New mothers are often faced with conflicting and confusing messages & advice on what they should eat (and avoid) while producing breast milk. Examples of well-intentioned, but untrue, tidbits of advice about how to eat while breastfeeding includes the following:
“When you are breastfeeding you need to eat a lot more calories and fat to make enough breast milk.” – FALSE
“You don’t need to worry about your caloric intake while breastfeeding because breastfeeding makes women lose weight.” – FALSE
“If you have a low breast milk supply, changing your diet will help you make more milk for your baby.” – FALSE
“Your baby's colic is probably caused by something in your diet. If you remove all dairy, soy, wheat, corn, and eggs from your diet, he or she will stop crying all the time.” – FALSE
In this article, we’ll take a deep dive into the current recommendations for a healthy diet and the best foods to eat while breastfeeding. Please bear in mind that there is
not a “one size fits all” approach to breastfeeding diets. For example, the dietary needs of vegan mothers are different from the dietary needs of mothers with celiac disease which are different from those of mothers without any food restrictions.
Newborns’ main energy sources are fat, carbohydrates, and protein. In order to make nutritionally complete breast milk that includes enough fat, protein, calories, vitamins, and minerals that baby needs, breastfeeding moms should strive to eat a healthy and varied diet that includes whole grains, leafy greens, lean sources of protein, and healthy fats. Breastfeeding requires about 500-600 extra calories per day during the first few months, but once babies start eating solids and table foods later in infancy, milk production does not require as many extra calories.
The amount of calories, protein, carbohydrates, and iron in breast milk are not affected by what mothers eat. However, levels of breast milk fat and fatty acids, certain vitamins, zinc, calcium, selenium, fluoride, choline, and iodine are all related to the amounts mothers get through their diets. It’s especially important that vitamins A, B1, B2, B3, B6, B12, and D are present in adequate amounts in mothers’ diets to ensure that their breastfed babies do not develop deficiencies of any of these essential vitamins.
How important is fat in a breastfeeding mother’s diet?
Fat is babies’ main energy source, so it’s important for breast milk to be high in fat. Mothers do use their fat stores from pregnancy to make breast milk but need to be sure to continue to get healthy forms of fat in their diets. Good sources of fat for lactating mothers include coconut oil, coconut milk, ghee, flax, chia, walnuts, salmon, eggs, olive oil, avocados, and almonds.
Omega-3 fatty acids, such as docosahexaenoic acid (DHA), are essential for babies’ brain and eye development. Research has shown that the majority of mothers in the U.S. are deficient in omega-3 fatty acids while pregnant and nursing. The two ways that mothers can be sure to get enough omega-3 fatty acids in their diet are to eat fish on a regular basis or to take a DHA supplement. Mothers can get enough DHA in their diet by eating 2-3 servings of fish per week. The best fish sources of DHA are salmon, trout, herring, and sardines. DHA supplements of at least 300 mg per day have been recommended for several years, and many experts are now recommending that breastfeeding women take up to 1g of DHA per day.
What other vitamin and mineral supplements should I take while breastfeeding?
Vitamin D is an essential nutrient for healthy bones for both moms and babies. For the most part, breastfeeding mothers in the U.S. need to supplement their diet with Vitamin D to ensure that they have high enough levels in their breast milk. It’s currently recommended that mothers take at least 1000-2000 IU of Vitamin D every day while breastfeeding. The American Academy of Pediatrics (AAP) also recommends that all breastfed babies receive a daily Vitamin D supplement (400 IU/day) until their first birthday.
Breastfeeding depletes mothers’ calcium, so many women need to increase the amount of calcium they get in their diets. This can be done by eating dairy foods or by eating calcium-rich, non-dairy foods, such as leafy greens, tofu, or sesame seeds.
