Table 5: D-A-CH recommendations of nutritional intake during lactation [68] and tolerable upper intake level (UL) according to EFSA Guidelines [102] or the NIH [103] for healthy nonbariatric women as well as recommendations for intake after bariatric surgery for women (when available, data specific for lactation are reported).

NutrientRecommended daily dietary intake during lactation (D-A-CH reference)UL per dayRecommended daily intake after bariatric surgery

Iron20 mg45 mg45–60 mg [6, 62] up to 300 mg [104]
Calcium1000 mg62500 mg1200–1500 mg [6, 62], 1500–2000 mg RYGB [104], BPS/DS 1800–2400 mg [62, 104]
Vitamin D20 µg = 800 IU4100 µg = 4000 IU4 [82]At least 3000 IU [6] up to 6000 IU [62]
Vitamin A1500 µg equivalent13000 µg = 10000 IU5000–10000 IU9 [62, 104]
Vitamin E17 mg equivalent2,3,7300 mg, 1000 mg [62]Lactation 19 mg, else 15 mg [62]
Vitamin K60 µgNo recommendation90–120 µg, BPS 300 µg [62]
Vitamin B124.0 µg8No recommendation1000 mg/month i.m. or s.c. [6, 62]. 350–500 µg p.o. [62, 104]
Folic acid450 µg1 mg400 µg [6, 104], 400–800 µg, 800–1000 µg10 [62]
Iodine260 µg600 µg, 1100 µg
Zinc11 mg25 mg, 40 mgBPS 16–22 mg RYGB 8–22, mg, SG, LABG 8–11 mg [62]
Magnesium390 mg250 mg5, 350 mg5

11 mg retinol equivalent = 6 mg all-trans-β-carotene = 12 mg other provitamin A carotenoids = 1 mg retinol = 1.15 mg all-trans-retinyl acetate = 1.83 mg all-trans-retinyl palmitate; 1 IU = 0.3 µg retinol. 21 mg RRR-α-tocopherol equivalent = 1 mg RRR-α-tocopherol = 1.49 IU; 1 IU = 0.67 mg RRR-α-tocopherol = 1 mg all-rac-α-tocopheryl acetate. 31 mg RRR-α-tocopherol (D-α-tocopherol) equivalent = 1.1 mg RRR-α-tocopheryl acetate (D-α-tocopheryl acetate) = 2 mg RRR-β-tocopherol (D-β-tocopherol) = 4 mg RRR-γ-tocopherol (D-γ-tocopherol) = 100 mg RRR-δ-tocopherol (D-δ-tocopherol) = 3.3 mg RRR-α-tocotrienol (D-α-tocotrienol) = 1.49 mg all-rac-α-tocopheryl acetate (D, L-α-tocopheryl acetate). 41 µg vitamin D = 40 IU. 5The UL does not include magnesium from nutritional sources or fluid and accounts for supplements only. 61200 mg calcium in women <19 years of age. 7Around 260 µg RRR-α-tocopherol equivalent extra per 100 g secreted milk. 8Around 0.13 µg vitamin B12 extra per 100 g secreted milk. 9Depending on procedure, LABG 5000 IU, RYGB or SG 5000–10000 IU, BPS 10000 IU per day, β-carotene form does not contribute to vitamin A toxicity. 10To women of childbearing age. All NIH recommendations for women >18 years of age; i.m., intramuscular; p.o., per os; BPS = biliopancreatic diversion; RYGB = Roux-en-Y gastric bypass; SG = sleeve gastrectomy; LAGB = laparoscopic gastric banding; DS = duodenal switch surgery.