Breastfeeding for Vegans: Ensuring Healthy Breast Milk on a Vegan Diet

Many women are choosing vegetarian or vegan diets, thanks to numerous reports about the health benefits of such diets, including decreased incidence of heart disease, diabetes, hypertension and obesity. For many patients who change from carnivorous diets to vegetarian or vegan diets, they report “feeling better” and in my experience have fewer issues with inflammatory diseases including eczema, asthma and arthritis, for example.

The concern some have over a vegan diet is maintaining an adequate intake of certain key vitamins and minerals. The most common issues are vitamin B12 deficiency, as well as iron deficiency. In fact, vegan mothers are some of Lactation Lab’s most common clients, eager to ensure that their babies are getting the nutrition they need.

One interesting study found that vegan and vegetarian mothers are more likely to breastfeed their children when compared to non-vegetarian mothers and they also did so for a longer period of time(1).

Although plant-based diets are at risk for nutritional deficiencies such as protein, iron, VItamin D, calcium, iodine, omega-3’s and B12, well-planned diets rich in grains and legumes combined with supplements can provide adequate nutrition to both mother and baby during pregnancy and breastfeeding.  Following a rich plant-based diet during pregnancy can also be protective against the development of preeclampsia, pregravid obesity and reduce the risk of their child developing asthma, diabetes and even some pediatric tumors (2).

In our own testing of the breast milk of vegan and vegetarian mothers at Lactation Lab,  we have seen tendencies of lower in B12, calcium and iron. We recommend all vegan and vegetarian women make sure they have an adequate source of B12, which is important for maintaining healthy a healthy central nervous system, production of DNA and RNA, formation of red blood cells and overall metabolism.

Protein intake should also be increased by 10% in vegan pregnant and breastfeeding women (3,4) and additional servings of protein-rich plant foods such as legumes, soy milk, soy yogurt, tofu, and meat analogs based on wheat or soy protein, nuts and seeds are essential.

Bottom Line: There are many benefits to vegan and vegetarian diets. We recommend that vegans that are nursing consider taking the following supplements: Calcium, iron, B12, DHA and Vitamin D (universally recommended for all breastfeeding infants).


  1. Pawlak R., Ding C., Sovyanhadi M. Pregnancy outcome and breastfeeding pattern among vegans, vegetarians and nonvegetarians.

  2. Pistollato F., Summalla C., Elio I et al., Plant-based and plant-rich diet patterns during gestation: beneficial effects and possible shortcomings.

  3. Agnoli C., Baroni L., Bertini I. et al. Position Paper on vegetarian diets from the working group of the Italian Society of Human Nutrition.

  4. Kniskern, M. Johnston C., Protein dietary reference intakes may be inadequate for vegetarians if low amounts of animal protein are consumed.

Other resources:

Pawlak R., Vos P., Shahab-Ferdows S et al. Vitamin B12 content in breast milk of vegan, vegetarian and nonvegetarian lactating women in the United States

Sebastiani G., Barbero A., Borras-Novell C et al. The effects of vegetarian and vegan diet during pregnancy on the health of mothers and offspring.

Baroni L., Goggi S., Battagliano R. et al., Vegan Nutrition for Mothers and Children: practical tools for health care providers.

Implants and Breastfeeding: What You Should Know

Implants and Breastfeeding: What You Should Know

One topic of concern to some mothers with breast implants is whether they present any health risk to their baby through possible contamination of their breast milk. In particular, they ask about whether silicon, silicone gel or platinum used in implants can leak into their breast milk.

The American Academy of Pediatrics Committee on Drugs does not feel that the evidence currently justifies classifying silicone implants as a contraindication to breastfeeding.

Mothers With Thyroid Issues Should be Cautious in Using Fenugreek as a Lactation Aid

Mothers With Thyroid Issues Should be Cautious in Using Fenugreek as a Lactation Aid

Fenugreek is listed as generally recognized as safe (GRAS) by the FDA and as long as mothers are aware of the possible side effects, this is a good option to try to increase supply. However, mothers with thyroid conditions should proceed cautiously and consult with their physician before taking a fenugreek supplement.

The Modern Mom: New Challenges, New Solutions

The Modern Mom: New Challenges, New Solutions

A group of entrepreneur moms gathered recently to discuss how they’re working to support moms through the new challenges of modern motherhood. In an honest, unfiltered conversation, they shared their own ups and downs as parents, and shared advice and tips.

One recurring theme was the importance of paying attention to what we put into and on our bodies, minimizing exposure to toxins and other environmental hazards.

Infant Exposure to Heavy Metals -  A Cause For Concern

Infant Exposure to Heavy Metals -  A Cause For Concern

Consumer Reports has weighed in on the topic of exposure to toxic heavy metals by infants.

Consumer Reports’ testing shows concerning levels of arsenic, cadmium and lead in many popular baby and toddler foods.

This includes foods made just for babies and toddlers, such as popular snacks, cereals, prepared entrées, and packaged fruits and vegetables.

Over time, exposure to heavy metals can harm the health of adults and children. One of the biggest worries: cognitive development in very young children.

