Is It Safe to Diet While Breastfeeding?

After you give birth, you are often bombarded with this feeling of how and when am I going to lose weight? Please know you are not alone, and it is important to remember that the first 6 months of breastfeeding are a time to support your body in healing from delivering your baby and establishing a strong milk supply, and weight loss should not be the number one priority. If you are breastfeeding and interested in learning more about healthier eating habits, be sure to talk with a health care provider including a registered dietitian nutritionist about what eating behavior changes are best for your overall health before making any significant shifts in what you eat (Academy of Nutrition and Dietetics, 2023). You can also check out this source on how to plan a healthy diet during breastfeeding. First and foremost, you need to make sure you are getting enough nutrition, no matter what type of eating plan you choose. Your body still needs extra fuel to make breast milk (approximately 300 to 500 additional calories per day).

A highly recommended eating plan is to consider moderation. Consider increasing the amount of fruits, vegetables, lean protein, higher calcium and vitamin D items you consume, and drink plenty of water. Please know it is okay to enjoy your favorite treat or family foods as well, and the main goal is to nourish yourself during this time. 

If you are interested about the feasibility of certain diets while breastfeeding, read on.

The flexitarian diet consists of mostly plant-based foods, but allows meat and other animal products in moderation. It is not as restrictive as a vegetarian (consume no animal products and may consume milk, eggs, and cheese) or vegan diet (no animal products including milk, eggs, and cheese). Any of these are options for breastfeeding mothers are great choices as long as you are getting enough nutrients. A number of studies have shown the breast milk of a woman who is following a vegetarian or vegan diet is similar to those who do not.  However, their diets may be lower in fatty acids (e.g., omega-3 fatty acids/heart healthy fats), vitamin B12 (found primarily in animal products) or iodine (found in fish, dairy and iodized table salt). These nutrients are also very important for a baby's brain development (Pawlak, 2023; Karcz, 2021). Also, some mothers following a vegetarian diet may need a higher level of calories during breastfeeding (Sebastiani, 2019).

Many people have long-term success with the Mediterranean diet and DASH (Dietary Approaches to Stop Hypertension) diet; however, some individuals may find it hard to meet all of the expectations of each of these diets, and they may not include your favorite family or cultural foods (MedlinePlus, 2018; MedlinePlus, 2022). These diets often focus on creating meals around vegetables, whole grains, fruits, olive oil, beans and seeds - but they also encourage wine and fish consumption. As you are breastfeeding, it is okay to follow either of these diets as long as you are limiting your alcohol use and are eating fish lower in mercury as high levels of mercury can be harmful to your baby (CDC, 2022). Fish to avoid during pregnancy and breastfeeding include shark, swordfish, king mackerel, marlin, orange roughy, and tilefish. Eight to 12 ounces of a variety of lower mercury fish every week is recommended with a maximum of 6 ounces of white (albacore) tuna per week. If you would like to find out which fish are lower in mercury, check out this information from the Environmental Protection Agency (U.S Environmental Protection Agency, 2022). 

Weight Watchers is about tracking your food. They have a plan for breastfeeding moms to follow to offer advice on how to still get the calories and nutrients they need. This diet can be modified and adapted to meet your needs while helping you work towards your goals. Note that for some people counting calories and tracking food may lead to weight loss right away, but may not be attainable, especially if the foods are different from what your family or support system is eating. Counting calories or tracking food may not support you in living a healthy and balanced diet as it may lead to not eating enough of the nutrients you need and/or increase stress, anger and guilt about eating which may not assist you in meeting your health or lactation goals (Kaufman, 2022). 

On the Whole 30/Paleo, you eliminate sugar, alcohol, grains, legumes, soy and dairy from your diet for 30 days. If you are interested in trying this diet, there is a list of modifications recommended for breastfeeding women. The Paleo diet is similar in its restrictions, but allows natural sweeteners like honey and maple syrup. These diets may be difficult for breastfeeding moms to follow because of the restrictions. The main issue breastfeeding moms may run into while on either diet is decreased milk supply resulting from the elimination or reduction of calories or carbohydrates (Lee, 2016).

