Why an Elimination Diet For Breastfeeding Could Be Dangerous For Nursing Mamas

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As a new, breastfeeding mom, I remember frantically searching every questionable sign and symptom I saw in my baby. Nursing in the wee hours of the morning was the prime time for over- analyzing my parenting abilities. Sleep deprivation and fear made a bad combination for those early postpartum days while I desperately learned how to breastfeed my baby.

The truth was that breastfeeding didn’t come easy for me. My baby always seemed to be fussy and cried a lot, making me wonder if I was doing something wrong. I also had recurring bouts of mastitis and plugged ducts, which seriously made me question my choice to breastfeed. Truthfully, my baby and I were both miserable as we learned how to figure this whole thing out.

Among all the advice and suggestions I received were to cut out foods from my diet. Inevitably, food became a culprit for all my difficulties, and the solution seemed pretty straight forward:

Just cut it out from your diet.

Suddenly, I seemed to question every food choice I made, only adding more chaos to this stressful season of new motherhood. “The baby is fussy again - was it that piece of chocolate I just ate?”, or, “She won’t fall asleep - is it the glass of milk I had before bed?”

The list of all the “bad” foods that could somehow be poisoning my baby grew longer and longer: gluten, dairy, soy, tree-nuts, peanuts, fish, shellfish, and on and on.

As an eating disorder survivor, cutting out food from my diet was simply not an option for me, and fortunately, my daughter did not have any diagnosed food allergies or signs of a true food sensitivity. With time, breastfeeding got easier for us, and I realized a lot of the things I were struggling with had more to do with postpartum depression and other factors.

My experience breastfeeding 5 babies really opened my eyes to the chaos that many new moms face when it comes to food and eating while nursing. Many of the things we may have previously enjoyed can suddenly come under scrutiny when breastfeeding comes into the picture. Sadly, countless of women are advised to unnecessarily cut out several foods and/or entire food groups from their diet without any real basis or meaning.

Let’s be real: postpartum mamas already have enough going on as it is after birthing a baby into the world, and feeling scared or worried about what you’re eating while breastfeeding isn’t conducive to physical, mental, and emotional well-being. After all, when a breastfeeding mom is told she shouldn’t or can’t eat certain foods, what options does that leave her with?

As a maternal health registered dietitian, I’ve worked with hundreds of breastfeeding moms who were literally on the brink of a breakdown because they had such limited options, in terms of what they felt like they could eat. There are enough stressors as a new mom, and food doesn’t need to be one of them.

What is a Breastfeeding Elimination Diet?

So why would a breastfeeding mom be advised to restrict different foods from her diet while nursing? Elimination diets might be recommended when a breastfed baby is suspected to be sensitive to certain foods that mom might be eating or allergic to a food in a mom’s diet. Some of the main foods/food groups that would be advised to eliminate may include:

  • Dairy, including milk, cheese, yogurt

  • Gluten and grains

  • Certain fruits and vegetables

  • Soy and/or soy based products

  • Fish, shellfish

  • Spicy foods, spices

  • Peanuts, tree nuts

  • Eggs

  • Processed foods, sugar

According to the Academy of Breastfeeding Medicine, it is recommended that moms follow an elimination diet in the case that allergic colitis (an allergic reaction to certain proteins) is suspected in an exclusively breastfed baby.

However, allergic colitis (AC) in healthy, breastfeeding infants is difficult to identify and treat. One study found that a significant proportion of infants may be misdiagnosed with AC and mothers may undergo unnecessary diet changes that discourage breastfeeding.

The problem is when elimination diets are inappropriately recommended for mothers of babies that are exhibiting normal behaviors or who have misdiagnosed conditions. Elimination diets have become all too commonplace and are often prescribed without no real medical basis.

Research has also found that a majority of breastfeeding mothers will restrict certain foods unnecessarily. In one study of breastfeeding moms, researchers found that all of the woman who participated were restricting at least 1 type of food without medical necessity, and over a third of these breastfeeding mothers experienced difficulties as a result of dietary restrictions.

Why are Elimination Diets Recommended While Breastfeeding?

If a breastfed baby is inconsolable, fussy, or colicky, it is a common recommendation to eliminate one or more foods from mom’s diet. Unfortunately, many moms are given dietary recommendations that may actually make food and eating more confusing and chaotic. When a baby’s behavior becomes directly connected with a breastfeeding mother’s eating habits, this can cause unnecessary stress around every bite of food eaten.