Why We Test Breast Milk - A Case Study

Why We Test Breast Milk - A Case Study

I’m often asked why it’s helpful to test breast milk -- and one of the best answers is in addressing a very common issue: helping babies who aren’t gaining enough weight through breastfeeding.

It’s a common occurance: a mom feels passionately about breastfeeding, but baby isn’t gaining enough weight; her pediatrician recommends formula to supplement and that’s the end of the story. But now that we can test breast milk for fat and calories, that story can be rewritten.

Here’s an example. Baby S’s birth…

Can Lead Be Present in Breast Milk and Is It Harmful?

Can Lead Be Present in Breast Milk and Is It Harmful?

Recent reports of high levels of lead in baby formula raise the question of whether lead can be found in breast milk. The short answer is that while breast milk is generally safe, it is possible for it to contain lead. Lead is a common contaminant in the environment and can make its way into breast milk if absorbed by the mother through food, water or airborne pollution.

Dr. Stephanie Canale, founder of Lactation Lab, developed a unique and proprietary test kit for measuring the level of lead and other toxins in breast milk.

How Much Protein Does a Breastfeeding Mom Need?

How Much Protein Does a Breastfeeding Mom Need?

How much protein does a breastfeeding mom need? And does it matter what kind? These are a couple of questions raised by a recent Consumer Reports article suggesting that most people require less protein than they think.

Proteins are important for immune and neurological function and are the building blocks for tissues, muscle and bones, says Dr. Stephanie Canale, founder of Lactation Lab. “It’s important that when we’re talking about a mother's recommended protein intake, we take into account a breastfeeding mother’s need for protein to recover from the physiological strain of pregnancy and childbirth," she said.

Educating Breastfeeding Mothers About DHA Pays Dividends

Educating Breastfeeding Mothers About DHA Pays Dividends

Long-chain polyunsaturated fatty acids such as DHA are essential nutrients required for normal health, growth and development. Increasing evidence shows that feeding infants breast milk with a higher DHA content improves  their vision and neuro-development.

So, does educating mothers about the DHA levels in their milk have any impact on those levels? Numerous studies have found a link between maternal intake of DHA (through diet and supplements) and increased DHA levels in breast milk. A study in South Dakota examined 84 women who were educated about their DHA levels and looked at the resulting impact on the DHA levels in their milk. 

Do Supplements Really Work to Increase Milk Supply?

Do Supplements Really Work to Increase Milk Supply?

My patients often ask me about the efficacy and safety of the supplements that claim to increase your milk supply. Do they really work?

If you’re struggling with milk supply issues, the first step is to evaluate simple factors including latch evaluation, oral examination of the infant, frequency of feeding or pumping and thoroughness of breast emptying. A lactation consultant, often available at your local hospital or breastfeeding support store, can be invaluable in identifying if there are underlying issues contributing to milk supply.

Breastfeeding Boosts Babies' Good Bacteria

Breastfeeding has long been known to positively impact the health and immune systems of babies, but now new research is uncovering the power of breastfeeding in helping to prevent long term illnesses including asthma, allergies, celiac disease, Type 1 diabetes and obesity.

The New York Times reports that many studies have strongly suggested that the trillions of microorganisms that inhabit the human body influence our current and future health and may account for the rising incidence of several serious medical conditions.

How Can I Be Sure To Pump Enough Milk?

It has been said many times over and most mothers who nurse would agree that there is no better breast pump than baby! From my experience, there appears to be a growing proportion of women who choose to pump milk from the outset. Some women either have difficulty with latching, have nipple issues or simply prefer to pump.

Here are a few tips I would like to share as a physician, mother, and “master pumper!”

Low Vitamin B in Lactating Mothers Can Slow Baby's Growth


Low levels of B vitamins in breastfeeding mothers can translate into low levels in their babies, and may slow growth in the early stages of life.

That's the conclusion of a paper analyzing the scientific research on the topic by Lindsey H. Allen of the U.S. Department of Agriculture. A lack of data places some limits on these conclusions, as much of the evidence is from the world's poorest areas where malnutrition is prevalent.  But the overall picture  points to an urgent need to improve the information available on breast milk quality.

Poor maternal status of thiamin, riboflavin, vitamin B-6, vitamin B-12, and choline, causes the concentrations of these nutrients to be low in breast milk and the infant to become deficient.

Mothers with a low intake of animal source foods are at higher risk of nutrient deficiency, especially for riboflavin and vitamin B-12.  Inadequate intake of thiamin and vitamins B-6 and B-12 could contribute to reducing babies' growth in the first year of life.

Taking supplements during lactation rapidly increases the concentrations of thiamin, riboflavin, and vitamin B-6 in milk, but increases in vitamin B-12 levels are small even when high doses are given to the mother for 2 months.

The first month of a baby's life is thought to be a special period of vulnerability to vitamin B12 deficiency as it can be linked to poor neurodevelopment and slow growth. 

Nutrient deficiency is usually not an issue for mothers consuming a healthy diet, but since animal products are the main dietary source of Vitamin B-12, vegetarians should be careful about deficient vitamin B-12 levels.

