Vitamins and Minerals

From LLL in VA/WV References

The RDAs, AIs, and ULs listed are specifically calculated for breastfeeding mothers. Recommended amounts for non-nursing or pregnant women may be different.

When considering nutritional supplements, be sure to take into account all the other vitamin and mineral sources in your diet, including multivitamins or prenatal vitamins, and fortified foods like breakfast cereals, snack bars, energy bars, nutritional shakes, etc. There may be some health risks in regularly exceeding RDAs through the use of vitamin and mineral supplements. [1]

Recommended Dietary Allowance (RDA) 
The average daily intake amount that is sufficient to meet the nutrient needs of most healthy people.
Adequate Intake (AI) 
A daily intake level that is estimated to be sufficient to meet the nutrient needs of healthy individuals—used when an RDA can't be established.
Tolerable Upper Level Intake (UL) 
The highest daily intake level that is not likely to cause negative side effects in most people. The greater the intake over the UL, the greater the risk of adverse effects. If a nutrient doesn't have an established UL, it does not necessarily mean it's safe in large amounts; it means there isn't enough scientific data to determine what the safe limit is. Use caution if exceeding the RDA.


Fat-Soluble Vitamins

Vitamin A

May be listed as:
Retinol: retinyl palmitate, retinyl acetate
Carotenoids: beta-carotene, alpha-carotene, beta-cryptoxanthin
Daily Allowance for Breastfeeding Mothers:
Recommended amount (RDA):
4,300 IU of retinol (preformed vitamin A), or
8,000 IU of beta-carotene (proform vitamin A)
Vitamin A in supplements is usually a combination of preformed and proform
Upper limit (UL) (do not exceed): 9,000–10,000 IU of retinol
InfantRisk advises breastfeeding mothers not to exceed 5,000 IU of retinol per day.
Supplemental Use:
Be sure to consider total vitamin A intake from both dietary and supplemental sources.
Adults who eat low-fat dairy products, which are fortified with vitamin A, and lots of fruits and vegetables usually do not need vitamin A supplements or multivitamins that contain vitamin A.
Liver damage can occur at doses as low as 15,000 IU of retinol per day.
Beta-carotene is not known to be toxic, even in large doses.
Regular intake of 18,000 IU (30 mg) or more per day of beta-carotene—from supplements, fruits and vegetables, or a combination—can cause carotenodermia, a harmless yellowing of the skin. It's easily reversible by reducing beta-carotene intake.
Anecdotally, a mother in the LLLI Mother-to-Mother Facebook group noticed her milk looked orange after she started taking a multivitamin with 10,000 IU of beta-carotene along with a diet high in carrots and sweet potatoes.
Transfer to Breastmilk:
Taking large doses of retinol increases the levels of vitamin A in the milk of mothers who are at risk of vitamin A deficiency. It's not clear whether excessive vitamin A supplements can increase the retinol concentrations in the milk of well-nourished mothers. [2], [3]
Beta-carotene levels in breastmilk correspond to the mother's intake. [4]

Vitamin D

May be listed as:
Cholecalciferol, Ergocalciferol, Vitamin D2, Vitamin D3
Daily Allowance for Breastfeeding Mothers:
Recommended: 600 IU
Upper limit (do not exceed): 4,000 IU
Supplemental Use:
Many mothers have low vitamin D levels and may need to supplement.
Medical organizations such as the American Academy of Pediatrics and Health Canada recommend that all breastfed babies be given vitamin D supplements of 400 IU per day, starting right after birth. [5] [6]
One clinical trial found that breastfed babies received sufficient vitamin D through breastmilk when their mothers took a daily supplement of 6,400 IU. [7] This dose exceeds the current UL of 4,000 IU per day, although it's below the level that is known to cause toxicity. It's unclear whether long-term supplementation in amounts above the UL can be harmful. [8]
Babies who have dark skin or who have little exposure to sunlight may need supplemental vitamin D even if the mother is also taking supplements.
Transfer to Breastmilk:
Vitamin D levels in breastmilk can be increased if the mother takes a supplement of 4,000–6,400 IU per day. [9]
Supplement amounts should be kept below 10,000 IU per day. Excessive doses of vitamin D could cause high calcium levels in the baby's system as well as the mother's. [10]

Vitamin E

May be listed as:
Alpha tocopherol, dl-Alpha tocopheryl acetate
Daily Allowance for Breastfeeding Mothers:
Recommended: 19 mg or 28.5 IU
Upper limit (do not exceed): 1000 mg or 1500 IU
Supplemental Use:
High doses of supplemental vitamin E might increase the risk bruising and bleeding.
Taking vitamin E supplements in addition to medications that slow clotting—including aspirin, ibuprofen, and naproxen—or herbs that slow clotting might further increase the risk of bleeding.
Transfer to Breastmilk:
Supplementation by the mother does appear to raise vitamin E levels in breastmilk, but it's not clear how much.

