01/17/2025
Why This Matters To Me
So my wife Emma and I were discussing the possibility of having another baby. She is still breastfeeding our first and we wondered how taxing it would be on her to breastfeed while growing a baby at the same time. Would it be safe? Researching a bit past the surface recommendations reveals that supplements seem to be slightly different for the support of breastfeeding vs the support of pregnancy despite most doctors just telling their patients to keep taking prenatal vitamins to support breastfeeding. Some supplements impact breast milk production in negative ways and some of those supplements we have found in various prenatal vitamin mixes. Our doctor when asked about breastfeeding while pregnant only said that it shouldn’t be a problem, but didn’t elaborate and didn’t give any guidance beyond the standard rhetoric of just continuing to take prenatal vitamins while breastfeeding. And the doctor just looked at me blankly when I asked about dosage recommendations. So it seemed like more research was in order. And after about a week and a half of research, this is what I found.
Simultaneously breastfeeding an existing child while pregnant presents unique nutritional challenges. The mother's body must supply adequate nutrients to support her own health, the growth and development of the fetus, and the nutritional needs of the breastfeeding child. From my research, I have come up with a list of the top 20 vitamins and supplements intended to meet these needs. I will present my research results on the top 20 recommended supplements, the effectiveness and recommended dosages of these nutrients, and I will discuss my findings for potential impacts on milk production and fetal development. I will also present additional strategies I found to support the health of the mother, fetus, and breastfeeding child and some things to avoid.
Top 20 Supplements That Support Simultaneous
Breastfeeding and Pregnancy.
1. Folic Acid (Vitamin B9)
Dosage: 600-800 mcg daily
The recommended dosage of 600-800 mcg of folic acid is appropriate for pregnant women. Folic acid is crucial for preventing neural tube defects in the fetus, especially during the first trimester. It also supports DNA synthesis and cell growth, which are beneficial during lactation. In addition to the recommended dosage, include folate-rich foods like leafy greens, legumes, and fortified cereals in your diet.
Considerations: While folic acid does not negatively impact milk production, ensuring adequate intake is essential. Women with a history of neural tube defects may require higher dosages, but this should be guided by a healthcare provider.
2. Iron
Dosage: 27 mg daily
The suggested 27 mg aligns with the recommended dietary allowance (RDA) for pregnant women. Iron supports increased blood volume during pregnancy and prevents anemia, which can cause fatigue and reduce milk quality. Also incorporate iron-rich foods like lean meats, beans, and spinach.
Considerations: High iron levels do not inhibit milk production but can cause gastrointestinal discomfort. Iron absorption is enhanced by vitamin C, so combining iron supplements with vitamin C-rich foods is be
3. Calcium
Dosage: 1,000-1,300 mg daily
The dosage is appropriate for pregnancy and breastfeeding; calcium is essential for fetal bone development and maintaining maternal bone density, which can be depleted during breastfeeding. This recommended dosage combined with consuming calcium-rich foods such as dairy products, fortified plant-based milks, and leafy greens is ideal.
Considerations: Adequate calcium intake supports milk production and quality. Insufficient calcium may lead the body to draw calcium from the mother's bones, increasing the risk of osteoporosis.
4. Vitamin D
Dosage: 600-800 IU daily
While this dosage meets the general RDA, some experts suggest that pregnant and breastfeeding women may benefit from higher doses (up to 2,000 IU daily) to ensure sufficient levels in breast milk and support fetal development. Discuss vitamin D levels with a healthcare provider to determine if a higher dosage is necessary. Include safe sun exposure and vitamin D-rich foods like fatty fish and fortified products.
Considerations: Vitamin D enhances calcium absorption and supports immune function. It does not negatively affect milk production.
5. Vitamin B12
Dosage: 2.8 mcg daily
The dosage is appropriate for both pregnancy and breastfeeding. Vitamin B12 is vital for neurological development in the fetus and breastfeeding child. Ensure sufficient intake through supplements or fortified foods, especially for those on plant-based diets. Regular monitoring of B12 status is advisable.
Considerations: Vitamin B12 deficiency is a risk for vegans and vegetarians. Adequate levels do not harm milk production.
