Frequently Asked Questions About Breastfeeding and Diet

Many mothers wonder how their diets may affect the quantity and quality of their breastmilk. With so much emphasis in both the popular media and the medical literature on the effects of processed foods, sugar, and artificial ingredients on health, women who have difficulty eating a more natural diet may worry that breastfeeding might not always be the safest or most nutritious choice. Maybe you have heard that you should change your diet while you are breastfeeding, or perhaps you have been told that it’s fine to eat “whatever you want.” Here are some answers to these questions. Please contact us via the website or Facebook page if your question does not appear here.

31st Annual Thunderbird Mid-summer Native American Festival

I have heard that the way we eat today puts us at higher risk for illnesses like diabetes and heart disease. What about my baby’s health? Is my milk still best for him?

Yes! Even if your diet contains more processed and convenience foods than is best for your health, your milk will still be the best available food for your baby.

It is clear from the research that breastfeeding is the single best way for a mother to safeguard her infant’s health: babies not breastfed have higher risk of diabetes, diarrhea, ear infections, rashes, allergies, childhood cancer, respiratory illnesses, asthma, and SIDS, (Bartick & Reinhold, 2010; Stuebe, 2009), and the protection offered by breastfeeding does not depend on the mother’s diet.

Formula, whether milk-based or soy-based, factory-produced or homemade, can never provide your baby with all the specific nutrients and immune factors essential for his health. Your milk changes composition in order to best meet your baby’s needs as he grows. Also, breastmilk contains immune factors to protect him against illness–no formula offers immune protection. While most infants can survive and grow on formula, some ingredients are associated with health problems. The proteins in formula are different from the proteins in your milk and are associated with increased risk for certain diseases like juvenile diabetes (Virtanen et al., 1994; Kolb & Wassmuth, 2000) and colitis (Host, 1994; Savilahti et al., 2010). The iron in formula is less available and harder to absorb than the iron in your milk, and it may cause undesirable changes in your baby’s gut bacteria (Balmer & Wharton, 1989; Mevissen-Verhage et al., 1985). When considering how to feed your baby, remember that milk from your breast is always fresh. Formulas, whether homemade or store-bought, carry the additional risk of contamination with disease-causing bacteria from processing facilities (Power et al., 2013) or farm animals.

Research has found little significant variation between the milks of mothers with different diets. For example the amounts and types of fats may vary (Cruz-Hernandez et al., 2013; Innis & Kuhnlein, 1988), but no diet has been found to result in breastmilk that is inferior to formula or inadequate to meet an infant’s needs. Humans are “omnivores” and have the ability to both stay healthy and produce high-quality breastmilk on diets that vary widely in both composition and quantity of foods. When your body makes milk, it produces the nutrients, non-nutritive elements, and immune factors your baby needs in the proper quantities (Hassiotou et al., 2013).

Even if a formula were just as nutritious as breastmilk, breastfeeding is about so much more than the milk. It is a special relationship that is uniquely yours–something only you can do for your baby. Breastfeeding keeps your baby safe and warm, promotes normal sleep patterns, allows normal brain development, and develops his immune system (including his thymus gland). The breastfeeding relationship cannot be bottled, and breastfeeding is best for your health, too.

My diet is limited to my budget, and I don’t always have access to fresh fruits and vegetables–is my milk still nutritious?

Absolutely! Your milk is always the most nutritious food for your baby, even if your diet is not as varied and nutritious as recommended by health experts. Information about nutrition during pregnancy and breastfeeding may not take into account the limitations that many mothers face: lack of food, limited access to fresh foods, and limited or no access to common food-preparation needs such as running water, stove, refrigerator, or microwave. That said, eating as wisely as possible is best for your health and that of your children. Cutting back on fast and convenience foods and increasing your intake of fruits and vegetables and other whole foods will be better for your health, especially for reducing the risk of diabetes and heart disease. If you are in a situation that limits the food you have available, here are some ideas:

  • Buy fresh fruits and vegetables from a local fruit stand, farmers’ market, or Community Supported Agriculture (CSA) organization. They are usually cheaper than your local grocery store (especially if you live where convenience stores are your main shopping centers or where fruits and vegetables are usually trucked or flown in). Many accept SNAP benefits or WIC cash value checks. You may even be able to barter for fresh food this way simply by asking.
  • Keep dry ingredients like beans, rice, and pasta on hand: they make inexpensive bases for healthy meals.

  • Pre-packaged “health foods” like granola bars and cereals are costly and often have unnecessary added sugar. Making your own snacks from bulk ingredients like nuts, oatmeal, cornmeal, and whole-grain flour costs less than buying commercial snacks and are healthier because you control the ingredients.

