What to eat while breastfeeding for the health of the child and the mother?

When breastfeeding, the mother's diet must be adapted to limit the intake of substances harmful to the infant, such as :

• There caffeine, theophylline and theobromine : these substances pass easily into breast milk. In excess, they would disrupt the sleep and development of the infant (especially if the latter is premature).

• Trans fatty acids: a trans fatty acid designates a particular geometric configuration. Trans fatty acids reduce breast milk lipid levels. However, lipids are essential for the development of infants (they represent 50% of the infant's total energy intake (AET). In addition, trans fatty acids may increase the risk of eczema in children.

• Phytoestrogens: phytoestrogens are molecules available in foods of plant origin. Thanks to their structure close to estradiol (a hormone from the estrogen family), they have estrogenic activity, that is, they are capable of binding to estrogen receptors. Phytoestrogens decrease iodine absorption, affecting iodine levels in breast milk. In excess, phytoestrogens promote thyroid development disorders in infants.

• Phytosterols: phytosterols are compounds naturally present in plants. They belong to the sterol family, like cholesterol. Phytosterols interfere with the absorption of other nutrients, including beta-carotene. In excess, there is a drop in the concentration of beta-carotene in breast milk and in the blood of infants. Beta-carotene is important for the growth of babies.

• Mercury : once in the environment, mercury is transformed into methyl mercury by bacteria. Mercury passes into breast milk. In excess, it disrupts the development of the child's brain and nervous system.

Conversely, the mother's ideal diet emphasizes:

• Omega-3s: it would seem that an omega-3 deficiency or an imbalance between the omega-6 and omega-3 ratio would increase the risk of pathologies (obesity, skin disorders) in infants. In addition, breast milk rich in omega-3 shows better neurological maturation in the newborn.

Apart from the nature of lipids, the dietary recommendations for breastfeeding women aim to preserve the mother's reserves. The body draws on the mother's reserves, even if they are thin: the needs of the newborn come before those of the mother. It is therefore more than necessary to build up solid nutritional reserves by focusing on the following nutrients:

• The water : fluid needs increase in breastfeeding women. Breast milk is 90% water, which represents on average 450 mL to 810 mL of water per day used to make milk.

• THE calcium : in 100 mL of breast milk, we find on average 30 mg of calcium. The quantities consumed by a baby in a day are between 150 and 270 mg of calcium used to make milk. Increasing calcium requirements preserves the integrity of the mother's skeleton.

• There vitamin D : vitamin D improves the digestive utilization coefficient (CUD) and bone fixation of calcium. The CUD corresponds to the absorption rate: the higher its score, the better the absorption of the nutrient.

• There vitamin A : vitamin A is part of the composition of milk. It is essential for the growth of the infant. To meet the infant's needs as well as their own, vitamin A requirements increase in breastfeeding women, rising to 1300 µg/day (needs are 650 µg/day in women).

• There vitamin B9 : vitamin B9 requirements increase in breastfeeding women: 500 µg/day, compared to 330 µg/day in women. This vitamin contributes to the development of the nervous system in newborns. It is just as important for breastfeeding women, since it participates in cellular metabolism: synthesis of DNA, RNA, red blood cells, neurotransmitters, white blood cells, etc.

Milk production has a significant energy cost. Therefore, it is wise to favor:

• foods with a moderate glycemic index weak : the glycemic index is a reflection of blood sugar levels after ingesting a food. The lower the score, the more balanced the blood sugar level: the absorption of carbohydrates is slow, which provides energy throughout digestion. Providing energy throughout the day prevents post-feeding hypoglycemia and the fatigue that accompany it.

Alcohol passes into breast milk 30 to 60 minutes after consumption. The newborn's immature body is incapable of metabolizing alcohol, which disrupts its development. Alcohol consumption also decreases lactation.

We recommend you :

• not to consume alcohol.

• not to consume culinary preparations containing alcohol: alcohol-based chocolate (liqueur chocolate), coq au vin, baba au rhum, wine-poached pear, flambéed bananas, original tiramisu (liqueur-based), sauce béarnaise, crepes (suzettes, with beer or rum), black forest, Savoyard fondue, certain fruit cakes, etc.

