When I was pregnant and preparing to breastfeed my first baby, I turned to my inner nutrition nerd to dive into all of the research on breast milk nutrition. Since I kept hearing that breast milk was the perfect food for baby, I wondered if that meant that its composition didn’t change based on what I ate or what supplements I took. Nope. Breast milk’s nutritional composition changes based on a mother’s diet and nutrient stores. And yes, it can be deficient in nutrients.
So of course I had all the intentions of making the most nourishing meals postpartum. Then I had a baby. Ha. I felt like I was hit by a truck. There was no way I was roasting vegetables and sauteing salmon. More like trying to tell my husband how to hard boil an egg so that I could eat one handed while I was nap-trapped by my baby.
Yes, Breastfeeding is a beautiful way to bond with and nourish your baby, but it can also be physically and emotionally exhausting. Nourishing your body during this postpartum period is important for both you and baby, but trying to sort out what you really need can be overwhelming.
So here’s a summary - what nutrients you and baby actually need, how to get them, and how best to supplement if the perfect plate can’t always happen!
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Full disclosure. This is a long and nerdy blog. If you’re a nerdy mom like me, you’ll love it. If long and nerdy sounds overwhelming, skim through the key nutrients and head to the last paragraph of each section which talks about which foods have that nutrient. And of COURSE, please don’t let the pressure of perfection or the threat of mom guilt add stress and anxiety to your life. Know that no matter what, you are providing your baby with an amazing start!
Can You Boost Your Breast Milk?
Of course, breast milk is always a superfood for baby, containing immune-boosting antibodies, human milk oligosaccharides (HMOs) to support the infant microbiome, easy-to-digest proteins, fats, and carbohydrates, folate, and many trace minerals. But the levels of many other micronutrients will vary according to the composition of mama’s food and supplement intake.
To be clear, this is NOT to suggest that you should ever stop breastfeeding for fear that your quality isn’t enough! It is to empower you with information on how you can boost nutrient content if you want to.
So what foods and nutrients are ideal to eat to optimize your milk quality during this time? Is there an ideal balance of certain foods? Let’s take a look.
How to Optimize Breast Milk Quality
In short, optimizing breast milk quality relies on maximizing nutrient density of the nutrients baby needs most.
Nutrient density refers to the amount of key nutrients that are in the foods and supplements you consume. For example, a snack of two hard boiled eggs contains choline, B vitamins, vitamin A, protein, and fat. A snack of some crackers or chips is devoid of pretty much any nutrition at all.
A note on supplementation
As a quick disclaimer before we get into the discussion, I want to note that food is generally the best first line of defense to get the nutrients you need. However, when it comes to some of the most nutritionally demanding phases of your life (pregnancy and breastfeeding), supplements can be incredibly supportive to make sure that you and your baby are getting what you need. Plus, it can be pretty overwhelming to try to check a bunch of nutrient boxes each day with a newborn or baby. I typically say to do your best with food and supplement the rest. But while breastfeeding, I always recommend you continue your prenatal vitamin while breastfeeding, and ideally for 2-3 months after weaning.
Nutrients to Optimize Breast Milk Quality
There are several key nutrients that your body needs while breastfeeding, but some of them will be in your breast milk in sufficient amounts regardless of your intake, while others will vary significantly with diet. As the American Academy of Pediatrics stated in 2018, “Failure to provide these key nutrients during this critical period of brain development may result in lifelong deficits in brain function despite subsequent nutrient repletion.”
Since the goal is to optimize milk quality, we’ll focus on discussing the key nutrients you need for healthy milk that vary with diet – in other words, the ones you can control. The following sections list each nutrient, why baby needs it, and how you can get it.
Fat is needed for baby’s neurological development and also supports blood sugar balance in mama. While the quantity of fat in your milk doesn’t vary much with diet, the quality and type of fat that appears in your breast milk does. Yes, the type of fat you consume is actually reflected in your milk, and that’s why it’s worthy of discussion! High quality fats provide important fatty acids for neurological development and a number of other important functions within the body, while low quality fats are inflammatory and detrimental to health.