  • Build your weekly or daily menu around what is on sale at your local grocery store. Shop for markdowns in the meat, produce, dairy, and bakery sections. These sales may save you 30-50% of the cost.

  • If you do most of your shopping at convenience stores, choose more healthful options like mixed nuts instead of potato chips.

  • If you use a food bank, don’t be afraid to ask specifically for healthy foods.

  • Remember that WIC and SNAP both allow produce purchases and make special allowances for families who have limited resources for cooking and food storage (for example, SNAP would allow you to purchase hot foods from a grocery store). Both agencies provide nutritional counseling, as well as food-preparation classes.

  • Your tribal or community wellness agency may provide nutritional counseling and special assistance in buying wholesome foods.

Here is one tribe’s answer to the problem of where to find fresh, affordable, local food: Oneida Community Integrated Food Systems

Some families find getting enough food to feed a family especially difficult. If you need assistance in finding food, please contact these helpful agencies:

 WIC (Women, Infants, and Children)

USA Federal food programs

Community food programs

Do I need to take a multivitamin to breastfeed?

Your body will use your stores of vitamins and minerals to ensure that your milk has exactly what your baby needs. Finishing the prescribed prenatal vitamin is usually enough to meet your own health requirements (Nutrition During Lactation, 1991). However, if your diet is high in processed foods, you eat fewer than 2700 calories per day, you avoid or limit certain food groups, or you have any health conditions that may limit how well your body absorbs nutrients or vitamins, nutrition counseling is recommended. Increasing your intake of certain foods and food groups is likely to provide a greater benefit than a supplement (Lawrence & Lawrence, 2011).

Even though you are able to produce high-quality breastmilk on a diet deficient in some nutrients, when you take in more vitamins and minerals through supplements and dietary changes, some of them also increase in your milk. If you take in more of vitamins A, D, B1, B2, B3, B6, or B12, your milk will have more of these vitamins as well. Fatty acid and iodine supplements may also influence quantities in your milk. (Valentine & Wagner, 2012).

If you are concerned that you or your baby may not be getting enough of all the vitamins you need, talk to your health-care provider. She may recommend simple testing or vitamin supplements. Breastfeeding is still best in these situations.

Do I have to eat certain foods or take supplements in order to produce enough milk?

 No. However, in some cultures it is customary to eat certain foods after the baby is born in order to promote milk production. Interestingly, many of these customary “mother foods” are packed with B vitamins, iron, calcium, protein, antioxidants, and anti-inflammatory properties, which may help support lactation nutritionally. If your traditions recommend eating (or avoiding) certain foods after birth, you should feel encouraged to do so.

Sometimes mothers are told they need to take a certain herb, drink a commercial herbal tea, drink cow’s milk, eat oatmeal or oatmeal-based “lactation cookies”, or even drink one dark beer each night in order to produce enough milk. While most of the recommendations aren’t harmful, and some may even be beneficial from a nutritional standpoint, they aren’t likely to make or break your breastfeeding relationship. Milk production is controlled inside the breast, by the frequency and thoroughness of milk-removal. The best way to encourage your body to make all the milk your baby needs is to feed on demand.

 Please keep in mind that alcohol consumption should be limited while you are breastfeeding. Always talk to your health-care provider or traditional healer before taking any herbs or over the counter medications. If you are concerned about your milk production, talk to an IBCLC or other breastfeeding support specialist.

 Can I diet while breastfeeding?

 Reducing the number of calories you eat daily and avoiding desserts, sodas, chips, and other foods with “empty calories” will not cause your milk to lose nutritional value. Many mothers find that breastfeeding alone helps them lose the extra weight they gained during pregnancy. It is possible to lose additional weight through restricting calories while you are breastfeeding, but the current recommendation is that the diet not include fewer than 1800 calories per day (Lauwers & Swisher, 2011).

 Are there foods I should avoid while breastfeeding?

 The short answer is that there are no foods all mothers should avoid. Diets vary around the world, and so do the traditions of foods to eat or avoid while breastfeeding. Many experts recommend avoiding fish that are known to have high levels of mercury (tuna, swordfish, and others), foods like margarine that are high in trans fats, and foods that are common allergens like peanuts. However, the research on these topics is incomplete. Discuss any dietary restrictions you would like to make with your health care provider or IBCLC. It should be noted that milk-based formulas, including homemade formulas, contain trans fats (Mozaffarian et al., 2006; Satchithadandam et al., 2002; Ratnayake et al., 1997), and most formulas contain common allergens such as animal milk or soy proteins.

 I have heard that certain diets will make my milk much healthier for my baby. Should I still breastfeed if I don’t eat a traditional or natural-food diet?

