Balancing a Plant-Based Diet and Breastfeeding

Nurturing Your Baby: Vitamin B12, Iron, and Calcium on a Plant-Based Breastfeeding Journey

In my 9-5 job, I work extensively with women at increased risk of developing breast cancer. In our first session together, I typically review the American Institute of Cancer Research’s recommendations for reducing cancer risk. 

One of these recommendations is to increase the consumption of whole grains, fruits, vegetables, and legumes. In other words, strive to follow a more plant-based diet. Another recommendation encourages breastfeeding your baby if you can. I often get asked if these two recommendations can be followed simultaneously, and the good news is that they certainly can be!

There are several nutrients that plant-based mothers ask me about, specifically: vitamin B12, iron, and calcium. 

Vitamin B12 is essential in supporting healthy brain development in infants. 

This vitamin is primarily found in animal products, including meat, poultry, eggs, seafood, and dairy. If a plant-based mom excludes these choices from her diet, she risks becoming deficient in Vitamin B12, and her breast milk may not pass this nutrient on to her baby. In this instance, her physician or registered dietitian may recommend that she take a vitamin B12 supplement to ensure that both mother and baby are getting all of this important nutrient that they may need. 

Here are some plant-based foods that have been fortified with vitamin B12. Make sure you check the nutrition label to compare amounts of vitamin B12 across products!

• Nutritional yeast
• Cereals
• Soy milk
• Tofu
• Meat alternatives

When it comes to iron, the iron content of a mother’s diet is more important during pregnancy than during lactation. 

According to the CDC, when infants are born, most have enough iron stored up for the first 6 months of their life. This does vary and depends on factors, including the mother’s iron stores during pregnancy. Most moms, including plant-based and non-plant-based moms, are encouraged to monitor iron intake or even take a supplement containing iron during pregnancy. This aims to support the baby’s iron status in the womb and for the first 6 months of life.

Unfortunately, breast milk contains little iron. After about 6 months of life, if they are being exclusively breastfed, it is important to talk to your doctor to determine if iron supplementation is suitable for your baby. 

Plant-based sources of iron include:

• Fortified cereals
• Oatmeal
• Enriched rice
• Tempeh
• Soymilk
• Almonds and pistachios
• Dried figs and raisins
• Spinach 
• Swiss chard
• Molasses 

Calcium is another nutrient to consider when breastfeeding. 

The good news is that your baby is unlikely to become calcium-deficient if breastfed. To supply sufficient calcium through breastmilk, your body takes the calcium stored in your bones. While your baby will get adequate amounts, mothers lose some bone density through this process. Typically, the majority of this bone loss is replaced once you discontinue breastfeeding. However, ensuring you get enough calcium in your diet can help replace this bone loss faster or prevent it from occurring in the first place.

For plant-based mothers who avoid dairy products, you may need to increase your intake of calcium-containing plant foods and non-dairy kinds of milk that are fortified with calcium or discuss with your physician whether a supplement is right for you. 

Plant-based sources of calcium include:

• Fortified plant-based milk
• Fortified orange juice
• Leafy greens, including collard greens, kale, turnip greens, or mustard greens
• Soy products, including tofu, soybeans, edamame, tempeh
• Almonds
• Flaxseeds and chia seeds
• Molasses
• Dried figs
• Black and navy beans

If you are a plant-based momma and are hoping to breastfeed, rest assured that it is possible with a little bit of consideration. As always, it is a great idea to let your doctors know about your dietary patterns to help guide you to ensure you and your baby are healthy and thriving. 

1. _{American Institute of Cancer Research (n.d.). How to prevent cancer: 10 recommendations. From AICR.org. Retrieved July 11, 2023.}
2. _{Centers for Disease Control and Prevention (2023). Breastfeeding: Iron. From cdc.gov. Retrieved July 11, 2023.}
3. _{Rosen, H.N. (2023). Patient education: calcium and vitamin D for bone health (beyond basics). From UpToDate.com. Retrieved July 11, 2023.}