Tag Archives: infants

Breast Milk | The Paleo Diet

Hello Dr. Cordain and Team,

My wife and I are Paleo adherents ever since we learned of the Paleo diet about 5 years ago. We have a 9 month old little daughter who we are trying to raise according to Paleo principles as best we can with regards to diet and lifestyle. Initially, our daughter would not take to latching and very quickly decided that she just wanted to drink her mother’s milk straight from a bottle. So, from roughly 2-3 months, she has been eating pumped breast milk (Paleo) received from her own mother or another trusted Paleo milk donor. Now, both mother and the donor have stopped their supply of milk and our daughter is, as I said, only 9 months old.

She has been eating solid foods, squash, zucchini, chicken, lamb, turkey, spinach, etc. (basically an awesome Paleo diet like mommy and daddy) for the last 3 months. Along with such awesome whole foods (which we blend up nicely and she eats most of the time without concern) we were still supplementing her food diet with Paleo breast milk. Now, as a stop-gap because the donor suddenly informed us of her inability to meet our needs, we have been supplementing our daughter’s diet with almond milk (pure organic almond milk made by a small batch farmer which includes just almonds and water). We chose almond milk for the positive fat it would provide but understand that the nutritional makeup does not even come close to resembling mother’s milk or even dairy milk with lactose etc.

We take our daughter to a holistic, organically inclined, and progressive pediatrician, but when we asked the doctor her advice, she suggests our best option is to give our daughter the ‘best’ formula that we can find. She suggested an organic dairy based formula that also contains soy products (soy-like products frankly) in it as well. On the face of it, this doesn’t sit well with us as we believe in adhering to Paleo principles as best we can and the idea of soy and various hormone/thyroid issues that can arise from ingesting soy concern us. Soy’s high phytic acid levels also concern us for nutrient absorption reasons as well.

So, we find ourselves in a unique situation and we are leaning towards finding some sort of 100% grass-fed (potentially raw) dairy solution, such as supplementing with a Whole Fat – Bulgarian yogurt that my wife uses sparingly on her ‘off days.’ The main reason we are considering dairy is because we have read that babies need lactose (which is in mother’s breast milk as well as cow’s milk) to help with their developing brains.

Now, for concerned yet incredibly lay parents when it comes to the world of nutrition, we feel overwhelmed and at a loss for what might be the right or best balance we can find with the variables that we have at hand. Of course, we understand that sometimes choices need to be made that are less than optimal, but provide the best chances of success, but we’d also like to make sure we feel confident that whether we go ahead with our Dr.’s recommendation or we find another alternative (supplementing the almond milk with lactose?) we are making the best choice available to us.

So, if you have any personal advice or can point me in the right direction towards some answers regarding our situation, my gratitude would know no bounds.

Thanks in advance!

A Grateful Paleo Poppa

Dr. Cordain’s Response:

First and foremost, I don’t have all of the definitive answers on how to raise infants into healthy toddlers, into healthy children, into healthy adolescents and finally into healthy young adults.

Nevertheless, Lorrie and I somehow managed to overcome the obstacles of contemporary, western world living and diets, as we raised our three sons (now 18, 22, and 24) who all grew up with parents who not only followed the Paleo diet, but probably were the very first parents in the western world who raised their children with this concept in mind. By the way, all three boys ended up being tall, strong, athletic, good students, free of acne, myopia, and dental carries. Moreover, they all became calm, happy children, adolescents, and young men.

Like your wife, we did not have the option of nursing for an extended period, as there was no mother’s milk available for each of our three sons. Hence, we were stuck with the commercial formulas available at the time (early to mid 90s). At this juncture, the USDA did not allow infant formula to be supplemented with long chain fatty acids (DHA and AA) that are normally found in mothers milk. Fortunately, I had scientist friends at the National Institute’s of Health (NIH) who had access to formulas containing DHA and AA which we gave to our first son. Our other two boys simply received commercial formula without these long chain fatty acids. Today, many baby formulas contain DHA and AA which have been shown in clinical trials to improve cognitive performance.

