Low Carb Diet For Weight Loss During Breastfeeding

  • Shahzaman Ganai Doctor of Medicine (MD), Medicine, Charles University, Prague, Czechia
  • Ellie Kerrod BSc Neuroscience - The University of Manchester, England
  • Nisha Cornford Clinical Nutrition MSc at Liverpool Hope University, UK

Overview

Importance of weight loss during breastfeeding

Over time, it has become evident from systematic reviews and NICE (National Institute of Clinical Excellence) public health recommendations that there are no gaps in our understanding of the most efficient and sensible weight management strategies for postpartum women. Effective weight reduction assistance techniques are required to assist women in maintaining their ideal weight throughout their reproductive years and beyond.1 Except in cases of eating disorders, such as anorexia, losing weight has never been demonstrated to be detrimental to health; instead, being overweight increases the risk of developing several serious long-term health issues. Weight after delivery is a reliable indicator of obesity, which harms healthy longevity. Women are advised to lose the weight they gain during pregnancy, but many of them struggle to do so.2

Understanding a low-carb diet

Cutting back on carbohydrates lowers insulin levels and improves cardiometabolic health, therefore triggering weight loss by producing an anabolic, fat-consuming state. People dieting on low-carb diets are advised to consume 30 to 50% of their total calories as protein.3

Safety considerations for breastfeeding mothers

If you are nursing, you should aim to reduce weight gradually. Rapid weight loss can cause less milk to be produced, which is not favourable. Losing weight gradually is very crucial because breastfeeding itself burns calories.

Is a low-carb diet safe for postpartum weight loss while breastfeeding? 

Currently, there isn't any proof that low-carb diets are dangerous for nursing mothers. Concerns about ketosis, long-term cardiovascular safety, lipid response, and renal health are the main ‘’theoretical’’ issues with low-carbohydrate diets.

Addressing concerns about keto-diets during breastfeeding 

The keto diet, which is a diet high in protein, is one of the low-carbohydrate diets often mentioned while discussing postpartum. Making sure "nutritional ketosis" doesn't escalate into "ketoacidosis" is the main issue in this situation. When the body is in ketosis, it switches from using glucose as the main energy source to using fat as the main energy source. Nutritional ketosis occurs when levels are above normal but not alarming (often between 1 and 7 mmol/L) and does not result in acidosis (an acidic state) in the body, which can result in unwanted side effects which are sometimes fatal.3

Expert opinions and medical recommendations

The recommendation towards low-carb diets is that they are generally accepted because they are beneficial for maintaining a healthy lifestyle and improving athletic performance, especially in the present day, where many people's diets are in carbohydrate excess. A diet like this supports general physical function even for people with long-term comorbidities like diabetes, where it can improve glycemic control. Those with such comorbidities should be put on a recommended plan that helps them to reach their goals.3

Planning a low-carb diet for postpartum weight loss

If you are considering a low-carbohydrate diet, check with your doctor or nutritionist if it is advisable for you. They can help you come up with a plan that will make sure you’re getting enough fruits, vegetables and lean protein foods.

Understanding macronutrient requirements for breastfeeding mothers 

There are various low-carbohydrate diets, and they vary according to the daily carbohydrate allowance. Less than 26% of the daily total calories in a typical low-carb diet come from carbohydrates. Less than 130g of carbohydrates are consumed daily for people on a 2000-calorie diet (which is considered an average person's calorie requirement).3 Low-carb diets typically restrict foods with added sugar, such as sweets, processed grains, and candy. On a low-carb diet, however, the items you can eat depend on how many carbohydrates you consume each day. In some low-carb diets, even higher-carb foods like fruits, starchy vegetables, and whole grains can be included in moderation.

