Breastfeeding and Eating

What can I eat? Well, eat a healthy well balanced diet of course.

There are no hard and fast rules when it comes to eating and breastfeeding. Some healthcare providers suggest a good rule of thumb is to eat everything in moderation. Another would be to eat when hungry and to drink to thirst. Every woman is encouraged to eat a healthy well-balanced diet, low in sugars and fats. It is no different while breastfeeding except that an adult breastfeeding woman needs an additional serving of calcium per day (two if you are a teenager) and 2 more ounces of protein per day. Some women worry so much about the diet that they decide not to breastfeed their child. This makes no sense simply because by choosing to breastfeed you are supplying your child with far superior source of nutrition than if you used artificial milk made with sugars and saturated fats. Dietary concerns are not a basis for deciding not to breastfeed, your baby will be far better off if you were to eat poorly and nurse than to be bottle-fed artificial milk. Continuation of prenatal or other multivitamin is encouraged. Occasionally vitamins can cause colicky symptoms.

What about needing to eat OMEGA-3 fatty acids while breastfeeding? Omega-3 fatty acids are an important part of everyone's diet. Eat them, irrespective of breastfeeding, they are good for you.

These fatty acids are part of your breastmilk so your need for them is probably increased. Good sources of these fatty acids are: salmon, tuna, (no more than once a week), other fatty fishes, walnuts, flax seed, and green or edammne soybeans.

What about gassy foods, spicy foods? Rarely a problem.

There are a lot of myths and cultural beliefs about what you can and cannot eat. Many people believe they need to limit gas-forming foods such as broccoli, onions, beans or spicy foods. The truth is that what you eat rarely causes problems. If you are concerned that a food will cause a problem just eat a little and see if it bothers your baby. If you think that a food is causing discomfort eliminate it for 2 weeks to see if the symptoms disappear. If they disappear then try eating it again and if the discomfort reappears then it was the cause. The foods most commonly associated with problems are cow's milk, citrus, melons, peaches and spicy foods.

What about coffee and alcohol? These are drugs, not foods so LIMIT THEM.

Caffeine and alcohol are not foods but drugs. Drugs can affect your baby. The caffeine recommendation is no more than 2 cups of coffee per day. Other sources of caffeine are chocolates and teas. Too much caffeine will make your baby jittery and fussy. It is O.K. to have some alcohol while nursing. Be aware that if you are feeling the euphoric effects of the drink then it is in your milk. If you do not feel those effects, it's not in your milk. So drinking a glass of wine with dinner is very unlikely to get into your milk. There is no need to pump and dump because as your blood levels drop the alcohol is sucked out of your milk and into your bloodstream. Now if you are not drinking in moderation and are feeling drunk and your breasts are uncomfortably full, pump and dump until the effects of the alcohol disappear. Resume nursing when you are no longer feeling tipsy.

What if we have many food allergies in my family? Limit or eliminate allergic foods from your diet starting in the last trimester of pregnancy.

The mother of an infant with a family history of food allergies may want to watch her diet a bit closer. Allergic foods have certain proteins that can be absorbed through the mother's gut and then into the mother's bloodstream and from the bloodstream into her unborn child or mother's milk. They include: cow's milk, seafood, peanuts, egg whites, and fish. Limiting allergic foods in the last trimester of pregnancy may prevent sensitization of the unborn child to these food allergens. Again, you may choose to further lower your child's risk of developing an allergy to these foods by eliminating them from your diet. However, simply by choosing to breastfeed alone you are lowering your child's chances of becoming allergic especially since artificial milk formulas are highly allergic. It would be most important to eliminate highly allergic foods until your child is 6 months of age. At six months of age your child's gut is more developed and can handle some solid foods (see "hypoallergenic food introduction" handout). Delay introduction of highly allergic foods (this includes those foods previously mention and any food that your close family members have allergy to) until the child is 3-5 years of age. It takes 3-5 years before a child's gut is fully developed.

I do not want to accidentally eat something my baby is allergic to, would it be better for me to use one of those "hypoallergenic formulas? Breastmilk is the most hypoallergenic food for your baby. In addition, it can protect the gut from allergens and it matures the guts so it can protect itself when your child is older.

Formulas by contrast DO NOT protect your child and they may harm. Cow's milk proteins (what most formulas are made from) are the most common food allergen. About 30% of children allergic to cow's milk are also allergic to soy. There have even been instances of children who are allergic to cow's milk having life threatening asthma attacks when place on the "Hypoallergic, pre-digested" formulas such as "Nutramagen" TM or "Alimentum"TM. This makes sense if you understand that, these expensive formulas are also made from cow's milk. Some women unfortunately choose not to breastfeed if they think they need to restrict their diet. However, the risk of allergy is far greater with artificial milks, so it would be better to CHOOSE to breastfeed without dietary restrictions than to choose giving a formula. So, I want to make it clear that by CHOOSING to breastfeeding and by CHOOSING to eliminate certain foods you are CHOOSING to go an extra step to protect your child from allergy.

BREASTMILK PROTECTS YOUR CHILD FROM ALL ALLERGIES--FOOD, ENVIRONMENTAL, SKIN, AND ASTHMA. The longer you breastfeed the better the health outcome for your child.

A mother of a child with a family history of allergies is not only protecting her child from developing a food allergy but also from allergy related illness such as asthma, eczema and hay fever. Children should be breastfed one year and beyond.

Developed by Christine Betzold MSN RNP IBCLC. May be used for educational purposes only. 9/01.