vitamin D

Dosing: 400–6,400 IU per day (Wagner 2020)(Jouanne 2021)

Supporting evidence:

  • A 2023 cross-sectional study in Latvia found that postpartum women had lower serum vitamin D levels on average (31.8 ng/mL) compared to pregnant women (42.9 ng/mL), emphasizing the need for continued supplementation postpartum. (Meija 2023)
  • Maternal vitamin D status directly affects the vitamin D content of breast milk. Daily vitamin D3 supplementation can raise maternal and infant vitamin D levels, providing an alternative to direct infant supplementation. (Wagner 2020)
  • The response to vitamin D supplementation postpartum is primarily determined by baseline vitamin D status and the dose of supplementation; consider these factors when determining the dose needed to achieve optimal levels. (Levy 2021)
  • A 2025 systematic review of 39 articles highlights the positive outcomes of maternal vitamin D supplementation on childhood health outcomes, including better bone and neurological development and reduced risk for respiratory tract infections and autoimmune disease. (Svensson 2025)
Vitamin D in the Fullscript catalog

Ashwagandha (Withania somnifera)

Dosing: 300 mg twice daily for eight weeks (Chandrasekhar 2012)(Akhgarjand 2022)

Supporting evidence:

  • Postpartum women are at increased risk for stress and anxiety due to hormonal changes, sleep deprivation, and the demands of caring for a newborn. Studies indicate that postpartum anxiety affects up to 20% at six weeks postpartum as stress levels heighten during the transition into motherhood. (Nakić Radoš 2018) 
  • Ashwagandha is recognized for its adaptogenic properties and for helping the body cope with stress. A systematic review and meta-analysis supported that ashwagandha supplementation has a large effect size on reducing stress and anxiety levels. (Akhgarjand 2022)
  • In a randomized, double-blind, placebo-controlled study, ashwagandha supplementation was associated with a significant reduction in morning salivary cortisol levels, translating clinically to reduced stress and anxiety symptoms as measured by improved Perceived Stress Scale (PSS), General Anxiety Disorder-7 (GAD-7), and Quality of Life (QOL) scores. (Majeed 2023)
  • There is insufficient scientific data on the safety of ashwagandha during breastfeeding. Because of the potential risks to the infant, providers may choose to avoid recommending ashwagandha to breastfeeding mothers until more evidence becomes available. (NCCIH 2023)
Ashwagandha in the Fullscript catalog

Lifestyle recommendations

Nutrition

  • A well-balanced, healthy, and diverse diet is essential to support recovery from childbirth and milk production (if breastfeeding). Emphasis should be on whole, unprocessed foods. (Marshall 2021) 
  • Prioritize dietary intake as the first line of defense in meeting nutritional requirements. While supplements can be beneficial, they should complement, not replace, a well-balanced diet. Key nutrients for lactating women include:
          • Calcium (1,000 mg per day): Dairy, tofu, dark leafy greens, sardines (USDA 2024)
          • Magnesium (390 mg per day): Leafy green vegetables, brown rice, almonds, cashews (Fiorentini 2021) 
          • Zinc (19 mg per day): Oysters, beef, crab, pumpkin seeds (NIH 2022)
          • Vitamin C (130 mg per day): Citrus fruit, broccoli, cabbage, bell peppers (Doseděl 2021) 
          • Vitamin D (400 IU per day): Fatty fish, eggs, sun-exposed mushrooms, liver (Dominguez 2021)
          • Iron (60 mg per day): Oysters, sardines, beef, spinach, lentils, soybeans (USDA 2024)
          • Folate (400 mcg per day): Green leafy vegetables, broccoli, Brussels sprouts, beans (Chan 2013)
          • DHA (100 mg per day): Two servings of low-mercury fish (e.g., sardines, anchovies, salmon, skipjack tuna) or seafood per week (Jouanne 2021)(Cetin 2024)
  • Lactating women should aim to eat at least 1,800 calories daily to support a sufficient milk supply. Caloric needs may vary based on the mother’s activity level and whether the infant is exclusively breastfed. The Centers for Disease Control and Prevention (CDC) recommends that breastfeeding mothers consume 340–400 more kilocalories daily than pre-pregnancy. (Mutic 2017)(CDC 2024)
  • Encourage mothers to consume at least 3.8 L (16 cups) of water daily. Of this, 13 cups should come from drinking water; the remaining amount can come from foods with high water content. (IOM 2005)
  • Fiber supports healthy bowel function. Advise patients to include fiber-rich foods (i.e., fruits, vegetables, whole grains, legumes, nuts, and seeds) to meet the recommended daily intake of 29 g. (Drehmer 2012)(Khorasaniha 2023)