Including a good quality fat in every meal and snack will benefit both you and baby. It will help keep your blood sugar balanced which can help stabilize your mood and energy and keep you full. It also supplies good fats to your milk for your little one!
Ideal sources of healthy fats include nuts and seeds and their butters (e.g., almonds, walnuts, flax, chia, sunflower, pumpkin, hemp), coconut and olive oils, avocado, and grass-fed butter or ghee (if tolerated). It also includes fats from animals that are responsibly raised, like eggs from pasture-raised chicken, fatty fish from sustainable and wild-caught sources, and fat from grass-fed cows and pasture-raised pigs and chickens.
Fats to limit or avoid include industrial seed or vegetable oils (e.g., soybean, canola, corn, safflower), fried foods, margarine, trans fat or anything with “hydrogenated” on the label.
DHA is one of the omega-3 fatty acids and is absolutely critical to baby’s brain development and neural and visual development as well as mama’s mental health. At birth, a baby’s brain is only about 25% developed. It will double in size in the first year of life. This process is heavily dependent on adequate nutrition, including sufficient DHA. You can read more on the importance of DHA for baby’s brain here (and once solids are introduced, the SK salmon pouch is a great way for baby to get it!).
There’s no way around it – you need to consume DHA in order to have DHA in your breast milk for baby. Plus, mama needs some DHA for her own health too. It is essential for brain health no matter your age, and several studies have linked low levels of DHA to postpartum depression and DHA supplementation to reduced risk of postpartum depression.
Good sources of DHA include salmon, sardines, mackerel, and some algae. If you aren’t a fan of fish, or if cooking up fish a few times each week postpartum just isn’t happening, a supplement is needed. Make sure the company you purchase from tests for heavy metals and other toxins.
It’s worth noting that while some plant foods like flax seed are marketed as high in omega-3s, they are not reliable sources of DHA. Flax contains a different fatty acid, alpha-lipoic acid (ALA) and its conversion to DHA is incredibly poor in humans (research estimates that less than 10% gets converted). However, if you avoid fish at all costs, there are good quality plant based (algae) DHA supplements (fish actually get their DHA from eating algae).
Research suggests breast milk concentrations of DHA reach a “saturation” level at maternal intake of 500 -1,000 mg/day. Amounts beyond this are not harmful and can still support your own health, but may not provide added benefit to your breastmilk.
The B vitamins, especially vitamin B12, are needed for baby’s brain development, nerve development, and development of gross motor skills. Due to high demands during both pregnancy and lactation, vitamin B12 is one of the most common micronutrient deficiencies affecting pregnant and nursing women.
Because vitamin B12 is vital for brain development and ensuring that your baby’s nerves get a protective coating of myelin, failure to get enough in the first year of life has been linked to irreversible neurological damage in up to 50% of infants who face deficiency (even after improving B12 status with supplementation). Studies have shown that mothers who don’t get enough only provide an estimated 16% of their baby’s vitamin B12 requirements.
Animal foods like beef liver, beef, clams, tuna, salmon, yogurt, milk, cheese, and eggs are rich sources of B vitamins, including B12. Because of this, vegan and vegetarian mamas are more commonly deficient.
Fortunately, almost all prenatal vitamins contain vitamin B12, but look for one with the adenosylcobalamin and methylcobalamin forms. These are the two active coenzyme forms that are readily usable by the body.
It’s also worth noting that many experts believe that the RDA for vitamin B12 is set quite low, and as a water-soluble vitamin it is uncommon to have too much. Therefore, supplementing is generally a smart and safe way to ensure you meet the needs of both you and baby.
Choline is an underdog in the nutrition world – especially the prenatal and postpartum nutrition world. It simply doesn’t get the glory it deserves given how critical it is to mama and baby’s health.