“Uncertainty over the nutrient composition of breast milk is what led me to develop a test for exactly what is in it,“ said Lactation Lab founder Stephanie Canale, M.D.

"While breast milk of mothers consuming a healthy diet is typically nutritious, special diets and other factors can result in less than optimal nutrition for the baby. Lactation Lab’s test kits and followup recommendations are designed to help ensure that a mother’s breast milk is the best it can be.” 

Mothers who are concerned about the nutrient composition of their breast milk can use Lactation Lab's test kit to find out whether they need to adjust or supplement their diet.  

Read more: B Vitamins in Breast Milk: Relative Importance of Maternal Status and Intake, and Effects on Infant Status and Function

Probiotics have benefits for baby, too



The live active cultures found in yogurt and probiotics have been shown to promote healthy gut bacteria in adults, with positive effects on digestion and bowel regularity.

A new study suggests that consumption of probiotics by mothers may also be beneficial for their breastfeeding babies.

In a study of 57 moms, those that took a daily probiotic supplement had higher levels of iron, calcium and other nutrients in their breast milk than those that did not. Their babies also gained slightly more weight. The experimental group was supplemented with two synbiotic capsules containing different probiotic strains 30 minutes after dinner for 30 days.

UCLA physician Stephanie Canale recommends breastfeeding mothers take a probiotic, such as PRO-Women from Hyberbiotics.

For mothers who want to see how their diet affects their breastfeeding babies, Dr. Canale has developed a simple breast milk test that measures levels of iron and calcium and other nutrients.

“I developed these tests as I was concerned about my own breastfed baby gaining weight fast enough. Now we are delighted to offer these tests to any breastfeeding mother, from the comfort of their own home.”

Source: R. Mahdavi et al. / Journal of Trace Elements in Medicine and Biology 30 (2015) 25–29


Arsenic in rice: A cause for concern

A recent study by Healthy Baby Bright Futures finds that infant baby cereal contains six times as much arsenic as other cereals.  

International Rice Research Institute

International Rice Research Institute

While arsenic is strictly regulated in drinking water, it is legal in any amount in infant rice cereal. It is a potent human carcinogen and a neurotoxin shown to permanently reduce children’s IQ.  

Arsenic is also found in higher concentrations in brown rice and rice milk, leaving us to wonder whether there is any risk to breastfeeding babies if the mother consumes large amounts of brown rice or rice milk.

“Infants are especially vulnerable because their bodies are so small, and on a per-pound basis, they’re getting much higher exposure than anyone else in the population,” HBBF research director Jane Houlihan told the New York Times. “They’re also vulnerable because it is a neurotoxic compound, and their brain is developing.”

The study’s sponsors, an alliance of scientists, nonprofit groups and private donors that aims to reduce children’s exposures to chemicals that may harm developing brains, recommends choosing these cereals instead of rice cereal: oatmeal, mixed grain, quinoa, barley, buckwheat, and wheat.

“As a precaution, I recommend breastfeeding mothers limit consumption of rice products,”- Stephanie Canale, MD, founder of Lactation Lab and a practicing family physician at UCLA.

Consumer Reports says rice eaters seeking to minimize their exposure to arsenic should  choose either white basmati or sushi rice from California, India or Pakistan, or brown basmati from the same origins. Further tips for reducing consumption of arsenic through rice can be found here.                                                               

As an added layer of security, Lactation Lab’s Premium Test Kit detects and measures levels of arsenic and other toxins in a mother’s breast milk, all from the comfort of her own home.

“Our tests revealed elevated levels of arsenic in one breastfeeding mother’s milk, which we believe originated from regular rice consumption at dinnertime,” said Dr. Canale. “With this information, she was able to adjust her diet to limit the risk of arsenic in her milk.”

Source: Arsenic in 9 Brands of Infant Cereal

Avocados linked to more nutritious breast milk


Avocados offer a range of beneficial nutrients that can make a substantial contribution to a nutrient-rich diet when offered as a staple food for the breastfeeding mom.

That’s the conclusion of recent research published by the Journal of Nutrients.

The researchers note that avocados are unique among fruits and vegetables in that, by weight, they contain much higher amounts of the key nutrients folate and potassium, which are normally under-consumed in maternal diets.

Avocados also contain higher amounts of several non-essential compounds, such as fiber, monounsaturated fats, and lipid-soluble antioxidants, which have all been linked to improvements in maternal health, birth outcomes and  breast milk quality.

Did you know that avocados contain high amounts of folate, potassium, fiber, antioxidants, Vitamin A and Oleic acid - an essential omega 3 fatty acid?

Maternal diet affects every major aspect of reproduction from the early peri-conceptional period to the postnatal stages. It influences the entire range of maternal functions, including the production of adequate and nutritious breast milk.

The researchers recommend that avocados be considered for inclusion in future dietary recommendations for expecting and new mothers.

Source: The Role of Avocados in Maternal Diets during the Periconceptional Period, Pregnancy, and Lactation by Kevin B. Comerford (University of California), Keith T. Ayoob (Albert Einstein College of Medicine), Robert D. Murray (Ohio State University) and Stephanie A. Atkinson (McMaster University).