Lecithin and Breastfeeding

Summary of use during lactation

Lecithin is a mixture of choline, choline esters, fatty acids, glycerol, glycolipids, triglycerides, phosphoric acid, and phospholipids, such as phosphatidylcholine that are normal components of human milk. Supplemental lecithin has been recommended as a treatment for plugged milk ducts,[1-3] and as an additive to human milk that is given to preterm infants via pumping through plastic tubing in order to prevent fat loss.[4] No scientifically valid clinical studies exist on the safety and efficacy of high-dose lecithin supplementation in nursing mothers or infants. Most nursing mothers do not have adequate choline intake and mothers of very preterm infants may have reduced levels of choline in milk.[5,6] Supplementation with one component of lecithin, phosphatidylcholine, increases choline, but not phosphatidylcholine concentrations in breastmilk and supplementation with choline increases choline metabolites, but not choline in breastmilk. A meta-analysis found that higher maternal choline intake was likely to be associated with better child neurocognition and neurodevelopment.[7] Lecithin is usually well tolerated and is considered to be "generally recognized as safe" (GRAS) by the U.S. Food and Drug Administration. Dietary supplements do not require extensive pre-marketing approval from the U.S. Food and Drug Administration. Manufacturers are responsible to ensure the safety, but do not need to prove the safety and effectiveness of dietary supplements before they are marketed. Dietary supplements may contain multiple ingredients, and differences are often found between labeled and actual ingredients or their amounts. A manufacturer may contract with an independent organization to verify the quality of a product or its ingredients, but that does not certify the safety or effectiveness of a product. Because of the above issues, clinical testing results on one product may not be applicable to other products. More detailed information about dietary supplements is available elsewhere on the LactMed Web site.

Drug levels in milk and infant serum

No published information was found as of the revision date on milk levels of lecithin following maternal supplementation. However, lecithin components such as choline and its esters are normally found in breastmilk. Maternal Levels. A meta-analysis found that the average total water- and lipid-soluble choline (including choline esters) content of milk increased from 71.5 mg/L in colostrum to 152.2 mg/L in transitional milk, then stabilized at 145.0 mg/L in mature milk. The total choline concentration was higher in developing countries than in developed countries.[8] A study of 94 women in China measured choline concentration in breastmilk over time. Choline concentration were 151.48 μmol/L (15.8 mg/L) at 15 days, 134.69 μmol/L (14.0 mg/L) at 30 days, and 119.00 μmol/L (12.4 mg/L) at 90 days postpartum, respectively.[9] Lactating women were given either 480 or 930 mg of choline daily. Both doses increased the breastmilk content of the choline metabolites, phosphocholine, glycerophosphocholine, glycine and trimethylamine oxide.[10] Infant Levels. Relevant published information was not found as of the revision date.

Effects in breastfed infants

Relevant published information was not found as of the revision date.

Effects on lactation and breastmilk

Relevant published information was not found as of the revision date.

References

1. Scott CR. Lecithin: It isn't just for plugged milk ducts and mastitis anymore. Midwifery Today Int Midwife Winter 2005;76:26–7.16419666 PubMed
2. McGuire E. Case study: White spot and lecithin. Breastfeed Rev 2015;23:23–5.25906494 PubMed
3. Lawrence RA, Lawrence RM, Noble L, et al. Breastfeeding: A guide for the medical profession, 9th ed. Philadelphia: Elsevier; 2022.
4. Chan MM, Nohara M, Chan BR, et al. Lecithin decreases human milk fat loss during enteral pumping. J Pediatr Gastroenterol Nutr 2003;36:613–5.12717084 PubMed
5. Minarski M, Maas C, Heinrich C, et al. Choline and betaine levels in plasma mirror choline intake in very preterm infants. Nutrients 2023;15:4758.38004152 PubMed
6. Obeid R, Schön C, Derbyshire E, et al. A narrative review on maternal choline intake and liver function of the fetus and the infant; implications for research, policy, and practice. Nutrients 2024;16:260.38257153 PubMed
7. Obeid R, Derbyshire E, Schön C. Association between maternal choline, foetal brain development and child neurocognition; systematic review and meta-analysis of human studies. Adv Nutr 2022;13:2445–57.36041182 PubMed
8. Yang M, Zhou Y, Wu S, et al. Choline concentration and composition in human milk across lactation stages: a systematic review and meta-analysis. Crit Rev Food Sci Nutr 2025:1–10.40913782 PubMed
9. Liu P, Deng H, Chen H, et al. Fabrication of dBSA@Hemin@Ag nanozyme based biosensor and application for the assessment of longitudinal concentration changes of choline in human breast milk. Food Chem 2025;495:146427.40975988 PubMed
10. Davenport C, Yan J, Taesuwan S, et al. Choline intakes exceeding recommendations during human lactation improve breast milk choline content by increasing PEMT pathway metabolites. J Nutr Biochem 2015;26:903–11.26025328 PubMed