Choline is essential for a baby’s brain development. In fact, research shows that higher choline levels in breast milk correlate with better infant recognition memory.
The tricky thing about choline is that needs are extremely high during lactation (550mg per day is recommended) but it is found in limited sources in foods.
Certain animal foods are the richest sources. Eggs have about 140mg each while beef liver has about 350mg in a 3 oz. serving. Beef has about 75-100mg per serving, and cod contains 70mg per serving. Other sources that contain less than 50mg per serving include wheat germ, kidney beans, quinoa, milk, yogurt, brussels sprouts, broccoli, mushrooms, and peanuts. However, based on the sources listed, you can see that it is difficult to get the full 550mg needed each day unless you’re eating 4 eggs daily, or quite a bit of beef or beef liver.
You can also turn to a supplement for support, but if you’re looking to your prenatal vitamin to supply your needs, chances are, it’ll fall short. Incredibly, about 95% of prenatal vitamins don’t contain adequate choline.
You can also get a standalone choline supplement. Choline bitartrate is a common and well-absorbed form. Pure Synergy makes a vegan choline supplement.
Finally, you can feel comfortable going above and beyond the 550mg recommended daily. In fact, research has shown that up to 930mg per day in pregnancy and lactation may provide additional benefit.
Vitamin A is needed for infant growth, immune system health, and brain and vision development. In fact, in the first 6 months of life, babies receive 60 times the amount of vitamin A that they received during the entire 9 months of pregnancy.
Vitamin A is available in 2 forms:
- Retinol: This is the active form found exclusively in animal fats. While fears around animal fat have caused some to limit these foods and therefore vitamin A intake in the diet, the reality is that these fears are largely unfounded, and babies need retinol in breast milk for proper development. Good sources of retinol include liver and other organ meats (including cod liver oil), butter or ghee, lard, tallow, and some seafood. Of course, the quality of the animal matters when it comes to the quality of fat and protein they produce – go for grass-fed and pastured animals.
- Beta carotene: This form is found in plants and must be converted by the body into the active form. Unfortunately, this conversion is inefficient and cannot be exclusively relied on for vitamin A needs. Beta carotene is generally found in orange-colored vegetables like sweet potatoes and carrots. These are nourishing foods and healthy carbohydrate sources, so they are great additions to your diet, they just can’t be relied on for vitamin A needs.
You can also get your active vitamin A/retinol through a supplement if needed. But be sure to check your prenatal. It should list vitamin A as retinyl palmitate, not just beta-carotene.
Vitamin D is needed for baby’s immunity, and bone and tooth formation. It is also important for mama’s own immunity, bone health, and emotional health.
Vitamin D is limited in foods. Mushrooms have a small amount, but the best source is sunlight. Since it can be tough for mama and to get enough sun exposure (especially without risking too much UV exposure), supplements are used often.
Vitamin D is one of the most common deficiencies, and when mama doesn’t get enough, she’s compromising not only her own health, but the nutrition content of her breast milk as well.
Mama should supplement with 6,400 IU of vitamin D3 daily to provide enough vitamin D for both herself and her baby. Look for a supplement that includes both vitamin D3 and K2. Of course, if you are already deficient, you’d need to supplement at a higher level to make up for the deficit while also supplying your baby. Your provider can test your levels, or you can get an inexpensive home test. You can also supplement baby directly with infant vitamin D3 drops, just place a drop on your nipple before breastfeeding.
Vitamin C is needed to help build baby’s immunity. It also provides baby with key antioxidants and supports antibody production. Vitamin C also supports mama’s immunity and is necessary for collagen production. Collagen is a key component of postpartum recovery as it supports tissue repair as well as hair and skin health.
Good sources of vitamin C include citrus fruits, broccoli, strawberries, bell peppers, and Brussels sprouts.
