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Nutrition Guidance for Breastfeeding Women

Decades of research have demonstrated the many benefits of breastfeeding. Babies get all the nutrients they need from breastmilk. Antibodies are also passed from mother to baby, protecting them both from certain illnesses and diseases. What a lactating mother eats and drinks can affect what is passed on to her baby through breastmilk. During pregnancy and the postpartum period, it's important to make healthy choices to promote growth and development for the baby.

How much should I be eating?

Breastfeeding women have similar nutrition needs to pregnant women and should follow the same healthy diet guidelines. There is one exception—about 200 more calories a day. But that doesn't mean an extra dessert! It's important to have a nutritious, colorful diet. Half of your plate should include fruits and vegetables while the other portions should include proteins and fiber-rich carbs.

Tip: Opt for nutrient-rich snacks such as whole-grain bread with peanut butter, an apple or banana, or eight ounces of yogurt.

What foods should I eat?

The guidelines for breastfeeding women are:

  • Protein (2-3 servings a day): Meat, poultry, seafood, eggs, cheese, milk, yogurt, cottage cheese, tofu, dried beans
  • Calcium (1,300 milligrams a day): Milk, yogurt, hard cheese, calcium-fortified orange juice, tofu
  • Iron (10 milligrams a day): Meat, poultry, seafood, dried beans, dried fruit, egg yolks
  • Vitamin C (120 milligrams a day): Citrus fruits, broccoli, cantaloupe, potato, bell pepper, tomato, kiwi, cauliflower, cabbage

Tip: To make it easier to include nutritious snacks in your day, prepare some quick options in advance such as a snack-sized bag of trail mix, string cheese, fruits and vegetables, or celery and peanut butter.

What foods should I avoid?

Sushi date nights and charcuterie boards are back on the table. And don't forget about those spicy foods! In fact, research has shown that pregnant women who consume a varied diet have babies who are less picky eaters when they get older. While inside the womb, babies absorb flavors from food through the amniotic fluid. Outside the womb, they get those flavors through breastmilk.

There are some foods to still be cautious of, including:

  • Mercury: While it's okay to have sushi and raw fish, lactating mothers should still be careful with mercury. Throughout breastfeeding, you should avoid fish high in mercury such as shark, swordfish, king mackerel, and marlin. Albacore tuna should be limited to 6 oz. per week. Other low mercury fish can be enjoyed in amounts of 8 to 12 oz per week.
  • Caffeine: Coffee drinkers can continue to rejoice! The caffeinated beverage is safe to drink while breastfeeding—about two to three cups a day. Energy drinks and soda should be kept to a minimum.
  • Alcohol: One serving of alcohol, such as a glass of wine, a shot of hard liquor, or a 12-ounce beer, should not impact breastmilk. If a lactating mother is feeling altered from drinking, she should not nurse. In this situation, a mother should avoid the next feeding. Test strips that claim to test for alcohol in your breastmilk are not accurate and are not recommended as a reliable way to monitor alcohol intake.

How much water should I drink?

Drinking the appropriate amount of water is key to proper hydration during pregnancy and postpartum. But don't overdo it!

"Oftentimes, people provide misinformation about water, including that they have to drink excessive amounts while they're breastfeeding," says Elizabeth Kirts, MPH, IBCLC, ICCE, a lactation consultant and business operations manager of Women's Health Services at University of Utah Health. "You should be drinking to thirst and not drinking to a set amount."

Drinking too much water could potentially decrease breastmilk supply. "Over hydration can impact the posterior pituitary, decreasing the hormonal regulation, and thus decreasing milk supply," Kirts says. "Additionally, the body adjusts to regulate electrolytes which further impacts milk production."

Other fluids, such as high sugary beverages or high amounts of caffeine, should be avoided. If you need something besides water, you could dilute orange juice or have a glass of unsweetened iced tea. Drinking excessive amounts of caffeine or sugar can negatively impact breastmilk supply.

Tip: Have a glass of water whenever you are nursing or pumping.

What supplements or vitamins should I take?

Supplementation is generally not necessary in the presence of a balanced, healthy diet, according to Sarah Zou, MPH, RDN, CD, CDE, a clinical dietitian at U of U Health. Prenatal vitamins should continue throughout pregnancy and during breastfeeding. While a healthy diet is the best way to get all the vitamins and minerals you need, a prenatal vitamin will help capture what is missing from the maternal diet. Check with your doctor before taking any herbal supplements.

Tip: If you do not have access to a prenatal, you can take a multivitamin.

Can certain foods help boost breastmilk supply?

Breastfeeding mothers wanting to boost their breastmilk supply may get advice to consume certain foods like oats, coconut water, or brewer's yeast. However, there is limited evidence that these foods help. "There could be a slight increase if consuming these foods, but some of it is anecdotal and not evidence-based information," Kirts says.

Herbs such as fenugreek seed, marshmallow root, or alfalfa—also called galactagogues—can help increase breastmilk supply. While most mothers do not need galactagogues to maintain their supply, you should consult your doctor or seek an evaluation from a lactation consultant (IBCLC) before taking these herbs as they can interfere with some medications.

Tip: The best way to take galactagogues is while increasing the number of times you pump or breastfeed.

What if I have gestational diabetes?

Women with gestational diabetes should limit their intake of added sugars and refined carbohydrates. According to Zou, to help manage blood sugar, pregnant women should:

  • Choose complex carbohydrates in managed portions
  • Increase lean protein
  • Increase non-starchy vegetables
  • Exercise regularly

Most importantly, pregnant women with gestational diabetes should work with their provider and a registered dietitian to help meet their blood sugar goals.