6. Omega-3 Fatty Acids (DHA)
Dosage: 200-300 mg daily
This dosage simultaneously supports fetal brain and eye development and enriches breast milk DHA content. Also include omega-3-rich foods like fatty fish (low in mercury), flaxseeds, and walnuts in your diet.
Considerations: Omega-3s do not inhibit milk production and may improve maternal mood.
7. Vitamin C
Dosage: 120 mg daily
This dosage exceeds the RDA (85 mg for pregnant women), but the upper limit is 2,000 mg. Vitamin C enhances iron absorption and supports immune function. Vitamin C is better tolerated and more bioavailable when sourced from consuming vitamin C-rich foods like citrus fruits, berries, and bell peppers.
Considerations: Excessive vitamin C can cause gastrointestinal discomfort but does not affect milk production.
8. Vitamin A
Dosage: 770-1,300 mcg RAE daily
The RDA for pregnant women is 770 mcg RAE. The upper limit is 3,000 mcg RAE to avoid teratogenic effects. Avoid exceeding 770 mcg RAE unless advised by a healthcare provider. Focus on beta-carotene-rich foods like carrots and sweet potatoes.
Considerations: Vitamin A does not lower milk production. Excessive vitamin A (especially retinoid forms) can be harmful to the fetus. Beta-carotene sources are safer so avoid retinoid supplements and focus on beta-carotene sources.
9. Zinc
Dosage: 12 mg daily
The RDA for pregnant women is 11 mg, and for lactating women, 12 mg, so this dosage is appropriate for pregnant women who are also breastfeeding. Also include zinc-rich foods like meat, shellfish, legumes, and nuts.
Considerations: Zinc supports immune function and does not negatively impact milk production.
10. Magnesium
Dosage: 350-360 mg daily
The RDA for pregnant women aged 19-30 is 350 mg and 360 mg for those aged 31-50. In addition, include magnesium-rich foods like whole grains, nuts, seeds, and green leafy vegetables.
Considerations: Magnesium supports muscle function and may prevent preterm labor. It does not inhibit milk production.
11. Choline
Dosage: 450-550 mg daily
The RDA is 450 mg for pregnant women and 550 mg for lactating women. Also include choline-rich foods like eggs, meat, and soy products.
Considerations: Choline is critical for fetal brain development and supports breast milk composition. It does not affect milk production negatively.
12. Iodine
Dosage: 220-290 mcg daily
The RDA is 220 mcg for pregnant women and 290 mcg for lactating women. Ensure adequate intake through iodized salt and iodine-rich foods like dairy and seafood.
Considerations: Adequate iodine is essential for thyroid function. Deficiency can harm fetal and infant brain development but does not reduce milk supply.
13. Vitamin K
Dosage: 90 mcg daily
This dosage meets the adequate intake (AI) for adult women. Include vitamin K-rich foods like leafy greens, broccoli, and Brussels sprouts.
Considerations: Vitamin K is important for blood clotting and bone health. It does not affect milk production.
14. Vitamin E
Dosage: 19 mg daily
The RDA is 15 mg for both pregnant and lactating women. 19 mg slightly exceeds this, but is nowhere near the upper limit. If possible, obtain vitamin E from foods like nuts, seeds, and good for you oils like Olive and Avocado oil. Do not exceed the upper limit of 1,000 mg. Excessive vitamin E intake can cause blood thinning. It does not inhibit milk production
15. Vitamin B6 (Pyridoxine)
Dosage: 2 mg daily
The RDA is 1.9 mg for pregnant women and 2 mg for lactating women. This dosage plus foods like poultry, fish, and whole grains is a good way to get Vitamin B6.
Considerations: Vitamin B6 supports brain development and may help with morning sickness, and may also help with nipple vasospasm. At higher dosages (600 mg/day) Vitamin B6 can negatively impact milk production, but anyone should consult a heath professional before taking high doses. Taking more than 50 mg of Vitamin B6 a day may cause peripheral neuropathy.
16. Vitamin B1 (Thiamine)
Dosage: 1.4 mg daily
The RDA is 1.4 mg for both pregnant and lactating women. Also consume thiamine-rich foods like whole grains, legumes, and pork.
Considerations: Thiamine is essential for energy metabolism and does not affect milk production.
17. Vitamin B2 (Riboflavin)
Dosage: 1.6 mg daily
The RDA is 1.4 mg for pregnant women and 1.6 mg for lactating women. Also include dairy products, eggs, and green vegetables.
