What to eat when breastfeeding

Breastfeeding has so many benefits both for mum and baby. It meets the nutritional needs of most babies for healthy growth and development, and because it contains anti-infective and anti-bacterial substances, it also gives your baby protection from a variety of infections and illnesses. Amazingly, the composition of breast milk also changes with time to adjust to the changing needs of your growing baby. 

Do I need to eat more? 

It’s unlikely that you need any extra calories during breastfeeding. However, you may find you are especially hungry, and this is completely normal - making milk is an intensive process! If you are feeling extra peckish, you can have up to 500 extra calories a day compared to your pre-pregnancy calorie intake, which can be easily attained by incorporating one or two extra nutritious snacks into your daily routine.

For example:

  • Nut Butter and banana on 1 slice of whole grain toast: approx 300 calories
  • 200g Greek (soya or dairy) yoghurt with berries and a handful of nuts: approx 250 calories 

The number of calories you need depends on how old and big your baby is, how hungry they are, your body mass index (BMI), how active you are, whether your baby is eating solids, and whether you are feeding more than one baby. Breastfeeding is deemed successful when your baby is experiencing appropriate weight gain.

Throughout pregnancy, women typically store an additional 2 to 5 kg of tissue, primarily as fat. This is equivalent to 19,000 to 48,000 calories. This happens naturally to prepare the body for breastfeeding. If these extra calories aren't consumed, the body's existing stores are used to support breastfeeding. For this reason, it’s common for women who are breastfeeding to lose around 0.5 to 1.0 kg per month starting from the second month after giving birth. However, this isn’t the case for some women. 

During the initial weeks, try not to worry about shedding the "baby weight" gained during pregnancy. Instead, focus on keeping yourself and your baby nourished and content, and don’t consume below 1,800 calories per day. 

Do I need to eat and drink more? 

You may also find you are more thirsty. Listen to your body's signals - thirst is a natural indicator that you need to drink fluids, so let your thirst guide you in how much to drink. 

Pay attention to signs like dark yellow urine, feeling excessively thirsty, or a dry mouth. Your urine should be the colour of straw, so if it’s a dark yellow it could be a sign you need to drink more water. However, do note that some b-vitamins in supplemental form, like you would find in a multivitamin, can also cause a strong yellow-coloured urine. 

Water is the best choice for hydration. Keep a water bottle handy and take sips throughout the day, especially during nursing sessions - perhaps make it a habit to have a glass of water each time you breastfeed. 

If you're breastfeeding in hot weather or after intense exercise, consider consuming foods or drinks with natural electrolytes (like coconut water) to help maintain electrolyte balance.

Should I avoid anything while breastfeeding?

Generally, there are no foods or drinks that you need to avoid while breastfeeding. Some strongly flavoured foods might alter the taste of your breast milk, but many babies seem to enjoy the variety of flavours it offers! 

Women often worry about including peanuts in their breastfeeding diet, but rest assured you can include them in your diet while breastfeeding, as part of a healthy, balanced eating plan (unless you are personally allergic to them, of course). 

In fact, Recent studies indicate that incorporating peanuts into your diet while breastfeeding and introducing them to your infant's diet within the first year can potentially reduce the likelihood of your baby developing a sensitivity to peanuts. 

However, if you have a family history of allergies, it's worth being cautious about your diet and avoiding known allergens during pregnancy and breastfeeding. Speak with your doctor if you are unsure. 

If you observe a pattern of fussiness or tummy troubles in your baby after eating a particular food, it might be best to avoid that food for a while. For example, some babies react to traces of cow’s milk in breast milk. You can test whether the food was the cause by reintroducing it later and observing your baby's response. 

If you're considering eliminating an entire food group (e.g., dairy) from your diet, it's essential to discuss this with your healthcare provider to ensure you won't be at risk of any nutritional deficiencies.

It is also advisable not to consume more than 1 portion of fish high in mercury per week, such as oily fish (herring, trout, mackerel) and tuna, swordfish, shark or marlin. 