For all three infant boys, after formula and the little mother’s milk we could provide for (~3-6 months), we included freshly puréed fresh fruits and veggies (via our home blender) into their diets and also started them on commercially puréed baby meats, as we didn’t have the machinery to puree fresh meats ourselves. We did not give our children cow’s milk or dairy products during their first 3-5 years of life and rarely or never wheat or cereal containing products. Instead of iron fortified cereals (as suggested by most pediatricians), we gave them commercially available, pureed baby meats which provided their little bodies with the iron that was gradually being depleted after birth, but did not cause constipation or colic.

Once their teeth came in, we pretty much fed them any and all foods Lorrie and I ate. However, we were not “Paleo Police” and allowed them non-Paleo foods at parties, school functions, and elsewhere while encouraging them to eat fresh fruits, veggies, meats, fish, seafood, nuts, eggs, etc. We never stocked bread, cereals, candy, ice cream, soda or processed foods in our house. However, we also had an incredible cornucopia of fresh food available at all times which they could eat ad libitum.

After nearly 25 years of promoting Paleo, but not requiring or enforcing it, our children (now men) are adherents to Paleo, not because of their parents’ earlier admonitions and suggestions, but rather their own choice.


Human breast milk is often called liquid gold, and should be considered the most original Paleo food available in modern times. Although today’s standards for the human diet have migrated away from our evolutionary roots,1 research still supports numerous health benefits for both infants and their mothers when breastfeeding exclusively during the first six months of life.2

However, it turns out that is quite challenging for mothers today to stick to these guidelines, often citing insufficient milk supply or a still hungry infant as the main reasons to supplement with commercial formulas or to abandon nursing altogether.3 One study showed that 92% of new mothers experienced issues, such as difficulty with the infant latching on to the breast, pain during nursing and a fear of insufficient milk production during the first week postpartum.4

Breastfeeding isn’t easy. Primate behavior indicates that breastfeeding requires learning for both mother and infant in order to be successful. We need to revise our current expectations for a realistic perspective on the process5 and support women as they form a solid feeding relationship with their babies, just as hunter-gatherers pulled together in their communities.6,7,8

It’s safe to assume, that our Paleolithic ancestors were able to successfully feed their newborns human milk, despite that is isn’t an intuitive process and requires learning,9 and the obstacles faced by their modern counterparts today didn’t discourage them. Many factors are at play, such as the parent’s attitudes and mothers returning to work outside the home that influence the declining rates and duration of breastfeeding,10 which typically lasts two to four months compared to two to four years for contemporary hunter-gatherer populations.11

Today women have the choice and privilege whether or not and for how long to breastfeed. However, many mothers experience anxiety and frustration over their perceived lack of ability to nourish their child without supplementation12 with commercial infant formula, which may feel like the only option available to them.

What tools from the Paleo lifestyle can we provide to mothers today to empower them to successfully and sufficiently breastfeed their young?


Without the availability of cribs and strollers, hunter-gatherers were more likely to carry their young. Skin to skin contact between mother and baby have been shown to increase breastfeeding success. 13 Lactation is a neuro-hormonal process involving intact neural pathways and further activated by the mechanical action of the infant’s demand for milk. Therefore, the more frequent and longer the time an infant is encouraged to feed, the greater response from the body to adequately produce milk,14,15 and increase its fat content.16


The nutrient-dense Paleo diet provides mothers with the appropriate building blocks for rich breast milk,17 with high levels of Omega-3 fatty acids similar to those found in traditional societies. 18 The nutritional composition of breast milk is dynamic and varied depending on the infant’s needs.19,20 In general, the fat content of breast milk is 35% – 50% saturated fat, where 20% of the content is lauric and capric acid.21 Cooking with coconut milk and coconut oil can significantly boost lauric and capric acid concentrations of breast milk.22


Hunter-gatherer women didn’t have the societal pressure to try and “do it all” like women today who juggle a family and career, while still in the postpartum year. The levels of anxiety, fatigue, and stress experienced today are all major inhibitors of lactation. 23 It is also common for women who received interventions during delivery, such as the use of pain medications or C-sections to have delayed onset lactation further leading to the pressures on a new mother.24  Luckily, breastfeeding suppresses the physiological and physical responses to stress.25

The Paleo lifestyle can boost a mother’s confidence, and allow her body to respond to the demands of her infant, which will impact her ability to nurse her baby as long as she chooses.



