Vitamin C Supplementation During Breastfeeding
Yes, breastfeeding mothers can and should take vitamin C supplements, with a recommended total daily intake of 155 mg/day (95 mg baseline plus an additional 60 mg for lactation). 1
Recommended Dosage
The European Food Safety Authority (EFSA) recommends lactating women consume 155 mg/day of vitamin C total: the standard 95 mg/day for non-lactating women plus an additional 60 mg/day to compensate for vitamin C secreted into breast milk. 2, 1
Any standard vitamin C supplement providing this recommended amount is suitable and safe for breastfeeding women. 1
Safety Profile
No specific upper limit for vitamin C has been established for lactating women, and standard adult safety guidelines apply, making vitamin C supplementation very safe during breastfeeding. 1
Vitamin C is a water-soluble vitamin with an excellent safety profile, and excess amounts are simply excreted in urine rather than accumulating to toxic levels. 2
Impact on Breast Milk and Infant Health
Vitamin C concentration in breast milk directly reflects maternal vitamin C intake, with healthy supplemented mothers producing milk containing 35-90 mg/L of vitamin C. 2, 1
Exclusively breastfed infants maintain optimal plasma vitamin C concentrations that are approximately 2-fold higher than maternal concentrations, even when maternal intake is marginal. 3
The infant's vitamin C status is relatively independent of maternal plasma concentration but is influenced by maternal dietary intake. 3
Clinical Considerations and Common Pitfalls
Maternal deficiency risk: Approximately 6% of lactating mothers develop subnormal plasma vitamin C concentrations without obvious symptoms, with the lowest levels occurring around 2 months postpartum and during spring months. 3 This highlights the importance of consistent supplementation rather than relying on dietary sources alone.
Dietary sources vs. supplements: Research suggests that vitamin C from food sources may be better absorbed and transferred into breast milk compared to synthetic supplements, though both are effective. 4 The vitamin C concentration in milk correlates positively with maternal intake from food in non-supplemented diets (r = 0.402, p = 0.041). 4
Inadequate dietary intake: Studies show that nearly 20% of breastfeeding mothers consume less than 50 mg of vitamin C daily from diet alone, far below requirements. 4, 5 Maternal dietary vitamin C intake is significantly correlated with breast milk vitamin C content (r = 0.61, p < 0.01). 5
Seasonal variation: Breast milk vitamin C levels vary by season, being higher in summer (3.9 mg/100 ml) than winter (3.02 mg/100 ml), reflecting dietary availability of fresh fruits and vegetables. 5
Practical Implementation
Continue or initiate a multivitamin supplement containing at least 60 mg additional vitamin C during the entire breastfeeding period. 6
Women who took multivitamin supplements during pregnancy should continue them postpartum, as discontinuation leads to inadequate vitamin provision to the infant through breast milk. 6
Mothers who do not take vitamin supplements provide only about half of their infant's vitamin C needs through breast milk alone. 6