Movement/Exercise

  • After clearance by a healthcare professional, recommend the gradual reincorporation of gentle and low-impact exercise, such as walking or gentle yoga. These exercises are associated with reduced pelvic girdle pain severity and stress urinary incontinence. (Piercy 2018)(ACOG 2020)
  • Encourage women to gradually increase exercise intensity as tolerated, which may be guided by factors like the individual’s recovery, mode of delivery, and perinatal complications. Provide the goal of working up to 150 minutes of moderate-intensity aerobic activity each week, preferably spread throughout the week. (Piercy 2018)
  • Women who were habitually engaged in vigorous-intensity aerobic activity or were physically active before pregnancy can continue these activities during the postpartum period, as long as they do not have any medical or obstetric complications. (ACOG 2020)
  • Postpartum pelvic floor muscle training (PFMT) effectively reduces the odds of urinary incontinence and organ prolapse due to a weakened pelvic floor. (Beamish 2025)
  • Twice-weekly resistance training sessions, such as weight lifting or resistance bands, provide additional health benefits. (Evenson 2023)

Stress/Relationships

  • Ensure continued access to mental health screenings and treatment resources during the postpartum period. The Edinburgh Postnatal Depression Scale (EPDS) is one validated tool for this purpose. (Stewart 2016)(USPSTF 2019) 
  • Consider counseling and psychotherapy as a first-line therapy for patients at high risk or those experiencing mild-to-moderate perinatal depression and anxiety. (USPSTF 2019)(ACOG 2023)
          • Cognitive behavioral therapy (CBT) has been shown to reduce symptoms of perinatal depression, anxiety, and stress both in the short- and long-term. (Li 2022) 
          • Interpersonal therapy (IPT) can facilitate social support, improve symptoms of depression and anxiety, and enhance relationship quality/satisfaction. (Bright 2020)
  • According to one study, an eight-week mindfulness-based cognitive therapy (MBCT) program effectively reduced depression and anxiety symptoms and increased mindfulness levels in women who were within the first year following childbirth. (Shulman 2018)
  • Selective serotonin reuptake inhibitors (SSRIs), including sertraline and escitalopram, can be prescribed to women who do not respond to non-pharmacologic therapies. (ACOG 2023)

Sleep

  • Up to 67.2% of women experience sleep disturbances in the postpartum period. (Yang 2020) The primary reasons for these disturbances include newborn care demands, hormonal changes, and psychological factors. (Hunter 2009)(Swanson 2020)(Palagini 2022)
  • Cognitive behavioral therapy for insomnia (CBT-I) is a preferred treatment for insomnia during the peripartum period, shown to improve mood, anxiety, and fatigue. (Palagini 2022)
  • Non-pharmacological strategies that can improve sleep quality include listening to music, exercising, relaxation exercises, sleep hygiene, acupressure, and massage. (Owais 2018)(Paulino 2022)
  • Short naps during the day can help mitigate the effects of nighttime sleep disruption, especially for mothers unable to achieve consolidated nighttime sleep. (Hunter 2009)
  • Encourage partners or support persons to share nighttime caregiving responsibilities to help mothers achieve longer periods of uninterrupted sleep. This strategy may be particularly important for women at high risk for postpartum depression. (Leistikow 2024)

Environment

  • Advise continued avoidance of alcohol and substance use, especially when breastfeeding. (Chapman 2013)(Prior 2024)
  • Ensure the mother’s home environment is safe, supportive, and conducive to her recovery and the child’s healthy development. This includes creating a nurturing space and minimizing exposure to environmental toxins. (Li 2019)

Patient Resources

Disclaimer

The Fullscript Integrative Medical Advisory team has developed or collected these protocols from practitioners and supplier partners to help health care practitioners make decisions when building treatment plans. By adding this protocol to your Fullscript template library, you understand and accept that the recommendations in the protocol are for initial guidance and may not be appropriate for every patient.

