7 Things to Avoid When You're Breastfeeding

Want to keep your breast milk flowing—and your baby safe? Avoid these foods, medications, and herbs, which could reduce your breast milk supply, make your baby fussy, or otherwise be unsafe.

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Not all foods and herbs increase milk supply. In fact, some plants, herbs, and medications can decrease milk supply. Some, like alcohol or parsley, will slowly de­crease milk supply, while others, like pseudoephedrine, will dramat­ically stop the production of milk within hours of the first dose. Learn all about the food, herbs, and medications that can decrease your milk supply.

1. Alcohol

For many years, health care pro­viders recommended that mothers enjoy a beer before nursing to help with the milk ejection reflex, offer relaxation, boost milk supply, and improve milk quality. However, this advice was a bit misguided. While alcohol certainly has the ability to help one relax, it does so by acting as a depressant of the central nervous system. It also blocks the release of oxytocin, which results in a de­crease of circulating oxytocin and a decrease in the amount of letdowns a mother will have in each nursing session. In studies, after mothers consumed a modest amount of al­cohol, infants initially seemed to suck more frequently. However, pre- and post-feed weights revealed that infants who are fed milk by mothers who have consumed alcohol tend to take in less milk than mothers who were consuming a nonalco­holic placebo. The reason behind this is not yet understood, although it has been noted that alcohol can change the taste and odor of human milk. Mothers have reported that their breasts feel much fuller after drinking alcohol; however, we now know the full feeling is the result of inefficient milk transfer to the in­fant due to alcohol consumption by the breastfeeding mother. It turns out that the myth that alcohol im­proves milk supply is rooted in the fact that many types of beer used to contain therapeutic levels of barley or barley malt, which are known galactagogues. However, modern beer-making results in subthera­peutic levels of barley or oats.

The recommendation still stands that four ounces of wine, one ounce of hard liquor, or eight ounces of beer will not have any appreciable negative impact on your infant, your milk supply, or your infant’s abili­ty to nurse. Any amounts beyond this should be avoided.

While the occasional alcoholic beverage won’t negatively impact your milk supply, in the long term, chronic alcohol consumption will negatively impact your milk quality and milk volume. Additionally, after a night of heavy drinking, you’ll no­tice that your milk supply rapidly declines. Some women are able to recover quickly from this rapid de­cline, usually within 24 to 48 hours. For other women, frequent pumping in addition to ga­lactagogues will be needed to build back a healthy milk supply that will meet the nutritional needs of your baby.

2. Sage, parsley, peppermint, and menthol

Many herbs are naturally lactogen­ic foods that can provide you with the boost in breast milk production you’re looking for. However, not all herbs are created equal. Sage, pars­ley, peppermint, and menthol have all been noted to decrease milk supply in women who consume large quantities of each. There are no formal studies that look at the exact quantity needed for each herb to make a negative impact on breastfeeding; however, anecdot­al evidence has shown that these herbs can and do decrease milk supply. You don’t need to worry about avoiding each of these herbs altogether, but be mindful of dishes that contain large amounts. For in­stance, sage is a popular herb used around on Thanksgiving, parsley is found in large quantities in dish­es like tabbouleh, and peppermint is often found in teas, gums, and candies.

3. Chasteberry

Chasteberry, the dried fruit of the chaste tree, is native to the Mediterranean. It has long been used for a variety of reproductive issues including symptoms related to PMS, endome­triosis, and menopause. Chasteberry has also traditionally been used to help breastfeeding mothers who are experiencing engorgement or any other type of painful swelling of the breast. However, chasteberry exerts its therapeutic effects by acting directly on the pituitary gland and inhibits the secretion of prolactin. When prolactin levels are reduced in a breastfeeding mother, milk supply typically reduces with it. Therefore, it isn’t recommended that breastfeeding mothers take chasteberry supplements for the duration of lactation. If you’re looking for an herb to help ease the inflammation associated with en­gorgement, turmeric is a well-studied option that doesn’t have a negative effect on milk supply.

4. Pseudoephedrine, methergine, and bromocriptine

Some medicines adversely affect breastfeeding. Pseudoephedrine (the active ingredient in Sudafed and similar cold medications), methergine (often used to treat severe uterine bleeding after child­birth), and bromocriptine (brand names Parlodel or Cycloset, used for a variety of issues) have been shown to have a negative effect on milk supply. If your supply has dropped, and you realize you’ve taken one of the medications list­ed here, ask your doctor about an alternative treatment for your cold or health ailment. Increased breast­feeding, supplementation with lactogenic herbs and foods, and possibly additional pumping will help you build up your milk produc­tion again.