Choline is a nutrient that is increasingly recognized as important for developing babies’ brains and nervous systems. Eggs are the best dietary source of choline, but it is also found in fish, many types of meat, soybeans, wheat germ, and cruciferous vegetables (such as broccoli and cauliflower). If moms continue to take their prenatal vitamins while breastfeeding, it’s a good idea to choose formulations that include choline as an ingredient.
What much water do breastfeeding mothers really need to drink every day?
Mothers should drink based on their thirst when breastfeeding. For most this equates to at least 6 to 8 eight-ounce glasses of fluids per day. Contrary to popular belief, drinking excessive amounts of water or other fluids will not lead to an increase in milk production.
What are the suggested bare minimum food sources for breastfeeding mothers each day?
Dairy: 3 one-cup servings of milk, yogurt, cheese, etc. to provide Vitamin D and calcium.
Protein: 6.5 ounces from lean meats, chicken, eggs, beans, peas, nuts, and/or seeds.
Omega-3 fatty acids: 2-3 servings per week of salmon, trout, herring, and sardines
Whole grains: 8 half-cup or 1 slice servings. Make sure whole grains are fortified with folic acid and iron.
Vegetables: 3 one-cup servings of dark green and yellow vegetables. Vitamin and nutrient-rich choices include carrots, pumpkin, squash, sweet potatoes, cooked greens, tomatoes, sweet red papers, and other leafy greens.
Fruits: 2 one-cup servings. Vitamin and nutrient-rich choices include cantaloupe, mango, apricots, bananas, honeydew melon, and oranges.
Do breastfeeding mothers on special diets need to do anything special for optimal breast milk production?
It’s important for vegetarian and vegan mothers to make sure to eat foods that are rich in iron and zinc, such as beans, dried fruits, nuts, seeds, and dairy. They also need to have adequate sources of Vitamin D, calcium, omega-3 fatty acids, and Vitamin B12 in their diets.
In addition, vegan mothers need to ensure they have adequate protein and calcium in their diets. Nuts, seeds, beans, grains, and leafy greens are all good non-animal sources of protein. Vegan sources of calcium include almonds, fortified plant-based milk, soy, tofu, cruciferous vegetables, and dried figs.
Most importantly, breastfeeding vegan mothers need to supplement their diets with Vitamin B12 to prevent their babies from becoming B12 deficient. Low B12 levels can cause serious problems in babies, including anemia and problems with the brain and nervous system development. B12 supplements should be taken separately (not as part of a multivitamin) and either dissolved under the tongue or chewed very slowly to increase absorption.
Breastfeeding mothers with celiac disease, an autoimmune disease that is triggered by exposure to a food protein called gluten, need to adhere to a gluten-free (GF) diet at all times while breastfeeding. Being on a gluten-free diet increases the risk of several micronutrient deficiencies including folate, calcium, iron, and zinc. Thus it’s important for GF mothers to make sure that they increase their intake of foods that are rich in these minerals during milk production.
The bottom line is that any breastfeeding mom who is on a special diet should consult with a registered dietician to make sure that the nutrient needs of both her and her baby are being met through a combination of diet and supplementation.
Can avoiding certain foods while breastfeeding prevent my baby from developing food allergies?
It’s recommended that breastfeeding mothers eat a full, balanced diet and only restrict certain foods if medically necessary. The latest research demonstrates that introducing babies to common allergens through breast milk, including peanuts, tree nuts, wheat/gluten, milk, soy, and eggs, actually helps to prevent them from developing food allergies later on.
Will the foods I eat affect the taste of my breast milk?
Breast milk not only changes color but also can taste and smell differently based on mothers’ diets. Eating a lot of beets can make milk look pinkish-purple, and the carotenoids (Vitamin A components) in carrots and sweet potatoes can make milk turn orange – eating these foods can also make breast milk taste different too. The flavors of foods that mothers eat enter into their breast milk about 2-3 hours after consumption and can be detected for up to 8 hours.
Research has shown that infants prefer sweet and savory flavors during their first few months of life and that a preference for salt starts to emerge around 4 months. This is thought to be evolutionary, as it assures that newborns will prefer the taste of breast milk which is on the sweet side due to being high in lactose.
