Case Study: Low Carb Diets and Breastfeeding Mothers

(not case study dyad. Molly nursing A in 2011)

I recently had an interesting experience helping a mother with a breastfeeding situation. I received her permission to share her story here as a case study to help other mothers/breastfeeding counselors.

Helping situation:

The mother contacted me because her baby was experiencing poor weight gain. Baby was three months old and after having gained steadily during the first two months had not gained weight in a month and was still at nine and half pounds. In addition to talking about signs of dehydration, we explored a ton of possibilities during the hour-long call, including the fact that baby started daycare and then weight gain stopped. Towards the end of the call, I asked a couple of questions about the mother’s diet, mentioning that sometimes certain proteins in foods can cause sensitivities in the baby. Mother paused and then said, “so protein might possibly be related to this?” She then shared that she has been on a high protein/low-carb diet that she started last month. My brain tickled with a memory and sure enough in the conference notes from Diana West’s presentation at the 2011 LLL of Missouri conference, I found the note that, “Low carb diets have been observed to significantly decrease milk production.” I suggested mama go back to eating the way she used to do.

Follow-up results:

At the beginning of this month, the mother emailed me to let me know that she’d discontinued the low-carb diet and baby gained a pound in a week. A second follow-up email reported another pound of weight gain and a third email showed pictures of a happy, chubby breastfeeding baby. I was fascinated at the potent results from this seemingly small/possibly unrelated change.

LLLI has additional information about low-carb diets and breastfeeding women here, but it does not seem to include information about the possible drastic milk supply consequences that we experienced in the case study above. I do recognize that all mothers are different and that some mothers may not experience this effect from a low-carb diet (I fully expect to get some comments reporting that mother is on a low-carb diet and baby is doing just fine). However, after this experience, I know I am going to remember to ask about low-carb diets in future calls with weight gain issues with young babies, because I’m wonder if this might be more common than I’ve realized. Low carb diets are a popular weight-loss solution and there is a lot of information available about them online. People perceive it as a healthy choice and may not ever think to mention it to me.  Even though we remind people to expect it to take at least nine months to lose the “baby weight,” postpartum mamas can be very concerned with weight loss and may find a low-carb diet a logical “trick” to try. As I reflect back on the numerous helping calls I receive and put these two elements together, I find myself wondering if some of the “not enough milk”/”baby isn’t gaining weight” calls might have a low-carb connection that I’ve not been catching onto…

 

 

22 thoughts on “Case Study: Low Carb Diets and Breastfeeding Mothers

  1. I experienced something similar. I was overweight before I became pregnant with my second child and was subsequently diagnosed with gestational diabetes. It was a mild enough case, managed by a controlled diet. I ended up weighing less at nine months pregnant than I weighed at conception!

    Three months after the birth, I started to gain weight again, so I decided to start a low carb diet. I immediately noticed a change in my milk supply and in my baby’s behaviour – fussiness where there had been none, still hungry after a ‘one-boob’ feed etc. We’d had a very straightforward breastfeeding journey up until that point, with a fairly fixed demand-led routine, even accounting for growth spurts and developmental leaps. I linked the new problems to my diet immediately and switched instead to a more balanced low GI diet similar to the one I had been on during the pregnancy which allowed me carbs but in controlled portions along with protein, heaps of fruit & veg etc. My supply quickly returned to normal and baby returned to her happy self. I’ve also continued to lose weight, gradually but in a sustainable way.

    As a breastfeeding mother, you are still eating for two. It makes sense that limiting aspects of your own diet will impact upon the diet you provide for your child. I would definitely recommend speaking to your family doctor or an accredited nutritionist – not a nutritionist in a book – before embarking on a diet which may affect your baby.

