Maternal Diet

Diet considerations for breastfeeding mothers.

Do mothers need more calories while breastfeeding?

Yes. Breastfeeding mothers generally need more calories to meet their nutritional needs while breastfeeding. An additional 330 to 400 kilocalories (kcal) per day is recommended for well-nourished breastfeeding mothers, compared with the amount they were consuming before pregnancy (approximately 2,000 to 2,800 kcal per day for breastfeeding women verses 1,600 to 2,400 kcal per day for moderately active, non-pregnant women who are not breastfeeding). The number of additional calories needed for an individual breastfeeding woman is also affected by her age, body mass index, activity level, and extent of breastfeeding (exclusively breastfeeding verses breastfeeding and formula feeding). The Dietary Reference Intake (DRI) Calculator for Healthcare Professionalsexternal icon can be used to estimate calorie needs based on sex, age, height, weight, activity level, and pregnancy and lactation status.

Refer to guidance from the US Department of Agriculture (USDA) and Health and Human Services (HHS) for more information on vitamins, minerals, and calories needed while breastfeeding in the Dietary Guidelines for Americans. pdf icon[PDF-30.6MB]external icon

Should mothers take a multivitamin while breastfeeding?

Maybe. Continued use of a prenatal vitamin postpartum may exceed the iron and folic acid needs of a breastfeeding mother. However, some people, such as those with vegetarian and vegan diets, may not get adequate nutrients through their diet alone and may be at greater risk for nutritional deficiencies.  In addition, the recommended dietary allowances (RDAs) (the average amount of a vitamin or mineral that meets the daily nutrient needs of nearly all healthy people) for some nutrients (such as iodine and choline) increase while breastfeeding; therefore, it is possible that diet alone may not be sufficient to ensure adequate nutrition for women who are breastfeeding. In these cases, breastfeeding mothers may benefit from taking a multivitamin supplement. Health care providers should work with lactating women to determine appropriate dietary supplements during lactation.

Are there any nutrients that mothers should increase while breastfeeding?

Yes. A mother’s need for iodine and choline increases during lactation. The Dietary Guidelines for Americans recommend lactating parents consume 290 mcg of iodine and 550mg of choline daily throughout the first year postpartum. Iodine can be found in dairy products, eggs, seafood, or in iodized table salt. Choline can be found in dairy and protein food groups, such as eggs, meats, some seafood, beans, peas, and lentils. Health care providers should work with lactating mothers to determine if they need an iodine or choline supplement to achieve adequate intake.

Are there any foods that mothers should avoid or limit while breastfeeding?

Photo: A mother preparing food with her baby

Generally, women do not need to limit or avoid specific foods while breastfeeding. Mothers should be encouraged to eat a healthy and diverse dietexternal icon. However, certain types of seafood should be consumed in a limited amount and some mothers may wish to restrict caffeine while breastfeeding.

Seafood:

Although fish remains an excellent source of protein and contains essential vitamins and minerals for breastfeeding women, some care must be taken in deciding on the amount and types of seafood to consume. Most fish contain some amount of mercury, which accumulates in fish flesh and can pass from mother to infant through breast milk. This can have adverse effects on the brain and nervous system of the breastfed infant.

Breastfeeding women (as well as pregnant women, women of childbearing age) should follow the US Food and Drug Administration’s (FDA) advice about eating fish:

  • Eat a variety of fish.
  • If you eat fish caught by family or friends, check for fish advisoriesexternal icon. If there is no advisory, eat only one serving and no other fish that week.
  • Try to avoid eating the “Choices to Avoid” fish or feeding them to children. It is best to eat a variety of fish from the “Best Choices” and “Good Choices” categories on this chart.external icon

For adults:

  • 1 serving = 4 ounces of fish, measured before cooking. Eat 2 to 3 servings (between 8 and 12 ounces) of fish a week from the “Best Choices” list OR 1 serving (4 ounces) from the “Good Choices” list on this chartexternal icon.

Mercury can be harmful to the brain and nervous system of any person exposed to too much of it over time. Thus, lower mercury fish are a good choice for everyone.  Learn more from the FDA’s advice about eating fishexternal icon and CDC’s Mercury page.

Caffeine:

Caffeine passes from the mother to infant in small amounts through breast milk, but usually does not adversely affect the infant when the mother consumes low to moderate amounts (about 300 milligrams or less per day, which is about 2 to 3 cups of coffee). Irritability, poor sleeping patterns, fussiness, and jitteriness have been reported in infants of mothers with very high intakes of caffeine, about 10 cups of coffee or more per day.

If an infant appears to be more fussy or irritable after the mother consumes high amounts of caffeine, she should consider decreasing her intake. Preterm and younger newborn infants break down caffeine more slowly, so mothers of these infants might consider consuming even less caffeine.

Common dietary sources of caffeine include the following:

  • Coffee.
  • Sodas.
  • Energy drinks.
  • Tea.
  • Chocolate.

Search “caffeine” in LactMedexternal icon for more information on caffeine consumption and breastfeeding.

Are there any special diet recommendations for mothers who eat a vegan or vegetarian diet while breastfeeding?

Yes. Breastfed infants of women who do not consume any animal products may have very limited amounts of vitamin B12 in their bodies.  These low amounts of vitamin B12 can put their infants at risk of vitamin B12 deficiency, which can result in neurological damage. Iron may also be of concern as plant source foods only contain non-heme iron, which is less bioavailable than heme iron. The American Dietetic Association recommends vitamin B12 supplementation during pregnancy and while breastfeeding for mothers who eat vegan or vegetarian diets. Health care providers should work with lactating individuals eating a vegetarian or vegan diet to determine if they also need supplementation of iron and other nutrients such as choline, zinc, iodine, or omega-3 fats (EPA/DHA).

Visit the National Institutes of Health Office of Dietary Supplementsexternal icon for more information on vitamin B12.

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