Anemia and Breastfeeding
Anemia and breastfeeding
By Karen Miles | Medically reviewed by Cheryl Axelrod, M.D., ob-gyn | June 10, 2021
You can breastfeed if you have anemia. It's important to treat your anemia, though, so that you feel better and are able to produce plenty of milk. If you're anemic, ask your provider which iron supplement to take while breastfeeding. Most prenatal and multivitamins contain enough iron, unless you're very deficient (because of blood loss at delivery, for example). Even if you're anemic, your full-term infant will have enough iron stored for at least the first 4 months of life. If your baby was born prematurely, she may need iron drops.
Can I breastfeed if I have anemia?
Yes. Breastfeeding is good for you and your baby even if you have iron-deficiency anemia. Iron-deficiency anemia means that your body doesn't have enough iron to help make red blood cells. It's the most common cause of anemia in pregnancy and postpartum.
It's not unusual to have anemia after your baby arrives. One study of almost 1,500 postpartum women found that almost 30 percent were anemic. The main symptoms of anemia – fatigue and weakness – aren't uncommon postpartum, so many women don't even realize that they have it.
Many women are anemic toward the end of their pregnancies. This condition can be worsened by blood loss during delivery. After delivery, your red blood cell count will be checked, and your healthcare provider will make a plan for you that includes iron supplements and vitamins if necessary. You may even receive an intravenous infusion of iron before leaving the hospital to replace your body's iron more efficiently. Some women have anemia that's so severe they need blood transfusions right after delivery.
If you're anemic, you'll want to work with your healthcare provider to treat your anemia. The condition can affect:
How you feel. Because anemia can make you feel tired and even lightheaded or dizzy, caring for your newborn can be extra challenging. Accept all the help you can get at home, at least until you get some of your energy back.
Your ability to produce milk. One study found that anemic mothers reported producing insufficient breast milk, and as a result weaned their babies earlier than they would have otherwise. If you think this may be happening to you, talk with your provider and/or a lactation consultant. It's very important to make sure your baby is receiving adequate nutrition and gaining weight on schedule.
Your risk of anemia in future pregnancies. Having anemia puts you at higher risk for developing anemia again during a future pregnancy.
Should I take iron supplements while breastfeeding?
If you were anemic after delivery, then yes – it's important to take an iron supplement. Depending on the severity of your anemia, you may need to take an iron supplement, or get an iron infusion or blood transfusion.
Iron supplements are perfectly safe to take when you're breastfeeding. Your provider may give you a prescription, or recommend an over-the-counter supplement that's right for you.
Your need for iron decreases after pregnancy – partly because you're no longer maintaining that extra blood volume, but also because you probably aren't having a menstrual period yet (especially if you're exclusively breastfeeding).
The recommended dietary allowance (RDA) for elemental iron during pregnancy is 27 milligrams (mg) per day. For breastfeeding women, the RDA for iron drops to 9 mg daily if you're 19 to 50 years old, and 10 mg per day if you're 14 to 18 years old.
Note: Elemental iron is the amount your body can absorb. Labels will often also list ferrous gluconate or ferrous sulfate (sources used for iron supplements) in milligrams. Be sure to look at the amount of elemental iron.
Most prenatal vitamins and multivitamins have enough iron to supplement your diet. (It's a good idea to continue taking your prenatal vitamin – or a multivitamin – for six to eight weeks after your baby arrives, especially if you're breastfeeding.) You can also make an effort to eat foods that are rich in iron – such as lean beef and turkey, fortified cereal and oatmeal, lentils, kidney beans, spinach, and tofu.
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If you were given an iron supplement to take before leaving the hospital, your provider will check your blood count during your postpartum visit to make sure the supplement is working. If it's not, she'll explore possible underlying conditions that could be making it difficult for your body to absorb iron.
Note: Be sure to keep all iron supplements out of the reach of babies and children because they can be toxic in large doses.
How can I make sure my baby gets enough iron?
If you've had anemia, it's understandable to worry that your baby will have an iron deficiency too. But that won't necessarily be the case. First, the iron levels in your breast milk aren't affected by the amount of iron you consume or by anemia. Second, most infants have enough iron stored in their bodies to last at least the first 4 months of their lives.
Feeding your infant breast milk or standard, iron-fortified formula will give her all the iron she needs for her first 4 months. The American Academy of Pediatrics (AAP) recommends that infants who are exclusively breastfed be given a daily iron supplement starting at 4 months. Once a baby starts solids – at around 6 months – her iron needs can be met by feeding her iron-rich foods. Include sources of vitamin C, too, to help your baby absorb the iron in foods.
The recommended dietary allowance of iron for a baby from birth to 6 months is 0.27 mg per day. From 7 to 12 months it's 11 mg, and from 1 to 3 years it's 7 mg.
There may be reasons your baby might not have as much iron stored as he needs, however. For example:
If your baby was born prematurely or had a low birth weight, then he probably won't have as much iron stored in his body as a larger or full-term infant. That's because babies get their initial iron stores from Mom during the last trimester of pregnancy. If this is the case, your baby may need iron drops.
Theoretically, babies born to moms who were anemic during pregnancy may also have lower iron stores at birth, though we don't have studies to back this up. So far, studies show that babies born to mothers who were anemic during pregnancy aren't at increased risk for iron deficiency.
Follow your healthcare provider's advice about how much iron to give your baby, and store it safely out of reach.
Should I give my baby formula or cow's milk?
If you're not able to breastfeed (or choose not to), it's still important to ensure that your baby gets enough iron. Choose iron-fortified formula so your baby gets the right amount of iron from day one.
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Don't give your baby cow's milk before the age of 1. It's low in iron; doesn't have the right type of fat, and babies can't digest it as easily as breast milk or formula. Because it can irritate the lining of your baby's digestive system and lead to blood in his stools, it may even cause iron-deficiency anemia.
After age 1, you can give your toddler cow's milk, but limit the amount you give her to no more than 24 ounces daily. (Once she's 2 years old, you should limit her cow's milk consumption to 20 ounces a day, according to the AAP.) Many kids love drinking milk, but if your child fills up on milk instead of iron-rich foods, this could lead to anemia.
To feel your best after your baby arrives, you'll want to eat plenty of iron-rich foods as part of an overall healthy diet while you're breastfeeding. Here are some tips for boosting your energy and boosting your mood with your food choices, too.
https://www.babycenter.com/baby/breastfeeding/anemia-and-breastfeeding_10414725
