From the Guidelines
A ketogenic diet is not recommended during breastfeeding due to its potential to reduce milk supply and compromise maternal and infant nutrition. Breastfeeding mothers require a balanced diet that provides adequate calories, protein, and essential nutrients to support milk production and infant development 1. The ketogenic diet's severe carbohydrate restriction (typically 20-50g per day) may interfere with this process, and its high fat content may not provide sufficient nutrients for both maternal health and infant growth.
Key nutritional considerations for breastfeeding women include:
- Adequate calorie intake, typically 300-500 calories above pre-pregnancy needs 1
- Plenty of fluids, with a recommended intake of at least 2.0 L/day for females, and an additional 700 mL/day for lactating women 1
- Sufficient protein, with a recommended intake of 19 g/day during the first six months of lactation, and 13 g/day after six months 1
- Adequate intake of essential nutrients, including calcium, iron, vitamin D, and omega-3 fatty acids 1
Instead of a ketogenic diet, breastfeeding women should focus on a balanced diet that meets these nutritional needs. If weight loss is desired, a moderate approach with a smaller caloric deficit is safer and can be achieved through a balanced diet and regular physical activity. Any dietary changes during breastfeeding should be discussed with a healthcare provider or lactation consultant to ensure the best possible outcomes for both mother and baby.
From the Research
Safety of Ketogenic Diet in Breastfeeding
- The safety of a ketogenic diet during breastfeeding has been studied in several research papers 2, 3, 4.
- A study published in 2024 found that human milk and breastfeeding can be incorporated safely into ketogenic diet therapy, and with expert guidance, human milk and breastfeeding do not reduce diet effectiveness 2.
- Another study published in 2022 found that a ketogenic diet can be used to treat seizures in breastfeeding infants diagnosed with epilepsy, by managing the mother on a ketogenic diet and altering the composition of the mother's own milk 3.
- A retrospective study published in 2020 found that inclusion of breast milk into the ketogenic diet is feasible, safe, and effective for treating infants with severe childhood epilepsy 4.
Potential Risks
- However, there are also potential risks associated with a ketogenic diet during breastfeeding, such as lactation ketoacidosis 5, 6.
- A case report published in 2019 found that a strict ketogenic diet can induce severe ketoacidosis in a lactating woman, highlighting the importance of prompt diagnosis and immediate treatment 5.
- Another case report published in 2021 found that a deliberate ketogenic diet can induce metabolic acidosis in a lactating woman, emphasizing the need for a dietary history in patients with unexplained metabolic derangements 6.
Key Findings
- The key findings from these studies suggest that a ketogenic diet can be safe during breastfeeding, but it is essential to be aware of the potential risks and to monitor the mother's and infant's health closely 2, 3, 4.
- Healthcare professionals and mothers should be made aware of the potential risks associated with a strict ketogenic diet when combined with lactation, and prompt diagnosis and immediate treatment are crucial in case of any adverse effects 5, 6.