View protocol on Fullscript
References
  1. Adams, J. B., Kirby, J. K., Sorensen, J. C., et al. (2022). Evidence based recommendations for an optimal prenatal supplement for women in the US: vitamins and related nutrients. Maternal Health, Neonatology and Perinatology, 8(1), 4. https://doi.org/10.1186/s40748-022-00139-9
  2. Adams, J. B., Sorenson, J. C., Pollard, E. L., et al. (2021). Evidence-Based Recommendations for an Optimal Prenatal Supplement for Women in the U.S., Part Two: Minerals. Nutrients, 13(6), 1849. https://doi.org/10.3390/nu13061849
  3. Akhgarjand, C., Asoudeh, F., Bagheri, A., et al. (2022). Does Ashwagandha supplementation have a beneficial effect on the management of anxiety and stress? A systematic review and meta‐analysis of randomized controlled trials. Phytotherapy Research, 36(11), 4115–4124. https://doi.org/10.1002/ptr.7598
  4. Alexander, E. K., Pearce, E. N., Brent, G. A., et al. (2017). 2017 Guidelines of the American Thyroid Association for the Diagnosis and Management of Thyroid Disease During Pregnancy and the Postpartum. Thyroid, 27(3), 315–389. https://doi.org/10.1089/thy.2016.0457
  5. Allen, L. H. (2025). Micronutrients — Assessment, Requirements, Deficiencies, and Interventions. New England Journal of Medicine, 392(10), 1006–1016. https://doi.org/10.1056/nejmra2314150
  6. American College of Obstetricians and Gynecologists. (2020). Physical Activity and Exercise During Pregnancy and the Postpartum Period: ACOG Committee Opinion Summary, Number 804. Obstetrics & Gynecology, 135(4), 991–993. https://doi.org/10.1097/aog.0000000000003773
  7. American College of Obstetricians and Gynecologists. (2023). Treatment and Management of Mental Health Conditions During Pregnancy and Postpartum: ACOG Clinical Practice Guideline No. 5. Obstetrics and Gynecology, 141(6), 1262–1288. https://doi.org/10.1097/aog.0000000000005202
  8. Aparicio, E., Jardí, C., Bedmar, C., et al. (2020). Nutrient Intake during Pregnancy and Post-Partum: ECLIPSES Study. Nutrients, 12(5), 1325. https://doi.org/10.3390/nu12051325
  9. Ashwagandha. (2023, March). National Center for Complementary and Integrative Health. https://www.nccih.nih.gov/health/ashwagandha
  10. Association of Women’s Health, Obstetric and Neonatal Nurses. (2022). Breastfeeding Recommendations for People Who Use Substances: AWHONN Practice Brief Number 16. Journal of Obstetric, Gynecologic & Neonatal Nursing, 52(1), e1–e4. https://doi.org/10.1016/j.jogn.2022.08.003
  11. Baldassarre, M., Di Mauro, A., Mastromarino, P., et al. (2016). Administration of a Multi-Strain Probiotic Product to Women in the Perinatal Period Differentially Affects the Breast Milk Cytokine Profile and May Have Beneficial Effects on Neonatal Gastrointestinal Functional Symptoms. A Randomized Clinical Trial. Nutrients, 8(11), 677. https://doi.org/10.3390/nu8110677
  12. Ball, L., De Jersey, S., Parkinson, J., et al. (2022). Postpartum nutrition: Guidance for general practitioners to support high-quality care. Australian Journal of General Practice, 51(3), 123–128. https://doi.org/10.31128/ajgp-09-21-6151
  13. Beamish, N. F., Davenport, M. H., Ali, M. U., et al. (2025). Impact of postpartum exercise on pelvic floor disorders and diastasis recti abdominis: a systematic review and meta-analysis. British Journal of Sports Medicine, 59(8), 562–575. https://doi.org/10.1136/bjsports-2024-108619
