Breastfeeding and diet: let's set the record straight

Breast milk is made directly from what we eat - MYTH

Breast milk is produced by the body from the elements present in the blood.
Foods are digested and broken down into nutrients (vitamins, minerals, amino acids…) which reach the breasts via the bloodstream, making their way to the cells in the alveoli and then into the milk. This process is known as diffusion.

If our diet is not "perfect", our milk will be of poor quality - MYTH

The diet that is good for a pregnant and breastfeeding woman is exactly the same as the one that is good for everyone: varied, balanced, made up of foods that are as natural as possible, and not too rich in sugars or fats.

Our milk, however, will always be nourishing. Research has shown that diet has no impact on the milk levels of the main constituents of breast milk (proteins, lactose, cholesterol, calcium…). For many minerals (except iodine and selenium), milk levels remain stable regardless of maternal status, which could worsen any existing maternal deficiencies (our bodies will find ways to source certain minerals, at our own expense) [1]. As for fats, the quantity of fat in milk also remains stable regardless of the mother's diet [2]. However, the qualitative profile of milk lipids depends on our dietary intake, as does the milk level of certain fat-soluble vitamins [3]. It is therefore important to consume essential or long-chain fatty acids such as DHA, which are essential for the healthy development of our child's brain and nervous system.

Our milk is "living" and goes far beyond nutrition: it adapts over time according to our environment and our baby — that is the magic of our bodies! It contains many components that will not change regardless of our diet (stem cells, etc.).

To find out more, see our article on composition of breast milk.

If you are vegan, you need to change your diet if you want to breastfeed - MYTH

If you follow a vegan diet, you are at risk of deficiency in vitamin B12 and zinc. It is particularly important to maintain good B12 levels through supplementation. However, breastfeeding is entirely possible. You can seek support for optimal nutritional monitoring. 

To make sure you are covering your needs, our breastfeeding supplement Post essentials provides 17 vitamins and minerals. 

Breast milk does not contain enough iron - MYTH

Human milk contains little iron (0.3 to 0.4 mg/l of iron), but it is present in a highly bioavailable form [4], more easily absorbed by the baby than cow's milk or iron-fortified infant formula. The amount of iron in breast milk is therefore optimal for your baby, even if it is lower than in cow's milk. You still need to make sure you maintain good iron intake.

The iron level in breast milk is constant, as with most other minerals. Variations will occur in the amounts available and stored for the mother [5].

A full-term infant does not need additional iron until 6 months, at the start of weaning. The infant's hepatic iron stores, combined with the high bioavailability of iron in human milk, cover the needs of an exclusively breastfed baby for approximately the first 6 months [6].

For full-term babies, delayed cord clamping increases the baby's blood volume and iron stores. The baby can thus receive iron reserves for 3 months! A 2013 review showed that infants who had cord clamping after 1 minute of life had higher iron levels at 2 and 6 months than others. [7] For more information, see our article on delayed cord clamping of the cord.

You need to pay attention to your iodine intake when breastfeeding - TRUE

Iodine is involved in brain maturation, and a deficiency may be associated with neurocognitive developmental disorders in children.

Iodine is the only mineral, along with selenium, whose level in breast milk depends on maternal intake.

During breastfeeding, the transfer of iodine from breast milk to the infant is around 50 μg/day; this makes it important to prioritise the consumption of natural foods rich in iodine and the use of iodised salt.
 

Iodine is found in milk and dairy products, shellfish, marine fish (fresh, frozen, or deep-frozen), eggs, and iodised salt… and in our granola Choco nut and Tomato'croq ! Our postnatal vitamins Post essentials are also rich in iodine.

It should be noted that organic dairy products ccontain around 45% less iodine than standard dairy products.

Breast milk is low in vitamin D - TRUE

Breast milk is a poor source of vitamin D. Your baby's vitamin D requirements are 400 IU/day (according to the latest recommendations currently being updated), and vitamin D supplementation is recommended for all infants, particularly breastfed ones (infant formula is often fortified with vitamin D). This recommendation is made in general, but it may be worth checking on a case-by-case basis. It is not always necessary for the infant to be supplemented if the mother is not deficient — this is why many healthcare professionals carry out blood tests on the mother to assess individual needs. However, this test is not covered by social security, but having it done could help avoid supplementing a baby who does not need it.

