Can You Do Keto While Breastfeeding?

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Written by Brenda Peralta, Registered Dietitian and medically reviewed by Abby Courtenay

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It is common to want to go back to your pre-baby weight soon after you give birth. Since the ketogenic diet is well-known for its weight loss benefits, many women wonder if they can do low-carb when breastfeeding. 

Of course, the health of your child is by far the most important priority. Giving the baby key nutrients is crucial for optimal growth and development. 

So, can you do keto while you are breastfeeding? This article will explore how dietary choices can affect breast milk, what the risks of going low-carb are, and whether or not this is a safe option for nursing moms.

 

Keto and breastfeeding

Doing keto while breastfeeding is a common topic women search for when looking for ways to lose weight after their pregnancy. However, there is little evidence to determine the side effects or benefits of this type of diet in this population. 

The lack of studies related to this topic is due to ethical reasons. Following a ketogenic diet can significantly increase your chances of ketoacidosis1. However, we will discuss the relationship in the next section. 

The main goal should be to provide the necessary nutrients for the growth and development of the baby. 

Producing breast milk is a very costly process. Thus, women are typically recommended to increase daily caloric intake by 300-400 kcal2 to ensure you can produce enough milk for the baby without depleting all the maternal supplies. 

That means that if your base calories are 1,800 kcal, you should be consuming 2,100-2,200 calories daily for a lightly active breastfeeding woman. 

Now, this doesn’t mean that you cannot lose weight after you give birth. You can achieve weight loss, but more gradually. Research shows that losing 0.5 kg per week won’t affect milk production3

While you still need to be in a caloric deficit to lose weight, a very restrictive diet is not recommended. Going below your energy needs will compromise your nutrient intake, which will affect your health and the quality of the milk4

Some nutrients in your breastmilk are dependent on your diet, including some B vitamins. Healthy carbohydrate sources are a good source of these nutrients. To make sure you are getting your fill of these nutrients, it’s recommended that 45-60% of your calories come from carbs. For most people, this means having more than 150 g of carbs per day.

Thus, a low-carb diet is not encouraged, and a keto diet is not recommended while breastfeeding.

 

Ketosis and breastfeeding

When the body doesn’t have enough carbs, it produces ketones as a backup for energy. While this is a normal condition that won’t affect people in regular situations, breastfeeding itself increases rates of ketone production and then a low carb diet on top of that can cause ketoacidosis. This condition involves dangerously high levels of ketones that can have a negative effect on the mother’s health.

A case report study showed that one woman who was following a ketogenic diet while breastfeeding had a severe case of ketoacidosis5. This produced symptoms like chest pain, nausea, vomiting, and inability to tolerate oral intake for several days. 

Even though this is a rare situation and she was able to be stabilized, there seems to be an increased risk of developing ketoacidosis. While this might not happen to every woman following a ketogenic diet, it's better to prevent it due to the lack of research. 

 

Can you take ketones while breastfeeding?

People often take exogenous ketones to speed up the ketosis process when following a ketogenic diet. There is no research to determine any risks or benefits of taking ketones when you are breastfeeding. 

However, most professionals would recommend against taking any type of exogenous ketones when breastfeeding, because during this time you are already producing high levels of ketones and adding more ketones to the mix (in the form of a low-carb diet or exogenous ketones) can increase a mothers risk for ketoacidosis. 

 

Risks of doing keto while breastfeeding

There are several risks associated with following a keto diet while breastfeeding. Here are the most common. 

  • Possible dangers for the mother, such as an increased risk for ketoacidosis and malnutrition.
  • Nutritional deficiencies. One of the most common side effects of a ketogenic diet is that you lack certain nutrients, including B vitamins, which are usually found in abundance in foods containing carbohydrates. Not only does a deficiency affect the mother, but it also affects the quality of the breast milk. This means that the child may not get the nutrients they need for the healthy development of their body and brain.
  • Constipation. A reduction in carb intake can cause constipation. 

 

Is it safe to do keto while breastfeeding?

Following a ketogenic diet while breastfeeding is not recommended or encouraged. It can be dangerous for mom’s health due to the risk of ketoacidosis, and nutritional deficiencies from a restricted diet may limit the amount of beneficial nutrients available in her milk. 

A balanced diet is recommended for breastfeeding women. A high intake of fruits, vegetables, whole grains, lean protein, and healthy fats can provide both the mother and the child with the recommended nutrients. 

Remember that if you are thinking about making a big change in your eating habits, make sure to consult with your healthcare provider first.  

 

References 

  1. Nnodum BN, Oduah E, Albert D, Pettus M. Ketogenic Diet-Induced Severe Ketoacidosis in a Lactating Woman: A Case Report and Review of the Literature. Case Rep Nephrol. 2019 Jul 8;2019:1214208. doi: 10.1155/2019/1214208. PMID: 31360561; PMCID: PMC6644245.
  2. Breastfeeding - Maternal Diet. Centers for Disease Control and Prevention (CDC). September 2021. https://www.cdc.gov/breastfeeding/breastfeeding-special-circumstances/diet-and-micronutrients/maternal-diet.html
  3. Amorim Adegboye AR, Linne YM. Diet or exercise, or both, for weight reduction in women after childbirth. Cochrane Database Syst Rev. 2013 Jul 23;(7):CD005627. doi: 10.1002/14651858.CD005627.pub3. PMID: 23881656.
  4. Institute of Medicine (US) Committee on Nutritional Status During Pregnancy and Lactation. Nutrition During Lactation. Washington (DC): National Academies Press (US); 1991. 5, Milk Volume. Available from: https://www.ncbi.nlm.nih.gov/books/NBK235589/
  5. Osborne KC, Oliver JJ. Lactation ketoacidosis induced by breastfeeding while on a ketogenic diet: A case report. Am J Emerg Med. 2022 Feb 27:S0735-6757(22)00139-5. doi: 10.1016/j.ajem.2022.02.054. Epub ahead of print. PMID: 35277297.