Avoiding certain foods in the mother's diet

Can I eat spicy foods and cabbage?

There is very little evidence that any foods eaten by a breastfeeding mother has such an impact on the otherwise healthy baby that it should be avoided. The baby has already tasted all the flavours of the mother’s meals while in the uterus. If the baby is allergic or reacting to a food the mother has eaten, the baby will become noticeably ill or significantly unhappy and mothers should consult their health-care providers. Caffeine can affect babies and caffeinated drinks should be limited to two per day. Mothers should also avoid large amounts of cocoa and chocolate. The effect of sweeteners on breastfeeding babies is not well studied but high fructose-corn sweetener may increase the risk of obesity in children. 

A) Worries about the mother’s diet

Foods that are safe for the mother to eat generally pose no risk to the baby. Many mothers worry that their diet is contributing to their baby’s crying, tummy cramps, and gas (Kidd 2019). Rather there are a number of causes for a normal baby’s unhappiness and these are not related to the mother’s diet. 

Studies have shown that parents tend to over-diagnose food allergies. Please discuss any changes in your diet or concerns about your baby's possible allergies with your health-care providers.

On occasion, a baby may be upset by foods that a mother eats without this being a true allergy. In this situation, if you do change your diet, ensure that it has the desired effect within a few days. It is also reasonable to retry the food after a few weeks as delaying exposure to certain foods for extended periods can increase the risk of allergies. 

Mothers who avoid a number of foods need to ensure that their overall needs are met. There are also other possible drawbacks to avoiding some foods. 

B) Spicy foods

Of course mothers can eat spicy food! Some cultures discourage breastfeeding mothers from eating it, but this practice is not supported by scientific evidence.

The baby has already tasted all the flavours of the mother's meals while in the uterus. Her foods flavour the amniotic fluid that the baby tastes and swallows (Mennella 2001). Tasting these same flavours in breast milk will seem normal to the baby.

Babies like flavour. For example, garlic flavours breastmilk after mothers eat it (Scheffler 2019). Studies showed that babies tend to take in more milk and breastfeed more after their mothers had eaten garlic (Mennella 1991; Mennella 1993).

Early exposure to many flavours through breast milk may encourage babies to accept a wide variety of foods and be less picky once they start solid food (Mennella 2017). Some will even reject bland foods in favour of spicier items.

All of this means mothers shouldn’t hesitate to enjoy spicy foods.

C) Gassy foods

There is only minimal evidence that any food, including cabbage, onions, garlic, beans, cow’s milk, and chocolate have a major impact on the baby such that it should be avoided (Iacovou 2018; Lust 1996).

D) Caffeine

Caffeine is found in coffee, colas, energy drinks, yerba mate, and black and green tea.

Caffeine stimulates the nervous system. Fussiness, jitteriness, and poor sleep patterns have been seen in babies whose mothers drank more than the equivalent of 10 cups of coffee each day (NIH). It is usually recommended that mothers do not drink more than 2 cups of caffeinated drinks each day. Decaffeinated coffee has low levels of caffeine but can accumulate if a mother drinks large amounts of it (McCusker 2006).

Premature babies do not remove caffeine quickly from their systems. This makes them more sensitive to caffeine. Caffeine is also used as a medication, to stimulate the breathing of premature babies. Taking in caffeine-containing breast milk can further increase the baby’s levels and mothers of such babies should review their caffeine consumption.

Chocolate and cocoa drinks contain small amounts of caffeine and much larger amounts of the closely related compound, theobromine. Small amounts of either are not a problem but large amounts can affect a breastfeeding baby (Cambria 2006).

E) Sweeteners

There is very little information about the safety of artificial sweeteners while breastfeeding. If mothers choose to use such products, aspartame may be preferred as it does not enter breast milk (Anderson 2019).

High-fructose corn sweetener is found in many non-diet soda (fizzy) drinks and increase the levels of fructose in breast milk (Berger 2018). This may increase the risk of obesity in babies and it may be wise to limit such items (Anderson 2019).