[1] Cordain, Loren, et al. “Origins and evolution of the Western diet: health implications for the 21st century.” The American journal of clinical nutrition 81.2 (2005): 341-354.

[2] Centers for Disease Control and Prevention (CDC. “Breastfeeding trends and updated national health objectives for exclusive breastfeeding–United States, birth years 2000-2004.” MMWR. Morbidity and mortality weekly report 56.30 (2007): 760.

[3] Wagner, Erin A., et al. “Breastfeeding concerns at 3 and 7 days postpartum and feeding status at 2 months.” Pediatrics (2013): peds-2013.

[4] Nommsen-Rivers, Laurie A., et al. “Comfort with the idea of formula feeding helps explain ethnic disparity in breastfeeding intentions among expectant first-time mothers.” Breastfeeding Medicine 5.1 (2010): 25-33.

[5] Macadam, Patricia Stuart, and Katherine A. Dettwyler, eds. Breastfeeding: biocultural perspectives. Transaction Publishers, 1995.

[6] Bender, Barbara. “Gatherer‐hunter to farmer: A social perspective.” World archaeology 10.2 (1978): 204-222.

[7] Apicella, Coren L., et al. “Social networks and cooperation in hunter-gatherers.”Nature 481.7382 (2012): 497-501.

[8] Raj, Vinitha Krishna, and Stacey B. Plichta. “The role of social support in breastfeeding promotion: a literature review.” Journal of Human Lactation 14.1 (1998): 41-45.

[9] Volk, Anthony A. “Human breastfeeding is not automatic: Why that’s so and what it means for human evolution.” Journal of Social, Evolutionary, and Cultural Psychology 3.4 (2009): 305.

[10] Arora, Samir, et al. “Major factors influencing breastfeeding rates: Mother’s perception of father’s attitude and milk supply.” Pediatrics 106.5 (2000): e67-e67.

[11] Li, Ruowei, et al. “Prevalence of exclusive breastfeeding among US infants: The third national health and nutrition examination survey (Phase II, 1991-1994).”American Journal of Public Health 92.7 (2002): 1107-1110.

[12] Vandiver, Trish A. “Relationship of Mothers’ Perceptions and Behaviors to the Duration of Breastfeeding.” Psychological Reports 80.3c (1997): 1375-1384.

[13] Moore, Elizabeth R., and Gene Cranston Anderson. “Randomized Controlled Trial of Very Early Mother‐Infant Skin‐to‐Skin Contact and Breastfeeding Status.” Journal of midwifery & women’s health 52.2 (2007): 116-125.

[14] Lawrence, Ruth A. and Lawrence, Robert M. Breastfeeding: A Guide for the Medical Profession. 5th ed. New York; C.V. Mosby, 1999.

[15] Daly, Steven EJ, and Peter E. Hartmann. “Infant demand and milk supply. Part 1: Infant demand and milk production in lactating women.” Journal of Human Lactation 11.1 (1995): 21-26.

[16]  Kent, Jacqueline C., et al. “Volume and frequency of breastfeedings and fat content of breast milk throughout the day.” Pediatrics 117.3 (2006): e387-e395.

[17] Picciano, Mary Frances. “Pregnancy and lactation: physiological adjustments, nutritional requirements and the role of dietary supplements.” The Journal of Nutrition 133.6 (2003): 1997S-2002S.

[18] Innis, Sheila M., and Harriet V. Kuhnlein. “Long-chain n-3 fatty acids in breast milk of Inuit women consuming traditional foods.” Early human development18.2 (1988): 185-189.

[19] Riordan, Jan, and Karen Wambach, eds. Breastfeeding and human lactation. Jones & Bartlett Learning, 2010

[20] Ballard, Olivia, and Ardythe L. Morrow. “Human milk composition: nutrients and bioactive factors.” Pediatric Clinics of North America 60.1 (2013): 49-74.

[21] Francois, Cindy A., et al. “Acute effects of dietary fatty acids on the fatty acids of human milk.” The American journal of clinical nutrition 67.2 (1998): 301-308.

[22] Koletzko, Berthold, Iris Thiel, and Philip O. Abiodun. “The fatty acid composition of human milk in Europe and Africa.” The Journal of pediatrics 120.4 (1992): S62-S70.

