Nutrition Considerations For Breastfeeding Moms

Congrats, Mama! You made it to the finish line of pregnancy.

And while you’ve FINALLY regained some line of vision to your lower extremities and are, at long last, able to hold and kiss that sweet babe of yours, unfortunately your body isn’t off the clock just yet. That is, if you plan to breastfeed.

The American Academy of Pediatrics recommends postpartum mamas breastfeed until 12 months of age, and the World Health Organization recommends breastfeeding until age 2. However, I fully recognize that despite well-intentioned efforts, not all moms are able to breastfeed for a number of reasons. With lip ties, duct infections, inverted nipples, latching issues and sleep deprivation throwing enough at us in the way of difficulty reaching our breastfeeding goals – I’ve made it my goal to create the antidote to all your boob-related anxieties.

Today’s post on Nutrition Considerations for Breastfeeding Moms aims to serve you in all your milky endeavors by neatly laying out the body’s specific nutrient needs for adequate milk production, my evidence-based recommendations for postpartum supplementation, and the first of many recipes to come for healthy lactation.

While some nutrients in breast milk remain stable, others depend heavily on maternal intake. Fatty acids, certain B vitamins, and vitamins A, C, and D are all affected greatly by mom’s intake. The good news is if you’re reading this – you likely care abundantly about supporting healthy development in your babe. And if you already focus your diet largely around whole plant foods, you’re truly ten steps ahead of the game. Research shows that vegetarian moms’ breast milk has just 1-2% of the environmental pollutants found in non-vegetarian women’s milk.

That’s not to say that a strictly whole-foods plant-based diet is necessary to support a growing babe by any means. In fact, as we’ll learn today, the addition of vegan-friendly supplements or the occasional intake of certain nutrient-rich animal-based foods can aid in ensuring your little one has all it needs to thrive. Follow along as we review the most critical nutrients for healthy milk production, my favorite dietitian-approved sources of those, and finally – a decadent recipe to tie it all together and ensure your supply is jam-packed with critical nutrients for your babe.

Note: This post does not speak to any herbal supplements thought to boost milk supply, as the research on herbs like fenugreek, blessed thistle, goat’s rue and moringa as galactagogues is sparse and largely inconclusive. We will instead dive into the specific micronutrients known to be critical for high-quality breast milk production, as this is where the best-available postnatal nutrition literature is scientifically sound and conclusive.

Top Nutrients of Concern for Breastfeeding Mamas:

1. Calories:

Women who are breastfeeding need about 500 extra calories per day to meet the demands of lactation. That’s even more than required in the third trimester of pregnancy! However, your body will remind you of this. Never push yourself to eat past fullness in order to meet the demands of your caloric prescription. Our bodies eb and flow from day to day (and specific needs vary greatly from individual to individual). Just make sure to listen to your hunger and satiety queues, honor those through balanced meals and snacks, and avoid dieting in the postpartum period - as under-eating can significantly compromise your milk supply.

2. Vitamin B12:

Critical for red blood cell formation, protein metabolism, and a healthy nervous system vitamin B12 is a must for postpartum mamas (especially vegan ones!). Vitamin B12 is produced by bacteria. Animals typically get their fair share by eating bugs, dirt, feces, or receiving supplementation of it while on factory farms. And while we may have once gotten all we needed by eating crops with small amounts of soil on them or drinking out of mountain streams and wells, modern society now chlorinates its water supply and has stripped its soil nearly sterile. Hence, the need for supplementation. The good news is fortified foods and supplements are the cheapest, safest, and most effective sources of the stuff, for omnivores and vegans alike. In order to absorb the recommended ~3-7 mcg needed daily, it is suggested that breastfeeding mamas supplement with at about 50 mcg (cyanocobalamin or methylcobalamin) on a daily basis, or at least 2000 mcg once a week. Best to choose sublingual sprays or dissolvable tablets here, as gummy vitamins tend to have lower absorption rates - and often contain gelatin too. Other ways to add B12 to the diet include frequently consuming vitamin B12 fortified foods such as nutritional yeast, B12-fortified tofu, soy milk and breakfast cereals.

3. Omega-3 Fatty Acids EPA/DHA:

Fatty acids remain critical during lactation as they play a paramount role in cell membrane composition. Two important fatty acids for breastfeeding mothers are EPA and DHA, which are those biologically active forms of omega-3 fatty acids, typically concentrated in fish or algal oil.

These are especially important during breastfeeding, as babies have a limited ability to synthesize these fats from ALA (the precursor to EPA/DHA, found in certain nuts, seeds and oils) on their own, making them dependent on mom’s intake or stores.

DHA plays a major role in babies' brain development, body composition, and risk for developing diseases later in life. Meanwhile, EPA may help reduce symptoms of postpartum depression. Experts recommend breastfeeding moms supplement with at least 300 mg DHA per day (and there is currently no recommended amount for EPA). For plant-based moms, I recommend an algae oil-based supplement such as Nordic Naturals Algae Omega (which you can purchase at a discounted rate in my online dispensary, linked here) which contains a good amount of both.

4. Vitamin D:

Vitamin D plays vital roles in bone health, immune function and postpartum depression prevention. And although breastfeeding is praised as the gold-standard for infant nutrition, its shortcomings fall evident in poor rates of transfer from maternal vitamin D stores to the infant. With this in mind, it is recommended that exclusively breastfed infants are supplemented with 400 IU of vitamin D daily. For predominantly vegan mamas, vitamin D supplementation is even more critical given the fact that it is found primarily in animal-based foods. Fatty fish, egg yolks, UV- treated mushrooms, and certain fortified juices, cereals and dairy products are some of the only dietary sources of the stuff. With vitamin D intake from food sources alone tending to be inadequate, and decreased rates of vitamin D synthesis from sun exposure due to a polluted atmosphere, I recommend moms consume between 600 - 2000 IUs daily. If you’d like to avoid supplementing your infant with 400 IUs each day separately, research suggests that maternal supplementation with 6400 IUs of vitamin D per day can effectively increase the levels present in human breastmilk to supply adequate levels to a breastfeeding babe.

5. Choline:

Choline plays a major role in infant brain development, including helping to form the protective sheath around brain cells. Choline needs increase further during breastfeeding, and because it’s mainly found in animal-based products, plant-based mamas may want to consider supplementation. Research indicates that supplementing with choline increases the amount of free choline present in breastmilk. If you do not regularly eat choline-rich foods like eggs and think you may be falling short of the recommended 550 mg per day of choline, consider taking a supplement. Nested Naturals and Pure Science are great brands if you’re seeking a high-quality vegan choline supplement.

There is such a thing as too much choline, however - although this is mostly a concern with high-dose supplements, as it is difficult to get too much through food alone. High intakes of choline are associated with a fishy body odor, vomiting, excessive sweating, and liver toxicity. Excess choline intake has also been shown to increase production of TMAO, a substance linked to increased risk for cardiovascular disease. The upper limit for choline is 3000-3500 mg/day for pregnant and lactating women.