  2. I think it should also be taken into account how old the baby is……. any sort of diet should be scrutinized for younger babies especially….. not necesarrily just low carb diets. I eat low carb, My breastfed son is 11 months old….. he is breastfed, gets solid foods and a little bit of water in a sippy cup with his solids….. He is right on target and I have not noticed any dramatic change in my milk supply. I do regularly use flax seed and nutrional yeast in my yogurt and in my cooking….. both known to help milk supply….. I also take vitamin supplements….. Diet should always be considered when breast feeding, but age of child, weight of child, moderation etc should always be kept in mind as well…

  3. I have been one of those women that cannot seem to keep weight on. No matter how wonderful that sounds to some, it is really quite frustrating to me and I am sure there are some out there that can sympathize. With that being said, I am not one that is concerned aout losing weight and so do not ever attempt dieting, low carb or otherwise. However, through the last 9 months of breastfeeding, i have had my ups and downs with anxiety and eating. Some days/weeks i was unable to eat a lot of food, especially food that was rich. I noticed that with not eating high carb foods, my milk supply dropped drastically and the milk was not as rich or creamy as it usually is. My son was also hungry more, nursing more often. I began to pay attention to my eating habits in conjuction with my milk supply and my son’s nursing amounts and discovered that when eating meals high in carbs, he did not nurse as often(he was nursing every 20 minutes to half an hour, latched for 30 minutes each side when i wasn’t eating properly.), slept better, and gained weight more quickly, I also noticed an increase in my milk supply. I know that there are women who are concerned about their weight post partum, and understandably so, but one thing that I have learned and have been told numerous times, if you are breastfeeding, you are burning the food you eat faster than if you are not. Eating a high carb diet, or eating often, is not going to mean that you will not lose the post partum baby weight, nor does it mean that you will gain weight. Your body is going through those carbs and proteins faster than you realize. Eat healthy, eat well, laugh often and love that little one. He (or she) loves the squishy mama belly, and needs that creamy goodness that mama milk provides. Exercise, stay active, eat properly and healthy, and smile as much as you can. Not only will your baby be happier, healthier, and fuller, but you will be as well. ;-)

  4. I don’t like the word “diet” for the most part, because I agree that women shouldn’t be “dieting” (as in, eating primarily for weight loss). However, I do wonder if the mother went low-carb and stayed low-fat as well, or tried for a low-carb, *high-fat*, high protein diet. The mothers that breastfeed in my gym do not have any milk issues that I’m aware of and all the babies look fat and healthy. They don’t diet or anything, but they do eat low-carb, high-fat, high protein.

    I wasn’t nursing at the time, but when I first started eating like this (low carb) I felt hungry all the time. Reassessing what I was eating, I realized I wasn’t taking in enough fat. When I adjusted and started eating smarter, instead of just staying within “guidelines,” I wasn’t hungry anymore.

    Based on what I’ve seen (not in studies, but rather women I know), I would imagine her fat intake was not high enough.

  5. This may be one thing (among many) that contributed to my low supply with my first. Her “birth weight” was grossly inflated due to ivs and swelling on my part at birth so she hadn’t regained her “birth weight” quickly enough. Her ped told me to try a higher protein, higher-fat (and thus lower-carb) diet. *I* gained plenty of weight and all she did was nurse, but actually slowed down in weight gain. That was when the ped threatened to report me for medical neglect if I “insisted on starving! My daughter instead of supplementing with formula.

  6. I had a client whom had a baby who almost starved to death….she was following a strict gluten free diet and was not getting enough EFA. When she added grains back in, she started producing more milk and he was doing better. It was hard though!

  7. One thought — if low carb diets reduce milk supply, how were the Inuit able to survive as a race in the Arctic for thousands of years on a “NO CARB” diet?? That’s right — their traditional diet was fat and meat only, and don’t tell me that their biochemistry is different from ours — that is a myth. I am wondering if the loss of milk supply had to do with something else that was going on — maybe not enough fat, or the right kind of fat, maybe not enough calories (which IS associated with decreased milk supply) or maybe it was the result of a sudden shift from a high carb diet to a low carb diet. I can’t explain why these women are experiencing a shift in milk supply, but biochemistry does not support the idea that women will not produce lactose in their milk (which supports the rapid growth of babies) if she is not consuming carbs. In the absence of carbs from diet, our livers make sugar from protein and fats to supply our brains, and mammary epithelial cells construct proteins and lactose from available substrates in the mother’s blood. Studies show that the only real thing that mother’s diet can influence with regards to the contents of her milk is the type of fat that predominates in her milk, which can only come from her diet (ie. regarding EFAs and fat soluble vitamins). Clearly, there is something else going on here.