Some studies have found that exclusively breastfed infants had an increased risk of vitamin D deficiency compared with infants receiving other sources of intake in addition to breast milk. The level of vitamin D in breast milk, like certain fat-soluble vitamins, is indeed dependent on maternal intake.

According to La Leche League, the risk of vitamin deficiency is higher in children with darker skin, who have limited direct sun exposure, who are exclusively breastfed for a long period by a mother with low calcium and vitamin D intakes during pregnancy. [8]

High maternal supplementation could be sufficient to meet both her needs and those of her baby. Indeed, one study showed that with a supplement of 6,400 IU/day, the breastfeeding mother would have enough vitamin D for herself and her baby, without any adverse effects related to overdose, which could allow consideration of supplementing only the mother [9]. Maintaining the mother's optimal vitamin D status is the key factor in preventing deficiencies in the child.

Do be mindful of overdosing, however. Currently, there are gaps in the risk assessment of toxicity associated with excessive vitamin D supplementation. But nothing stops us from supplementing you first, for your own benefit! To find out more, read our article on vitamin D and breastfeeding.

We need to pay attention to our omega-3 intake, particularly DHA during breastfeeding - TRUE

Fats are not something to avoid — quite the opposite! Omega-3s are fatty acids described as essential because the body cannot produce them on its own; they must be obtained through diet. Our breastfed baby depends on us to meet their needs, particularly for DHA. They cannot convert ALA (found in seeds and nuts) into DHA the way we adults can.

Maternal DHA levels drop during breastfeeding, reflecting the transfer of this important fatty acid into breast milk for the baby's development. [10]

After birth, omega-3 deficits can persist for up to six weeks following delivery, and even more so in mothers who are breastfeeding [11]. Some studies also suggest a link between low omega-3 intake and a postnatal depression in the mothers concerned. [12] [13]

What do we do in practice?
Vary the type of oil (olive, rapeseed, sunflower, walnut, linseed…)
Limit saturated fats found in processed meats, ready meals…
To top up on DHA, eat fish several times a week (to find out which fish to eat and how often, see our guide here)
And otherwise our breastfeeding snack Cho-chocolat 200 mg of DHA, or the DHA supplement with Omega Mama.

TRUE: Dieting whilst breastfeeding is not recommended 

Our bodies are remarkable: a study on children living in Gambia showed that even though they consumed on average 74% of the milk volume consumed by British babies, their intakes of calories, proteins, fats and lactose were similar, despite the chronic malnutrition suffered by Gambian mothers. Of course, for certain minerals (iodine, selenium), certain vitamins and the quality of fats, the composition of breast milk will depend on maternal intake [14].

Dieting whilst breastfeeding is best avoided (never go below 1,800 kcal, even though some studies only note an effect on milk below 1,500 kcal, with a reduction in lactation).

But by cutting calorie intake, you expose yourself to nutritional deficiencies, extreme fatigue, more pronounced hair loss… in short, something best avoided!

TRUE: If I eat poorly, I will feel more tired and risk developing deficiencies

Watching what you eat is also something you do for yourself — to avoid deficiencies and fatigue. Eat until you feel satisfied. You might, for example, have 3 meals a day and two snacks (mid-morning and mid-afternoon). Follow a balanced and varied diet, not too high in sugar, with plenty of vegetables and 2 to 3 pieces of fruit per day.

For many minerals (except iodine and selenium), the level in breast milk is stable regardless of the mother's nutritional status, which could worsen any existing maternal deficiencies (our body will find ways to obtain sufficient quantities of certain minerals, at our own expense).[15]

You have to give up coffee when breastfeeding - MYTH

Coffee, tea and chocolate contain methylxanthines (caffeine, theophylline, theobromine…) which have a stimulating effect. 

Coffee can be consumed without exceeding 2 to 3 cups per day. Beyond that, there is a risk of transient hyperexcitability in the baby: insomnia, irritability, colic… which stops when coffee is stopped.

Premature babies or newborns metabolise these molecules less efficiently. 

Its level in breast milk also varies between women, and is thought to be higher in women who smoke.

Dark chocolate is fine, as long as you keep consumption reasonable. 