  14. Bright, K. S., Charrois, E. M., Mughal, M. K., et al. (2020). Interpersonal Psychotherapy to Reduce Psychological Distress in Perinatal Women: A Systematic Review. International Journal of Environmental Research and Public Health, 17(22), 8421. https://doi.org/10.3390/ijerph17228421
  15. Carter, E. B., Martin, S., Temming, L. A., et al. (2017). Early versus 6–12 week postpartum glucose tolerance testing for women with gestational diabetes. Journal of Perinatology, 38(2), 118–121. https://doi.org/10.1038/jp.2017.159
  16. Cetin, I., Carlson, S. E., Burden, C., et al. (2024). Omega-3 fatty acid supply in pregnancy for risk reduction of preterm and early preterm birth. American Journal of Obstetrics & Gynecology MFM, 6(2), 101251. https://doi.org/10.1016/j.ajogmf.2023.101251
  17. Chan, Y.-M., Bailey, R., & O’Connor, D. L. (2013). Folate. Advances in Nutrition, 4(1), 123–125. https://doi.org/10.3945/an.112.003392
  18. Chandrasekhar, K., Kapoor, J., & Anishetty, S. (2012). A Prospective, Randomized Double-Blind, Placebo-Controlled Study of Safety and Efficacy of a High-Concentration Full-Spectrum Extract of Ashwagandha Root in Reducing Stress and Anxiety in Adults. Indian J Psychol Med, 34(3), 255–262. https://doi.org/10.4103/0253-7176.106022
  19. Chapman, S. L., & Wu, L.-T. (2013). Postpartum Substance Use and Depressive Symptoms: A Review. Women & Health, 53(5), 479–503. https://doi.org/10.1080/03630242.2013.804025
  20. Dalton, L. M., Ní Fhloinn, D. M., Gaydadzhieva, G. T., et al. (2016). Magnesium in pregnancy. Nutrition Reviews, 74(9), 549–557. https://doi.org/10.1093/nutrit/nuw018
  21. Delgado-Noguera, M. F., Calvache, J. A., Bonfill Cosp, X., et al. (2015). Supplementation with long chain polyunsaturated fatty acids (LCPUFA) to breastfeeding mothers for improving child growth and development. Cochrane Database of Systematic Reviews, 2015(7), CD007901. https://doi.org/10.1002/14651858.cd007901.pub3
  22. Djokic, G., Vojvodić, P., Korcok, D., et al. (2019). The Effects of Magnesium – Melatonin – Vit B Complex Supplementation in Treatment of Insomnia. Open Access Macedonian Journal of Medical Sciences, 7(18), 3101–3105. https://doi.org/10.3889/oamjms.2019.771
  23. Dominguez, L. J., Farruggia, M., Veronese, N., et al. (2021). Vitamin D Sources, Metabolism, and Deficiency: Available Compounds and Guidelines for Its Treatment. Metabolites, 11(4), 255. https://doi.org/10.3390/metabo11040255
  24. Doseděl, M., Jirkovský, E., Macáková, K., et al. (2021). Vitamin C—Sources, Physiological Role, Kinetics, Deficiency, Use, Toxicity, and Determination. Nutrients, 13(2), 615. https://doi.org/10.3390/nu13020615
  25. Drehmer, M., Camey, S. A., Nunes, M. A., et al. (2012). Fibre intake and evolution of BMI: from pre-pregnancy to postpartum. Public Health Nutrition, 16(8), 1403–1413. https://doi.org/10.1017/s1368980012003849
  26. Elmore, C., & Ellis, J. (2022). Screening, Treatment, and Monitoring of Iron Deficiency Anemia in Pregnancy and Postpartum. Journal of Midwifery & Women’s Health, 67(3), 321–331. https://doi.org/10.1111/jmwh.13370
  27. Evenson, K. R., Brown, W. J., Brinson, A. K., et al. (2023). A review of public health guidelines for postpartum physical activity and sedentary behavior from around the world. Journal of Sport and Health Science, 13(4), 472–483. https://doi.org/10.1016/j.jshs.2023.12.004