Crying, fussiness or irregular sleeping patterns are too easily blamed on mom’s food choices, which can cause her to doubt everything she is eating. Many moms then begin to cut out multiple foods from her diet for fear on how they may be negatively impacting her baby. In actuality, most infant fussiness is normal behavior and is completely unrelated to mom’s diet. Fussiness in a baby without any other symptoms is likely not a food-related issue.

Poor Nutrition in Postpartum While Breastfeeding

When a breastfeeding mother limits the foods that she can eat, this increases the risk of poor nutrition postpartum. A restrictive postpartum diet can put a mother at danger for multiple things, including:

  • Increased risk of maternal mental illness, such as postpartum depression and anxiety

  • Prolonged healing from pregnancy and childbirth

  • Malnutrition

  • Low milk supply

  • Difficulty breastfeeding

  • Sub-optimal quality of life

Nutrient demands are increased from pregnancy and breastfeeding, which can be impossible to meet under the restrictions of an elimination diet. A mother who is nutrient deficient may be susceptible to more complications. A postpartum, breastfeeding mother who is following a restrictive diet runs the risk of crashing and burning.

The demands and stressors on a new mother are already hard enough as it is. Adding the pressure to follow a limited diet makes new motherhood exponentially more difficult. A restrictive diet makes it impossible for breastfeeding mothers to thrive. As the Academy of Breastfeeding Medicine has noted, “The maternal risks of an extensively restrictive elimination diet must be weighed against the potential infant benefits.”

Elimination Diets Can Trigger Eating Disorders in Breastfeeding Moms

For mothers with a history of an eating disorder, such as anorexia, bulimia, or binge eating disorder, following an elimination diet while breastfeeding could trigger a relapse. The transitions that come with pregnancy and postpartum can contribute to risk factors for a woman susceptible to having an eating disorder. When this is combined with the advice to follow an elimination diet, it can create the perfect storm for an eating disorder relapse to occur in a breastfeeding mother.

Postpartum is a precarious time for maternal mental health. Many new mothers are silently struggling with disordered eating and body image dissatisfaction during this time, and lack of support and screening often puts women under the radar for severe maternal psychiatric illnesses, including eating disorders.

Dieting in any form, especially something restrictive like a breastfeeding elimination diet, can be damaging for a woman who may be struggling with food and her body. Intentionally restricting multiple foods and entire food groups can be the trigger that causes a breastfeeding mom to slip back into the abyss of dangerous eating disorder behaviors.

Dealing With Food Allergies and Sensitivities in Breastfed Babies

What about breastfeeding babies who may actually have a food-related sensitivity or allergy? It’s always important to look at the big picture before jumping to conclusions or beginning an elimination diet.

Food allergies or sensitivities very rarely appear as just fussiness, which alone, is not usually food-related. In many cases, there may be a family history of food allergies and sensitivities. In addition, a breastfed baby may exhibit the following signs of a food allergy:

  • Vomiting

  • Rashes

  • Recurring Congestion and/or Ear Infections

  • Inconsolable crying for long periods of time

  • Unresolved skin issues, such as eczema, hives, and dry skin

  • Asthma, Wheezing

  • Gastrointestinal distress, such as diarrhea, constipation, or stools with mucus or blood

  • Failure to Thrive

As always, it’s important to take a collaborative approach to cases like this. A breastfeeding mother’s health should not be jeopardized or neglected while searching for underlying causes. This is where the help of a specialized registered dietitian can be helpful along with a pediatrician and lactation consultant, to ensure that all her nutrient needs are maintained while safely breastfeeding her baby.

What Foods Should I Eat While Breastfeeding?

The bottom line is, unless there is a diagnosed food allergy in a mother or her nursing infant, or suspected signs of food allergies or reactions to certain foods, it is safe for a breastfeeding mother to eat a balanced diet and enjoy a variety of foods. There is no list of foods that breastfeeding moms should avoid.

Ultimately, if a nursing mother is able to meet her nutrient needs without any adverse reaction to her baby, this is setting her up for optimal health, postpartum recovery, and a likelihood to thrive as a new mother.

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