GOOD IN BALANCE

What I wish someone had told me

When I was nursing my twins, Beckham and Dylan, the advice was completely contradictory and relentless. My mother-in-law said to drink a beer for my supply. My lactation consultant said oatmeal at every meal. A mommy blog had a list of 23 foods to avoid, including garlic, broccoli, and "anything acidic." My own mother called from Ohio to warn me about spicy food.

I was a registered dietitian with a master's degree in nutrition science. And I was still stressed about what I was eating because the noise was so loud.

Meanwhile, I was so hungry I was eating cold leftover pasta at 2 AM with one hand while nursing a baby with the other. By month three, I was nursing two babies and barely keeping up with my own calorie needs.

What I know now, after 15 years of working with postpartum moms and after surviving 10 months of tandem nursing: your body is remarkably good at making milk regardless of what you eat. Classic research published in the New England Journal of Medicine documented that milk composition stays relatively consistent even in malnourished women — the body prioritizes milk production. What suffers when you eat poorly isn't your milk. It's you. Your energy, your mood, your recovery, your bone density. Eating well while breastfeeding is about taking care of yourself so you can keep doing this.

How much you actually need to eat

Breastfeeding burns roughly 300-500 extra calories per day. That's for one baby. I was nursing twins, so closer to 700-900. To put that in perspective, it's the caloric equivalent of running 3-5 miles — except you're doing it while sitting on a glider at 3 AM watching the same four Netflix shows on rotation.

I see new moms trying to "eat clean" and cut calories while breastfeeding because they want to lose baby weight. I understand the impulse. I had the same one. But restricting calories while nursing almost always backfires. Supply dips. Energy crashes. You end up face-first in a bag of Goldfish crackers at midnight because your body is screaming for fuel it didn't get during the day.

What I tell clients who are exclusively nursing:

• One baby: aim for roughly 2,300-2,500 calories per day, about 450-500 more than your pre-pregnancy needs
• Pumping part-time or supplementing with formula: 2,000-2,300 calories
• Breastfeeding multiples: you need significantly more — work with a dietitian, because the math gets complicated

You don't need to count calories. Nobody has time for that when there's a newborn involved. Just eat three real meals with protein at each one, snack when you're hungry, and pay attention to how you feel. Lightheaded by noon? You're not eating enough. Exhausted in a way that goes beyond "new parent tired"? Same answer. Your hunger is not lying to you right now.

Protein, fat, and carbs — why all three matter

I keep this framework as simple as possible for breastfeeding clients because they are operating on fragmented sleep and genuinely limited brain capacity. I say this with zero judgment, because I was right there with them.

Protein (the non-negotiable)

Protein supports tissue repair from delivery, helps with milk production, and is what stands between you and the 3 PM energy collapse. I aim for 20-30g at each meal, which is roughly a palm-sized piece of chicken, two eggs plus a yogurt, or a cup of Greek yogurt with some nuts.

What I actually ate when I was nursing Beckham and Dylan: eggs every single morning. Scrambled, fried, sometimes just boiled and eaten standing over the sink. Rotisserie chicken for lunch almost every day because I could eat it cold with one hand and didn't have to cook it. Whatever Joe made for dinner plus extra protein. String cheese and almonds between meals. Not glamorous. Got the job done.

• Animal sources: eggs, chicken, salmon and other fatty fish, beef, turkey, Greek yogurt, cottage cheese
• Plant sources: beans, lentils, tofu, nut butters, hemp seeds, edamame

A 2012 review in Nutrients found that breastfeeding women need approximately 1.5g of protein per kilogram of body weight per day — notably higher than non-pregnant, non-lactating adults. Most women I work with aren't hitting that without paying attention to it.

Fat (yes, eat it)

I had a client who ate fat-free everything while breastfeeding because she was trying to lose baby weight. Her hair was falling out in visible clumps. Her skin was cracked and painful. She was exhausted in a way that sleep wasn't fixing. Fat is not optional when you're nursing. Your body needs it for hormone production, your baby needs it for brain and nervous system development (breast milk is roughly 50% fat by calories), and fat-soluble vitamins A, D, E, and K cannot be absorbed without it.

• Avocados, olive oil, nuts, seeds — these should be daily
• Fatty fish like salmon and sardines: rich in DHA, which directly concentrates in breast milk and supports infant brain and visual development
• Full-fat dairy, nut butters, whole eggs (including the yolk)

The DHA thing is worth paying attention to. If you're not eating fatty fish 2-3 times a week, a postnatal DHA supplement is worth taking. The concentration of DHA in breast milk directly reflects mom's dietary intake, and it matters for the baby.

Carbs (your body cannot make milk without them)

Lactose, the primary sugar in breast milk, is synthesized from glucose. Glucose comes from carbohydrates. If you dramatically cut carbs while breastfeeding, you're restricting one of the literal building blocks of your milk. I've had clients try keto while nursing. Supply dropped within a week in almost every case.