Choosing the right low-carb diet approach

Types of low-carb diets:

  • Ketogenic - this is a high-protein & high-fat diet. Carbohydrates make up less than 10% of total calories, around 20-50g of carbohydrate daily. Fats include avocados, olive oil, and full-fat dairy products.
  • Atkins - this is a low-carbohydrate & high protein diet, usually consumed in phases. Usually, intake begins with 20-40g of carbohydrates per day until it reaches 100g per day, but it doesn't exceed this.
  • South Beach - This is a low-carbohydrate & high-protein plus-fat diet, but fats only include lean meats and heart-healthy fats. This diet is also consumed in phases. In the beginning grains and fruits are off-limits.
  • Paleo - This diet encourages eating like our hunter-gatherer counterparts once did. It isn't necessarily a low-carbohydrate diet, but it is fairly naturally low in carbohydrates as it eliminates carb-rich foods, including grains, legumes, and dairy products. 

Meal planning and balanced nutrition

Part of a balanced nutrient list would be to include the following foods in the diet:4

  • Meat, fish, eggs
  • Non-starchy vegetables: spinach, broccoli, cauliflower, carrots, asparagus, tomatoes
  • Low-carb fruits: oranges, blueberries, strawberries, blackberries
  • Nuts and seeds: almonds, walnuts, chia seeds, pistachio
  • High-fat dairy: cheese, butter, heavy cream, greek yoghurt
  • Fats and oils: lard, avocado, avocado oil, olive oil, coconut oil

Incorporating these foods into a meal plan  would look something like the following for one day:4

  • Breakfast : protein source + nuts/yoghurt + fruit
  • Lunch : Meat/protein source + vegetables + dairy (cheese/ cream) + nuts + fruits
  • Dinner : Meat/protein source + vegetables + dairy + fruits

Caloric intake is still important to keep in mind. Therefore, you must consult a nutritionist or dietitian so that they can do the technical aspect of meal planning for you and to ensure that you are getting all the nutrients you need.4

Top tips for successfully following a low-carb diet while breastfeeding:4

  • Consulting a medical professional such as a nutritionist or dietitian
  • Stay hydrated and monitor water intake
  • Be mindful of carbohydrate sources and portion sizes
  • Managing snacking and hunger cravings
  • Using a food diary or nutrition app to monitor and record progress
  • Monitor milk supply and consult a medical professional if supply changes following a change in diet

Combining exercise with a low-carb diet 

Studies have shown that after giving birth, women lose much of the gained weight within the first 6 weeks. On average, the weight retained after those 6 weeks is around 5-7 kgs. To lose this weight, interventions including both diet and physical activity along with individualised support and self-monitoring are more likely to be successful in promoting weight loss.1

Randomised controlled trials investigating exercise-only intervention following the delivery of a baby are currently too limited to draw meaningful conclusions about the best ways to engage postpartum women in physical activity.1 In addition, other studies showed that combined treatment did not yield significant weight or body composition changes beyond dietary treatment alone.5

Potential challenges and how to overcome them 

It is also evident holistically and through research data that women on this trajectory of weight management will face ups and downs. Data has shown that women struggle to balance the demands of postpartum life with taking care of themselves in general. The key challenges that women face include infant care responsibilities, alongside caring for other children, running a home, and working outside the home. Some women also feel that priorities change, and they put the rest of the family's needs before their own, thus also making it difficult.

The most common enabler during these times, after speaking with multiple women, turns out to be partner support and the desire to feel better.1

Supporting milk supply while on a low-carb diet

Ensuring adequate calorific intake for breastfeeding 

Mothers don't necessarily need to eat more calories after giving birth because this tactic aids in postpartum weight loss. For women who are breastfeeding, however, there is a slight increase in calorific requirement of around 450–500 calories daily.6 A newborn baby needs about 500 calories per day on average, and by the time they turn one, they need 800 calories.7

Signs of reduced milk supply and when to seek help

Signs of decreasing milk supply are sometimes misconstrued. Most mothers assume that softer breasts, shorter feeds, breasts that don't feel engorged or leaky, and other symptoms are indicators of low milk production. However, these are deceptive; other indicators of a supply issue can include:6

  • Having insufficient amounts of dirty or wet diapers each day, particularly in the first few weeks of life. A baby should typically use 6 to 8 soiled diapers each day.
  • Lack of weight gain: Following birth, babies lose weight before gaining it. By two weeks, they ought to be restored to their original weight. And then gradually gaining weight for the ensuing few weeks to months.
  • Signs of dehydration: Infants who haven't urinated in several hours, don't scream when they're upset, have sunken soft areas on their heads, are overly lethargic, and have low energy levels may be dehydrated.

