Best Breastfeeding Diet and Foods to Avoid

There are several foods to avoid eating during pregnancy from liver to certain types of fish or soft cheese 1. But what about when you are breastfeeding? Are there any foods to avoid while breastfeeding? What is the best breastfeeding diet?

Foods to Avoid While Breastfeeding

Unlike during pregnancy a breastfeeding mother can eat and drink most things and there aren’t any specific foods to avoid. It’s advisable to have a nutritious diet because that is healthier for you and your milk supply but generally you can eat your usual pre-pregnancy diet while you are breastfeeding. What you eat and drink isn’t thought to substantially affect the amount of milk your body makes although some foods and herbs are thought to help milk supply. If you are severely malnourished or if certain nutrients are missing in your diet this could affect the quality of your breast milk 2. Generally you don’t need to worry as an average diet will guarantee adequate breast milk. The authors of The Womanly Art of Breastfeeding explain:

Eating more won’t make more milk, and not eating enough won’t make less milk. You don’t need a perfect diet to keep your milk nutritious. Your milk is made from your blood. If you haven’t been worrying about the quality of your blood lately, there’s no need at all to worry about the quality of your milk!

Should I avoid allergenic food?

There are currently no recommendations to avoid typically allergenic foods such as nuts or fish during breastfeeding unless the mother is herself allergic to something that she needs to avoid 3 4.

Allergy author Maureen Minchin summarises:

in general, it is best not to exclude any foods from the mother’s diet, as breastfeeding is intended to create tolerance. In general, it is also best to exclude from the diet of the pregnant woman and breastfeeding mother foods to which she -and/or the biological father of the child – is clearly reactive

My baby seems fussy, is my diet affecting my breast milk?

Traces of a mother’s diet do pass into breast milk and generally this is a way for a breastfed baby to gradually become accustomed to table foods. Sometimes, a baby can be sensitive to particular foods which may cause them to fuss or have tummy ache. If your baby seems to be particularly fussy or uncomfortable after something specific you have eaten, try to avoid that food for a while and see if the symptoms settle down. It is not unusual for a baby to react to dairy produce in his mother’s diet. See Elimination Diet for more information about cutting out problem food but bear in mind that there can be plenty of other reasons for a baby to be fussy.

Can I eat baked beans, cabbage or spicy food…?

You may hear stories that you can’t eat certain food items when you are breastfeeding because they will give your baby tummy ache or wind (gas). Occasionally a baby may be sensitive to a particular food, but there’s no need to restrict your diet just in case.

Can I eat peanuts while breastfeeding?

Yes, unless you know you are allergic to peanuts. The UK’s National Health Service (NHS) advises:

If you’d like to eat peanuts or foods containing peanuts, such as peanut butter, while breastfeeding, you can do so as part of a healthy, balanced diet (unless, of course, you are allergic to them). There’s no clear evidence that eating peanuts while breastfeeding affects your baby’s chances of developing a peanut allergy. If you have any questions or concerns, you can talk to your GP, midwife or health visitor.

Can I drink coffee or caffeine?

Yes, a few cups of coffee won’t normally upset your baby when you are breastfeeding. However caffeine does get into breastmilk and is difficult for a baby to metabolise (get rid of) especially in the first few weeks of his life. If you drink a lot of coffee, watch out for signs that your baby is particularly wakeful or jittery and read more about recommended daily limits in our article Coffee, Caffeine and Breastfeeding.

Can I drink alcohol while breastfeeding?

Small amounts of alcohol while breastfeeding do not pose a problem for your baby see Breastfeeding and Drinking Alcohol for recommended limits.

Can I eat fish while breastfeeding?

Some types of seafood contain high levels of mercury due to marine pollution. Pregnant and breastfeeding mothers are advised to limit their potential exposure to mercury as it is particularly dangerous in the early stages of a baby’s development. The UK’s National Health Service recommends breastfeeding women eat no more than one portion of shark, swordfish and marlin per week and no more than two portions of oily fish a week. There is no limit on canned tuna 5.

Can I take medications when breastfeeding?

Lots of medications are compatible with breastfeeding. For resources to check the compatibility of medicines see Medications and Breastfeeding.

What to eat while breastfeeding

You can eat whatever you like while you are breastfeeding and there isn’t a specific breastfeeding diet to follow for the sake of your baby if everything is going well. Exceptions can include:

Do I need to eat extra food while breastfeeding?

During the first six months of his life your baby will double his birthweight on breast milk alone. Your metabolism efficiently handles this energy requirement by using the fat stores laid down in pregnancy alongside eating around 500 extra calories a day 6. Women who are very underweight or malnourished with no fat stores will need to eat more.

Do I need to drink a lot of water?

You will probably find you are more thirsty than usual. Drinking just enough fluid to quench your new thirst and ensure your urine is pale coloured will keep you well hydrated and provide enough liquid to make plenty of breast milk. There’s no need to drink huge amounts of extra water (or other drinks such as cows’ milk) to increase the amount of breast milk you make 7 8 9. Breast milk volume is increased by efficient and continual breast emptying, not by how much fluid you drink. One study by Dusdieker 1990 suggested drinking 25% more fluids than baseline could even reduce the volume of breast milk slightly. Several other authors refer to excess fluids having the potential to reduce milk supply.

You don’t need more fluids than you want in order to make milk, and your supply won’t decrease if you’re mildly dehydrated. If your urine is medium to pale yellow, then you’re doing fine. Oxytocin release can make you suddenly thirsty (carrying a water bottle helps).