Avoid drinking large quantities of tea (more than 1 litre) as it can reduce the absorption of plant-based iron. As an alternative, you could try a breastfeeding herbal tea, to stay well hydrated and boost your milk supply. 

To find out more, have a look at our article coffee and breastfeeding.

You must never drink alcohol while breastfeeding, just as during pregnancy - MYTH
 

While regular alcohol consumption during breastfeeding cannot be recommended, there are equally no genuinely well-founded arguments to formally advise against consuming a modest and/or occasional amount of alcoholic drinks. 

For occasional consumption, specialists generally advise planning to breastfeed your baby just before you start drinking alcohol, making sure to wait at least 2 hours (or more depending on your weight, see this table: ttps://www.meilleurdepart.org/resources/alcool/pdf/desk_reference_fre.pdf ) before breastfeeding your baby.before putting them back to the breast. 

Very low and occasional alcohol consumption is compatible with breastfeeding. 
 

Please note! The smaller the baby, the more cautious you will need to be. In infants, metabolic capacity is lower than in older babies. A baby metabolises alcohol twice as slowly as an adult after the first week of life.

Alcohol passes into breast milk, where it is found at a level similar to that present in the blood at the time of feeding. Research shows that approximately 5 to 6% of alcohol passes into breast milk. 
 

Peak alcohol levels in milk are observed after 30 to 60 minutes if alcohol was consumed on an empty stomach, and after 60 to 90 minutes if food was also consumed. Expressing milk, however, has absolutely no impact on the speed at which alcohol is eliminated.
 

Alcohol can affect both mother and baby: disrupted sleep, impacts on the baby's development, reduced let-down reflex, etc. 
 

To find out more, have a look at our article alcohol and breastfeeding. 

When breastfeeding, you must avoid certain foods like cabbage that cause wind - MYTH

The myth stems from a study that identified a link between consumption of cruciferous vegetables in particular (cauliflower, cabbage, broccoli, onion) and colic in exclusively breastfed babies [16]. However, this study was unable to show that these vegetables caused colic. 

Babies adapt very well to their mother's diet, and if certain foods cause wind in mothers, this is not necessarily the case for babies.
 

When breastfeeding, you must avoid foods with strong flavours, or that are too spicy - MYTH

Certain foods such as garlic, spices… can indeed change the taste of breast milk. But your baby is already tasting foods through the amniotic fluid in the womb! All these new flavours may even help the child become familiar with the family's eating habits, well before weaning. [17]
 

Garlic consumption has a reputation for causing colic in infants. However, two studies have refuted this belief. In the first, 153 mothers completed a questionnaire about their diet. Those who consumed garlic were no more likely to report colic in their baby than those who had not. In the other randomised study, mothers were given either a garlic capsule or a placebo capsule for three days. The prevalence of colic in infants was similar in both groups. [18]

MYTH: Breast milk is contaminated through our diet and environment, and formula milk would be a better option

We live in a polluted world, so it is inevitable that pollutants find their way into it. Exposure to toxins is greater during pregnancy, a particularly sensitive period.

Pollutants include dioxin, mercury, DDT (insecticides) and PCBs (polychlorinated biphenyls) — chemical substances used in construction, now banned due to their high toxicity, but which persist in the environment because of their very slow natural decomposition.

Research in recent years shows that even slightly contaminated breast milk remains by far the best choice for babies!! And the best for our already heavily polluted planet!

TRUE and FALSE: Sometimes our milk can cause allergies in your baby, which may manifest as intense crying or reflux 

In cases of allergy or intolerance, it is not your milk that causes the allergy, but the allergenic proteins that find their way into the bloodstream and then into the milk. So please don't feel guilty!

Whereas it was long believed that to prevent allergies in cases of family history, these allergens should be avoided during pregnancy or breastfeeding, more recent studies suggest that a mother's consumption of these allergens could in fact help prevent allergic reactions [25] [26]. The transfer of antigens via breast milk may encourage their acceptance by the baby's immune system.  

Do not hesitate to consult your paediatrician, who can refer you to an allergy specialist. Even if a test comes back negative for a particular food, clinical signs should nonetheless take precedence.