For all the above situations, it is important to go see a doctor.

FAQs

What diet is best for breastfeeding moms?

To support your milk production, try to choose healthy options. Pick foods that are high in protein. Choose a variety of fresh produce, whole grains, and fruits. To ensure that you and your infant are receiving all of the vitamins you require, your doctor may advise continuing to take a daily multivitamin and mineral supplement until you wean your baby.

How can I lose fat while breastfeeding?

You can lose fat/weight by following a calorie deficit diet which is recommended by a professional after they have consulted with you and taken into account your details. One such example is a low-carb diet (as mentioned in the article) that helps increase fat burning to provide the energy required by your body.

Can I breastfeed while on a keto diet?

Because keto is high in protein and fat, it may be very satiating. As a result, it might be challenging to consume enough calories to create enough milk for your baby while maintaining your health. Low-carb diets, as indicated in this article, are alternatives to consider.

Summary

Low-carb dieting after giving birth can help mothers lose weight. Currently, there is no data that suggests losing weight during breastfeeding is harmful to one's health. Losing weight generally helps prevent long-term comorbidities. However, it has to be noted that going on a diet during breastfeeding can be stressful both physically and mentally as mothers have to handle multiple tasks on top of taking care of their children. Nevertheless, this can be managed with the proper support and care in place.

References

  1. McKinley MC, Allen-Walker V, McGirr C, Rooney C, Woodside JV. Weight loss after pregnancy: challenges and opportunities. Nutr Res Rev. 2018 Dec;31(2):225–38. https://pubmed.ncbi.nlm.nih.gov/29984681/
  2. Makama M, Skouteris H, Moran LJ, Lim S. Reducing postpartum weight retention: a review of the implementation challenges of postpartum lifestyle interventions. J Clin Med [Internet]. 2021 Apr 27 [cited 2023 Jul 31];10(9):1891. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8123857/
  3. Oh R, Gilani B, Uppaluri KR. Low carbohydrate diet. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 [cited 2023 Jul 31]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK537084/
  4. Blackburn GL, Phillips JCC, Morreale S. Physician’s guide to popular low-carbohydrate weight-loss diets. CCJM [Internet]. 2001 Sep 1 [cited 2023 Jul 31];68(9):761–74. Available from: https://www.ccjm.org/content/68/9/761
  5. Bertz F, Brekke HK, Ellegård L, Rasmussen KM, Wennergren M, Winkvist A. Diet and exercise weight-loss trial in lactating overweight and obese women. Am J Clin Nutr. 2012 Oct;96(4):698–705.https://pubmed.ncbi.nlm.nih.gov/22952179/
  6. U.S. Department of Health and Human Services Office on Women's Health. (2014).Your guide to breastfeeding. Retrieved June 1, 2016, from http://www.womenshealth.gov/publications/our-publications/breastfeeding-guide/
  7. U.S. Department of Agriculture (USDA) (2009). Nutritional needs for infants. In Infant Nutrition and Feeding: A Guide for Use in the WIC and FSF Programs (11–40). Retrieved October 13, 2016, from https://wicworks.fns.usda.gov/wicworks//Topics/FG/CompleteIFG.pdf
This content is purely informational and isn’t medical guidance. It shouldn’t replace professional medical counsel. Always consult your physician regarding treatment risks and benefits. See our editorial standards for more details.

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Shahzaman Ganai

Doctor of Medicine (MD), Medicine, Charles University

Shahzaman is a Junior Doctor currently working in India, over the last year, with future specialist interests in psychiatry. Along with his Interests in medicine, he is an ardent follower of finance, business and health tech news and events. He plans on further enhancing his knowledge in medicine with his interests in business and health tech for future endeavours.

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