[23] Feher, Stephen DK, et al. “Increasing breast milk production for premature infants with a relaxation/imagery audiotape.” Pediatrics 83.1 (1989): 57-60.

[24] Grajeda, Rubén, and Rafael Pérez-Escamilla. “Stress during labor and delivery is associated with delayed onset of lactation among urban Guatemalan women.” The Journal of nutrition 132.10 (2002): 3055-3060.

[25] Heinrichs, Markus, Inga Neumann, and Ulrike Ehlert. “Lactation and stress: protective effects of breast-feeding in humans.” Stress: The International Journal on the Biology of Stress 5.3 (2002): 195-203.


How Early Should Infants Eat Meat? | The Paleo Diet

An infant’s rate of weight gain during the first year of life can strongly predict obesity later in life.1 Various studies published in recent years have linked cow-milk protein with weight gain for infants.2, 3 Collectively, these studies have led to recommendations that protein should not exceed 15% of total energy during later-infancy and the second year of life.4 Such recommendations, however, don’t differentiate between dairy protein and protein from other sources. Could dairy protein be uniquely problematic, causing weight-gain problems not associated with meat protein? According to 2014 study published in the American Journal of Clinical Nutrition, yes.

Human breast milk contains progressively less protein during later-stages of lactation, particularly the 4-6 month window when infants start consuming complementary foods (while continuing to breastfeed). But how much protein should those complementary foods contain? Would a higher-protein diet be beneficial, provided the protein comes primarily from sources other than dairy? This was the hypothesis for the 2014 study mentioned above. Accordingly, the scientists tested complementary diets with both higher and lower amounts of protein, observing the effects on infants’ growth and their metabolic profiles.5

42 infants five or six months old were randomly assigned to one of two groups. For four months (six to nine months after birth), Group 1 (higher protein) ate complementary diets consisting of meat purees, whereas Group 2 (lower protein) ate iron- and zinc-fortified cereal purees. To qualify for the study, infants had to have had normal birth weights, be breastfed since birth, to continue being breastfed during the study, and no abnormalities nor conditions that would influence growth rate. For both groups, fruits, vegetables, yogurt, and cheese were also allowed (and continued breastfeeding was required). Energy intake for both groups was nearly identical, but with significant differences in macronutrient distributions. By the ninth month, the groups’ calorie consumption were:

How Early Should Infants Eat Meat? | The Paleo Diet

The study yielded two major findings. First, despite widely differing macronutrient ratios, caloric consumption between the two groups was nearly identical. This suggests that infants can effectively regulate energy intake; they’re not prone to overeating because they know when to stop. The second finding was that diets higher in protein are associated with greater linear growth and proportional weight gain. This is a key point. Dairy protein intake during infancy has been correlated with obesity by age seven. In other words, increased weight gain absent proportional linear growth.

So why would milk protein promote obesity/overweight but meat protein promote proportional height/weight gains? The answer is not entirely clear, but the study’s scientists propose two mechanisms. First, dairy, but not meat, could promote the stimulation of insulin-like growth factor I (IGF-I), which in turn could promote obesity/overweight. Second, meat provides plenty of bioavailable zinc and iron, whereas neither dairy nor breast milk provide these nutrients in quantities sufficient to meet the nutritional needs of older infants (greater than six months).6

Although the scientists acknowledge their study requires follow-up research, their findings “reinforce the potential value of introducing flesh foods early.” Indeed, the available research supports the Paleo diet during all stages of life, including infancy. Compared to dairy- and cereal-based complementary diets, meat fares best for infants after six months of breastfeeding. Meat promotes increased growth and proportional height/weight.

Christopher James Clark, B.B.A.
Nutritional Grail

Christopher James Clark | The Paleo Diet TeamChristopher James Clark, B.B.A. is an award-winning writer, consultant, and chef with specialized knowledge in nutritional science and healing cuisine. He has a Business Administration degree from the University of Michigan and formerly worked as a revenue management analyst for a Fortune 100 company. For the past decade-plus, he has been designing menus, recipes, and food concepts for restaurants and spas, coaching private clients, teaching cooking workshops worldwide, and managing the kitchen for a renowned Greek yoga resort. Clark is the author of the critically acclaimed, award-winning book, Nutritional Grail.



