Nutrition for mom while pregnant & breastfeeding or tandem breastfeeding

Remember that both pregnancy and lactation are
states for a woman’s body, not a medical condition.

Special Dietary Considerations (Pregnant & Nursing or Tandem Nursing)

If a mother is reasonably well-nourished her body can continue to meet her own needs and the needs of both her unborn child/infant and the older nursling. This is especially true if the older nursling is at least a year old when mom gets pregnant. In some cases, the health care provider may recommend that the mother consume more calories and/or take prenatal vitamins (but it’s unwise to take more than one a day).

The only mothers who are likely to need special dietary consideration would be those who fall into the following categories:

If the mother is… Consider…
anemic iron
dairy-free calcium
vegan vitamin B12
taking supplemental iron adding zinc, too, but at a different time of day
unable to consume enough calories using supplements to increase calorie intake, and decide if reduced breastfeeding would be helpful


When eating for three, who comes first?

When the subject of breastfeeding during pregnancy comes up, it is often said that the mother’s body gives first to the fetus, then to the nursling, and then to her own reserves. This may unintentionally be a bit misleading. First, we do not know how nutrients are partitioned between placenta and human milk production during times of nutritional stress. And secondly, you could take this to mean that your body will provide for your children to your own detriment. There is no reason to believe this is true for well-nourished mothers.

— Hilary Flower in Adventures in Tandem Nursing, p. 249


Pregnant and/or nursing mothers do not need additional calcium other than that normally required for their age group. The Institute of Medicine recommends that nursing mothers over the age of 18 consume 1,000 mg. of calcium daily — the same as other adults.

Hilary Flower researched this question for Adventures in Tandem Nursing: Breastfeeding during Pregnancy and Beyond. She found three important facts that have come from the research of Dr. Ann Prentice in recent years:

  1. Recovery of bone mineral density occurs BEFORE weaning. The recovery begins after the baby’s diet begins to be supplemented with other foods or liquids (the “partial breastfeeding phase”). By 12 months breastfeeding mothers have fully recovered their bone mineral density.
  2. If a mother becomes pregnant before the recovery is complete, bone mineral density increases during pregnancy, a phenomonon not usually seen.
  3. Mothers who are tandem nursing fare the same as their breastfeeding peers.

Flower comments: “Eventually popular beliefs will catch up to the scientific advances of the last five years, and breastfeeding mothers will no longer have to fend off admonishments that their bones are in jeopardy. For their part, scientists have moved on.” (Adventures in Tandem Nursing, p. 213)

For more on calcium see Calcium.

Nursing and pregnant (added calories)

Most mothers find that if they simply eat to satisfy their increased hunger they can easily consume enough calories to support the pregnancy and continued lactation. Let your hunger and thirst dictate how much you take in. If you feel hungry, then you need to eat, regardless of how large the amounts may seem. Some mothers notice a decrease in appetite when milk supply decreases later into the pregnancy.

You will want to gain weight just as you would if you were not nursing: 25-35 pounds is the current recommendation. See also What if I lose weight in the first trimester? 

Tandem nursing (added calories)

A tandem nursing mother may need considerable calories, and the exact number will vary due to several factors:

  • The percentage of breastmilk in the diets of the infant and older child. The more milk you are making, the more calories you will need. The Institute of Medicine estimates that a mother who is exclusively breastfeeding and does not have spare fat reserves will need an additional 650 calories; this same mother would need 500 additional calories for a baby aged 6-12 months who is getting solids. When nursing an older child who is getting less milk, calorie requirements would be proportionally less.
  • Mom’s activity level, weight and nutritional status. A mother who is less active, has more fat stores from pregnancy, and/or eats foods higher in nutritional value may need fewer calories than a mom who is more active, has fewer fat stores, and eats more processed foods.

As during pregnancy, let your appetite be your guide. If you are hungry, don’t be afraid to eat two of every meal and snack constantly. Fatigue can be a sign of not getting enough calories.

For research-based information on nutrition for mothers breastfeeding during pregnancy and tandem nursing, see Adventures in Tandem Nursing: Breastfeeding During Pregnancy and Beyond by Hilary Flower.

Nutrition topics covered include:

  • Natural Safeguards
  • First, Let’s Talk Quantity
    (How large should your diet be? Gauging milk volume during pregnancy)
  • Next, the Quality Question
    (Do I need to watch any particular nutrients? Will I need to supplement my baby’s intake? Should I take a prenatal vitamin? How do you follow a Pregnant – and Breastfeeding! – Appetite? Pregnancy Nausea and Vomiting)
  • Letting the Scale Guide You
    (Weight loss during the first trimester and during tandem nursing, Keeping up with your food needs while keeping up with a toddler)
  • Water Intake

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