What about alcohol, caffeine and nicotine? 

Small amounts of alcohol, caffeine and nicotine can pass into breast milk, and may affect your baby's sleeping and digestion, or make them irritable and fussy. 

Aim to limit your caffeine intake to 200mg/day, and perhaps opt for herbal teas and sparkling water when you can. Instant coffee contains 100 mg of caffeine per cup, and filtered coffee contains 140mg. Black and green teas contain about 75mg. 

Excessive caffeine can lead to dehydration. So perhaps if you consume caffeinated beverages, balance them with extra water. Herbal teas are another great option. Fenugreek tea is particularly useful if you are experiencing low milk supply. 

Having an occasional drink of alcohol is not likely to cause harm to your baby, especially if you wait at least 2 hours after drinking before nursing. 

Do I need a special diet during breastfeeding?

You don’t necessarily need to eat a special diet during breastfeeding, but it is important to ensure that what you consume is nutritionally well-balanced. However, your requirements for certain nutrients do increase, so do pay particular attention to these. 

Healthy Fats

DHA (Docosahexaenoic Acid), and EPA (Eicosapentaenoic Acid) are two forms of omega-3 fats which have many health benefits for both mums and their babies. In babies who are breastfed, supply of these essential fats is dependent on the maternal diet.  

Both EPA and DHA are found in oily fish such as salmon, sardines, mackerel, trout, herring and anchovies. Getting enough of these fats into your diet may reduce the risk of you getting postnatal depression. 

There is particularly increased demand for the DHA form of omega 3 during breastfeeding for the development of your baby's brain and eyes, their immune system and even their cognitive function and neurodevelopment too. 

Research shows that maternal DHA supplementation can impact the fat profile in breastmilk, and due to the high demand for DHA during pregnancy and breastfeeding, it is recommended the average daily intake of DHA should be at least 200 mg - 400 mg daily. To get this amount, you would need to eat 2 portions of oily fish a week. 

However, due to the potential mercury content of some fish, the NHS advises that breastfeeding women have no more than 2 portions of fish weekly whilst breastfeeding, only one of which should be oily. 

Fish such as shark, swordfish and marlin may also be high in mercury, which can be damaging to your babies developing nervous system. Whilst breastfeeding, you should avoid having more than 1 portion of these fish per week. 

There is also another type of omega 3 fat, ALA (Alpha-Linolenic Acid), found in flaxseeds, hemp seeds and walnuts (or their oils - flax oil, walnut oil or hemp oil). The body can partially convert ALA into EPA and DHA, however the conversion process is poor in humans.  

Therefore, it is a good idea to consider an omega 3 supplement to ensure you are getting adequate amounts, especially if you are vegan or vegetarian, or you don’t eat oily fish. 

Choose a supplement that provides at least the same daily amount as consuming 2 portions of oily fish a week (approx 450mg of combined EPA and DHA daily). Fish oil up to 3 grams daily is “generally recognized as safe”. Always check with your doctor before supplementing. 

If you don’t eat fish, there are algae based EPA/ DHA supplements available on the market which are vegan. 

Here are some ideas to get your daily omega fix without fish (please note you may need a supplement on top of this).

Flaxseed Overnight Oats: Mix rolled oats with almond milk, scoop of vanilla protein powder, a tablespoon of ground flaxseeds, and a touch of honey. Let it sit in the refrigerator overnight, and top with fresh berries in the morning.

Flaxseed or Hemp Seed Smoothie Booster: Add a tablespoon of hemp seeds or ground flaxseeds to your favourite smoothie for an extra omega-3 boost.

Walnut-Stuffed Dates: Stuff pitted dates with walnut halves for a naturally sweet and nutty snack.

Chia Seed Pudding: Mix chia seeds with milk, a touch of vanilla extract, and a bit of maple syrup. Let it sit in the fridge until it thickens into a pudding-like consistency.