Oatmeal became my best friend when I was nursing. There's a reason it shows up in every lactation cookie recipe on the internet — many nursing moms notice a supply boost after adding it to their daily routine. The evidence is mostly anecdotal rather than from controlled trials, but oats are cheap, filling, and full of iron and fiber, so there's no downside to eating them.

• Oatmeal, whole grain bread, brown rice, sweet potatoes, quinoa
• Fruit, especially bananas, which are also easy to eat one-handed
• Beans and lentils (bonus: also count toward your protein)

You are burning hundreds of extra calories every day just sitting there. Carbs are fuel. Eat them without guilt.

Galactagogues: what the evidence actually shows

Almost every breastfeeding client asks me about foods and herbs that supposedly boost milk supply. Here's my honest assessment after reviewing the research and working with hundreds of nursing moms.

Oats are the one food I consistently recommend, and I already said why. The evidence is mostly from observation rather than clinical trials, but the pattern in my practice is consistent enough that I take it seriously.

Fenugreek gets the most research attention among herbal galactagogues. A 2018 systematic review in Phytotherapy Research found some evidence for modest supply increases, but the studies are small and the results are inconsistent. It also causes GI side effects in some women and makes your sweat smell unmistakably like maple syrup, which is odd to discover in the shower. I tell clients to check with their OB before trying it, especially if they're on any medications.

Brewer's yeast, flaxseed, fennel seeds, blessed thistle — these show up in lactation supplement blends everywhere. Will any of them rescue a genuinely low supply? Probably not on their own. Are they nutritious foods worth including anyway? Yes. I think of them as "can't hurt, might help" additions to an already solid diet, not substitutes for it.

The thing that actually drives milk supply more than anything you eat: how often and how effectively milk is removed from your breasts. Supply is demand-driven. If supply is low, work with a lactation consultant before turning to supplements. The supplements can run alongside that work, but they can't substitute for it.

Staying hydrated (most nursing moms aren't)

Breast milk is about 87% water. Your body prioritizes milk production over your own hydration, which means dehydration shows up in you first — headaches, constipation, dark urine, fatigue, that sandpaper feeling in your skin.

I tell clients to aim for about 12 cups of water per day while exclusively nursing. The easiest system I've seen actually work: drink a full glass every time you sit down to nurse or pump. If you're nursing 8 times a day, that's 8 glasses built automatically into things you're already doing.

I kept a 32-oz insulated water bottle on the side table next to the rocking chair where I nursed. Before I sat down for each session, I filled it. By the end of the session, I tried to finish at least half. It wasn't perfect, but it got me close to my daily goal without ever having to think about it as a separate task.

Coffee and alcohol — the questions everyone actually wants answered

Let's just get here directly, because I know this is what half of you scrolled down looking for.

Coffee: yes. The CDC guidelines say up to 300mg of caffeine per day, which is roughly two to three 8-oz cups of coffee, is considered safe while breastfeeding. About 1% of what you drink ends up in your milk. Most babies handle trace caffeine without issue. Some are sensitive — if your baby is unusually fussy or wakeful, it's worth experimenting with cutting back for a few days. My twins were apparently immune to caffeine in breast milk, which was a relief because I was not prepared to give up coffee.

Alcohol: an occasional drink is fine. The practical guideline is to wait 2-3 hours after one drink before nursing, which is roughly how long it takes for a standard drink to metabolize. Your milk alcohol level mirrors your blood alcohol level — if you feel sober, your milk is essentially clear. "Pump and dump" is mostly unnecessary unless you're engorged and need to relieve pressure for comfort. It doesn't speed up alcohol clearance. Worth noting: research published in Alcoholism: Clinical and Experimental Research found that alcohol temporarily reduces both milk production and infant feeding, so save it for occasional evenings out, not a nightly habit.

The "avoid" list is much shorter than the internet suggests

Every breastfeeding forum has a thread where moms compare the lists of foods they've eliminated. Dairy, gluten, soy, eggs, nuts, cruciferous vegetables, garlic, onions, anything that might possibly cause a fussy afternoon. I've had clients show up to our first appointment eating plain chicken breast and white rice because they'd systematically removed everything else, were miserable, and were still dealing with a gassy baby.

The actual evidence-based list of what to avoid:

• High-mercury fish: swordfish, shark, king mackerel, tilefish, and bigeye tuna. Stick to salmon, cod, sardines, shrimp, and canned light tuna.
• Excessive caffeine (more than 300mg/day)
• Alcohol beyond occasional, moderate use
• Any specific food your particular baby clearly and consistently reacts to — identified through a careful, deliberate elimination trial, not by guessing based on one fussy afternoon

That's genuinely it. Garlic, broccoli, onions, spicy food, chocolate, dairy: none of these are on a universal avoid list. A 2011 review in Pediatrics found that cow's milk protein sensitivity affects only about 2-3% of breastfed infants. Don't preemptively eliminate food groups. Eat normally and only investigate if your baby shows consistent, specific symptoms — things like blood in stool, severe rashes, or persistent mucousy stools after every single feeding, not just occasional fussiness that all newborns have.

