How Can You Breastfeed With a Specific Diet? (Dairy-Free, Weight Loss, Religious Fasting, Vegetarian/Vegan)

Here’s a little food for thought for those of you with alternative diet choices, or interested in making some changes to your consumption repertoire while lactating.

I’ve noted several popular ‘restricted’ nourishment styles on the table among breastfeeding mothers’ discussion groups: dairy-free diets; fad, crash and weight-loss diets; religious fasting; and vegetarian or vegan diets.

Let’s take a closer look…

*Please keep in mind that although I’ve been on the hiring end of nutritionists/dieticians for a number of years and aced a few human nutrition classes in university (ahem, just let me be proud), I am NOT a nutritionist, dietician, doctor, or licensed to give medical advice in any way. The following information is shared for educational purposes only. What you choose to do with it is strictly up to you. See my general Disclaimer for more details.*

Dairy-Free Diets

Do you have concerns about getting adequate calcium with a dairy-free diet? It turns out that despite prior common belief, even though much calcium leaves a woman’s body in her breast milk, it has recently been shown that she does not need to consume extra calcium to maintain and preserve her bone health. The recommended daily intake for a breastfeeding mother is the same as other women in her age group.

Important notes about breastfeeding, re-calcification, and nursing during pregnancy, as quoted from KellyMom in reference to Hilary Flower’s  Adventures in Tandem Nursing:

“Recovery of bone mineral density occurs BEFORE weaning. The recovery begins after the baby’s diet begins to be supplemented with other foods or liquids (the ‘partial breastfeeding phase’). By 12 months breastfeeding mothers have fully recovered their bone mineral density…

If a mother becomes pregnant before the recovery is complete, bone mineral density increases during pregnancy, a phenomenon not usually seen…

Mothers who are tandem nursing fare the same as their breastfeeding peers.”

Calcium source ideas for women who adhere to a dairy-free diet, adapted from La Leche League International and KellyMom:

• Sheep/goat milk or cheese
• Canned fish (containing bones) and whole-anchovy paste
• Whole grains, whole grain flours
• Beans (chickpea/garbanzo, navy, pinto)
• Orange juice, calcium fortified
• Total cereal, calcium fortified
• Leafy green veggies
• Nuts (especially almonds and walnuts) and dried fruit
• Sesame seeds (eaten whole, as tahini (sesame butter) and gomasio (a salt substitute containing sesame seeds, or food topper). LLLI notes to chew the seeds well in order to maximize the body’s ability to absorb the calcium.
• Tofu or soy cheese
• Tortillas made with lime-processed corn
• Some sea vegetables (algae), fermented foods (miso and sauerkraut), and seasoned sauces like soy and tamari

Of course, there’s also breast milk itself. Breastfed babies generally always get plenty of calcium even if the mother doesn’t have enough in her diet (it’s she who ultimately suffers from inadequate calcium intake).

Breast milk contains 5.9-10.1 mg/oz of calcium, 67% of which is readily absorbed (bioavailable) by the infant. For comparison’s sake, infant formulas contain 15.6 mg/oz of calcium and toddler formulas contain 24-27 mg/oz of calcium; however, the higher amounts are necessary because much less is actually absorbed and processed by an infant’s system. Whole cow milk contains 36.4 mg/oz of calcium, of which only 25-30% is bioavailable.

Also read:

• “Calcium Supplementation During Breastfeeding” by The New England Journal of Medicine
• “Eating Dairy-Free for Your Baby” by Beanmom
• “Reduced Risk of Osteoporosis With Nursing?” by Debbie Donovan, BCLC

Fad, Crash & Weight-Loss Diets

Mothers should avoid consciously trying to lose weight for at least the first eight weeks postpartum, says Dr. Judith Roepke (a nutritionist at Ball State University in Indiana) and should instead work on establishing milk supply during this time. Weight loss drugs and diuretics should also be avoided as they can interfere with lactation ability (read about other possible drug contraindications to milk supply here).

In “Weight Loss While Breastfeeding,” Mel Wolk writes:

“Crash diets, fad diets and rapid weight loss present problems for breastfeeding mothers. Environmental contaminants including PCBs and pesticides are stored in body fat. Losing weight rapidly can release these contaminants into the mother’s bloodstream quickly and it was once thought that this would increase contaminant levels in her milk. Research brought to our attention after the Breastfeeding Answer Book was published does not demonstrate a significant increase.”

Though fad diets aren’t necessarily healthy for mothers, a modest maternal weight loss won’t affect the nutritive health of the nursling. Anne Smith, IBCLC explains how even especially imperfect eating habits shouldn’t affect milk quantity or quality:

“Mothers whose diets are poor deplete their own energy levels, and may become anemic, but their bodies will continue to produce the milk their baby needs by pulling from the mother’s energy stores at her expense, but not her baby’s.”

What if an obese or overweight breastfeeding mother wants to adopt a healthy weight loss plan? Expert consensus suggests she should discuss her goals with her doctor or a licensed nutritionist first. If a structured program suits her well, she may consider Weight Watchers, which offers a version tailored to breastfeeding moms.

Guidelines for women who are restricting calories, from “Nutrition During Lactation” by Institute of Medicine:

Mothers who get 2200 calories per day may need extra calcium, zinc, magnesium, thiamin (vitamin B1), vitamin B-6 & vitamin E.

Mothers who get 1800 calories per day may need extra calcium, zinc, magnesium, thiamin, vitamin B6, vitamin E, folic acid, riboflavin (vitamin B2), phosphorus and iron.