 Definitely. While a diet rich in fresh fruits and vegetables and low in processed foods is an ideal choice for your and your family’s health, breastfeeding always provides the best possible nutrition for your baby, even if your diet is not as wholesome as it should be. A mother eating a typical American diet and a mother eating a whole-food diet may have some different types of fat and slight differences in the levels of some vitamins in breast milk, but this variation is not as great as the nutritional difference between broccoli and candy. Your milk is still best, even if your diet is not.

I have heard that what I eat and drink goes into my milk–so if I eat french fries or drink soda, my baby gets the same fat and sugar through my milk?

 The old adage “you are what you eat” sounds catchy, but it is not helpful to breastfeeding mothers wondering if their milk is nutritious enough for their babies. Most of the nutrients found in your milk do not pass directly from your food to your blood to your milk–the process your body uses to produce breastmilk is much more complex. Many substances in the foods you eat are never found in your milk, while others can pass through. However, no matter how much junk food you eat, there is no evidence to support the idea that your milk is not the best available food for your baby.

 If my milk is still the best choice for my baby, why should I bother to try to make healthier food choices for myself?

 Your health is important, too! Breastfeeding helps protect you from diseases like breast cancer (Bartick & Reinhold, 2010; Stuebe, 2009), but your diet is also crucial in maintaining your health. Also, your baby will not be breastfeeding forever–he will soon learn to eat table foods, and he will want the same foods he sees on your plate. Now is the perfect time to begin making those changes in your diet which will help your baby learn to eat healthily, and the foods you eat will flavor your milk so he will grow accustomed to their tastes. Some first table foods for your baby are also great for you: sweet potatoes, avocados, bananas, beans, lean meats, and oatmeal are simple to prepare, easily mashed with a fork, and very nutritious. Fresh ingredients cost less than prepared baby foods and cereals, and they are free of added sugar and other unnecessary ingredients.

 All children benefit when their parents are healthy, and good health will allow you to have the energy and positive mood you need to meet the intense demands of motherhood.

 Is it true that you shouldn’t eat “gassy” foods like broccoli, onions, and beans while breastfeeding?

 Don’t worry! These vegetables are great choices for breastfeeding mothers. Even if they give you gas, the substances in them that can cause gas do not get into your milk.

 I am diabetic. If my blood sugar is high, will my milk have too much sugar?

 No–your body produces the main sugar in your milk, lactose, in the breast, and the amount of sugars in your milk remain fairly constant no matter how high the level of glucose in your blood may be (Dewey et al., 1991). Many mothers find that breastfeeding keeps their blood sugar lower than it was before they were breastfeeding, but if your blood sugar does get too high, do not worry about your milk–glucose only makes up a tiny percentage of all the sugars in breastmilk (Butte et al., 1987). However, if you have uncontrolled diabetes, you should seek treatment from your health-care provider as soon as possible for the sake of your own health.

 You may be happy to know that breastfeeding reduces the risk of your child’s developing both obesity and diabetes.

 I keep hearing conflicting advice about breastfeeding, and I am so confused! Where can I find the most accurate information?

 Breastfeeding is a hot topic in the media right now, and many people are eager to voice their opinions. Many mothers are unsure where to turn for answers. Fortunately, there are trained professionals who have access to high-quality research and can help. Find them here:

Guide to breastfeeding support professionals

Find a lactation consultant

References

 Balmer, S. E., & Wharton, B. A. (1989). Diet and faecal flora in the newborn: breast milk and

infant formula. Archives of Disease in Childhood, 64, 1672-1677

Bartick, M., & Reinhold, A. (2010). The Burden of Suboptimal Breastfeeding in the United States: A Pediatric Cost Analysis. Pediatrics, Published online April 5, 2010. (doi: 10.1542/peds.2009-1616)

Butte, N. F., Garza, C., Burr, R., Goldman, A. S., Kennedy, K., & Kitzmiller, J. L. (1987). Milk composition of insulin-dependent diabetic women. J Pediatr Gastroenterol Nutr., 6 (6), 936-41.

Cruz-Hernandez, C., Goeuriot, S., Guiffrida, F., Thakkar, S. K., & Destaillats, F. (2013). Direct quantification of fatty acids in human milk by gas chromatography. J Chromatogr A. 1284,174-9. (doi: 10.1016/j.chroma.2013.01.094).

Dewey, K. G., Heinig, M. J., Nommsen, L. M., & Lonnerdal, B. (1991). Maternal Versus Infant Factors Related to Breast Milk Intake and Residual Milk Volume: The DARLING Study. Pediatrics, 87(6), 829 -837.