Vitamin K

May be listed as:
Vitamin K-1, Vitamin K-2, Phytonadione, Menaquinone, Menatetrenone
Daily Allowance for Breastfeeding Mothers:
Recommended: 90 mcg (0.09mg)
Upper limit (do not exceed): Not established
Supplemental Use:
Vitamin K is not known to be toxic, even in large amounts.
Transfer to Breastmilk:
Only small amounts of supplemental vitamin K transfer to breastmilk.

Water-Soluble Vitamins

Biotin

May be listed as:
Vitamin B-7, Vitamin H
Daily Allowance for Breastfeeding Mothers:
Recommended: 35 mcg
Upper limit (do not exceed): Not established
Supplemental Use:
Biotin is believed to be nontoxic even in high doses.
Transfer to Breastmilk:
Biotin actively transfers into breastmilk.

Vitamin B-6

May be listed as:
Pyridoxine
Daily Allowance for Breastfeeding Mothers:
Recommended: 2 mg
Upper limit (do not exceed): 100 mg
Supplemental Use:
Vitamin B6 deficiency is uncommon, but breastfeeding mothers with limited diets may benefit from B6 supplements.
No adverse effects have been reported from high amounts of vitamin B6 in food.
Vitamin B6 supplements in large amounts above the UL have been associated with nerve damage.
Very high doses of vitamin B6 (>450 mg/day) may decrease milk production. [11]
Transfer to Breastmilk:
Vitamin B6 transfers into breastmilk in amounts directly proportional to the mother's intake.

Vitamin B-12

May be listed as:
Cyanocobalamin
Daily Allowance for Breastfeeding Mothers:
Recommended: 2.8 mcg
Upper limit (do not exceed): Not established
Supplemental Use:
Supplementation is generally recommended for nursing mothers.
Vegetarian mothers, especially vegans, should take supplemental B12 during pregnancy to make sure their babies have sufficient stores after birth.
Large doses of vitamin B12 seem to be nontoxic but are not recommended for regular use.
Transfer to Breastmilk:
Levels in milk correlate with the mother's plasma levels, but supplementation seems to increase the amount in breastmilk only if the mother is vitamin B12 deficient.

Vitamin C

May be listed as:
Ascorbic acid
Daily Allowance for Breastfeeding Mothers:
Recommended: 115–120 mg
Upper limit (do not exceed): 2000 mg
Supplemental Use:
Supplementation is only required in undernourished mothers.
Chronic use of large doses may increase the risk of kidney stones.
Transfer to Breastmilk:
High doses of vitamin C only raise milk levels slightly.

Choline

May be listed as:
Choline bitartrate, Phosphatidylcholine
Daily Allowance for Breastfeeding Mothers:
Adequate intake: 550 mg
Upper limit (do not exceed): 3,500 mg (3.5 g)
Supplemental Use:
The average diet provides enough choline; supplements are rarely needed.
Amounts higher than the upper intake limit can cause sweating, diarrhea, and vomiting.
Transfer to Breastmilk:
Choline levels in breastmilk appear to correlate with the mother's plasma levels.

Folate

May be listed as:
Folic acid, L-methylfolate, Vitamin B-9
Daily Allowance for Breastfeeding Mothers:
Recommended: 500 mcg (0.5mg)
Upper limit (do not exceed): 1000 mcg (1mg)
Supplemental Use:
Supplementation is strongly recommended before and during pregnancy.
During breastfeeding, folate supplements are only needed if the mother is malnourished.
Transfer to Breastmilk:
Supplemental folate does not affect the levels in breast milk.

Niacin

May be listed as:
Niacinamide, Vitamin B-3
Daily Allowance for Breastfeeding Mothers:
Recommended: 17 mg
Upper limit (do not exceed): 35 mg
Supplemental Use:
Most Americans get more than enough niacin in their diets and don't need supplements.
Supplemental niacin may cause a flushing reaction, including burning, tingling, itching, and redness of the face, arms, and chest. It may also cause headaches and gastrointestinal distress.
Transfer to Breastmilk:
Niacin levels in breastmilk appear to correlate with the mother's intake.
Because supplemental niacin transfers to breastmilk, and large doses of niacin can be harmful to the liver, breastfeeding mothers should try to stick to the recommended amounts.