There is anecdotal evidence that babies who are exposed to a wide variety of flavors in breast milk may be more “adventurous” eaters later on. So if you like to eat spicy, flavorful foods, make sure to continue to do so while producing breast milk!
Is breastfeeding a good way to lose all of my pregnancy weight?
Losing weight should never be one’s primary motivation for breastfeeding!
For a long time breastfeeding was “marketed” as being a great tool for new mothers to shed weight and get back to their pre-pregnancy weight and body mass index (BMI). In reality, it takes up to a year for most new mothers to lose all of their pregnancy weight, regardless of whether or not they are breastfeeding. Some nursing mothers find themselves unable to drop their last few extra pregnancy pounds until their little ones are totally weaned.
Are there any foods and drinks that mothers should be cautious about eating or drinking while breastfeeding?
Alcohol: Alcohol can be consumed in moderation while breastfeeding. The Academy of Breastfeeding Medicine (ABM) defines “moderate” alcohol intake as up to one standard drink per day – 12 ounces of beer (5% ABV), 5 ounces of wine (12% ABV), or 1.5 ounces of hard liquor (40% ABV). It’s best to wait at least 2-3 hours after each alcoholic beverage to breastfeed or pump so that most of the alcohol consumed has been metabolized (cleared) and will not pass from mom to baby.
Fish: As discussed earlier, fish are a very important source of a healthy, omega-3 fatty acid called DHA. Lactating mothers should avoid types of fish that are high in mercury, such as mackerel, shark, kingfish, and swordfish. Good fish options that are high in DHA include salmon, bluefish, trout, flounder, tuna, and bass.
Caffeine: Caffeine can be consumed in moderation (i.e. up to 2-3 cups of coffee per day). Large amounts of caffeine may decrease breast milk supply and can also pass to one’s baby through milk and cause symptoms such as jitteriness and irritability.
Herbs: Galactagogues are herbs that are ingested in an attempt to increase one’s breast milk supply. Common galactagogues include fenugreek, goats’ rue, and blessed thistle. There are other herbs that have the opposite effect and decrease breast milk production, peppermint, parsley, and sage should be avoided in large amounts while breastfeeding as they are associated with a decline in milk supply.
Garlic and onion: Both of these foods can change the taste of your milk but some breastfeeding babies seem to really enjoy garlic and onion flavored milk! There is conflicting evidence as to whether garlic increases or decreases milk supply, so it’s probably best to eat it in moderation.
Are there any foods that can actually increase and boost one’s milk supply?
This is a great question, and an area in which we need a lot more research, as so much is unknown. Brewer’s yeast, oatmeal, and dates have all been touted to increase milk production, but there is not any science to back this up and most women do not experience any change in milk production after eating these foods.
Do artificial sweeteners pass into breast milk?
There are a handful of studies looking at whether or not artificial sweeteners, like aspartame and Stevia, pass into breast milk. Based on the results of these studies, the levels of artificial sweeteners in breast milk are extremely low and well below toxic threshold levels.
Can babies tolerate spicy and gas-producing foods in breast milk?
Yes, most babies tolerate spicy foods just fine. If you believe your baby has colicky symptoms due to a certain food, such as excessive gas or crying, it’s best to remove the suspected food for about 2 weeks – if he or she was reacting to that food their symptoms should significantly improve once it is removed. Keeping a detailed food diary can really help to figure out which food(s) your baby might be reacting to as well.
Can breastfeeding mothers “cure” their babies' colic by changing their diet?