Friesen, R., & Innis, S. M. (2006). Trans fatty acids in human milk in Canada declined with the introduction of trans fat food labeling. J Nutr., 136 (10), 2558-61. Source: The Nutrition Research Program, Child and Family Research Institute, University of British Columbia, Vancouver, British Columbia, Canada V5Z 4H4.

Hassiotou, F., Geddes, D. T., & Hartmann, P. E. (2013). Cells in Human Milk: State of the Science. J Hum Lact., [Epub ahead of print]

Host, A. (1994). Cow’s milk protein allergy and intolerance in infancy. Some clinical, epidemiological and immunological aspects. Pediatr Allergy Immunol., 5(5 Suppl), 1-36.

Innis, S. M. * Kuhnlein, H. V. (1988). Long-chain n-3 fatty acids in breast milk of Inuit women consuming traditional foods. Early Human Development, 18(203), 185–189.

 Lauwers, J. & Swisher, A. (2011) Maternal health and nutrition. In Counseling the Nursing Mother (5th ed., p. 171). Mississauga, Ontario, Canada: Jones and Bartlett.

 Lawrence, R. A. & Lawrence, R. A. (2011). Breastfeeding: A Guide for the Medical Profession, 7th Edition. Elsevior. Maryland Heights, MO.

Mevissen-Verhage, E. A., Marcelis, J. H., Harmsen-Van Amerongen, W. C., de Vos, N. M., & Verhoef, J. (1985).  Effect of iron on neonatal gut flora during the first three months of life. Eur J Clin Microbiol., 4(3), 273-8.

 Mozaffarian, D., Katan, M. B., Ascherio, A., Stampfer, M. J., & Willett, W. C. (2006). Trans Fatty Acids and Cardiovascular Disease. N Engl J Med, 354, 1601-1613. (DOI: 10.1056/NEJMra054035)

Power, K. A., Yan, Q., Fox, E. M., Cooney, S., & Fanning, S. (2013). Genome Sequence of Cronobacter sakazakii SP291, a Persistent Thermotolerant Isolate Derived from a Factory Producing Powdered Infant Formula. Genome Announc 1(2), e0008213. doi:10.1128/genomeA.00082-13

Ratnayake, W. M., Chardigny, J. M., Wolff, R. L., Bayard, C. C., Sebedio, J. L., & Martine, L. (1997).  Essential fatty acids and their trans geometrical isomers in powdered and liquid infant formulas sold in Canada. J Pediatr Gadtroenterol Nutr., 25(4), 400-7.

Riordan, J. & Wambauch, K. (2010). Nutritional values. In Breastfeeding and Human Lactation (4th ed., pp. 125-7). Mississauga, Ontario, Canada: Jones and Bartlett.

Satchithanandam, S., Fritsche, J., & Rader, J. I. (2002). Gas chromatographic analysis of infant formulas for total fatty acids, including trans fatty acids. J AOAC Int., 85(1), 86-94.

Savilahti, E. M., Saarinen, K. M., & Savilahti, E. (2010). Specific antibodies to cow’s milk proteins in infants: effect of early feeding and diagnosis of cow’s milk allergy. Eur J Nutr., 49(8), 501-4. (doi: 10.1007/s00394-010-0109-8). Epub 2010 Apr 20.

 Stuebe, A. (2009). The Risks of Not Breastfeeding for Mothers and Infants. Rev Obstet Gynecol, 2(4), 222–231. PMCID: PMC2812877 [PubMed]

 “1 Summary, Conclusions, and Recommendations.” Nutrition During Lactation. Washington, DC: The National Academies Press, 1991.

 Valentine, C. J., & Wagner, C. L. (2012). Nutritional management of the breastfeeding dyad. Pediatr Clin North Am., 60 (1), 261-74. (doi: 10.1016/j.pcl.2012.10.008)

Virtanen, S. M., Saukkonen, T., Savilahti, E., Ylonen, K., Rasanen, L. Aro, A., Knip, M., Tupmilehto, J., & Akerblom, H. K. (1994). Diet, cow’s milk protein antibodies and the risk of IDDM in Finnish children. Childhood Diabetes in Finland Study Group. Diebetologia, 37(4), 381-7.

 Wasmuth, H. E., & Kolb, H. (2000). Cow’s milk and immune-mediated diabetes. Proc Nutr Soc., 59(4), 573-9.


Whitney, E., Debruyne. L. K., Pinna, K. & Rolfes, S. R. (2011). The body’s energy budget. In Nutrition for Health and Health Care (4th ed., pp. 143-44). Belmont: Wadsworth, Cengage Learning.

© Adrienne Uphoff, IBCLC and Jolie Black Bear, IBCLC 2013–All Rights Reserved

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