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5. Unsafely prepared foods

Passing on harmful pathogens like those involved in food poisoning to your baby via breast milk is very rare, but it’s still important to always practice safe food-handling proce­dures. At the age of six months, your little one, who is still getting 100 percent of her nutrients from breast milk, will transition to getting about 85 percent from breast milk and 15 percent from complementary foods by the end of her first year of life. So starting good food-safety hab­its now is important. Always wash your hands and any surface you’ll be preparing food on thoroughly before cooking. Additionally, make sure to keep cross-contamination to a minimum. Cut meats and veg­etables with different knives and be sure to clean your cutting board thoroughly when switching from cutting meats to vegetables (or just use a separate cutting board for each). Finally, make sure your food is cooked through completely and at a safe temperature to prevent prolif­eration of food-borne illnesses.

6. Caffeine

Many mothers are excited to fi­nally get back to their morning latte routine after giving birth. Unfortunately, more often than not, moms quickly find out that re­introducing caffeine into their diet too soon can lead to a fussy and overtired infant. This is because caffeine is a stimulant that readily passes into breast milk. While the half-life of caffeine in adults is ap­proximately 4.9 hours, the half-life of caffeine in infants can be as high as 97.5 hours (four or more days)!

The older the infant is, the better she will tolerate caffeine. Studies have shown that by three to six months of age, most infants’ sleep wasn’t adversely affected by maternal caffeine consumption. Based on the clinical evidence avail­able, I advise my patients to wait until their infant is at least three months old to reintroduce caffeine into their diet and then watch their baby for any signs of discomfort or restlessness. For moms who work outside the home, I suggest that you always label any pumped milk that you have expressed after consum­ing caffeine to ensure that the infant is not given this milk right before naptime or bedtime. While coffee, tea, chocolate, and soda are obvious sources of caffeine, there are also significant amounts of caffeine in coffee- and chocolate-flavored foods and beverages. Even decaffeinated coffee has some caffeine in it, so keep this in mind if your baby is es­pecially sensitive to it.

7. High-mercury fish

When cooked in a healthy manner (such as baking or broiling), fish can be a nutrient-rich component of your diet. However, due to a wide array of factors, most fish and other seafood also contain unhealthy chemicals, particularly mercury. Mercury is an element found in the Earth’s crust that is typically only released in unhealthy quantities during events like a volcanic erup­tion. Unfortunately, mining, waste incineration, and other industrial processes release unsafe quantities of mercury into the environment. In the body, mercury can accumu­late and quickly rise to dangerous levels. High levels of mercury prin­cipally affect the central nervous system, causing neurological de­fects. For this reason, the US Food and Drug Administration (FDA), Environmental Protection Agency (EPA), and WHO have all cau­tioned against the consumption of high-mercury foods for pregnant women, nursing mothers, and chil­dren. As mercury is considered by the WHO to be one of the top ten chemicals of major public health concern, there are also specific guidelines set forth by the EPA for healthy adults based on weight and gender. In general, no more than two to three servings (a maximum of twelve ounces) of low-mercury fish should be eaten in a week.

Fish that tend to contain low levels of mercury include salmon, flounder, tilapia, trout, pollock, and catfish. (It should be noted, however, that all these fish still do contain mercury, just in lower levels.) Meanwhile, tuna, shark, swordfish, mackerel, and tilefish all tend to have higher levels of mercury and should be avoided. On a lighter note, for moms who have been waiting patiently for forty weeks to eat sushi, you can rest assured that sushi not containing high-mercury fish is considered safe for breastfeeding mothers due to the fact that the Listeria bacteria, which can be found in undercooked foods, is not transmitted readily through breast milk.

Excerpted from Boost Your Breast Milk: An All-In-One Guide for Nursing Mothers to Build a Healthy Milk Supply. © 2017 by Alicia C. Simpson. Reprinted with permission of The Experiment. www.theexperimentpublishing.com

Alicia C. Simpson Boost Your Breast Milk Book Courtesy of The Experiment
Alicia C. Simpson, MS, RD, IBCLC, LD, is an International Board Certified Lactation Consultant and registered dietitian specializing in maternal and pediatric nutrition. The executive director and founder of the nonprofit Pea Pod Nutrition and Lactation Support, she provides nutrition and breastfeeding education to mothers. In addition to Boost Your Breast Milk, she has written three cookbooks, including Quick and Easy Vegan Comfort Food, and lives in Atlanta, Georgia.

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