[1] Young BE, et al. (Sep 2012). Biological Determinants Linking Infant Weight Gain and Child Obesity: Current Knowledge and Future Directions. Advances in Nutrition, 3. Retrieved from //advances.nutrition.org/content/3/5/675.full

[2] Koletzko B, et al. (Jun 2009). Lower protein in infant formula is associated with lower weight up to age 2 y: a randomized clinical trial. American Journal of Clinical Nutrition, 89(6). Retrieved from //www.ncbi.nlm.nih.gov/pubmed/19386747

[3] Escribano J, et al. (Apr 2012). Effect of protein intake and weight gain velocity on body fat mass at 6 months of age: the EU Childhood Obesity Programme. International Journal of Obesity (London), 36(4). Retrieved from //www.ncbi.nlm.nih.gov/pubmed/22310472

[4] Michaelsen KF, et al. (Oct 2012). Amount and quality of dietary proteins during the first two years of life in relation to NCD risk in adulthood. Nutrition, Metabolism, and Cardiovascular Diseases, 22(10). Retrieved from //www.ncbi.nlm.nih.gov/pubmed/22770749

[5] Tang M and Krebs N. (Oct 2014). High protein intake from meat as complementary food increases growth but not adiposity in breastfed infants: a randomized trial. American Journal of Clinical Nutrition, 100. Retrieved from //ajcn.nutrition.org/content/early/2014/08/13/ajcn.114.088807

[6] Krebs NF, et al. (Jul 2012). Comparison of complementary feeding strategies to meet zinc requirements of older breastfed infants. American Journal of Clinical Nutrition, 1(30). Retrieved from //www.ncbi.nlm.nih.gov/pubmed/22648720

Predicting Childhood Cognitive Performance

How important are socioeconomic factors when it comes to your child’s future academic success? According to a recent report by Child Care Aware America, annual preschool education costs range from $4,500-$12,000 in the US, depending on the state.1 Although President Obama has proposed a program to improve quality and expand access to preschool for lower- and moderate-income families, Parents assume 60% of these costs.2

While preschool education may set the stage for future academic success, are there far less expensive and more effective measures? According to new research published by William Lassek, M.D. and Steven Gaulin, M.D., diet better predicts infants’ future cognitive performance than economics. Specifically, the omega-3 and omega-6 levels of their mothers’ breast milk.3So, where does prenatal and neonatal nutrition come into play?

By comparing the fatty acid profiles of breast milk from women from 28 countries with math, science, and reading ability test results from the Programme for International Student Assessment (PISA), Lassek and Gaulin determined that increased omega-3 docosahexaenoic acid (DHA) and decreased omega-6 linoleic acid levels most strongly predict higher test scores, with no improvements in predictive power when socioeconomic variables were considered. The Paleo Diet is low in omega-6 while featuring the richest dietary sources of DHA—cold-water, fatty fish, particularly salmon, sardines, mackerel, herring, and tuna.

Mothers who consume these fish while pregnant and breastfeeding have higher amounts of DHA in their milk. This was demonstrated in a previous study published by the same authors, among others, comparing the DHA breast milk levels of Tsimane women from Amazonian Bolivia with those of women from Cincinnati. The Tsimane women eat traditional diets consisting primarily of locally grown crops, wild game, and freshwater fish. The Cincinnati women, on the other hand, had typical US diets, including high amounts of trans fats and omega-6 fatty acids (abundant in industrial seed oils, including corn oil and soybean oil).

The Tsimane women’s milk was 400% higher in DHA, 260% lower in trans fats, and 84% lower in omega-6 linoleic acid.4 Lead author Melanie Martin said, “Despite living in economically impoverished conditions, Tsimane mothers produce breast milk that has more balanced and potentially beneficial fatty acid composition as compared to milk from U.S. mothers.”5 High levels of omega-6 are just as disconcerting as low levels of omega-3 because increased omega-6 consistently predicts lower test scores, according to the Lassek and Gaulin study.

