Carbohydrate restriction during lactation: A systematic review

Ana Laura Benevenuto de Amorim; Ester Ferreira Rodrigues; Elizandra Lopes Sussi; Lenycia de Cassya Lopes Neri

doi:10.1016/j.nutres.2024.02.007

Carbohydrate restriction during lactation: A systematic review

Nutr Res. 2024 Feb 29:125:91-100. doi: 10.1016/j.nutres.2024.02.007. Online ahead of print.

Authors

Ana Laura Benevenuto de Amorim¹, Ester Ferreira Rodrigues², Elizandra Lopes Sussi², Lenycia de Cassya Lopes Neri³

Affiliations

¹ Nutrition Department, Santos Metropolitan University, Santos, SP, Brazil; Children's Institute of Faculty of Medicine, Department of Pediatrics, University of São Paulo, São Paulo, Brazil.
² Children's Institute of Faculty of Medicine, Department of Pediatrics, University of São Paulo, São Paulo, Brazil.
³ Children's Institute of Faculty of Medicine, Department of Pediatrics, University of São Paulo, São Paulo, Brazil; Ketogenic Metabolic Therapy Laboratory, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy; Laboratory of Food Education and Sport Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy. Electronic address: lenyciadecassya.lopesneri@unipv.it.

PMID: 38565002
DOI: 10.1016/j.nutres.2024.02.007

Abstract

The quality of a mother's diet is important to ensure child growth and development and keep women healthy. This systematic review aimed to identify the outcomes of a carbohydrate-restricted diet during lactation. PubMed, EMBASE, Scopus, Web of Science, and LILACS were searched for studies published between 2012 and 2023; 16 studies were selected, all of them case reports or care series. The carbohydrate restriction described in the papers mainly was ketogenic, low-carb, low-carbohydrate and high-fat, and modified ketogenic diets. The main goal of women undertaking these diets was weight loss, with therapeutic purposes (monitored and supervised by health professionals) in only 2 cases: (1) ketogenic diet therapy for treatment of seizures in the infant and (2) to reduce symptoms of mother's gastroesophageal reflux. Most articles reported that lactating women were hospitalized, experiencing symptoms such as vomiting, muscle weakness, nausea, abdominal pain, general malaise, and fatigue. However, articles did not mention poor outcomes for the infants. Most of the studies in this review were published in the past 3 years, indicating a possible increase in cases of women practicing carbohydrate restriction during lactation for weight loss caused by body dissatisfaction. In conclusion, carbohydrate restriction during lactation may be harmful to the lactating woman and contribute to the state of lactational ketoacidosis, but infant outcomes are mainly a change in feeding patterns. Thus, education on food and nutrition is necessary for this population.

Keywords: Breast feeding; Carbohydrate; Ketogenic diet therapy; Lactation; Restriction diet.

Publication types

Review