Pantothenic Acid

May be listed as:
Vitamin B-5
Daily Allowance for Breastfeeding Mothers:
Recommended: 7 mg
Upper limit (do not exceed): Not established
Supplemental Use:
Pantothenic acid is present in almost all types of food, and a normal diet provides sufficient amounts. Supplementation is not needed.
Pantothenic acid deficiency probably only occurs in cases of life-threatening malnutrition.
High doses may cause diarrhea.
Transfer to Breastmilk:
Pantothenic acid levels in breastmilk appear to correlate to the mother's dietary intake, but supplements may not greatly increase the levels if the mother is already well-nourished.

Riboflavin

May be listed as:
Vitamin B-2
Daily Allowance for Breastfeeding Mothers:
Recommended: 1.6 mg
Upper limit (do not exceed): 50 mg
Supplemental Use:
Meat and dairy are the main dietary sources of riboflavin, so vegan mothers may need to supplement.
Excess riboflavin is mostly flushed out through urine and not stored in the body.
Riboflavin supplements may cause urine to turn a yellow-orange color. In high doses, it may cause diarrhea and an increase in urine output.
Transfer to Breastmilk:
Supplemental riboflavin increases the amount in breast milk.

Thiamin

May be listed as:
Thiamin, Thiamine, Vitamin B-1
Daily Allowance for Breastfeeding Mothers:
Recommended: 1.4 mg
Upper limit (do not exceed): Not established
Supplemental Use:
While most breastfeeding mothers get enough thiamin from their diets, those with limited diets may benefit from supplementation.
No adverse effects have been reported from large amounts of thiamin from either food or supplements.
The Institute of Medicine recommends using caution with high doses because the data is limited, and there may be unknown adverse effects. Breastfeeding mothers should avoid megadoses of thiamin.
Transfer to Breastmilk:
Supplements increase thiamin levels in breastmilk.

Minerals

Calcium

May be listed as:
Calcium salts, Calcium carbonate, Calcium lactate, Calcium gluconate, Calcium citrate
Daily Allowance for Breastfeeding Mothers:
Recommended: 1000 mg
Upper limit (do not exceed): 2000 mg
Supplemental Use:
Excessive doses of calcium supplements (including antacids) can cause constipation, may interfere with the absorption of iron and zinc, and may contribute to kidney stones and other kidney problems.
Transfer to Breastmilk:
Calcium supplementation does not significantly change calcium levels in breastmilk.

Chromium

May be listed as:
Chromium chloride, Chromium nicotinate, Chromium picolinate, High-chromium yeast, Chromium citrate
Daily Allowance for Breastfeeding Mothers:
Recommended: 45 mcg
Upper limit (do not exceed): Unknown; chromium poisoning is possible
Supplemental Use:
For non-breastfeeding adults, chromium supplements may be safe in amounts up to 1000 mcg per day.
In higher amounts, chromium may cause headache, dizziness, nausea, mood changes, impaired mental function, or loss of coordination in some people.
May decrease blood sugar levels, especially when taken in combination with other herbs that lower blood sugar.
Excessive chromium supplements have been linked to kidney and liver damage.
May interfere with the body's absorption of iron and zinc.
Transfer to Breastmilk:
Chromium levels in breast milk are independent of the mother's plasma levels.
Supplemental chromium does not significantly change levels in breast milk.

Copper

Daily Allowance for Breastfeeding Mothers:
Recommended: 1.3 mg
Upper limit (do not exceed): 10 mg
Supplemental Use:
Amounts higher than the UL can cause kidney and liver damage.
Transfer to Breastmilk:
Copper levels in breastmilk are not affected by the mother's intake.

Iodine

Daily Allowance for Breastfeeding Mothers:
Recommended: 290 mcg (0.29mg)
Upper limit (do not exceed): 1100 mcg (1.1mg)
Supplemental Use:
Be sure to take dietary sources into account before supplementing. One cup of yogurt or milk contains 20-25% of the recommended daily amount of iodine for breastfeeding mothers.
Seaweed and kelp may contain up to 20 times the recommended daily intake.
Large amounts of iodine can cause thyroid problems in breastfed babies.
Transfer to Breastmilk:
Supplemental iodine transfers into breastmilk at high levels.
The average amount of iodine in breastmilk exceeds the RDA for babies, so supplementation is rarely needed.