  28. Fiorentini, D., Cappadone, C., Farruggia, G., et al. (2021). Magnesium: Biochemistry, Nutrition, Detection, and Social Impact of Diseases Linked to Its Deficiency. Nutrients, 13(4), 1136. https://doi.org/10.3390/nu13041136
  29. Food Sources of Calcium. (2024). U.S. Department of Agriculture. https://www.dietaryguidelines.gov/sites/default/files/2024-08/Food-Sources-Calcium-Standard-508C.pdf
  30. Food Sources of Iron. (2024). U.S. Department of Agriculture. https://www.dietaryguidelines.gov/sites/default/files/2024-08/Food-Sources-Iron-Standard_508C.pdf
  31. Godfrey, K. M., Titcombe, P., El‐Heis, S., et al. (2023). Maternal B-vitamin and vitamin D status before, during, and after pregnancy and the influence of supplementation preconception and during pregnancy: Prespecified secondary analysis of the NiPPeR double-blind randomized controlled trial. PLOS Medicine, 20(12), e1004260. https://doi.org/10.1371/journal.pmed.1004260
  32. Hunter, L. P., Rychnovsky, J. D., & Yount, S. M. (2009). A Selective Review of Maternal Sleep Characteristics in the Postpartum Period. Journal of Obstetric, Gynecologic & Neonatal Nursing, 38(1), 60–68. https://doi.org/10.1111/j.1552-6909.2008.00309.x
  33. Institute of Medicine. (2005). Dietary Reference Intakes for Water, Potassium, Sodium, Chloride, and Sulfate. National Academies Press. https://doi.org/10.17226/10925
  34. Jackson, K. H., Klatt, K. C., Caudill, M. A., et al. (2021). Baseline red blood cell and breast milk DHA levels affect responses to standard dose of DHA in lactating women on a controlled feeding diet. Prostaglandins, Leukotrienes and Essential Fatty Acids, 166, 102248. https://doi.org/10.1016/j.plefa.2021.102248
  35. Jones, J. M., Reinke, S. N., Mousavi-Derazmahalleh, M., et al. (2024). Maternal prebiotic supplementation during pregnancy and lactation modifies the microbiome and short chain fatty acid profile of both mother and infant. Clinical Nutrition, 43(4), 969–980. https://doi.org/10.1016/j.clnu.2024.02.030
  36. Jouanne, M., Oddoux, S., Noël, A., et al. (2021). Nutrient Requirements during Pregnancy and Lactation. Nutrients, 13(2), 692. https://doi.org/10.3390/nu13020692
  37. Jun, S., Gahche, J. J., Potischman, N., et al. (2020). Dietary Supplement Use and Its Micronutrient Contribution During Pregnancy and Lactation in the United States. Obstetrics & Gynecology, 135(3), 623–633. https://doi.org/10.1097/aog.0000000000003657
  38. Khorasaniha, R., Olof, H., Voisin, A., et al. (2023). Diversity of fibers in common foods: Key to advancing dietary research. Food Hydrocolloids, 139, 108495. https://doi.org/10.1016/j.foodhyd.2023.108495
  39. Leistikow, N., & Smith, M. H. (2024). The Role of Sleep Protection in Preventing and Treating Postpartum Depression. Seminars in Perinatology, 48(6), 151947. https://doi.org/10.1016/j.semperi.2024.151947
  40. Levy, B., O’Callaghan, K. M., Qamar, H., et al. (2021). Basal Vitamin D Status and Supplement Dose Are Primary Contributors to Maternal 25-Hydroxyvitamin D Response to Prenatal and Postpartum Cholecalciferol Supplementation. The Journal of Nutrition, 151(11), 3361–3378. https://doi.org/10.1093/jn/nxab265
