The B vitamins are eight water-soluble vitamins that are found in foods like potatoes, bananas, lentils, tempeh, liver, tuna and brewer’s yeast. Water soluble vitamins are not stored by the body so these are needed more frequently in the diet than fat soluble vitamins. The B vitamins help the body convert food (carbohydrates) into fuel (glucose), which is used to produce energy. They also help the body use fats and protein. B complex vitamins are needed for healthy skin, hair, eyes, liver and healthy functioning of the nervous system. This article looks at the recommendations around taking vitamin B6 while breastfeeding and answers frequently asked questions.
What does vitamin B6 do?
Vitamin B6, also known as pyridoxine, is important for general cell metabolism and it helps the body make several chemicals that carry signals from one nerve cell to another (neurotransmitters) such as adrenaline, serotonin and dopamine. It is needed for normal brain development and function. 12 Vitamin B6 is sometimes suggested for relieving nipple vasospasm in breastfeeding mothers and, at high levels, to help dry up breast milk. It is sometimes suggested as helpful for symptoms of pre-menstrual tension or postnatal depression.
Which foods contain vitamin B6?
A breastfeeding mother’s diet will normally provide plenty of B6 which will also meet her baby’s needs for this vitamin via her breast milk. Poultry, fish, eggs, cereals and certain vegetables are good sources of this vitamin. For a comprehensive list of food sources see the National Health Service (NHS) website.
What is the recommended amount of B6 for a breastfeeding mother?
The National Institutes of Health, Office of Dietary Supplements states the Recommended Dietary Allowance (RDA) for vitamin B6 for a woman is 1.3 mg/day rising to 1.9 mg/day in pregnancy and to 2 mg/day in lactation3. Thomas Hale of Hale’s Medications & Mothers’ Milk, 2020 [paywall] notes that most prenatal vitamin supplements contain 10 mg/day which he comments is reasonable in lactation, but notes that excessive doses are not recommended as pyridoxine readily moves into breast milk and the levels in milk will increase with maternal intake. In addition, some studies have found that high levels of B6 can reduce milk supply (see below).
How much vitamin B6 is excessive?
The National Institutes of Health Vitamin B6 Fact Sheet indicates that a Tolerable Upper Intake Levels for Vitamin B6 is 80-100 mg/day. They state that anyone receiving higher levels for medical treatment should be under the care of their health professional 4.
Are there any side effects?
Hale 5 quotes several concerns to watch out for when taking B6 including sedation, sensory disturbances, nausea and changes in liver enzymes. Seizures are mentioned with high intravenous doses.
What if I am deficient in B6?
A deficiency in vitamin B6 is unusual and would usually be associated with deficiency in other micronutrients. In Breastfeeding and Medication author and pharmacist Wendy Jones recommends that B6 be taken as part of a multivitamin supplement rather than in large amounts on its own.
Can vitamin B6 help nipple vasospasm?
A vasospasm is a painful spasm or narrowing of blood vessels preventing blood from getting to an area. In some breastfeeding mothers and those with Raynaud’s Phenomenon this can happen in the nipple. See Nipple Vasospasm and Breastfeeding for more information on this painful condition. Canadian paediatrician Jack Newman suggests trying vitamin B6 supplements as one of several treatments for Raynaud’s Phenomenon:
Vitamin B6 seems to work best for vasospasm when it is taken as part of a B complex of vitamins that includes niacin. Take 100 mg of B6, in the complex, twice a day.
If there is no significant improvement within one week, stop the B complex. If the B complex decreases the pain, continue taking it until your pain has been stable (or you have been pain-free) for 2 weeks, and then stop.
Although other sources also refer to higher levels of vitamin B6 for helping Raynaud’s Phenomenon 6, the InfantRisk Centre urges caution stating that vitamin B6 has been associated with seizures at doses of 300 mg/day or more and doses above 600 mg/day could decrease a mother’s milk supply 7.
Can B6 supplements help postnatal depression or pre-menstrual syndrome?
Wendy Jones says that supplements of B6 are sometimes suggested for postnatal depression and pre-menstrual tension, however she states that there is no evidence that this is helpful compared with placebo—the belief that a treatment will bring positive results— and excessive doses could be harmful8.
Can B6 dry up breast milk?
There are many mentions online about taking B6 to dry up breast milk. High doses of 450-600 mg B6 per day B6 may suppress prolactin levels and cause a fall in breast milk production9. However while some older studies from the 70s showed this effect10 11 others from the same decade did not find this association1213 suggesting more research is needed. Breastfeeding mothers should be aware of the possibility that very high doses of B6 could reduce their milk supply.
How can I dry up my breast milk?
If you are looking for ideas to help with drying up breast milk see How to Stop Breastfeeding. If you are considering very high doses of B6 discuss this with your health professional first.
Can Brewer’s yeast increase my milk supply?
Brewer’s yeast is used in the production of beer and bread and is also used as a nutritional supplement. Brewer’s yeast is a good source of B vitamins including B6, however it does not contain vitamin B12. Some breastfeeding websites mention taking brewer’s yeast to increase a breastfeeding mother’s milk supply14 however e-lactancia says that evidence for its merit as a milk making food or herb (galactagogue) is lacking 15.
Nursing Mother’s Herbal is a herbal reference guide and comments that Brewer’s yeast may help a mother’s milk supply but can sometimes make a baby colicky:
A baby can become colicky after his mother eats a certain food, but this trigger food may vary from mother to mother. For some it may be green beans or tomatoes. For others brewer’s yeast, vitamins with iron or fluoride, or artificial sweetners.
Can B vitamins help cure thrush?
Some resources refer to taking B vitamin supplements to help treat a persistent fungal infection such as thrush on nipples. However, note that brewer’s yeast is not recommended as a source of these vitamins during a thrush infection, as any foods containing yeast can make thrush symptoms worse16.
Summary
A breastfeeding mother will normally get plenty of vitamin B6 naturally in her healthy diet. Recommended Dietary Allowance for vitamin B6 in breastfeeding women is 2 mg/day and daily prenatal supplements usually contain 10 mg. Vitamin B6 supplements are sometimes recommended for helping nipple vasospasm. There are mixed reports about high doses of vitamin B6 reducing a mothers’ milk supply but other harmful side effects have been noted at high levels. Always discuss with your health professionals before taking high medicinal doses of this vitamin.