Since I just got done researching and presenting a session entitled, "Maternal Diet, Exercise and Breastfeeding"  I thought that I should probably add something to this thread.  Due to the ethics involved, there is not a lot of long-term research into the effects of caloric deprivation on breastmilk production.  However, there are studies, many of which, seem to point in the same direction on a couple of points.

First of all, breastmilk production is extremely efficient and the oft-quoted "500 calories a day" needed for milk production is indeed, highly theoretical.  Both lactating and non-lactating mothers, if they are not consciously trying to diet, will lose weight at about the same rate, about 1.5 - 3 pounds per month.  Most of these moms were consuming around 2200 cal/day, give or take a few hundred.  Those who consumed the "recommended" 2700 cal/day or more did not lose weight or even gained weight.

There was a study on baboons which showed no drop in milk production at 80% of ad lib intake, but there was a significant drop when the intake was restricted to 60% of usual.  In human studies, there also seems to be a tipping point somewhere between 60 and 80% where milk production may be affected.

In a retrospective study, the few moms who reported problems with supply were also in the group with the lower intake, very close to that when they were not lactating.  One mother reported that she was able to drop supplemental feedings when she doubled her caloric intake from 1950 to 3910 cal/day.

As for the effect of fat stores, there are studies, both on chronically undernourished populations and normally well-nourished mothers that show that women who are very lean to begin with are more likely to suffer decreases in milk supply when diet is restricted during lactation.  Again, there seems to be a tipping point which may differ between different mothers or groups of mothers.  The body seems to have a lot of mechanisms, including the use of prolactin, to support lactation during calorie deprivation.

My conclusion after reading a lot of papers, both abstracts and full studies, is that we still have a lot to learn about this issue.  However, I think that diet can have an effect on production in some women and that being very lean before and during pregnancy may put them at slightly higher risk of production problems if diet is restricted.  I have seen in my own practise an increase in production when moms add 500-1000 cal/day to their diets, when they were a little on the low side to begin with. My inclination is to encourage a higher intake of protein and healthy fats in those moms in order to better support lactation.

Some commented in a post about the safety of low carb diets and their reliance on higher fat intake.  A few thoughts on this.  For millions of years many humans existed on what was basically a low carb diet - lots of meat, often raw, supplemented with berries and roots when available.  The reliance on carbs such as rice and flour is a relatively new diet regime for humans - I think that some have adapted to this and some have not.  The difference today is that our meat is high in saturated fat and low in omega-3 fatty acids, unlike most game which is quite lean and contains omega-3s, due to the fact the wild animals eat mainly grasses, not corn and other mass-produced foods.  So I would advise those who are pursuing a low-carb lifestyle to  consider substituting wild game or range-fed animals for the usual meats founds in the supermarket isles.

Well, I have to go to a meeting and will end here.  I have a very long bibliography on this topic.  If you would like a copy (in word format), I would be happy to email it to you as an attachment.



Warmly,
Sharon Knorr, BSMT, ASCP, IBCLC
Newark, NY (near Rochester on Lake Ontario)
mailto:[log in to unmask]

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