F) Special situations

1) Allergies

If your baby is truly allergic to a food you have eaten, the baby will become noticeably ill. Please consult your health-care provider if your baby has any of these symptoms:

2) Glucose-6-phosphate dehydrogenase (G6PD) deficiency

People of Mediterranean, African, or South Asian heritage are more likely to have low levels of an enzyme called glucose-6-phosphate dehydrogenase (G6PD deficiency). It is the most common cause of enzyme deficiency and affects 400 million people worldwide. It is passed from mother to child and boys are much more commonly affected.

G6PD deficiency causes red blood cells to break down when the person is exposed to certain foods (such as fava [broad] beans) or medications (such as quinine and quinine-type drugs and aspirin) or when ill.

Quinine is a medication used to treat malaria and babesiosis. It is also used in soda (fizzy) drinks such as tonic water. The amount of quinine found in breast milk after drinking tonic water and other drinks containing quinine may be enough to affect babies with G6PD deficiency (Bichali 2017).

References

Anderson PO. How Sweet It Is: Sweeteners in Breast Milk. Breastfeed Med. 2019 Jan/Feb;14(1):14-16

Berger PK, Fields DA, Demerath EW, et al. High-Fructose Corn-Syrup-Sweetened Beverage Intake Increases 5-Hour Breast Milk Fructose Concentrations in Lactating Women. Nutrients. 2018 May 24;10(6):669
 
Bichali S, Brault D, Masserot C, et al. Maternal consumption of quinine-containing sodas may induce G6PD crises in breastfed children. Eur J Pediatr. 2017 Oct;176(10):1415-1418
 
Cambria S, Manganaro R, Mami C, et al. Hyperexcitability syndrome in a newborn infant of chocoholic mother. Am J Perinatol. 2006;23:421-2
 
Iacovou M, Craig SS, Yelland GW, et al. Randomised clinical trial: reducing the intake of dietary FODMAPs of breastfeeding mothers is associated with a greater improvement of the symptoms of infantile colic than for a typical diet. Aliment Pharmacol Ther. 2018 Nov;48(10):1061-1073
 
Kidd M, Hnatiuk M, Barber J, et al. "Something is wrong with your milk": Qualitative study of maternal dietary restriction and beliefs about infant colic. Can Fam Physician. 2019 Mar;65(3):204-211
 
Lust KD, Brown JE, Thomas W. Maternal intake of cruciferous vegetables and other foods and colic symptoms in exclusively breast-fed infants. J Am Diet Assoc. 1996 Jan;96(1):46-8
 
McCusker RR, Fuehrlein B, Goldberger BA, et al. Caffeine content of decaffeinated coffee. J Anal Toxicol. 2006 Oct;30(8):611-3
 
Mennella JA, Beauchamp GK. Maternal diet alters the sensory qualities of human milk and the nursling's behavior. Pediatrics. 1991 Oct;88(4):737-44
 
Mennella JA, Beauchamp GK. The effects of repeated exposure to garlic-flavored milk on the nursling's behavior. Pediatr Res. 1993 Dec;34(6):805-8
 
Mennella JA, Daniels LM, Reiter AR. Learning to like vegetables during breastfeeding: a randomized clinical trial of lactating mothers and infants. Am J Clin Nutr. 2017 Jul;106(1):67-76
 
Mennella JA, Jagnow CP, Beauchamp GK. Prenatal and postnatal flavor learning by human infants. Pediatrics. 2001 Jun;107(6):E88
 
Scheffler L, Sharapa C, Buettner A. Quantification of volatile metabolites derived from garlic in human breast milk. Food Chem 2019;274:603-10
 
United States National Institute of Health (NIH), National Library of Medicine, Toxnet, Drugs and Lactation Database (LactMed) [Internet]. Bethesda: U.S. National Library of Medicine; [date unknown] [cited 2018 Nov 16]