The old saying, “You are what you eat,” certainly applies to breast-feeding moms and their babies. Breast milk delivers key nutrients that support a baby’s healthy development, especially during the first few critical months of life.

Just as during your pregnancy, it’s also important to eat fresh fruits and vegetables, whole grains, calcium-rich foods, and protein while you breast-feed.1,2 A healthy diet also provides the energy your body needs to function and produce enough milk for your baby.

How many extra calories does a nursing mom need?

If you are feeding your baby breast milk alone, then your body needs about 500 extra calories daily during the first six months to maintain your energy level and produce enough milk.1,3,4

But this doesn’t mean you should add a milkshake to your daily diet. To meet the demands of nursing, your body has stored fat while you were pregnant. Taking this into account, you need to add about 330 calories daily.3

By the time your baby is 7-12 months old, most of your fat stores will be depleted, bumping up the additional calories you need to 400 a day.3-5 This number can vary slightly depending on your weight, height, age, and activity level, and when you decide to wean your baby.3

Get enough of these key nutrients

The source of these extra calories is just as important as the number – in other words, quality is just as important as quantity. When you’re nursing, you have very specific nutritional needs. Make your calories count by focusing on small servings of nutritious foods instead of items loaded with extra fat or sugar.

Getting the right amount of the following nutrients can help you stay healthy and energetic, while producing enough milk to nourish your baby. These nutrients are recommended by the U.S. Government in amounts based on the average need to prevent a deficiency, so they might not represent your specific needs.

For example, if you experienced a significant blood loss during delivery, then your iron needs would be significantly higher than the recommended daily amount noted below.

1. Iron

Lactating women need 9 milligrams (mg) of iron daily – which is less than if you were not breast-feeding. Why? Because you don’t have menstrual cycles while you’re pregnant, which may continue while you are breast-feeding. Because you shed less iron, your body needs less iron.3 And your baby is not depending solely on breast milk for iron.

Babies have enough iron stores at birth to keep them from becoming deficient for the first six months.6

By that time, you will likely be supplementing your baby’s diet with foods other than breast milk. Plus, although breast milk does not contain a lot of iron, what iron is in breast milk is very well absorbed.7

Good sources of iron include lean meats, fish, dark leafy greens, dark meat poultry, and fortified cereals. Be sure to consume vitamin C with iron-rich foods to support iron absorption.4

2. Protein

When nursing, you need about 71 grams (g) of protein daily, or 25 g more than when you're not nursing.3 Protein helps your body build, repair, and maintain body tissues. Lean meat, poultry, eggs, peanut butter, nuts, dried beans, salmon, and tuna are all good sources of protein.4

3. Calcium

You need 1,000 mg (1,300 mg for pregnant teens) of calcium daily when you’re breast-feeding. Your body pulls calcium from your bones when you're nursing, and that supply is replenished when you wean your baby.3,8

If you are calcium deficient, then your baby might not get the needed amount.4 Supplements can help meet the increased need for calcium while you are breast-feeding.

In addition to supplementation, good food sources of calcium include milk, yogurt, cheese, tofu, dark leafy greens, dried beans, and cereals and juices fortified with calcium (read the labels).4

If you’re a vegan, then you will be particularly interested in leafy greens as a source of calcium – but not all leafy greens are created equal when it comes to calcium content.

The calcium in some green leafy vegetables is bound to oxalates, which inhibit calcium’s absorption. Examples include spinach, Swiss chard, beet greens, and collard greens. Five good leafy green sources of calcium are:9

Vegetable   
 Calcium (mg) per 1 cup raw, chopped

Turnip greens

104

Dandelion greens

103

Kale

53

Parsley

82.8

Chinese cabbage (bok choy)

73.5

Source: FoodData Central. U.S. Department of Agriculture, Agricultural Research Service. https://fdc.nal.usda.gov. Accessed April 16, 2019.

4. Omega-3 fatty acids

These important fats are good for your growing baby. Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are omega-3s that your body can readily use and are most commonly found in fish or fish oil supplements.

DHA promotes brain and eye development, and a baby’s brain and eyes are still developing in the first few weeks of life.10,11

The American Academy of Pediatrics suggests that breast-feeding moms consume 200-300 mg of omega-3 fatty acids daily or 1-2 six-ounce servings of fish weekly to maintain appropriate levels of DHA in breast milk.1,11

Choose fish low in mercury, such as wild Alaskan salmon, shrimp, scallops, pollack, tilapia, sardines, anchovies, trout, and mackerel (except king mackerel).12

Not a fan of fish? Then other options are flaxseeds and walnuts – or oils from these seeds and nuts.13 One thing to keep in mind, though:  while these are good sources of the omega-3 fatty acid alpha-linolenic acid, this fatty acid must be converted to EPA and DHA in the body, which for some individuals is not an easy conversion.

What about supplements?

A balanced diet filled with nutrient-dense foods is your starting point for healthy breast milk. Beyond that, some women can benefit from certain vitamin or mineral supplements while nursing.1

1. Prenatal vitamin

Many health-care professionals recommend that women continue to take a prenatal vitamin while nursing to ensure they get enough folic acid and other vitamins and minerals.4,8

2. Vitamin B12

If you're a vegetarian, then you might need a vitamin B12 supplement, because animal products are the only source of this important vitamin.1,2,8 Babies who don't get enough B12 sometimes show developmental delays.3

3. Vitamin D

You might need to take a vitamin D supplement, particularly if you live in northern latitudes where sunlight is less plentiful. Vitamin D helps your body absorb calcium.3,4,8

4. Fish oil

Because of the potential for mercury in fish, a daily fish oil supplement containing EPA and DHA can be helpful. Supplements are tested to ensure that heavy metals, PCBs, and other toxins have been removed.     