Yes, sometimes. FODMAPs (fermentable, oligosaccharides, disaccharides, monosaccharides, and polyols) are a group of carbohydrates found in certain foods, including wheat and beans. FODMAPs can cause digestive symptoms, such as excessive gas, abdominal pain, bloating, and diarrhea, in adults. Recent research from Australia has shown that a 10-day low-FODMAPS maternal diet is associated with a significant decrease in the frequency and length of colicky babies’ crying episodes. There is no scientific or medical evidence that major dietary restrictions of all dairy products, soy, wheat, eggs, and corn from mothers’ diets make any difference in symptoms of colic.
Can breastfed babies really get food allergies and/or react to food proteins in their mothers’ breast milk?
Yes, they can. The most common food allergies in young infants are dairy and soy proteins, followed by wheat and eggs. Symptoms of food allergies and intolerances in babies include rashes and/or digestive symptoms, such as reflux, refusing to feed, and blood and/or mucous in stools. If you are breastfeeding a baby who has been diagnosed with a food allergy, it’s essential to eliminate all possible sources of the food that your baby has reactions to in your diet.
How can I find the time to prepare and eat healthy foods while breastfeeding?
It can be really hard to find time to make healthy, nutritious meals when you have a newborn, so it’s okay to reach out for help and to ask family members, neighbors, and friends to make and drop off healthy meals and snacks for you. Other tips for healthy eating while breastfeeding includes the following:
- Prepping and cooking for several days’ worth of meals all at once. This can include chopping all vegetables for a week’s worth of recipes on a Sunday afternoon. It can also include “batch” cooking and duplicating the meals you prepare. One example is roasting two chickens at once – you can eat one roasted chicken for dinner and shred and save the second one for a second (or third) meal later in the week, like chicken fried rice or chicken soup.
- Utilize food and grocery delivery services, such as Instacart and Peapod.
- Starting a meal train for yourself tailored to your specific dietary needs. For example, if you have celiac disease and are gluten-free, not only request gluten-free meals but also make sure to give examples and suggestions of basic meals for others to prepare, i.e. plain roasted meats and vegetables, rice, and potato-based dishes, etc.
- Buy healthy snacks, like bags of almonds and yogurt in bulk, and always have chopped fresh vegetables and fruits ready to eat in your fridge.
- Aim for several quick but nutritious meals every week, like omelets with spinach (or other leafy greens), chicken stir fry, or oatmeal with fresh berries and almond milk.
Last of all, remember not to beat yourself up if you end up eating a non-healthy food or meal. None of us are perfect and most of us eat occasional “junk food.” Like all other aspects of mothering, do your best with eating a healthy diet, but don’t strive for perfection, as you’ll set yourself up for failure. Be sure to be as gentle and loving toward yourself as you are to your baby!
References
Diet for Breastfeeding Mothers. Children’s Hospital of Philadelphia website. Accessed 8/14/2021.
Copp, K., DeFranco, K., et al. Nutrition support team (NST) guide to maternal diet for the human milk fed infant. Nutr Clin Pract. 2018. 33(5): 687-693.
Iacovou, M., Craig, S., Yelland, G., et al. Randomised clinical trial: reducing the intake of dietary FODMAPs of breastfeeding mothers is associated with a greater improvement of the symptoms of infantile colic than for a typical diet. Aliment Pharmacol Ther. 2018. 48(10): 1061-1073.
Keikha, M., Bahreynian, M., Saleki, M., and Kelishadi, R. Macro- and Micronutrients of Human Milk Composition: Are They Related to Maternal Diet? A Comprehensive Systemic Review. Breastfeeding Medicine. 2017. 12(9): 517-527.
Marangoni, F., Cetin, I., Verduci, E., et al. Maternal diet and nutrient requirements in pregnancy and breastfeeding. An Italian consensus document. Nutrients. 2016. Volume 8, 629.
Pham, Q., Patel, P., Baban, B., Yu, J., Bhatia, J. Factors Affecting the Composition of Expressed Human Milk. Breastfeeding Medicine. 2020. 15(9): 551-558.
Valentine, C. and Wagner, C. Nutritional management of the breastfeeding dyad. Pediatr Clin N Am. 2013. 60: 261-274.