This is not surprising, considering that omega-3 and omega-6 fatty acids both compete for the same rate-limiting enzymes. In other words, the ratio of dietary omega-6 to omega-3 is vitally important. Eating fatty fish several times per week is ideal, but if you’re not concurrently limiting your omega-6 consumption, especially by eliminating seed oils from your diet, you won’t be absorbing enough of that omega-3 from the fish. From an evolutionary perspective, the omega-6 to omega-3 ratio should be roughly 1:1.6 Modern Western diets, however, typically yield ratios ranging from 10:1 to 30:1.7

According to the latest PISA results, US students lag behind students from 29 other nations in math and 22 in science, respectively.8 Is this the result of consuming too little DHA and far too much omega-6? Of the 300-million-plus acres planted with food in the US, half are devoted to soy and corn. Another 50 million go to wheat, with only 14 million acres reserved for fruits and vegetables.9 While these numbers are sobering and perhaps disempowering, change starts with the individual.

So if motherhood is on the horizon, now is the time to start eating a healthy Paleo Diet. Of particular importance to your child’s future cognitive performance is the elimination of all industrial seed oils from your diet, particularly corn, soybean, canola, sunflower, safflower, and grapeseed oils. At the same time, be sure to consume DHA-rich fish from the cleanest sources possible several times per week. Education is important, but clearly so are prenatal and neonatal nutrition.

Christopher James Clark, B.B.A.
Nutritional Grail

Christopher James Clark | The Paleo Diet TeamChristopher James Clark, B.B.A. is an award-winning writer, consultant, and chef with specialized knowledge in nutritional science and healing cuisine. He has a Business Administration degree from the University of Michigan and formerly worked as a revenue management analyst for a Fortune 100 company. For the past decade-plus, he has been designing menus, recipes, and food concepts for restaurants and spas, coaching private clients, teaching cooking workshops worldwide, and managing the kitchen for a renowned Greek yoga resort. Clark is the author of the critically acclaimed, award-winning book, Nutritional Grail.


1. Childcare Aware of America (March 2014). Child Care in America: 2014 State Fact Sheets. Retrieved September 28, 2014 from //usa.childcareaware.org/sites/default/files/19000000_state_fact_sheets_2014_v04.pdf

2. Mitchell, A., Stoney, L., & Dichter, H. (2001). Financing child care in the United States: An expanded catalog of current strategies. Ewing Marion Kauffman Foundation. Retrieved September 28, 2014 from //files.eric.ed.gov/fulltext/ED458932.pdf

3. Lassek, WD., and Gaulin, SJC. (August 2014). Linoleic and docosahexaenoic acids in human milk have opposite relationships with cognitive test performance in a sample of 28 countries. Prostaglandins, Leukotrienes and Essential Fatty Acids. Retrieved September 24, 2014 from //www.plefa.com/article/S0952-3278%2814%2900127-6/abstract

4. Martin, MA., et al., (July 2012). Fatty acid composition in the mature milk of Bolivian forager-horticulturalists: controlled comparisons with a US sample. Maternal & Child Nutrition, 8(3). Retrieved September 24, 2014 from //www.ncbi.nlm.nih.gov/pubmed/22624983

5. University of California at Santa Barbara. (June 9, 2012). Anthropologists finds high levels of omega-3 fatty acids in breast milk of Amerindian women. Press release published by Science Daily. Retrieved September 24, 2014 from //www.sciencedaily.com/releases/2012/06/120609152436.htm

6. Simopoulos, AP. (October 2002). The importance of the ratio of omega-6/omega-3 essential fatty acids. Biomedicine & Pharmacotherapy, 56(8). Retrieved September 24, 2014 from //www.ncbi.nlm.nih.gov/pubmed/12442909

7. Ibid, Simopoulos.

8. Layton, L. (December 3, 2013). U.S. students lag around average on international science, math and reading test. The Washington Post. Retrieved September 24, 2014 from //www.washingtonpost.com/local/education/us-students-lag-around-average-on-international-science-math-and-reading-test/2013/12/02/2e510f26-5b92-11e3-a49b-90a0e156254b_story.html

9. Haspel, T. (February 18, 2014). Farm bill: Why don’t taxpayers subsidize the foods that are better for us? The Washington Post. Retrieved September 24, 2014 from //www.washingtonpost.com/lifestyle/food/farm-bill-why-dont-taxpayers-subsidize-the-foods-that-are-better-for-us/2014/02/14/d7642a3c-9434-11e3-84e1-27626c5ef5fb_story.html

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