What foods should a nursing woman avoid?

Along with an “eat this” list, there are also foods to avoid or limit while breast-feeding. Exposure to too much of any of these can harm your baby.

1. Alcohol

Alcohol ultimately ends up in breast milk. Drinking too much alcohol can negatively impact your baby’s motor development by the time he or she is one year old.2 This is why it’s so important to limit or stop drinking alcoholic beverages during the months you are breast-feeding.

If you do have a drink, then do so right after nursing your child. Then refrain from alcohol for at least two hours before breast-feeding again.3,4

2. Caffeine

Keep your caffeine consumption in check while nursing. Less than one percent of the caffeine you drink ends up in breast milk, so a cup or two of coffee won’t harm your baby.5

But limit yourself to two cups a day. If you notice that your baby seems irritable or has trouble sleeping after you've had caffeine and nursed, then cut back on the coffee or tea to see if it makes a difference.

3. Mercury

Select fish and seafood that are low in mercury. Too much mercury can damage your baby’s nervous system.4 Avoid shark, swordfish, king mackerel, marlin, orange roughy, big-eye tuna, and tilefish.4,14-16

Also check for seafood advisories if you consume fish caught locally by family or friends. If there is no advisory, then limit yourself to one 6-ounce serving of fish that week.15

Eating a wide variety of foods ensures that you and your baby will get plenty of nutrients. As a bonus, those varied flavors will make their way into your breast milk, so your baby will be exposed to many different tastes long before solid food is introduced. This increases the likelihood your baby will eat a varied diet down the road.5


References

  1. Lawrence R, Lawrence R. Maternal nutrition and supplements for mother and infant. In: Breastfeeding: A Guide for the Medical Profession. 8th ed. Philadelphia, Pa.: Elsevier; 2016.
  2. Schanler R, Potak D. Breast feeding parental education and support. https://www.uptodate.com/contents/breastfeeding-parental-education-and-support. [Accessed April 15, 2019]
  3. Butte N, Stuebe A. Maternal nutrition during lactation. https://www.uptodate.com/contents/maternal-nutrition-during-lactation. [Accessed April 15, 2019]
  4. Younger-Meek J and American Academy of Pediatrics. Good nutrition helps. In: New Mother’s Guide to Breastfeeding. 3rd ed. New York, NY: Bantam Books; 2017.
  5. Duyff R. Academy of Nutrition and Dietetics Complete Food and Nutrition Guide. 5th ed. New York, NY: Houghton Mifflin Harcourt; 2017: 555-557.
  6. Canadian Paediatric Society. Iron needs of babies and children. Paediatr Child Health 2007;12:333-334.
  7. Saarinen U, Siimes M. Iron absorption from breast milk, cow's milk, and iron-supplemented formula: an opportunistic use of changes in total body iron determined by hemoglobin, ferritin, and body weight in 132 infants. Pediatr Res 1979;13:143-147.
  8. Gabbe S, Niebyl J, Simpson J, et al. Lactation and breastfeeding. In: Obstetrics: Normal and Problem Pregnancies. 7th ed. Philadelphia, PA: Saunders Elsevier; 2017. 
  9. FoodData Central. U.S. Department of Agriculture, Agricultural Research Service. https://fdc.nal.usda.gov. [Accessed April 16, 2019]
  10. US Department of Health and Human Services: Office on Women’s Health. You’re pregnant: now what? Staying healthy and safe. Vitamins and Minerals. https://www.womenshealth.gov/pregnancy/youre-pregnant-now-what/staying-healthy-and-safe. 2018. [Accessed April 15, 2019] 
  11. Cetin I, Alvino G, Cardellicchio M. Long-chain fatty acids and dietary fats in fetal nutrition. J Physiol 2009;587(Pt 14):3441-3451. 
  12. Consumer Reports. Choose the right fish to lower mercury risk exposure. https://www.consumerreports.org/cro/magazine/2014/10/can-eating-the-wrong-fish-put-you-at-higher-risk-for-mercury-exposure/index.htm. [Accessed April 15, 2019]
  13. 13.   American College of Obstetricians and Gynecologists. Nutrition during pregnancy. https://www.acog.org/Patients/FAQs/Nutrition-During-Pregnancy. [Accessed April 15, 2019]
  14. 14.   Horwitz-West E, Hark L, Catalano P. Nutrition during pregnancy. In: Obstetrics: Normal and Problem Pregnancies. 7th ed. Philadelphia, PA: Elsevier; 2017.
  15. US Food and Drug Administration. Advice about eating fish: What pregnant women should know. https://www.fda.gov/downloads/food/ResourcesForYou/Consumers/UCM536321. [Accessed April 15, 2019]
  16. U.S. Department of Health and Human Services and U.S. Department of Agriculture. 2015-2020 Dietary Guidelines for Americans. https://health.gov/dietaryguidelines/2015/guidelines. [Accessed April 15, 2019]