Courtney Papanicolaou became a vegetarian in 2011 after her dermatologist advised a plant-based diet could help boost her immune system and in turn treat her tinea versicolor, a fungal skin condition that causes discolored patches of skin. She had no intention of changing her diet once she became pregnant with her first child born in 2019 or when she began breastfeeding. (And yes, it's fine to be vegetarian and pregnant.) "I happened to make a very healthy and full-term baby so why would I need meat now?" says Papanicolaou, who lives in Washington, D.C.
Why indeed? Whether it comes as unsolicited advice from a well-meaning family member or a gentle suggestion from a lactation consultant, “You're going to need to eat lots of meat to get all the right nutrients,” is a common, yet misinformed refrain, mothers that are vegans, vegetarians and even pescartians and flexitarians often hear. Although these women already hear it when they're pregnant, the flack continues during breastfeeding, a time when moms typically need about 450 to 500 extra calories a day.
"Our culture is very focused on meat," says Lisa Doggett, M.D., a family physician based in Austin, Texas. "Some people believe that our bodies need meat, especially women who are breastfeeding. But a growing body of evidence does not favor a meat-rich diet for optimal health." Dr. Doggett, a vegetarian for more than 25 years, breastfed each of her daughters, now 11 and 14, for a year. Throughout her career, she has counseled patients of all ages about the importance of a healthy diet, including when breastfeeding.
Research has found a majority of vegetarian mothers breastfeed and may be doing so at larger rates than non-vegetarian mothers. And a 2019 study published in the journal Nutrients, concluded that “well planned vegetarian and vegan diets may be considered safe during pregnancy and lactation, but they require a strong awareness for a balanced intake of key nutrients.”
Experts weigh in on what you need to know about vegetarian breastfeeding and how to make sure you are consuming all the right ingredients.
How a Vegetarian Diet Affects Your Breast Milk
Breastfeeding moms may need more calories, but those don't have to all be protein-based. "I think we have an overemphasis on protein," says Dr. Doggett. "Many Americans get more protein than necessary and protein deficiency in the U.S. is very rare."
Breast milk is made up of a whole host of ingredients, including white blood cells, stem cells, proteins, amino acids, enzymes, hormones, vitamins and minerals water, antibodies, fat, and carbohydrates. “A vegetarian can absolutely breastfeed successfully, and her breast milk won't be lacking anything that a meat eating mother's milk has,” says Diana Gariglio-Clelland, a Washington-based certified lactation educator and registered dietitian at Balance One Supplements. A vegetarian diet also won't cause a low milk supply any more than a regular diet, as long as Mom is consuming adequate amounts of iron, calcium, vitamin B12, and zinc.
Keep in mind, like any moms, vegetarians may have to adjust their diet while breastfeeding if they notice that, after they’ve eaten certain foods, their tot becomes fussy. Since she started breastfeeding her 6-week-old daughter, for example, Papanicolaou has stayed away from dairy products. Aside from not craving them as much, she noticed her daughter vomited on two occasions when she breastfed her after eating ice cream. Sometimes, says Gariglio-Clelland, healthcare providers may suggest a new mother does a trial elimination diet of common allergens, such as wheat, dairy, and soy, if a baby has a suspected intolerance or allergy, but most of the time a mother’s diet won’t drastically alter her breast milk.
'I think we have an overemphasis on protein,' says Dr. Doggett. 'Many Americans get more protein than necessary and protein deficiency in the U.S. is very rare.'
Vegetarian Breastfeeding Issues
The reality is vegetarians do need to eat a variety of foods to make sure they are getting the right kinds of nutrients. "Continuing prenatal vitamins and eating a healthy, well-balanced diet with lots of different kinds of fruits, veggies, whole grains, legumes, and often soy, with or without low-fat dairy and eggs, is important," says Dr. Doggett.
But she suggests always talking with your doctor first about your diet when breastfeeding. It's a good idea to inquire about taking a supplemental vitamin B12, something that is recommended for vegans especially, whether they are breastfeeding or not, as B12 is naturally found in animal products. It also worthwhile to ask your doctor to check your iron levels as typically vegetarian diets are not as rich in iron as diets that include meat. To lower your risk of anemia, Dr. Doggett says to incorporate iron-rich foods into the diet, such as legumes, green leafy veggies, and tofu. Then there's zinc and calcium, two other minerals more commonly found in animal products. Look to consume whole grains, legumes, seeds, and nuts for zinc, and soy, dairy products, beans, and lentils for calcium.
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Papanicalaou focuses on consuming all these nutrients and some of her go-to meals and snacks are oats, salads, tofu, and Japanese sweet potato covered in guacamole and tomatoes. "I really don't feel limited," she says.
Experts say vegan and vegetarian moms can certainly breastfeed successfully as long as they are getting all their key nutrients. So make sure to incorporate enough iron, calcium, vitamin B12, and zinc into your diet and Baby will be just fine.