Do I need to eat more calories if I'm breastfeeding?

[Note: This article is being published in draft form for use in an active research study. Its contents may be adjusted as we receive feedback from collaborating health care professionals.]

There are few evidence-based recommendations regarding caloric intake and dietary recommendations when breastfeeding. The Dietary Guidelines for Americans as well as guidelines developed by the Institute of Medicine recommend that women who are lactating maintain a healthy diet similar to that recommended for all women.^1,2 There is no clear evidence that a healthy diet can improve the quality or volume of milk production. Calorie needs vary based on many factors including height, weight, and level of activity, but they increase by an estimated 330 calories for the first six months of lactation and 400 calories for the second six months of lactation.

Guidelines emphasize prioritizing increasing caloric intake using nutrient-dense foods.^1,2 Examples of nutrient-dense foods include vegetables, fruits, whole grains, seafood, eggs, beans, peas, lentils, unsalted nuts and seeds, fat-free and low-fat dairy products, and lean meats and poultry when prepared with little or no added sugars, saturated fat, and sodium. Exact daily dietary recommendations for 1,800-2,800 calorie diets include:

• 5-3.5 cups of vegetables
• 5-2.5 cups of fruits
• 6-10 oz of grains
• 3 cups of dairy
• 5-7 oz of protein foods (meats, poultry, eggs, seafood, nuts, seeds, and soy products)
• 24-36 g of oils
• Limiting intake from other sources to 140-370 calories

Based on limited research, nominal dieting and weight loss do not usually negatively affect lactation. A short-term study from 1986 (n=22) found that women who reduced their caloric intake by 19-53% (average caloric reduction from 2,316 to 1,591) for a week did not significantly affect mean infant intake (average intake dropped from 736 grams per day to 718).³

References

1. Dietary Guidelines for Americans, 2020-2025. 9th ed: US Department of Agriculture and US Department of Health and Human Services; 2020.
2. Nutrition during lactation. National Academy Press; 1991.
3. Strode MA, Dewey KG, Lönnerdal B. Effects of short-term caloric restriction on lactational performance of well-nourished women. Acta Paediatr Scand. Mar 1986;75(2):222-9. doi:10.1111/j.1651-2227.1986.tb10188.x