A keto diet is just wholesome, real food, minus sugar and starch. So, “Is keto safe while breastfeeding” is the wrong question. A better question is, “Is it safe to eat good quality proteins, healthy fats, and non-starchy vegetables during breastfeeding?” Then, the answer becomes self-evident.
We know that keto diets are excellent for reversing type 2 diabetes and metabolic syndrome, improving PCOS and fatty liver, and emerging research suggests keto can even lead to “unprecedented improvements” in psychiatric conditions. But just because eating a very low carbohydrate diet is beneficial for a long list of health issues doesn’t automatically mean it’s safe for a woman who’s breastfeeding, or for her baby.
So, let’s take a closer look at whether there’s cause for concern about following a ketogenic diet while breastfeeding.
Keto is Just Real Food
Asking if it’s safe to follow a keto diet while breastfeeding implies that there’s something inherently dangerous or questionable about this way of eating. This concern is based on a misunderstanding of what keto really is.
If your only exposure to keto comes from clickbait headlines and thumbnail images on social media, you might think it’s nothing but piles of bacon with melted cheese, topped with more bacon and more cheese.
(And a huge glob of butter in your coffee, too.) And sure, a diet of nothing but bacon and cheese would likely put you into a state of ketosis, but that’s not what most keto-oriented medical and nutritional professionals recommend eating.
A keto diet is just wholesome, real food, minus sugar and starch. So, “Is keto safe while breastfeeding” is the wrong question. A better question is, “Is it safe to eat good quality proteins, healthy fats, and non-starchy vegetables during breastfeeding?” Then, the answer becomes self-evident.
Maybe a better question is, is it safe to eat foods that jack up mom’s blood sugar and insulin during breastfeeding? Is it safe to drink liquid sugar and eat lots of refined carbs?
What Moms and Babies Need
Healthy moms make healthy babies. When mom is healthy, then baby has a better chance of being healthy, too. So, do mom and baby need carbs, or do they need adequate energy (calories) and good, complete nutrition?
In terms of essential micronutrients, there’s nothing you can get exclusively from high-carb foods that you can’t get from foods very low in carbs. Whether the concern is potassium, magnesium, vitamin C, folate, or some other vitamin or mineral, they can all be found in animal proteins or lower carb plant foods.
(News flash: bananas aren’t the only way to get potassium! And you can get plenty of vitamin C even if you never go near a glass of orange juice.)
Women around the world breastfeed and nourish healthy babies on diets that vary widely. Some consume a lot of fruit, grains, or starchy vegetables, and others consume very little of those. The ones who follow diets that contain less carbohydrate may not be doing strictly ketogenic diets, but we know that babies can grow and develop safely and strongly without mom eating a lot of starch and sugar.
There isn’t much published evidence with details about women following ketogenic diets during pregnancy. Anecdotally, keto groups on social media include accounts of women having safe pregnancies and successfully breastfeeding while following ketogenic and even carnivore diets. And there are case reports of women following ketogenic diets for the specific purpose of eliminating seizures in their babies.
(After all, keto was originally an epilepsy diet!) In one such case, the composition of the mother’s milk changed significantly (including becoming higher in fat), and the infant’s seizures stopped.
Words of Caution
Many people adopt a keto diet with the goal of losing weight. Breastfeeding sometimes naturally results in loss of the pregnancy weight, but not always. Postpartum women may be tempted to start a keto diet in order to speed this along, but breastfeeding may not be the appropriate time to focus on an aesthetic goal, and it’s not the time to restrict calories.
The goal is not for mom to look great in a bikini or to fit back into her pre-pregnancy jeans as soon as possible. The goal is to make sure both mom and baby are getting the nourishment they need.
The caution that applies to following a keto diet while breastfeeding is the same that applies to any way of eating: use common sense. If you are breastfeeding and you notice that your milk supply diminishes unacceptably, or your baby appears to be having an adverse reaction to something in your milk, work with a medical professional or trained lactation coach who can help troubleshoot and give you personalized guidance for your situation.
And if that guidance includes eating more carbs, that’s okay!
Keto isn’t the only way to be healthy, and carbs aren’t poison. If following a ketogenic diet isn’t a medical necessity for you, don’t be afraid to increase your carb intake if it supports you having an adequate milk supply.
There are case reports of women adopting ketogenic diets during breastfeeding and having adverse outcomes, such as hospitalization due to acidosis and associated symptoms, such as nausea, vomiting, weakness, fatigue and lethargy, and shortness of breath. However, the authors of a review that included several such reports noted that the overall quality of the studies was low, there was a high risk of bias, and confounding factors were not controlled for.
It’s important to be aware of a rare condition called lactation ketoacidosis. This is rare, and can occur even in women who are breastfeeding but not following ketogenic diets. However, it appears to be more prevalent in women who are breastfeeding and following very low-carb diets combined with fasting, calorie restriction, and potentially excessive exercise.
So again, if you are breastfeeding while following a ketogenic diet, don’t fast or restrict calories. The problems some women experienced while breastfeeding on a keto or low-carb diet may not have been because of the carbohydrate restriction, but rather, from a severe reduction in total food intake when the body’s energy demands are increased in order to support milk production.
Additional Resources
To learn more about following a healthy diet during pregnancy, or ahead of time during the preconception phase or if diagnosed with gestational diabetes, I recommend books by low-carb-friendly registered dietitian, Lily Nichols, who has written extensively on each of these specific topics.
Looking for a low-carb meal?
Then check out Keto Chow! Keto Chow is a keto shake mix with 1/3 of your daily recommended nutrients. It tastes like melted ice cream, and it comes in over 25 delicious flavors. Make it in seconds!
