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Plant-based nutrition during lactation
Table of Contents
1. The types of plant-based dietary regimens and the safety of their use
Among the diätetischen Ernährungsformen on a plant-based basis, 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 well-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 'well-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
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 breastfeeding period
The breastfeeding period is the time when the demand for most vitamins and minerals in the plant-based diet changes. Source: Kibil I., Wege. Plant-based diet in practice, Warsaw 2023. During breastfeeding, the demand for vitamins C, E and B may increase, however, if the diet includes products commonly found in the plant-based diet (whole grains of cereal grains, oat flakes, legumes, nuts, seeds or green vegetables), providing them in the right amount should not be a problem. The demand for vitamin A may almost double – it is therefore worth including fruits and vegetables that are a source of beta-carotene (e.g. carrot, pepper, sweet potato, pumpkin, tomatoes, spinach, peach) in meals and eating 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 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 based on the assessment of its reserves in the body.4. Fluid substances
During breastfeeding, the requirement for fluid substances also rises from 2000 ml to 2700 ml. This encompasses both beverages (water, juices, vapors) and water ingested through food (in the form of soup, found in fruits, vegetables, etc.).5. Beverage made from roasted and ground coffee beans
Due to its caffeine content, doubts may arise regarding the consumption of coffee. 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 found in drinks such as cola, as well as in cocoa and chocolate.6. Dietary supplementation
The application of a plant-based diet is linked with the necessity to introduce supplements to maintain a satisfactory nutritional state for a woman and to support appropriate food production. The table displays the doses of components that should be supplemented. It is worth noting 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 to eschew during breastfeeding
During breastfeeding, elimination diets are not required unless the mother's health necessitates them. Additionally, there is no need to cease 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 understood. However, the mother's diet does not impact its occurrence. Thus, it is not necessary to exclude products considered gassy (e.g., onions, cabbage, legumes) if they are well-tolerated by the nursing mother. Potentially allergenic foods should also not be avoided prophylactically.8. Effect of the vegan diet on the composition of female milk
Previous scientific research indicates that female milk contains comparable amounts of macro- and micronutrients in the traditional and plant-based diet (N. Ureta-Velasco et al., 2023; M. Perrin et al., 2022). Some differences have been observed in the concentrations of vitamin B12 and DHA, which are often lower in those consuming a plant-based diet, confirming the need for additional supplementation. The importance of adequate energy intake is also emphasized. Individuals following a plant-based diet often 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.
