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Plant-based nourishment during lactation
Table of Contents
1. Types of plant-based dietary regimens and the safety of their application
Among the plant-based dietary regimens, there are various variants - the most popular ones include vegetarianism (also known as lacto-vegetarianism), which involves abstaining from eating meat and fish, but allowing animal products (e.g. eggs, milk, honey), and veganism, which excludes meat, fish, and all other animal-derived products. Some people also abstain from dairy, but in their diets they allow consuming eggs (ovo-vegetarianism) or including dairy products in their diets, but excluding eggs (lacto-vegetarianism). The position of the American Academy of Nutrition and Dietetics states that properly planned vegetarian and vegan diets can be safely used during any stage of life, including lactation. This opinion is also supported by the Polish group of experts on nutrition recommendations during lactation (A. Bzikowska-Jura et al. 2023). However, the term 'properly planned' is key, which means that the diet must be balanced in such a way as to provide necessary amounts of nutrients and energy and at the same time consider the needs of breastfeeding women.2. Energy and Macronutrients in the Diet of Breastfeeding Women
It is assumed that the total energy consumption during this period increases by about 500 kcal during the first 6 months of lactation and gradually decreases over the next few months. Additional energy can be provided by increasing the amount of food already consumed or by introducing an additional snack. Consumption of a small amount of energy can also reduce the nutrient intake in the context of dietary acidity, thus negatively affecting the production of omega-3 fatty acids from the source of coconut oil or from the body of the ovaries.3. Micronutrients during the breastfeeding phase
The phase in which breast milk is the primary source of nutrition for infants is characterized by changing requirements for most vitamins and minerals in a plant-based diet. Source: Kibil I., Wege. Plant-based diet in practice, Warsaw 2023. During breastfeeding, there may be a need for increased intake of vitamins C, E and B, however, providing them in the right amounts should not be a problem if the diet includes products typical of a plant-based diet, such as whole grain cereals, oat flakes, legumes, nuts, seeds or green vegetables. The requirements for vitamin A may even be twice as high as before – therefore, it is advisable to include fruits and vegetables that are a source of beta-carotene, such as carrots, peppers, sweet potatoes, pumpkin, tomatoes, spinach or peaches, in meals and to consume them in combination with fat sources that facilitate the absorption of beta-carotene (converted to the active form of vitamin A). Vitamin B12 naturally occurs only in animal-derived food, therefore people on a vegan diet can only obtain it from fortified products and dietary supplements. During breastfeeding, the demand for this vitamin may increase, hence it is worth considering including individual-tailored supplementation to ensure adequate intake.4. Liquid substances
During breastfeeding, the necessity for liquid substances also increases from 2000 ml to 2700 ml. This includes both beverages (water, juices, herbal extract) and water derived from food (in the form of soup, contained in fruits, vegetables, etc.).5. Beverage prepared from roasted and ground coffee beans
Due to the caffeine content in coffee, doubts may arise regarding its consumption. Currently, the European Food Safety Authority (EFSA) considers it safe to consume 200 mg of caffeine per day, which is equivalent to about 2 cups of coffee or 6 glasses of tea. It should be noted that caffeine is also present in drinks such as cola, as well as in cocoa and chocolate.6. Nutritional support
The use of a plant-based diet is associated with the necessity to introduce supplements to maintain an appropriate nutritional status for a woman and to support adequate food production. The table displays the doses of components that should be supplemented. It is important to note that some women may require the use of additional supplements or different doses, therefore, consultation with a doctor is recommended. Source: Kibil I., Wege.7. What should be avoided during breastfeeding
During breastfeeding, it is not necessary to adhere to elimination diets unless the mother's health demands it. Additionally, there is no need to discontinue nursing if the infant develops colic. This is a disturbance of the infant's digestive tract that resolves on its own, and its causes are not well comprehended. The mother's diet, however, does not impact its occurrence. Consequently, it is not essential to exclude products deemed to be flatulent (e.g., onions, cabbage, legumes) if they are well-tolerated by the nursing mother. Potentially allergenic foods should also not be avoided prematurely.8. Impact of Vegan Diet on the Composition of Female Milk
Current scientific research indicates that the composition of female milk is comparable among individuals following traditional and plant-based diets (N. Ureta-Velasco et al., 2023; M. Perrin et al., 2022). However, differences have been observed in the concentrations of vitamin B12 and DHA, which are often lower in individuals consuming a plant-based diet, confirming the need for additional supplementation. The significance of adequate energy intake is also highlighted. Individuals following a plant-based diet typically consume fewer calories than those following a traditional diet. Although initial insufficient energy intake does not affect the amount or quality of milk, it can lead to maternal undernutrition, which can have negative health consequences and in extreme cases, lead to reduced milk production.
