Breastfeeding Nutrition: Country Specific Recommendations

Here are a few specific nutrient recommendations for breastfeeding women in the United States (US) and United Kingdom (UK). As you’ll see, some of these differ, so choose which recommendations you want to follow!

UNITED STATES

Fish Intake & Mercury—
Fish is a good source of vitamins, minerals and essential omega 3 fatty acids. The American Academy of Pediatrics (AAP) recommends an average daily intake of 200-300mg of omega 3 long-chain polyunsaturated fatty acids (docosahexaenoic acid [DHA]). This can be met through the consumption of 1-2 portions of fish a week. The general guideline is to aim for 8-12 ounces of cooked fish a week, choosing lower mercury containing fish (examples are herring, canned light tuna, salmon, flounder, tilapia, trout, pollock, catfish) while avoiding intake of predatory fish (e.g., shark, pike, marlin, King mackerel, swordfish, tile fish) due to their likely higher mercury levels. For the same reason, choose light canned tuna instead of canned “white” tuna (albacore). If you consume canned “white” tuna (albacore), have less than 6 ounces a week. If you don’t include fish in your diet, then some non-fish sources of omega 3 fatty acids are canola oil, soybean oil, ground flaxseed and walnuts.

Calcium—
In the United States, the calcium recommendations are the same for adult breastfeeding and pregnant women (19-50 years of age) at 1000mg/day. Look for calcium rich sources like dairy products, calcium and vitamin D fortified drinks, breakfast cereals and breads fortified with calcium.

Vitamin D—
For a breastfeeding mother, 600 international units (IU) or 15 ug of vitamin D is recommended daily. It is generally easier to meet these recommended vitamin D intakes in the United States because more commercial products tend to be fortified with vitamin D. Examples are many cow’s milk, yogurts, and cheese dairy products, calcium and vitamin D fortified soy milk and juices, and breakfast cereals like General Mills Total® cereal.

Vitamin & Mineral Supplementation—
According to the AAP, there are currently no routine recommendations for maternal supplements during breastfeeding, though many doctors recommend continued use of prenatal vitamins. Poorly nourished mothers or those on selective vegan diets may need multivitamin and omega 3 supplements.

UNITED KINGDOM

Fish Intake & Mercury—
Breastfeeding women are recommended to have no more than 2 portions of an oily fish a week (examples of oily fish are fresh tuna, salmon, mackerel, sardines, herring, pilchards and trout). If predatory fish like shark, swordfish, marlin are consumed, it is recommended that no more than 1 portion of these fish are consumed a week. There is no restriction on the amount of canned tuna a breastfeeding woman can have. In the UK, however, canned tuna does not count as oily fish as they are low in the good fats and in vitamin D due to the processing methods used.

Calcium—
Calcium recommendations actually jump from 700mg a day for an adult pregnant woman to 1250mg a day for a breastfeeding mother! One cup of milk has about 300mg of calcium, so this would mean aiming for at least 3-4 servings of calcium rich products a day. Examples are dairy products like cow’s milk, yogurt, cheeses, fromage frais; calcium and vitamin D enriched oat milk, rice milk and soy milk (note that ‘organic’ versions mean these are not fortified with calcium or vitamin D); calcium fortified breads and cereals.

Vitamin D—
The UK Department of Health recommends that all pregnant and breastfeeding women have 400 international units (IU) or 10 ug of vitamin D daily. Some food sources of vitamin D include oily fish, fortified margarine and eggs. Here are also some foods on the market that are fortified with both calcium and vitamin D: certain breakfast cereals like Kellogg’s Corn Flakes®, Weetabix Crunchy Bran®, Ready Brek® porridge, and calcium and vitamin D fortified cow’s milk alternatives like soy milk, rice milk and oat milk.

Though food in the diet can contribute to vitamin D levels, it may be difficult to obtain enough vitamin D from diet alone (especially in the UK where many foods on the market like dairy products are not fortified with vitamin D). Our bodies can also manufacture vitamin D through modest exposure to direct UVB sunlight. However, factors like variable weather conditions, use of sunscreens, different skin types and cultural practices may all impact on vitamin D levels. So for those who find it hard to get enough vitamin D from the sun and their diet, a vitamin D supplement might be needed.

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