Breastfeeding, DHA Supplements Essential for Vegan Moms

If well balanced, a vegan diet is absolutely compatible with breastfeeding. However, some nutrients must be taken in supplement form. Among these is DHA, essential for the development of the newborn’s brain and vision.

When discussing foods rich in Omega 3, lists almost always include plant-based foods, particularly walnuts. Therefore, those following a vegan diet (or who do not include fish, an animal source of Omega 3, in their diet) might tend not to worry about not consuming enough.

The reality, however, is different. Because the Omega 3s found in walnuts and other terrestrial plants are not the same as those available from fish and other marine sources – and this means that in some circumstances a lack of supplementation can have undesirable consequences.

Omega 3 and breastfeeding

One such circumstance is breastfeeding. The problem can be observed from two different perspectives:

• that of the mother, who during pregnancy could have consumed up to 50% of her stores of one of the biologically active Omega 3s (docosahexaenoic acid, more commonly known as DHA) and who might take up to 6 months to restore them;
• that of the infant, who daily receives from breast milk 13 to 26 mg of DHA.

But from whichever perspective one looks at it, the solution to this problem is the same: the mother must consume enough DHA to avoid deficiencies and produce milk that contains sufficient amounts to meet the needs of her baby. The latter will use it to build the membranes of its cells, particularly in the central nervous system and retina; this means that through a diet adequately rich in DHA, the breastfeeding mother contributes to ensuring her baby the best development and functioning of their brain and vision.

DHA in the vegan diet

In the vegan diet (which, by itself, is not a contraindication to breastfeeding) the Omega 3 sources do not provide DHA but its precursor, alpha-linolenic acid (ALA). The human body has the means to convert ALA into DHA, but it does so with very low efficiency (according to scientific literature, less than 5% on average); furthermore, it must use these means also to produce Omega 6 polyunsaturated fats from their precursor, linoleic acid, which modern Western diets contain in much higher amounts compared to ALA.

Currently, DHA supplementation is not recommended for all vegans or those who do not eat fish. However, the results of a study published in Nutrients by a group of researchers from the “12 Octubre” University Hospital in Madrid (Spain) suggest that supplement intake by women following such a diet is essential precisely during breastfeeding.

DHA in the milk of vegan mothers

The study authors compared daily DHA intake and DHA levels in milk produced by omnivorous women and by vegan or vegetarian women who did not eat meat or fish. The protocol required participants to record for 5 consecutive days everything they ate and supplements they took, and on the sixth day to collect all the milk they could “express” from one breast at one time.

It emerged that vegan or vegetarian mothers consumed much less DHA (110 mg per day) compared to omnivorous mothers (380 mg per day) and that DHA in the milk of vegan or vegetarian mothers was less than half that present in the milk of omnivorous mothers (0.15% compared to 0.33%).

“The most important differences between the milk of the two groups were found in the distribution of phospholipids and the fatty acid profile, consistent with the significant difference in the type and quantity of fats in vegetarian diets described in other studies and confirmed by our study,” explain the authors. “Regarding essential fatty acids,” they continue, “the Veg group showed significant negative aspects, due to an insufficient intake of DHA and EPA” [the other biologically active Omega 3, ed.] “and a low intake of Omega 3 fatty acids relative to Omega 6.”

As the study authors themselves recall, DHA content in breast milk should be at least 0.30%, a share double that detected by their analyses. Furthermore, their results are consistent with those of another study on the topic, published back in 1992 in The Journal of Pediatrics by two researchers from King’s College London (United Kingdom).

DHA in breastfeeding: which supplements to choose?

There therefore seems to be little doubt about the need, for women who exclude fish from their diet, to take DHA supplements during breastfeeding. Moreover, the effectiveness of supplementation-based strategies to compensate for nutrient deficiencies in the diet of breastfeeding women is proven. This same study indeed highlighted how it is sufficient to take vitamin B12 supplements (a nutrient very deficient in vegan diets for which supplementation is always advisable) so that even the milk of vegan women contains sufficient amounts.

Suitable DHA supplements for women who eat neither fish nor other animal-derived foods are not lacking. It is possible to choose, in particular, those based on algal oil, a plant-based source of marine-origin Omega 3s (EPA and DHA). Given the particular importance of taking products free from potentially harmful contaminants for the baby, the advice is to choose products certified 5 Star IFOS, a brand that guarantees the purity of marine-origin Omega 3 supplements.

Sources:

1. Ureta-Velasco N et al. Human Milk Composition and Nutritional Status of Omnivore Human Milk Donors Compared with Vegetarian/Vegan Lactating Mothers. Nutrients 2023, 15(8), 1855. doi: 10.3390/nu15081855

2. Sanders TA and Reddy S. The influence of a vegetarian diet on the fatty acid composition of human milk and the essential fatty acid status of the infant. Pediatr. 1992 Apr;120(4 Pt 2):S71-7. doi: 10.1016/s0022-3476(05)81239-9