Iron

May be listed as:
Ferrous salts, Ferric salts, Ferrous sulfate, Ferrous gluconate, Ferric citrate, Ferric sulfate
Daily Allowance for Breastfeeding Mothers:
Recommended: 9 mg
Upper limit (do not exceed): 45 mg
Supplemental Use:
Supplementation is only needed if the mother is deficient.
High doses of supplemental iron may cause constipation, nausea, and vomiting.
Transfer to Breastmilk:
Iron supplements taken by the mother do not increase the amount of iron in breastmilk.

Magnesium

May be listed as:
Magnesium aspartate, Magnesium chloride, Magnesium citrate, Magnesium gluconate, Magnesium lactate, Magnesium oxide
Daily Allowance for Breastfeeding Mothers:
Recommended: 310–320 mg
Upper limit (do not exceed): 350 mg (only applies to supplements; not food sources)
Supplemental Use:
High doses of magnesium supplements can cause diarrhea, nausea, and abdominal cramping.
Magnesium from food usually does not cause side effects.
Transfer to Breastmilk:
Magnesium levels in breastmilk are not affected by the mother's intake.

Manganese

May be listed as:
Manganese sulfate
Daily Allowance for Breastfeeding Mothers:
Recommended: 2.6 mg
Upper limit (do not exceed): 11 mg
Supplemental Use:
Amounts higher than the UL can cause neurological damage.
Transfer to Breastmilk:
No information available.

Molybdenum

Daily Allowance for Breastfeeding Mothers:
Recommended: 50 mcg
Upper limit (do not exceed): 2000 mcg (2 mg)
Supplemental Use:
Supplementation is rarely needed; a typical diet provides more than the RDA of molybdenum.
Transfer to Breastmilk:
No information available.

Phosphorus

May be listed as:
Phosphate salts, Calcium phosphate, Potassium phosphate, Sodium phosphate
Daily Allowance for Breastfeeding Mothers:
Recommended: 700 mg
Upper limit (do not exceed): 4,000 mg (4 g)
Supplemental Use:
Most foods contain phosphorus; it's almost impossible to be deficient. Supplementation is not needed.
Transfer to Breastmilk:
Phosphorus levels in breastmilk do not change with supplementation.

Potassium

Daily Allowance for Breastfeeding Mothers:
Adequate intake: 5000 mg
Upper limit (do not exceed): Not established
Supplemental Use:
Potassium from food sources does not seem to cause any adverse effects.
Potassium supplements may cause nausea, vomiting, and diarrhea.
Because of the potential for toxicity, the Institute of Medicine recommends potassium supplements only be used under medical supervision. [12]
Transfer to Breastmilk:
Potassium levels in breastmilk may be influenced by the mother's dietary intake.

Selenium

May be listed as:
Sodium selenite
Daily Allowance for Breastfeeding Mothers:
Recommended: 70 mcg
Upper limit (do not exceed): 400 mcg
Supplemental Use:
Most breastfeeding mothers get enough selenium from their diets and don't need supplements.
Long-term use of high doses may lead to symptoms of toxicity, such as hair loss, streaking on fingernails, brittle nails, fatigue, irritability, nausea, vomiting, garlic breath odor, and a metallic taste.
Brazil nuts contain very high amounts of selenium (544 mcg per oz), which could lead to toxicity if eaten regularly.
Transfer to Breastmilk
Selenium levels in breastmilk reflect the mother's dietary intake.

Sodium

May be listed as:
Sodium chloride
Daily Allowance for Breastfeeding Mothers:
Adequate intake: 1,500 mg
Upper limit (do not exceed): 2,300 mg
Supplemental Use:
The diets of most people in the US and Canada contain more than the upper intake level of sodium.
Getting less than the adequate intake level doesn't appear to cause problems for healthy people.
Transfer to Breastmilk:
The mother's sodium intake does not affect sodium levels in milk.

Zinc

May be listed as:
Zinc salts, Zinc gluconate, Zinc acetate, Zinc oxide, Zinc sulfate
Daily Allowance for Breastfeeding Mothers:
Recommended: 12 mg
Upper limit (do not exceed): 40 mg
Supplemental Use:
Because zinc absorption is lower in vegetarian diets, breastfeeding mothers who are vegetarian may need to take zinc supplements.
For women in the US, the average zinc intake from food is slightly lower than the recommended daily amount for breastfeeding mothers.
Amounts higher than the UL can cause nausea, vomiting, loss of appetite, abdominal cramps, diarrhea, and headaches, and may deplete copper levels in the body.
Transfer to Breastmilk:
Levels in breastmilk are not affected by zinc supplements.

Sources