  8. Wow, so if I wasn’t on a low carb diet i wonder what my 32 lb 6 month old might weigh, maybe 40. and here at 23 months he weighs 37 lbs, maybe he’d weigh 60!

    • As I said in my post, I recognize that not all mothers will have this experience with a low-carb diet. I also think about other mammals, like cows, who eat only grass and yet produce milk with ample fat, protein, calories, etc. suitable for growing a very large and heavy animal (also, note that consuming fats is not particularly necessary for producing fatty milk though–at least with cows–so I don’t know that fat is the answer/clue here either). Though, in Diana West’s presentation she also notes that in the dairy industry, increasing the amount of roughage in a cow’s diet increases the amount of cream in the milk.

  9. Wow, so if I wasn’t on a low carb diet I wonder what my 32 lb 6 month old might weigh, maybe 40lbs? And here at 23 months he weighs 37 lbs, maybe he’d weigh 60lbs!

  10. I love to have some low carb diet due to the fact it is much healthier and it has been observed that low calorie diets extend the life of a human being. :,,`; Warmest wishes wellness blog

  11. I’m a low-carber, and I’m about fed up with all the mythology going around about them being “unbalanced” and other such nonsense, but I think there may be something to very-low-carbing causing milk supply issues. For a very simple reason: if you have been eating high-carb for most of your life *anyway*, your body is accustomed to having that easy glucose source in your diet. That matters, because glucose cascades into galactose in a lactating mother’s body, and from there it turns into lactose. Now, your body CAN make its own glucose; that’s the reason you don’t wake up dead after sleeping eight hours or so. But if your body is not very efficient at increasing its own glucose supply when needed, you will need to eat more glucose to meet your lactation demands.

    Don’t go crazy with it though. Your hormones are all over the place because you just gave birth; the last thing you need to be doing is having your insulin levels constantly sky-high, which will make your hormonal situation that much worse. Play around with adding starches to your diet til you get to a level that both you and kiddo can live with. But be sure it’s starches that you’re adding for the carbs and not, say, huge amounts of fruit (berries and melon are more than adequate–you want to not go overboard with fructose right now too) or table sugar or soda or whatever. And I would get my starches from rice or potato before I got them from, say, oats or wheat.

    My two cents, and your mileage may vary.

    • This response makes all kinds of sense, Dana. The abrupt shift to a very low carb diet is what has the impact probably, rather than the diet itself. I also think the other commenters’ remarks about having enough *fat* (ie not low carb/low fat) also make sense and shed light on this case. Thanks!

  12. Pingback: 2012 blog year in review | Talk Birth

  13. I do think it’s the abrupt shift in diet that effected her supply, not the fact that it’s low carb. There are many cultures who eat low carb all the time, and have managed to feed their babies for millennia.
    When I cut out gluten my body freaked out for about two months, and then I cut out all grains, which was another shock. It did amazing things for my health in the long run, but it was hard at first. I can’t imagine what would have happened if I was breastfeeding at the time. Any kind of stress is not good for supply.

  14. Thanks for this article, my milk supply also dropped to virtually nothing when I went on a low/virtually no carb diet (I know this as I was suddenly unable to pump any more than a few drops having previously pumped plenty, and I also suddenly had a very fussy baby that was only settled when I decided to top up with formula). I fell of the low carb band wagon due to lack of willpower and suddenly I had an abundance of milk for my baby, it was only then that I made the connection and found this- amongst others- article. I am positive there is a link, overnight I went from having to feed 75% formula to having to only do one bottle a day and the rest breastfeeding, baby is gaining weight still and seems settled.

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