• for your dishes deglazed with alcohol, let your preparation simmer for at least 2 hours to let the alcohol evaporate: beef bourguignon, pot au feu, blanquette de veau, chicken Basquaise, braised veal, braised fish, etc.

Caffeine, theophylline and theobromine are stimulants. Reasonable consumption of these components does not affect the child. In excess, observational studies indicate that children are more agitated and irritable, which disrupts their sleep.

We recommend you :

• 2 to 3 standard cups of coffee per day maximum.

• consume a maximum of 1 L of tea per day.

• to opt for decaffeinated coffee or decaffeinated tea.

• to limit chocolate-based foods: a maximum of 10 squares of dark or milk chocolate per week (around 50 g).

• avoid energy drinks, energy bars, cola drinks, guarana powder, mate, etc.

In excess, trans fatty acids reduce the lipid concentration of breast milk and increase the risk of skin pathology and the prevalence of obesity.

We recommend you :

• to favor home cooking.

• to favor “natural” fats: cold-pressed vegetable oils, butter, crème fraîche, etc.

• avoid hydrogenated margarines.

• to avoid ultra-processed products.

Phytoestrogens reduce the absorption of iodine, which increases the risk of thyroid disorders in infants. In small quantities, the impact of phytoestrogens is not visible. Above 1 mg/kg/day, risks for the infant are present.

We recommend you :

• a maximum of one soy product per day (soy vegetable oil does not contain phytoestrogen, it is not affected by these restrictions).

• if you regularly consume soy products, it is preferable to increase your iodine intake by consuming seafood, seaweed and iodized salt.

Phytosterols are part of the composition of many plants. It does not cause any particular problem if consumption remains decent. It is the excess, through products enriched with phytosterols, that would be problematic.

We recommend you :

• to favor butter for spreads.

• to favor cooking with vegetable oil.

Considering the recommended consumption, fish are our main sources of mercury. Mercury accumulates in the muscle tissues of fish. Be careful, not all fish are equal: the mercury concentration is higher in fish-eating fish (predators). By consuming their prey, they absorb large amounts of mercury. In addition, certain species of fish accumulate mercury particularly more than other species. These are fatty fish that live in contact with sediments, we speak of bioaccumulator fish.

Please note: although tuna is a predatory fish (rather at the end of the food chain), the restrictions particularly concern fresh or frozen tuna. Concerning canned tuna, the restriction is gentler, because the fish used for canning are younger and smaller in size than fresh tuna. We distinguish between canned light tuna and canned white tuna (or albacore or albacore). Canned white tuna contains more mercury than light tuna. Thus, only canned white tuna (albacore or albacore) have consumption restrictions.

We recommend you :

• to avoid swordfish, marlin, siki, lamprey and shark.

• to consume a maximum of 150 g per week of wild predatory fish: monkfish (or monkfish), bass, bonito, tuna (fresh or frozen), salmon, scabbardfish, skate, eel, emperor, grenadier, halibut, pike and sea bream.

• to consume a maximum of once every 2 months freshwater fish that are highly bioaccumulators: eel, barbel, bream, carp and catfish.

• consume a maximum of 300 g per week of canned white tuna (albacore or albacore).

• to vary the origin, fishing locations and supply methods (wild or farmed).

From the moment of pregnancy, the child gets used to family eating habits through amniotic fluid. During breastfeeding, the mother's diet also modulates the smell or taste of breast milk. Sometimes, the baby may be less fond of milk due to changes in flavors. This depends on your personal experience, your eating habits and your baby's tolerance. It's up to you to observe your baby, in order to find a possible correlation between a food and the sudden refusal of breast milk.

Here is a list of potentially unpleasant foods for babies : garlic, cabbage, cauliflower, citrus fruits, asparagus, broccoli, artichokes, raw onions, chili pepper, cumin, mint, cooked meats, anise, etc.

The production of breast milk requires water. As a result, water needs increase from 500 mL to 1 L per day.

To know if you are drinking enough, look at the color of your urine. If they are dark, this indicates that you are lacking water. If they are clear, great, you are hydrating your body enough.

We recommend you :

• to drink at least 2 L of water throughout the day.

• to opt for herbal teas to help cover fluid needs. L'anise, THE fennel and fenugreek, cumin and caraway are galactogenic plants: they stimulate the production of breast milk.