  41. Li, H.-L., Liu, L.-Y., Zhang, Z.-F., et al. (2019). Semi-volatile organic compounds in infant homes: Levels, influence factors, partitioning, and implications for human exposure. Environmental Pollution, 251, 609–618. https://doi.org/10.1016/j.envpol.2019.05.048
  42. Li, M., Xue, Y., Lu, H., et al. (2024). Relationship between infant gastrointestinal microorganisms and maternal microbiome within 6 months of delivery. Microbiology Spectrum, 12(10), e0360823. https://doi.org/10.1128/spectrum.03608-23
  43. Li, X., Laplante, D. P., Paquin, V., et al. (2022). Effectiveness of cognitive behavioral therapy for perinatal maternal depression, anxiety and stress: A systematic review and meta-analysis of randomized controlled trials. Clinical Psychology Review, 92, 102129. https://doi.org/10.1016/j.cpr.2022.102129
  44. Lim, S., Lang, S., Savaglio, M., et al. (2024). Intervention Strategies to Address Barriers and Facilitators to a Healthy Lifestyle Using the Behaviour Change Wheel: A Qualitative Analysis of the Perspectives of Postpartum Women. Nutrients, 16(7), 1046. https://doi.org/10.3390/nu16071046
  45. Magnesium Fact Sheet for Health Professionals. (2022). Office of Dietary Supplements; National Institutes of Health. https://ods.od.nih.gov/factsheets/Magnesium-HealthProfessional/
  46. Majeed, M., Nagabhushanam, K., & Mundkur, L. (2023). A standardized Ashwagandha root extract alleviates stress, anxiety, and improves quality of life in healthy adults by modulating stress hormones: Results from a randomized, double-blind, placebo-controlled study. Medicine, 102(41), e35521. https://doi.org/10.1097/MD.0000000000035521
  47. Makama, M., Awoke, M. A., Skouteris, H., et al. (2021). Barriers and facilitators to a healthy lifestyle in postpartum women: A systematic review of qualitative and quantitative studies in postpartum women and healthcare providers. Obesity Reviews, 22(4). https://doi.org/10.1111/obr.13167
  48. Marshall, N. E., Abrams, B., Barbour, L. A., et al. (2021). The Importance of Nutrition in Pregnancy and Lactation: Lifelong Consequences. American Journal of Obstetrics and Gynecology, 226(5), 607–632. https://doi.org/10.1016/j.ajog.2021.12.035
  49. Martín-Peláez, S., Cano-Ibáñez, N., Pinto-Gallardo, M., et al. (2022). The Impact of Probiotics, Prebiotics, and Synbiotics during Pregnancy or Lactation on the Intestinal Microbiota of Children Born by Cesarean Section: A Systematic Review. Nutrients, 14(2), 341. https://doi.org/10.3390/nu14020341
  50. Maternal Diet and Breastfeeding. (2024). Centers for Disease Control and Prevention. https://www.cdc.gov/breastfeeding-special-circumstances/hcp/diet-micronutrients/maternal-diet.html
  51. Meija, L., Piskurjova, A., Nikolajeva, K., et al. (2023). Vitamin D Intake and Serum Levels in Pregnant and Postpartum Women. Nutrients, 15(15), 3493. https://doi.org/10.3390/nu15153493
  52. Milman, N. (2012). Postpartum anemia II: prevention and treatment. Annals of Hematology, 91(2), 143–154. https://doi.org/10.1007/s00277-011-1381-2
  53. Mori, H., Tack, J., & Suzuki, H. (2021). Magnesium Oxide in Constipation. Nutrients, 13(2), 421. https://doi.org/10.3390/nu13020421
  54. Munhoz, J., Wattar, N., Goruk, S., et al. (2025). Determinants of maternal and infant omega-3 status at 3 months postpartum: findings from the APrON longitudinal cohort study. The American Journal of Clinical Nutrition, 121(3), 629–642. https://doi.org/10.1016/j.ajcnut.2025.01.002
