Anemia and Breastfeeding: Helpful Facts to Know

What is Anemia?

If you’re anemic, it means your body does not have enough healthy red blood cells or hemoglobin to carry oxygen to your body’s tissue. Hemoglobin is a protein found in red blood cells that carries oxygen from your lungs to all your other organs. This lack of oxygen distribution can leave you feeling more tired or weaker than usual – symptoms that most pregnant or recently postpartum mamas often simply chalk up to the fact that they are expecting or recently gave birth!

Other common symptoms include fatigue and brain fog, which is not exactly what an already-exhausted new mom needs! Besides, if you’re pregnant or postpartum, these symptoms are also easy to miss since things like being tired is really more of the default state for a mom with a newborn baby at home. That’s why it’s important to be aware of how you’re feeling and reach out to your healthcare provider – He or she can perform a blood test to determine if your levels are in the normal range.

Here are a few important facts to know about anemia:

• The three main causes of anemia are blood loss, lack of red blood cell production and high rates of red blood cell destruction.
• Anemia can be short-term or long-term.
• Typical anemia treatments may include supplements or dietary changes.
• Most anemia is caused by iron deficiency, which is also the most common nutritional deficiency in the world.
• Though less common, anemia can be a sign of a serious illness so always be sure to talk to your doctor if you’re experiencing symptoms.

Anemia in Pregnant Women

That said, anemia during pregnancy is relatively common because your blood volume increases by 20 – 30%, according to the Cleveland Clinic. In the first half of pregnancy, your body makes more red blood cells to accommodate both you and your baby. Each red blood cell requires iron, which is not naturally produced by your body but instead only absorbed from the foods you eat. Approximately 15 – 25% of all pregnant women experience iron-deficiency anemia.

It is critical that anemia while expecting is monitored and treated to avoid complications through your pregnancy and during childbirth. If a prenatal vitamin isn’t providing enough iron to you, your doctor may prescribe an iron supplement.

While there are more than 400 types of anemia, the three most common during pregnancy are:

• Iron-deficiency anemia: Caused by lack of iron
• Folate-deficiency anemia: Caused by lack of folic acid
• Vitamin B12-deficiency anemia: Caused by lack of vitamin B12

Risk Factors for Developing Anemia During Pregnancy

The American Society of Hematology notes that you’re at higher risk for developing anemia during pregnancy if one or more of the below applies to you:

• Two pregnancies close together,
• Diagnosed anemia during a previous pregnancy,
• Pregnant with more than one baby,
• Experienced morning sickness and frequent vomiting,
• Your diet in general is typically low in iron,
• and heavy menstrual flow before pregnancy.

Common Symptoms of Anemia

With mild anemia, you may not notice any symptoms. As anemia progresses, however, typical symptoms can include:

• Fatigue, including feeling weak or tired more often than usual
• Brain fog, which means challenges with concentration or thinking clearly
• Irritability
• Pale skin, lips and/or nails
• Shortness of breath
• Rapid or irregular heartbeat
• Dizziness
• Headaches

Your doctor will be monitoring your complete blood count (CBC) throughout your pregnancy, but be sure to report any symptoms immediately so you can focus on what’s important: the health of you and your growing baby. Rest assured that anemia is easily treatable once diagnosed!

Anemia After Childbirth

For some women, anemia can persist or occur after childbirth despite your best efforts of dietary changes or supplement intake. Iron stores that were depleted during pregnancy can take up to 6 – 12 months to build back up. Heavy bleeding during delivery or multiple births may also cause anemia.

If you’re anemic after giving birth, you’re not alone! About one in four women experience iron-deficiency anemia in the postpartum period. Keep in mind that some symptoms of anemia can mirror those of postpartum depression, so be sure to stay aware of how you’re feeling and discuss your symptoms with your provider regularly.

FAQs About Anemia and Breastfeeding

• Is there a link between maternal anemia and breast milk supply?
  Some limited evidence exists that links maternal anemia to low milk supply. In a study of first-time mothers, the results indicated that anemic mothers reported not having enough milk and, as a result, they stopped breastfeeding sooner.
  
  If you have been diagnosed with anemia, be sure to talk with a lactation consultant and your provider to ensure these challenges are addressed so you can feed your little one with your liquid gold for as long as you choose.
• Do I need to treat my anemia while I’m breastfeeding?
  Milk supply aside, it’s a good idea to ensure your anemia is addressed regardless! Recovering from pregnancy and taking care of a newborn baby is exhausting enough, mama – You don’t need the extra fatigue brought on by untreated anemia.
• If I’m anemic, does that mean my baby won’t get enough iron – or will get too much iron if I’m taking a supplement – through my breast milk?
  Iron is already present in breast milk. Taking a prenatal vitamin or another supplement will have a minimal impact on the iron level in your breast milk, so it’s safe to take any prescribed supplements from your healthcare provider if you have iron-deficiency anemia.
• Remember, your breast milk is perfectly made with the right amount of iron to complement your baby’s own iron stores while breastfeeding.
• The level of iron in breast milk is constant, despite any variations in a mother’s iron level.
• The iron from your breast milk is in a highly bioavailable form, which means your baby can easily absorb it.
• Babies can absorb 50% of the iron in breast milk, whereas only about 4 – 10% of the iron in fortified cereal is absorbed.

Nutrition Tips for Anemia: Incorporating Iron-Rich Foods into Your Diet

Your healthcare provider may recommend an iron supplement and/or a change in diet to include plenty of iron-rich foods. Some great iron sources include:

• Red meat, such as beef, lamb or pork
• Poultry, including chicken or turkey
• Eggs
• Dark, leafy greens – think spinach, kale, chard and broccoli
• Nuts and seeds
• Dried fruits, such as apricots
• Legumes, including beans, peas and lentils

Foods That are Helpful - and Not-So-Helpful - With Iron Absorption

Foods with vitamin C can help with the absorption of iron. With that in mind, be sure to add these fruits and veggies into your iron-rich meals for maximum impact:

• Oranges (or orange juice)
• Grapefruit
• Kiwi
• Melons
• Broccoli
• Cauliflower
• Brussel sprouts

If you’re drinking caffeinated teas and coffee, know that they contain tannins that can prevent your body from absorbing iron. Keep in mind, too, that caffeine consumption should be limited anyway while breastfeeding.

What About My Newborn and Iron Supplements?

In most cases, there is no need to worry, mama! The CDC reports that most newborns have enough iron stored for their first 6 months while breastfeeding exclusively. When your little one is about 6 months old, talk to your pediatrician about integrating an external iron source in addition to your breast milk.