Intermittent fasting can follow several different schedules. Some people choose a 5:2 alternate-day fasting plan (consuming 25% or less of their normal calories on the two days they are fasting). This may cause your milk supply to decrease and is often not recommended during breastfeeding. Another way to do intermittent fasting is known as the 16:8, meaning you fast for 16 hours and only eat during an eight hour time period each day. As long as a healthy, nutrient-dense (high fiber, lean proteins, sources of vitamins and minerals) diet is maintained during this eating schedule and milk supply is established, concern is lessened. It is important to monitor your health and your baby’s growth (Lee, 2016).

There are several benefits for you and your baby if you are trying to eat healthier, but you often do not have to follow a certain type of diet. Instead of worrying over the number on your scale, try to focus on how you are feeling and that you just brought another human into this world. Congratulations! Take care of yourself. Remember the societal pressure of bouncing back after having a baby is unrealistic and often unhealthy.

If you choose to follow any of these diet plans, please work with an IBCLC (International Board Certified Lactation Consultant) to assure you are maintaining your milk supply.  An IBCLC is an excellent resource to talk with about how to navigate the first year of feeding, how to pump your milk and to recommend a breastfeeding class. They are there for you to ask any questions you have about breastfeeding and lactation. You can schedule a one-on-one appointment with a lactation consultant here. Please talk with a trusted healthcare provider or registered dietitian nutritionist to assure you are getting the right amount of nutrients (Academy of Nutrition and Dietetics, 2023). No matter which path you choose, be gentle with yourself and give yourself time. 

References

• Academy of Nutrition and Dietetics. (2023). Find a nutrition expert.  Retrieved on April 27, 2023, from https://www.eatright.org/find-a-nutrition-expert.
• Centers for Disease Control and Prevention. (2022).  Alcohol.  Retrieved on April 27, 2023, from https://www.cdc.gov/breastfeeding/breastfeeding-special-circumstances/vaccinations-medications-drugs/alcohol.html.
• Gordon, B. (2022). Nursing your baby, what you eat and drink matters.  Academy of Nutrition and Dietetics. Retrieved on April 27, 2023, from https://www.eatright.org/health/pregnancy/breastfeeding-and-formula/nursing-your-baby-what-you-eat-and-drink-matters#:~:text=Keep%20Hydrated,is%20used%20to%20make%20milk.
• Karcz, K. & Krolak-Olejnik, B. (2021). Vegan or vegetarian diet and breast milk composition - a systematic review. Critical Reviews in Food Science and Nutrition, 61(7): 1081-1098.
• Kaufman, C. (2022). 4 ways low-calorie diets can sabotage your health.  Academy of Nutrition and Dietetics.  Retrieved on April 27, 2023, from https://www.eatright.org/health/wellness/weight-and-body-positivity/4-ways-low-calorie-diets-can-sabotage-your-health.
• Lee, S. & Kelleher, S. (2016). Biological underpinnings of breastfeeding challenges: the role of genetics, diet, and environment on lactation physiology. American Journal of Physiology Endocrinology and Metabolism, 311(2): E405-422.
• Medline Plus. (2018). DASH eating plan.  Retrieved on April 27, 2023, from https://medlineplus.gov/dasheatingplan.html.
• MedlinePlus. (2022). Mediterranean diet. Retrieved on April 27, 2023, from https://medlineplus.gov/ency/patientinstructions/000110.htm.
• Pawlak, R., Judd, N., Donati, G. & Perrin, M. (2023).  Prevalence and predictors of low breast milk iodine concentration in women following vegan, vegetarian, and omnivore diets.  Breastfeeding Medicine, 18(1): 37-42.
• Sebastiani, G., Barbero, A., Borras-Novell, C., Casanova, M., Aldecoa-Bilbao, V., Andreu-Fernandez, V., Tutusaus, Martinez, S., Roig, M. & Garcia-Algar, O. (2019). The effects of vegetarian and vegan diet during pregnancy on the health of mothers and offspring. Nutrients, 11(3): 1-29. 
  U.S. Environmental Protection Agency. (2022).  Guidelines for eating fish with mercury.  Retrieved on April 27, 2023, from https://www.epa.gov/system/files/images/2021-09/fish-chart.jpg.