• it is possible to optimize your calcium intake by using mineral water sources of calcium: Hépar®, Courmayeur®, Contrex®, Salvetat®, Vittel®, etc.

Small fatty fish are perfect to accompany breastfeeding thanks to their perfect nutritional composition. They bring :

• omega-3: mackerel and sardines provide on average 3 mg of omega-3 (alpha-linolenic acid, EPA and DHA) per 100 g of fish consumed. In addition, they contain little omega-6, around 0.1 mg per 100 g. They therefore help to rebalance the omega-3/omega-6 ratio. This advantage would improve the quality of breast milk lipids.

• vitamin D: they contain on average 5 µg of vitamin D per 100 g. They meet more than a third of the needs of breastfeeding women alone.

• of the'iodine : with their 35 µg of iodine in 100 g of mackerel or sardine, they contribute to iodine intake. Iodine participates in the functioning of the thyroid. Iodine requirements increase in breastfeeding women.

• mercury is almost absent: mackerel and sardines are among the first links in the aquatic food chain. The amounts of mercury they contain are low. The body manages to manage the little mercury they carry.

• moreover, they contribute to the needs of calcium and of vitamin B9. The quantities are small, but notable.

We recommend you to eat at least one mackerel or sardine dish per week.

Dairy products provide several interesting micronutrients for breastfeeding women:

• Water : milk is made up of more than 85% water. It helps cover water needs.

• Calcium : dairy products are the foods richest in calcium. In addition, this calcium is well absorbed, because the phosphocalcic ratio is slightly greater than 1, that is to say, phosphorus does not compete with calcium during absorption.

• Vitamin D : dairy products provide vitamin D. Vitamin D improves the absorption of calcium.

• Vitamin A : we find interesting contributions in retinol. Cheeses are richer, with 90 µg of retinol for a serving (30 g), 37 µg of retinol for 1 yogurt (125 g) and 35 µg for 100 mL of milk.

• Probiotics : cheeses and fermented milks (yogurt, buttermilk, kefir, lassi, etc.) are inoculated with lactic acid bacteria. These bacteria can belong to the genera Bifidobacterium or Lactobacillus. In nutrition, these bacteria are called probiotics: live microorganisms that have positive effects on our health. Studies show that taking probiotics in pregnant or breastfeeding women helps prevent and treat atopic diseases.

If you do not consume dairy products, it is possible to consume plant-based drinks (almond milk, rice drinks, soy drinks, oat drinks, etc.). Although they provide less calcium and lack vitamin D and vitamin A, they contain more PUFA.

We recommend you :

• to consume 2 to 4 dairy products per day.

• to favor seasonal cheeses. They contain more vitamin A thanks to grazing by cows, sheep, goats or mares.

• avoid skimmed milk. Skimming milk removes fat-soluble vitamins, such as vitamins A and D.

• to vary the origin of the milk: sheep, cow, goat, buffalo, etc.

As always, fruits and vegetables are to be encouraged. They are full of many nutrients necessary for successful breastfeeding:

• Water : mainly composed of water (80 to 90%), they help to cover water needs.

• Fibers : fiber reduces the blood sugar load of foods. Fruits and vegetables balance blood sugar. Balanced blood sugar levels limit fatigue caused by breastfeeding.

• Vitamin B9 : fruits and vegetables are the foods richest in vitamin B9.

• Beta carotene : beta-carotene is a precursor of vitamin A. The latter is important for child development. Plants help maintain stable reserves in the mother.

• Calcium : plants provide a significant amount of calcium. There is an average of 210 mg of calcium in 600 g of plants (daily portion), or 22% of the RNP of breastfeeding women.

We recommend you :

• to consume 2 fruits per day

• consume at least 3 servings of vegetables per day

• to favor plants rich in beta-carotene and vitamin B9: spinach, broccoli, asparagus, lettuce, cabbage, passion fruit, arugula, watercress, pepper, leeks, mangoes, peas, tomatoes, carrots, melons, papayas, green beans, watermelons, etc.

• to prefer local and seasonal fruits and vegetables, they are richer in vitamin B9.

• to increase your beta-carotene intake, it is possible to take a course of Urucum: 100 g of Urucum provides 1305 mg of beta-carotene.