Breastmilk levels of calcium, magnesium, phosphorus, zinc, iron and folic acid are fine even if your diet is deficient. If supplements are needed, they are for your benefit — not baby’s.

Levels of B vitamins in breastmilk are related to the mother’s intake, but a deficiency in the mother serious enough to affect her breastfed baby is very rare in the United States.

Keep in mind what tends to happen on the weight front with exclusive breastfeeding alone:

• A 1996 review article found that “exclusively breastfeeding mothers showed a greater loss of weight with a decrease in the percentage of body fat as well as hip and lower thigh circumference at three months postpartum than mothers who were bottle- feeding or partially breastfeeding.”

• “[D]uring the first three months, nursing mothers don’t necessarily lose weight faster, but between months three and six, there is significantly more weight reduction when the mothers continue breastfeeding. [In one study], by the end of the first year, nursing mothers lost an average of 2kg more than formula feeding mothers who took in the same number of calories,” writes Anne Smith, IBCLC.

• Surprisingly, one 2009 study found that a hypocaloric, high fat diet “might promote weight loss to a greater extent” than a reduced-calorie, high carbohydrate diet in healthy lactating mothers.

• An average woman holds about three pounds of extra tissue in her breasts while lactating.

• Though many nursing moms find that pregnancy weight burns off without additional effort, some others notice a delay in weight loss as their bodies stubbornly hold onto the ‘last ten pounds’ in reaction to a constant need for extra energy resources, or their appetites greatly increase (for me, it presented as mercilessly insatiable thirst!).

• An average breastfeeder who eats the minimum RDA for protein can expect to lose approximately 20% of her lean tissue to cover the lactation-induced nutrient shortage (The National Academies Press).

Religious Fasting

Here’s a few interesting findings about the effect of religious fasting on breastfeeding, as covered by Kelly Bonyata, IBCLC (read more here):

“[This 2009 study] tested the milk of Israeli women before and after religious fast days and found a number of biochemical changes in the milk associated with fasting 24+ hours. Studies in the United States by [these researchers in 1993], [this 1987 paper] and [this 2002 article] likewise showed no significant decrease in milk supply after a short fast (the women in these studies did drink water during the fast). The breastfeeding woman’s body appears to make several metabolic adaptations during short-term fasting to ensure that milk production is not affected [see the effect of water abstention here].

[This researcher in 2006] studied mothers with babies aged 2-5 months who fasted during Ramadan (no food or fluids between 5:00 am and 7:30 pm). They found that although infant growth and macronutrient content of breastmilk was not affected, levels of several nutrients in breastmilk (zinc, magnesium and potassium) decreased and the nutritional status of the breastfeeding mothers was affected. These authors noted that “it would seem prudent to excuse lactating women from fasting during Ramadan.” [These researchers in 1983] studied women in West Africa who were fasting for Ramadan and found that milk volume was not affected but milk composition did change to a certain extent. The researchers noted that the women appeared to superhydrate themselves overnight when fluids were allowed to lessen daytime dehydration.”

Also read (list credit to Kellymom):

• “Breastfeeding and Jewish Law” – Nishmat Women’s Online Information Center (with some fasting Q&A)
• “Fascinating research on Ramadan fasting gives breastfeeding mothers ‘food for thought’” – Sharjah Baby Friendly Emirate Campaign, 2012
• “Fasting on Yom Kippur During Pregnancy” – Hannah Katsman
• “Ramadan and breastfeeding” – BabyCenter Arabia
• “Straight from the Heart: A Torah Perspective On Mothering Through Nursing” – Tehilla Abramov

Vegetarian & Vegan Diets

Is your little bean sprout kind of literally a bean sprout, thanks to your meat-free milk? Many women remove animal products from their diets in hopes of improved health, and thankfully it has been shown that animal-friendly lifestyles are not only perfectly safe but also as beneficial to a breastfed baby as his mother.

Mel Wolk notes:

“The milk of vegetarian mothers is lower in environmental contaminants than the milk of non-vegetarian mothers. Environmental contaminants are stored mainly in fat. Vegetarian diets tend to be lower in fat than those containing animal products, so there is less transfer into human milk.”

Usually, there is great concern about getting enough protein in a vegan or vegetarian diet. This is rarely the case in reality. I myself was vegan throughout my second pregnancy and continue to live a vegan lifestyle as I exclusively nurse my baby — who is, by the way, in the 94th percentile for weight and clearly not starved for nutrients!

What mothers should actually pay close attention to is (this applies to all mothers, not just breastfeeding ones): Vitamin B12, Vitamin D (which isn’t truly a vitamin, but I digress), zinc, and fat intake.

Supplements for the vegetarian nursing mother are not necessary to ensure adequate vitamins for a breastfed baby, if she eats a generally balanced diet that includes other animal products such as dairy, fish, and eggs. Vitamin B12 is a necessary supplement for vegan mothers, however. Chances are, she’s already taking a B12 supplement and would thus not need to be concerned about her breastfed child’s B12 status. As for whether supplementing a particular baby is appropriate, you may find more information on that topic here.

Also read:

• “Being Vegan, Breastfeeding, and Infant Safety” – Tracy at Evolutionary Parenting
• “Breastfeeding While Vegan” – Anayah
• “Considerations in Planning Vegan Diets: Infants” – Anne Reed Mangels. PhD, RD, FADA & Virginia Messina, MPH, RD, Journal of the Academy of Nutrition and Dietetics
• “Feeding Vegan Kids” – Reed Mangels, PhD, RD
• “Nursing and the Primal Eating Plan” – Mark Sisson
• “The Vegetarian Breastfeeding Mother” – Mel Wolk