  55. Muñoz, M., Peña-Rosas, J. P., Robinson, S., et al. (2018). Patient blood management in obstetrics: management of anaemia and haematinic deficiencies in pregnancy and in the post-partum period: NATA consensus statement. Transfusion Medicine, 28(1), 22–39. https://doi.org/10.1111/tme.12443
  56. Muñoz, Y., Mercado, L., Farias, C., et al. (2024). Impact of Polyunsaturated Fatty Acids during and Pregnancy and Lactation: a comprehensive review. Prostaglandins Leukotrienes and Essential Fatty Acids, 203, 102656. https://doi.org/10.1016/j.plefa.2024.102656
  57. Mutic, A. D., Jordan, S., Edwards, S. M., et al. (2017). The Postpartum Maternal and Newborn Microbiomes. MCN, the American Journal of Maternal/Child Nursing, 42(6), 326–331. https://doi.org/10.1097/nmc.0000000000000374
  58. Nakić Radoš, S., Tadinac, M., & Herman, R. (2018). Anxiety during pregnancy and postpartum: Course, predictors and comorbidity with postpartum depression. Acta Clinica Croatica, 57(1), 39–51. https://doi.org/10.20471/acc.2018.57.01.05
  59. Nevins, J. E. H., Donovan, S. M., Snetselaar, L., et al. (2021). Omega-3 Fatty Acid Dietary Supplements Consumed During Pregnancy and Lactation and Child Neurodevelopment: A Systematic Review. The Journal of Nutrition, 151(11), 3483–3494. https://doi.org/10.1093/jn/nxab238
  60. Orlova, S., Dikke, G., Pickering, G., et al. (2021). Magnesium level correlation with clinical status and quality of life in women with hormone related conditions and pregnancy based on real world data. Scientific Reports, 11(1), 5734. https://doi.org/10.1038/s41598-021-85156-y
  61. Owais, S., Chow, C. H. T., Furtado, M., et al. (2018). Non-pharmacological interventions for improving postpartum maternal sleep: A systematic review and meta-analysis. Sleep Medicine Reviews, 41, 87–100. https://doi.org/10.1016/j.smrv.2018.01.005
  62. Palagini, L., Bramante, A., Baglioni, C., et al. (2022). Insomnia evaluation and treatment during peripartum: a joint position paper from the European Insomnia Network task force “Sleep and Women,” the Italian Marcè Society and international experts task force for perinatal mental health. Archives of Women’s Mental Health, 25(3), 561–575. https://doi.org/10.1007/s00737-022-01226-8
  63. Paulino, D. S. M., Borrelli, C. B., Faria-Schützer, D. B., et al. (2022). Non-pharmacological Interventions for Improving Sleep Quality During Pregnancy: A Systematic Review and Meta-Analysis. Rev Bras Ginecol Obstet, 44(8), 776–784. https://doi.org/10.1055/s-0042-1746200
  64. Piercy, K. L., Troiano, R. P., Ballard, R. M., et al. (2018). The Physical Activity Guidelines for Americans. JAMA, 320(19), 2020–2028. https://doi.org/10.1001/jama.2018.14854
  65. Prior, K., Piggott, M., Hunt, S., et al. (2024). Motherhood and Drinking: The Relative Importance of Mental Health and Psychosocial Factors on Maternal Alcohol Misuse During the Postpartum Period. Journal of Studies on Alcohol and Drugs, 85(4), 537–549. https://doi.org/10.15288/jsad.23-00391
  66. Schaefer, E., Demmelmair, H., Horak, J., et al. (2020). Multiple Micronutrients, Lutein, and Docosahexaenoic Acid Supplementation during Lactation: A Randomized Controlled Trial. Nutrients, 12(12), 3849. https://doi.org/10.3390/nu12123849