Nuts are interesting foods for their supply of alpha-linolenic acid (ALA, an omega-3). There is an average of 1 mg of ALA in 100 g of nuts. In addition, they are full of calcium, fiber and vitamin B9.

Cold-pressed vegetable oils are also a good way to enrich your diet with alpha-linolenic acid.

We recommend you :

• to consume 1 handful (15 g) of nuts per day. THE nut are the richest in ALA: around 1.1 mg for 15 g of nuts, compared to 0.15 mg for other nuts. Walnuts are also the richest in vitamin B9, alongside almonds : 18 µg for 15 g of nuts or almonds.

• consume 10 to 20 g of cold-pressed vegetable oil rich in omega-3 per day: soya oil, linseed oil, Colza oil, nut oil, camelina oil, chia oil, wheat germ oil, etc. Linseed oil is the richest in ALA: 5.3 mg of ALA in 15 g of linseed oil, compared to 0.3 mg for other vegetable oils.

• to consume raw vegetable oils. Heat destroys omega-3s.

Thanks to fiber, whole starchy foods will limit fatigue caused by breastfeeding. They harmonize blood sugar levels by regulating the absorption of carbohydrates. In addition, cereals and pulses provide calcium and vitamin B9.

We recommend you :

• to consume semi-complete or whole grains with each meal.

• to eat at least two meals per week with dried vegetables: lentils, dried beans, broad beans, chickpeas, etc.

Breast milk is made up of vitamin A. To preserve the mother's reserves and meet the child's needs, it is preferable to ensure their retinol intake. Beta-carotene (or provitamin A) also has biological activity. It is a precursor of retinol.

We recommend you :

• to consume 20 g of butter per day. 20 g of butter provides 160 µg of retinol, which represents approximately 13% of the daily needs of a breastfeeding woman.

• to consume 2 to 6 eggs per week. Egg yolk is rich in vitamin A: 1 egg yolk provides approximately 70 µg of vitamin A.

• to favor cheeses rich in vitamin A: Parmesan, Munster, Gorgonzola, Ossau-Iraty, Tome de Savoie, Comté, Gruyère, Abundance, Cheddar, Emmental, etc.

• to consume foods rich in beta-carotene: seaweed, sweet potatoes, carrots, pumpkin, cabbage, lettuce, fresh aromatic herbs, etc.

• While breastfeeding, no drastic diet: After pregnancy, many women seek to return to their ideal weight as quickly as possible. However, breastfeeding is just as important a phase as pregnancy. Weight control should not be a goal while breastfeeding. It will happen gradually with the return of lifestyle habits. While knowing that breastfeeding reduces the risk of being overweight (provided the diet is balanced).

• Be careful with diets without animal products: Exclusion diets are generally not recommended during breastfeeding, particularly vegan diets. For the health of the mother and her child, it is obvious that vitamin B12 supplementation must be impeccable: quality food supplements at recommended doses and without forgetting. In addition, iron supplementation may possibly be suggested by a healthcare professional. However, it seems that a vegetarian diet is safe for breastfeeding, and even the breast milk of a vegetarian woman would contain less “pollutant” than the breast milk of an omnivorous woman.

• Appropriate physical activity: lSports activity is recommended during breastfeeding. It tones the muscles and helps return a healthy weight. Did you know that sport changes the taste of breast milk. Studies have found an increase in lactic acid levels in breast milk after moderate to vigorous exercise. As a result, breast milk is slightly more acidic. It doesn't seem not to have negative effect for the newborn, except a possible reluctance to breastfeed (which is exceptional). To overcome this refusal, the authors recommend showering and taking a few milliliters of milk from each breast to throw it away. 

Although honey never expires, it is not free of microorganisms. Indeed, honey is an identified source of the spore of a bacteria called Clostridium botulinum. This bacterium secretes very resistant spores. Once in the body, the spores produce a toxin (also resistant) which attacks the nervous system. It is one of the most dangerous bacteria in our food. Clostridium spores are mainly found in dust and certain soils. When a bee forages, it can carry pollen containing a Clostridium spore, and thus contaminate the honey.

Babies' immune systems are immature, so they are particularly susceptible to infections. That's why honey is prohibited for children under one year old.

On the other hand, lactating women can consume honey, because Clostridium spores do not pass into breast milk.