Hemp Seed Hummus: Add a couple of tablespoons of hemp seeds to your favourite hummus recipe for added texture and nutrition. Or simply add it to store bought hummus. 

Calcium: 

During pregnancy, you only need 700mg of calcium, but during breastfeeding you will need 1,250mg - that’s a significant increase of an extra 550mg per day. 

If there isn’t enough calcium intake daily, the mother's body can withdraw calcium from her bones to meet the calcium requirements for producing breast milk. Consequently, it can deplete her own calcium reserves, potentially impacting her bone health. It's not uncommon for women to experience a loss of 3 to 5 percent of their bone mass while breastfeeding, but this typically resolves after discontinuing breastfeeding.

Sources include: 

30g (matchbox size) cheddar cheese: 222mg 
120g pot of whole-milk natural yoghurt: 193mg
100ml cows milk: 120mg.
100ml fortified non-dairy milk: 120-190mg 
100g calcium-set tofu (this is tofu fortified with calcium): 350-400mg
½ tin sardines with bones (60g): 270-400mg 
1 orange: 29mg
100g kale: 150mg

Vitamin D

Vitamin D plays a crucial role in your baby's bone development during breastfeeding, and a deficiency in vitamin D can lead to a condition called rickets in children. 

Food sources of vitamin D are limited and include oily fish, eggs, mushrooms, liver and fortified foods such as some breakfast cereals. We can also make Vitamin D when the sun’s UVB rays hit our skin. However, because the vast majority of us work indoors, or justifiably wear sunscreen in the summertime, it is advisable to take a vitamin D supplement. 

The NHS advises that breastfeeding women take 10 micrograms for themselves, and also provide your baby with a supplement of 8.5 - 10 micrograms of vitamin D from birth until one year of age, unless they consume more than 500 mls of formula milk per day which already has vitamin D added into it. 

Protein 

Studies have shown that the protein intake of breastfeeding mothers can impact the composition of breast milk. Nevertheless, even if a mother's protein intake falls below the recommended levels, breast milk continues to provide sufficient nourishment for exclusively breastfed infants during the first six months of life. However, she should ensure her protein intake is sufficient to both maintain the protein content of her milk and support her own muscle mass and protein requirements. 

Adult women should aim for 1.2-1.5g protein per kg of bodyweight daily. However, to strike a balance between maintaining their own muscle mass and supplying adequate protein through breast milk, lactating women should aim for an extra 25g of protein per day. 

Some ideas to up your protein intake: 

Snack Smartly: Choose protein-rich snacks like nuts, seeds, edamame, roasted chickpeas, Greek yoghurt, cheese and wholegrain crackers, nut butter with apple slices or hummus with oatcakes or veg sticks.

Choose Eggs: They are versatile and can be added to various meals. Make omelettes, scrambled eggs, or hard-boiled eggs as a snack.

Trail Mix: Make your own trail mix with a mix of nuts (almonds, walnuts, cashews), seeds (pumpkin, sunflower), and a small amount of dried fruits for sweetness.

Should I take a multivitamin/mineral? 

Maybe, it depends on how balanced and varied your diet is. Certain vitamins, such as vitamin A, D, K, C and B-vitamins can be reduced in breastmilk if there is not enough coming in from your diet. The good news is, supplement forms of these nutrients, such as those dosages found in a good multi, can increase breastmilk levels. 

In addition, a multi may be able to fill some nutritional gaps due to the increased requirement of some nutrients at this time. For example, non-pregnant or non-lactating women need 150 mcg of iodine daily, while lactating women need 200 mcg daily. The extra iodine in a multi in this case would be useful to make sure you are hitting your daily dose. 

If you are on a vegetarian or vegan diet, a multi may be useful for providing nutrients which are a little trickier to consume, such as Vitamin B12 and choline.  

With this in mind, a broad spectrum multivitamin/mineral specifically designed for the breastfeeding mother may be a good idea. 
Having an occasional drink of alcohol is not likely to cause harm to your baby, especially if you wait at least 2 hours after drinking before nursing. 

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