Considerations: Riboflavin supports energy production and milk quality.
18. Vitamin B3 (Niacin)
Dosage: 18 mg daily
The RDA is 18 mg for pregnant women and 17 mg for lactating women. In addition, consume niacin-rich foods like poultry, fish, and whole grains.
Considerations: Niacin aids digestion and nervous system function without affecting milk production.
19. Selenium
Dosage: 60-70 mcg daily
The RDA is 60 mcg for pregnant women and 70 mcg for lactating women. Also include selenium-rich foods like Brazil nuts (in moderation), seafood, and eggs.
Considerations: Selenium supports thyroid function and immune health. It does not inhibit milk production.
20. Probiotics
Dosage: Follow manufacturer's recommendation
Probiotics can support gut health and may benefit both mother and child. Choose high-quality probiotic supplements and include fermented foods like yogurt and kefir.
Considerations: Generally safe, but specific strains and doses vary.
6 Additional Recommendations
1. Hydration
Adequate fluid intake is essential for milk production. Aim for at least 8-10 glasses of water per day.
2. Balanced Diet
Consume a variety of foods to meet increased caloric needs—approximately an additional 300 calories during pregnancy and an additional 500 calories during breastfeeding.
3. Protein Intake
Protein supports fetal growth and milk production. Include lean meats, poultry, fish, eggs, dairy, legumes, and nuts.
4. Healthy Fats
Essential fatty acids support brain development. Include avocados, nuts, seeds, olive oil, and avocado oil.
5. Physical Activity
Engage in moderate exercise as approved by a healthcare provider to support overall health.
6. Rest and Stress Management
Adequate rest and stress reduction techniques like meditation or gentle yoga can positively impact milk production and maternal well-being.
8 Things to Avoid While Pregnant and Breastfeeding
Naturally while doing this research, I ran across things to avoid while pregnant and breastfeeding. My overall takeaway from this research is that before taking ANY supplements, medicines, ingesting anything, or even using any topical products natural or not, one should read labels, understand what the ingredients/contents are and if possible, research each and every ingredient for it’s impact on breastfeeding, pregnancy, or your health in general. The following are the eight vitamins/supplements that stood out to me as ones to avoid during pregnancy and breastfeeding:
1. Sage Supplements
Sage can decrease milk production due to its natural estrogenic properties. Avoid sage supplements and limit culinary use if concerned about milk supply.
2. Peppermint Oil
High doses may reduce milk supply. Use peppermint sparingly and monitor any changes in milk production.
3. Excess Vitamin A (Retinoid Form)
I know this was said before, but it is worth repeating. High levels of Vitamin A (Retinoid Form) can be teratogenic and harmful to the fetus. Avoid retinoid supplements and focus on beta-carotene sources.
4. Parsley Supplements
Large amounts may decrease milk supply. Limit parsley intake and avoid concentrated supplements.
5. Large Doses of Caffeine
Excessive caffeine can affect fetal heart rate and cause irritability in infants. Limit intake to under 200 mg per day (about one 12 oz coffee).
6. Fenugreek in Excessive Doses
While fenugreek can boost milk supply, excessive use may cause gastrointestinal issues. Use fenugreek cautiously and consult a healthcare provider.
7. Ginkgo Biloba
May have blood-thinning effects and lacks safety data for pregnancy and lactation. Avoid during pregnancy and breastfeeding.
8. Alcohol-Based Herbal Supplements
Alcohol can pass into breast milk and harm the fetus. Opt for alcohol-free preparations.
Conclusion
The Top 20 vitamins and supplements listed as recommended above are generally appropriate for supporting simultaneous pregnancy and breastfeeding. The recommended dosages align closely with established guidelines. It is crucial to avoid exceeding upper limits, particularly with fat-soluble vitamins like vitamin A and E, to prevent toxicity.
Most of the supplements do not negatively impact milk production or fetal development when taken within recommended dosages. However, certain herbs and excessive amounts of specific nutrients can pose risks. Therefore, it is essential to consult with a healthcare provider before starting any new supplements or making significant dietary changes.
By combining appropriate supplementation with a balanced diet and healthy lifestyle choices, mothers can support their own health while providing optimal nutrition for their breastfeeding child and developing fetus.