Iodine is needed for baby’s brain development, overall growth, and immunity. It is also critical to thyroid health for both mama & baby.
It might not be one you think much about, but iodine is essential and postpartum thyroiditis is common, even if mama never had thyroid issues before or during pregnancy. In fact, up to 23% of all new mamas experience thyroid dysfunction postpartum. Postpartum thyroiditis can be hard to identify without testing as symptoms mimic many common complaints during this time - extreme fatigue, depression, hair loss, difficulty losing weight, and trouble producing sufficient breast milk. If you are experiencing any of these issues, feel empowered to ask your provider for a full thyroid panel test – you and your baby are worth knowing and addressing it!
Good sources of iodine include seafood, seaweed, eggs, and dairy. While many people used to get their iodine from iodized salt, sea salts and Himalayan pink salt has taken the place of traditional table salt. If your diet consists of largely whole unprocessed foods (that’s a good thing!) and you aren’t consuming many foods naturally rich in iodine, you might find yourself (and your baby) deficient.
A Note on Hydration
While the nutrients in food are critical to healthy breast milk, it’s also important to hydrate. Breast milk is approximately 87% water, and if you have 30 ounces leaving your body each day, that’s at least 30 ounces that needs to be replenished. However, the amount needed to stay hydrated will vary day-to-day based on your food, environment, activity, etc. Signs that you may need to increase fluid include headaches, dark urine, and hard stools.
However, drinking large amounts of plain water can sometimes dilute some of the electrolytes in your body like sodium, potassium, and magnesium. Adding in natural sources of electrolytes like coconut water, or a high-quality supplement (I like LMNT) can help restore this balance.
A Note on Calories
Did you know that your calorie needs are actually higher when you breastfeed than during pregnancy? It’s true, but it’s also important to remember that not all calories are created equal. Whole, unprocessed foods help your body achieve the high nutrient needs you have to supply nourishing breast milk, whereas processed foods and refined carbohydrates.
In general, you’ll need an extra 500 calories daily while breastfeeding your little one. This estimate assumes you are removing 780mL or 26oz/day, which is fairly typical for an exclusively breastfeeding mama. For reference, it takes approximately 67 calories to produce 100mL or 20 calories to produce one ounce of breast milk. So, if you are nursing an older infant or toddler less, this number will decrease along with output.
Many mamas feel an increase in appetite when breastfeeding, but others find it difficult to find the time to prepare food while dealing with the demands of a newborn. Do your best to respond to your hunger cues with quick and easy nutrient dense snacks and meals, remembering that breastfeeding, especially in the first several months, is a season to continue nourishing your body and your baby.
Nourish for two
Breastfeeding is nutritionally demanding, but the benefits of optimizing your nutrition will pay off in your own health and baby’s health for years to come.
And since it’s so important, I’ll say it again: don’t let the pressure of perfection or the threat of mom guilt add stress and anxiety to your life. Know that no matter what, you are providing your baby with an amazing start.
In other words, the ideal balance for breastfeeding is to strike a healthy balance between nutrient density in the foods you choose and supplementation for when the realities of postpartum life prevent you from being prepared at all hours of the day with an ideal meal or snack. And don’t hesitate to ask for support - there are lots of great ways your partner can help!
Hungry for more tips on nourishing yourself while breastfeeding? Check out this blog post!
Hillary Bennetts is a nutritionist and business consultant focusing on health for mamas and babies through the prenatal, postpartum, and infant/toddler stages. In addition to nutrition consulting she provides business consulting and content creation for companies in the health and wellness industry. Hillary spent almost a decade in corporate consulting before shifting gears to combine her lifelong passion for health and wellness with her business background and nutrition education.
Hillary holds a Bachelors in Economics from Washington and Jefferson College, an MBA from Emory University’s Goizueta Business School, and is certified as a Holistic Nutritionist through Bauman College. She lives in Colorado with her husband and two sons.