Signs your baby might have a food sensitivity

A small percentage of babies do react to something in mom's diet. The signs to watch for:

• Excessive crying or fussiness that's consistent and hard to console, especially after feedings
• Green, mucousy stools happening repeatedly
• Blood in stool (see your pediatrician immediately — this one doesn't wait)
• Eczema or hives, especially if they track with your eating patterns
• Congestion or wheezing that isn't explained by illness

Cow's milk protein is the most common culprit, followed by soy, eggs, and wheat. If you suspect a sensitivity, eliminate the food completely for 2-3 weeks and see if symptoms genuinely improve. Don't try to eliminate multiple foods at once without medical guidance — you'll end up nutritionally depleted and you won't know which food was actually the issue.

What actually worked for me at night

I set up a small basket on the side table next to our nursing chair before the twins were born. I put protein bars in it, individual almond packs, a couple of those little mandarin oranges, and a stack of granola bars. I refilled it every Sunday.

This sounds like a small thing. It was not a small thing. At 2:30 AM when you're nursing a baby and your stomach is growling and the kitchen feels extremely far away, having food within arm's reach is the difference between eating something and eating nothing. I ate from that basket almost every night for months. I also kept a box of granola bars in the nightstand, because occasionally both babies would wake up at the same time and I needed backup supplies.

Joe was good about keeping the basket stocked. He also made it his job to have rotisserie chicken in the fridge at all times, which I ate cold, standing over the counter, more times than I can count. That chicken probably kept my supply going on the weeks when everything else was chaos.

Easy meals when survival mode kicks in

Some weeks you cook. Most weeks you survive. Both are fine.

Breakfast: overnight oats made the night before, scrambled eggs and toast, Greek yogurt with whatever fruit is in the bowl. The goal is protein within 30 minutes of waking up. It doesn't have to be elaborate.

Lunch: rotisserie chicken pulled apart over a bagged salad. Leftovers from dinner. A wrap with deli turkey and whatever cheese is in the fridge. Tuna on crackers. Hummus with vegetables and pita bread. None of these require cooking or two hands.

Dinner: this is where slow cooker meals earn their keep. Set it up during nap time, eat at 6 PM without having touched the kitchen again. Sheet pan dinners — protein and vegetables on one pan, into the oven — are also reliable. And yes, pasta with jarred sauce and frozen meatballs is a real dinner. So is ordering takeout. The goal is protein and calories, not Instagram.

Supplements worth taking

Even with good eating, some nutrients are hard to get enough of while breastfeeding:

• Postnatal vitamin: continue your prenatal or switch to a postnatal formula. Iodine is particularly important for breastfeeding — it concentrates in milk and supports infant thyroid development, and many prenatals don't have enough of it.
• Vitamin D: many women are deficient even before pregnancy. 2,000-4,000 IU daily is the range I recommend most clients, and the AAP also recommends supplementing exclusively breastfed infants with 400 IU of vitamin D directly because breast milk alone doesn't provide enough.
• Omega-3/DHA: if you're not eating fatty fish 2-3 times per week, supplement with 200-300mg DHA daily. It directly affects the DHA content of your milk.
• Iron: if you had significant blood loss during delivery or are anemic, your doctor will check this. Don't supplement iron without testing first.

When things fall apart (and they will)

Some days you'll eat well. Some days you'll eat crackers and half a banana and call it lunch because one baby won't stop crying and the other one finally just fell asleep and you are not moving from this spot. Both are real. Both are fine.

Your milk supply won't crash because you had a bad eating day. Your body has reserves. What you're building is a pattern over weeks and months, not a single-day performance.

The signs that something is actually off and needs addressing: supply is dropping noticeably over several days, you're dizzy when you stand up, you're losing weight faster than about a pound per week, your hair loss is extreme (some postpartum hair loss is normal; significant clumping is not). All of these are reasons to eat more, not just push through.

The bottom line

Breastfeeding nutrition is not complicated when you strip away the noise. Eat enough — more than you think you need. Get protein at every meal. Eat fat and carbs. Drink water constantly. Take a postnatal vitamin and probably a DHA supplement. Enjoy your coffee and the occasional glass of wine. Ignore the 47-item avoid lists on the internet unless your specific baby gives you a specific reason to investigate.

Taking care of yourself is taking care of your baby. A well-fed mom has more energy, better mood, and a more reliable supply than an exhausted mom who's been cutting calories and stressing about garlic. Feed yourself well. That's the whole thing.

Written by Erin Albert, RD

Registered Dietitian with 15+ years experience helping busy families find balance. Mom of twins who gets the real-life struggles of feeding a family.

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