By Julia Quam, MSPH, RDN, ORISE health policy fellow, Office of Disease Prevention and Health Promotion and Dennis Anderson-Villaluz, MBA, RD, LDN, FAND, nutrition advisor, Office of Disease Prevention and Health Promotion
August is National Breastfeeding Month and this year’s theme, Every Step of the Way, emphasizes providing coordinated support to meet the needs of breastfeeding families throughout this life stage. For the first time, the Dietary Guidelines for Americans, 2020–2025 includes an entire chapter dedicated to nutrition during pregnancy and lactation. Health professionals can use this information to support healthy eating for mothers who are breastfeeding, which benefits both the mother and baby.
Healthy Dietary Patterns While Breastfeeding
The Healthy Eating Index (HEI) score, which measures diet quality on a scale from 0 to 100 based on the Dietary Guidelines, is 62 for mothers who are breastfeeding compared to 54 for peers who aren’t pregnant or breastfeeding. Although diet quality is slightly higher, there’s still plenty of room for improvement. Mothers who are breastfeeding can adopt similar strategies as those recommended for adults, including:
- Increase vegetables, fruits, whole grains, and dairy
- Decrease added sugars, saturated fat, and sodium
- Achieve adequate dietary levels of the nutrients of public health concern — calcium, vitamin D, potassium, and dietary fiber
Health professionals can provide mothers who are breastfeeding with consumer-friendly information on healthy dietary patterns from MyHealthfinder.
Special Considerations for Mothers Who Are Breastfeeding
In addition to following the nutrition recommendations for the general U.S. population, mothers who are breastfeeding and health professionals who support them should keep these special considerations in mind:
- Weight management: It’s important to balance the additional calories needed for milk production with the goal of returning to a healthy weight in the postpartum period. About 1 in 7 mothers move from a healthy weight classification before pregnancy to an overweight classification postpartum, which may have long-term health consequences.
- Increased energy needs: For those with a healthy prepregnancy weight, estimated energy needs during the first 6 months of lactation are about 330 calories higher compared to prepregnancy energy needs. This increases to 400 calories during the second 6 months of lactation. Health professionals should tailor guidance on energy needs to each individual, considering factors such as prepregnancy weight status and gestational weight gain. It’s also important to encourage nutrient-dense food choices as part of a healthy dietary pattern.
- Increased needs for folate, iodine, and choline: It’s possible to meet increased folate needs by eating plenty of dark green vegetables and beans, peas, and lentils. Those who don’t regularly consume dairy products, eggs, seafood, or use iodized table salt may not consume enough iodine to meet increased needs. Health professionals shouldn’t encourage anyone to start using table salt, but they should recommend mothers check that any table salt they’re already using is iodized. In addition, most who are breastfeeding don’t meet recommended intakes of choline. Food sources include eggs, meats, and some seafood — as well as beans, peas, and lentils. Some may also need supplements containing iodine and/or choline to achieve adequate intake.
- Supplements: More than half of women continue to use prenatal supplements while they’re breastfeeding. Since nutrient needs differ for those who are breastfeeding and those who are pregnant, continuing to use these supplements may exceed iron and folic acid needs. Health care providers should consider this when advising on supplementation during breastfeeding.
- Seafood: Health professionals should encourage mothers who are breastfeeding to consume at least 8 and up to 12 ounces of a variety of seafood per week, from choices lower in methylmercury. The U.S. Food and Drug Administration (FDA) and the U.S. Environmental Protection Agency (EPA) provide joint advice regarding seafood consumption to limit methylmercury exposure for those who might become pregnant — or those who are pregnant or breastfeeding.
- Alcohol: Not drinking alcohol is the safest option while breastfeeding. Generally, moderate consumption of alcoholic beverages by a mother who is breastfeeding (up to 1 standard drink in a day) is not known to be harmful to the infant, especially if the mother waits at least 2 hours after a single drink before nursing or expressing breast milk. The Centers for Disease Control and Prevention (CDC) provides additional information on breastfeeding and alcohol.
- Caffeine: Caffeine passes through breast milk in small amounts, but it usually doesn’t adversely affect the infant when the mother consumes low to moderate amounts (about 300 milligrams or less per day, which is about 2 to 3 cups of coffee). More information about breastfeeding and caffeine is available on CDC’s website.
Resources for Supporting Mothers Who Are Breastfeeding
The postpartum period is a special time, and adopting healthy dietary patterns during this life stage has important health benefits for moms and babies. However, many mothers face challenges that may impact their ability to adopt healthy dietary patterns and meet their breastfeeding goals. Government programs such as the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and the Supplemental Nutrition Assistance Program (SNAP) can help families facing food insecurity. MyHealthfinder also provides easy-to-understand information about breastfeeding and how to get help. These resources can help ease the burden on mothers who are breastfeeding, enabling them to meet their breastfeeding goals while also achieving a healthy dietary pattern.