  67. Sheyholislami, H., & Connor, K. L. (2021). Are Probiotics and Prebiotics Safe for Use during Pregnancy and Lactation? A Systematic Review and Meta-Analysis. Nutrients, 13(7), 2382. https://doi.org/10.3390/nu13072382
  68. Shulman, B., Dueck, R., Ryan, D., et al. (2018). Feasibility of a mindfulness-based cognitive therapy group intervention as an adjunctive treatment for postpartum depression and anxiety. Journal of Affective Disorders, 235, 61–67. https://doi.org/10.1016/j.jad.2017.12.065
  69. Stewart, D. E., & Vigod, S. (2016). Postpartum Depression. New England Journal of Medicine, 375(22), 2177–2186. https://doi.org/10.1056/nejmcp1607649
  70. Stoutjesdijk, E., Schaafsma, A., Dijck-Brouwer, D. A. J., et al. (2018). Fish oil supplemental dose needed to reach 1g% DHA+EPA in mature milk. Prostaglandins, Leukotrienes, and Essential Fatty Acids, 128, 53–61. https://doi.org/10.1016/j.plefa.2017.11.003
  71. Sultan, P., Bampoe, S., Shah, R., et al. (2019). Oral vs intravenous iron therapy for postpartum anemia: a systematic review and meta-analysis. American Journal of Obstetrics and Gynecology, 221(1), 19-29.e3. https://doi.org/10.1016/j.ajog.2018.12.016 
  72. Svensson, N. S., Volqvartz, T., Vestergaard, A. L., et al. (2025). Effects of Maternal Vitamin D Supplementation on Childhood Health. Endocrine Reviews, bnaf001. https://doi.org/10.1210/endrev/bnaf001
  73. Swanson, L. M., Kalmbach, D. A., Raglan, G. B., et al. (2020). Perinatal Insomnia and Mental Health: a Review of Recent Literature. Current Psychiatry Reports, 22(12), 73. https://doi.org/10.1007/s11920-020-01198-5
  74. Turawa, E. B., Musekiwa, A., & Rohwer, A. C. (2015). Interventions for preventing postpartum constipation. Cochrane Database of Systematic Reviews, 2015(9), CD011625. https://doi.org/10.1002/14651858.cd011625.pub2
  75. US Preventive Services Task Force, Curry, S. J., Krist, A. H., et al. (2019). Interventions to Prevent Perinatal Depression: US Preventive Services Task Force Recommendation Statement. JAMA, 321(6), 580–587. https://doi.org/10.1001/jama.2019.0007
  76. Verma, S., Quin, N., Astbury, L., et al. (2022). Treating postpartum insomnia: a three arm randomised controlled trial of cognitive behavioural therapy and light dark therapy. Psychological Medicine, 53(12), 5459–5469. https://doi.org/10.1017/s0033291722002616
  77. von Schacky, C. (2020). Omega-3 Fatty Acids in Pregnancy—The Case for a Target Omega-3 Index. Nutrients, 12(4), 898. https://doi.org/10.3390/nu12040898
  78. Wagner, C. L., & Hollis, B. W. (2020). Early-Life Effects of Vitamin D: A Focus on Pregnancy and Lactation. Annals of Nutrition and Metabolism, 76 Suppl 2, 16–28. https://doi.org/10.1159/000508422
  79. Yang, Y., Li, W., Ma, T.-J., et al. (2020). Prevalence of Poor Sleep Quality in Perinatal and Postnatal Women: A Comprehensive Meta-Analysis of Observational Studies. Frontiers in Psychiatry, 11, 161. https://doi.org/10.3389/fpsyt.2020.00161
  80. Yu, Q., Xu, C., Wang, M., et al. (2022). The preventive and therapeutic effects of probiotics on mastitis: A systematic review and meta-analysis. PLOS ONE, 17(9), e0274467. https://doi.org/10.1371/journal.pone.0274467
  81. Zinc Fact Sheet for Health Professionals. (2022). Office of Dietary Supplements; National Institutes of Health. https://ods.od.nih.gov/factsheets/Zinc-HealthProfessional