Once symptoms have completely disappeared, it may be discussed whether to reintroduce the allergen in small doses, so that the child can become accustomed to it and develop tolerance, even though the appropriate dose can be difficult to determine.

Is it then worth avoiding allergens during pregnancy and breastfeeding? Studies have shown that such avoidance does not reduce the likelihood of developing an allergy before the age of 2, but may delay its onset [33]. It does not appear necessary in particular to avoid peanuts [34].

TRUE: When breastfeeding, you feel hungrier than usual

During breastfeeding, energy needs increase in order to produce milk. Some of these needs are met by pregnancy reserves, the rest by diet. You need to cover not only your own needs but also those of your baby. 

These additional needs depend on several factors, such as the age of your child, whether breastfeeding is exclusive, your level of physical activity, and your weight gain during pregnancy. [35]

Additional needs are estimated at around 500 kcal per day, evolving over the course of breastfeeding: 595 kcal/day between 0 and 2 months post-partum, and 670 kcal/day between 3 and 6 months (source: LLL).

Sometimes it can be difficult to eat well with a newborn. You can keep some snacks to hand, and prepare soups and collagen-rich broths before the birth — perfect for the postpartum period.

When breastfeeding, you need to drink a lot - TRUE AND FALSE

Do make sure you stay well hydrated, but there is no need to drink more than your thirst dictates.
Scientific evidence consistently shows that neither increasing nor restricting fluid intake affects the volume of milk produced.

If you don't drink enough water, there is no risk for your baby, who will receive what they need. But it will be at your expense. Hello headaches and dehydration!
For more details, we've written an article on hydration and breastfeeding !

You need to eat certain foods to breastfeed and produce enough milk - MYTH

Galactagogues are not essential for breastfeeding. Your milk production is not determined by what you eat [36], but by the law of supply and demand. It is the local and effective drainage of the breasts that maintains milk secretion.
In other words, if the breasts are not stimulated regularly and effectively enough, milk production decreases. This is why it is so important to put your baby to the breast as often as possible, without watching the clock.

As the La Leche League points out: "The use of galactagogues should be reserved for situations in which a careful assessment has not identified a treatable cause (maternal hypothyroidism, medication use, breast surgery...), and when increasing the frequency of feeds and/or milk expression has not produced the desired result."

You need to drink milk to produce milk - MYTH

Not at all! We are the only species that consumes the milk of another animal.
Our milk is perfectly suited to our baby, just as a cow's milk is suited to her calf.
Not to mention that many cultures do not consume dairy products at all, and yet women in those cultures breastfeed their children too!

If you are concerned about not getting enough calcium, don't worry - plenty of foods contain it:
Green leafy vegetables such as broccoli, cabbage, spinach...
Tinned sardines, salmon, anchovies or mackerel (with bones that soften and become edible)
Almonds, or other nuts, dried fruits such as figs.
For example, a large handful of almonds provides 80 mg of calcium, and 2 figs provide 167 mg [37].
Sesame seeds, which can be eaten whole, as tahini (sesame butter), as gomasio (ground sesame seeds mixed with a little salt), or added to many dishes. They should be chewed thoroughly to help the body absorb their calcium.
For example, 2 tablespoons of tahini provide 128 mg of calcium.
Mineral waters rich in calcium (> 150 mg/l) 
Plant-based milks enriched with calcium (a tiny alga that is exceptionally rich in highly absorbable calcium)
The bone broth, which is rich in calcium, as its long cooking time softens the animal's bones; it is also ideal for boosting collagen intake.
Certain types of seaweed (lithothamnion, wakame, nori, sea lettuce), fermented products (miso)

And on a positive note: plant-based calcium is generally better absorbed than dairy calcium. Research shows that calcium bioavailability is higher in plant-based sources than in animal sources (dairy products) [38].

For more details, see our article on Calcium and breastfeeding ! 

Many thanks to Julie Longy, IBCLC lactation consultant, for her review and advice!

Be careful not to self-supplement — food supplements are not without risk. They can interact with other supplements, foods and medications, and are not necessarily suited to your personal situation, not to mention the importance of choosing the right ones and adjusting dosages accordingly. It is therefore preferable to seek guidance from a healthcare practitioner specialising in nutrition (such as a naturopath or nutritional therapist).