Breastfeeding diet and milk supply

Efficient breast emptying is the main key to plentiful milk and, coupled with a reasonably healthy balanced diet, most mothers find they have more than enough milk for their baby. However, certain food and herbs are thought to help increase milk supply—see What is a Galactagogue? And author Hilary Jacobson believes a very poor diet can affect breast milk supply and composition 10. If you do have a low milk supply, and a baby who is not gaining weight contact an IBCLC lactation consultant or other breastfeeding specialist to help you and see How to Make More Breast Milk.

Can eating healthy fats make high calorie milk?

The type of fats (or fatty acids) in breast milk can vary with a mother’s diet. And Koletzko et al 11 found that a lot of the fat content of breast milk also comes from the mother’s body stores which will have been shaped by her past diet.

Some references maintain the variation in fatty acids doesn’t alter the total fat content and that even mothers on a low fat diet could provide enough fats in breast milk 12 13. However, author Hilary Jacobson argues that a low fat diet could create low fat milk for baby and Mohammed et al found that a high fat diet can increase the milk fat, energy content of milk and so a baby’s energy intake:

In conclusion, under moderate calorie restriction, milk production was not affected by maternal diet composition. Milk fat, energy content, and infant energy intake were higher during the [high fat] diet

Increasing fat in milk

Fat content of milk varies during a single breastfeed and between feeds. In addition to including healthy fats in a mother’s diet, finishing the first breast before offering the second and breast compression can increase the fat content of breast milk. See How to Make More Milk for more ideas to generally increase milk supply.

Can I breastfeed if I am underweight?

Very underweight mothers may have breast milk with low levels of some nutrients and fat but unless the mother is significantly malnourished she can often still make enough milk 14. Improving the mother’s diet and vitamin status will raise the vitamin levels in breast milk.

Because micronutrient levels are quickly reflected in breast milk, renourishment of the woman is effective for mother and infant. It is less expensive and safer to nourish the mother than it is to give the infant artificial baby milk

Very underweight mothers will not have substantial fat stores to draw on for the additional calorific demands of breastfeeding and may need more calories from their diet.

Can I breastfeed if I am overweight?

With good help from your IBCLC lactation consultant breastfeeding will have the best chance to get off to a good start whatever your size. Problems for overweight mothers can include:

  • Breast milk can be later “coming in” when a mother is overweight with a pre-pregnancy BMI above 26.
  • An overweight mother may have a low milk supply due to a lower prolactin response 15 16.
  • The underlying causes for obesity (BMI above 30) may also be associated with low milk supply e.g. polycystic ovary syndrome or hyperthyroidism or a mother may suffer from insulin resistance or diabetes which can affect milk supply.
  • Studies have found obese mothers are less likely to breastfeed 17.
  • Overweight mothers may be at risk for nutrient deficiencies if they consume a very poor diet.

Do I need to take breastfeeding vitamins?

In most cases if you are eating a healthy diet you will be getting all the vitamins and minerals you need and your body will automatically add these to your breast milk in just the right amounts. However, certain deficiencies can creep in with some diets and lifestyles for example:

Vitamin D

Vitamin D is made in the body following exposure of the skin to sunlight and a little comes from our diet. Some people are deficient in this vitamin due to lack of sunlight and it is hard to get enough from diet alone. Check our article Vitamin D and Breastfeeding for current recommendations on supplements for you and your baby.

Vitamin B12

Vegan diets and some strict vegetarian diets may not have enough natural sources of vitamin B12. Mothers on these diets may need to check their vitamin status or take supplements so that their babies will be sure to get enough vitamin B12 via their breast milk. Babies deficient in vitamin B12 may fail to thrive, be lethargic, have a developmental delay or have certain types of anaemia which require urgent treatment. Vitamin B12 deficiency is also a possibility for mothers who have had surgery to reduce the size of their stomachs (bariatric surgery).

Iodine

Iodine is a trace element found in sea food, cereals and grains which helps to make thyroid hormones. Levels of iodine in plants vary, depending how much iodine is available in the soil 18. As some diets can be low in iodine, some countries recommend routine iodine supplementation for breastfeeding mothers 19 20. Smoking can reduce iodine levels in breast milk even further 21 increasing the risk of iodine deficiency-induced brain damage.

In the UK the Association of UK Dietitians has produced a fact sheet on iodine discussing when supplements are needed during pregnancy and breastfeeding and the levels recommended. Consult with your health care professional whether iodine supplements are recommended where you live.

Iron

For further information about iron levels in breast milk and in which situations your baby’s iron levels might be low, see Iron in Breast Milk. Taking supplements won’t increase iron levels in breast milk but a low iron status for mother could be linked with low milk supply.

Should I take a multivitamin while breastfeeding?

Abe et al, 2016 22 have reviewed the effects of vitamin supplements and found there was insufficient evidence to make a recommendation and that further studies were needed. In the UK the NHS recommends taking vitamin D supplements but says other vitamins and minerals can be obtained by a varied and balanced diet23.

Summary

There are no strict rules to follow for a breastfeeding diet and there are no particular foods to avoid during breastfeeding. Great breast milk will be made to order by the breast using a less-than-perfect diet and a mother’s body stores. Check with your health care professionals if you have any concerns that your diet may be low in any essential vitamins or nutrients. Occasionally a baby will react to something in his mother’s diet and she can then avoid that food for a while.

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