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 450 to 500 kilocalories (kcal) of healthy food calories per day is recommended for well-nourished breastfeeding mothers, compared with the amount they were consuming before pregnancy  (approximately 2,300 to 2,500 kcal per day for breastfeeding women verses 1,800 to 2,000 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).

Refer to guidance from the U.S. Department of Agriculture (USDA) My Plate Daily Checklist for more information on vitamins, minerals, and calories needed while breastfeeding at the Choose My Plate website.

Calculate daily calories needed for pregnant and breastfeeding women using the My Plate Calculator.

Should mothers take a multivitamin while breastfeeding?

Maybe. Some people, such as those with restrictive diets (for example, diets that limit the number of calories per day and vegetarian 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) 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.

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

Generally, women do not need to limit or avoid specific foods while breastfeeding. Mothers should be encouraged to eat a healthy and diverse diet. 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, and parents and caregivers of young children) should follow the US Food and Drug Administration’s (FDA) advice about eating fish:

• Eat 2 to 3 servings of fish a week from the “Best Choices” list OR 1 serving from the “Good Choices” list from the FDA/EPA Advice on What Pregnant Women and Parents Should Know about Eating Fish.
• Eat a variety of fish.
• For fish caught by family or friends, check for fish advisories. If there is no advisory, eat only one serving and no other fish that week.
• Serve 1 to 2 servings of fish a week to children, starting at age 2.

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 Eating Fish: What Pregnant Women and Parents Should Know.

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 LactMed 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. Therefore, the American Dietetic Association recommends vitamin B12 supplementation during pregnancy and while breastfeeding for mothers who eat vegan or lacto-ovo vegetarian diets.

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