As a Certified Breastfeeding Counselor, you support clients throughout their breastfeeding journey. A common concern many breastfeeding parents have is milk supply. As a CBC, we do not diagnose, treat, or provide direct medical advice. However, we do help parents problem solve. It is not uncommon for parents to ask about anemia and milk supply.
Or, a parent might present with concerns about milk supply and we can provide them with some questions to ask their providers. One such question is to inquire about their birth experience, if they were anemic throughout pregnancy, or lost a lot of blood during or after birth.
Low milk supply as well as perceived low milk supply tends to be the most common reason for early breastfeeding cessation. If we can help parents problem solve, know what to ask their medical providers, and how to navigate low supply, we can help more parents meet their personal breastfeeding goals.
What is Iron Deficient Anemia?
Iron is vital for humans to make red blood cells which are necessary to carry oxygen to all the cells in your body. This includes cells responsible for making milk. When one has low iron, this can impact the body and milk supply.
Iron deficiency and anemia is when one lacks enough iron to produce enough health red blood cells. During pregnancy, many have lower levels due to increased blood volume. There is also a greater need for iron and red blood cells due to the placenta. During the third trimester, baby also develops iron stores, pulling from the mother. If she is not consuming enough iron, her stores will lower.
Pregnancy followed by blood lost during birth, can leave some breastfeeding parents with low iron levels.
Does Iron Deficient Anemia Impact Milk Supply?
We know that breast milk is produced on a supply demand process. When there is sufficient milk transfer, there should be sufficient supply. Low milk supply despite a good latch and ‘best practice’ breastfeeding habits is often poorly understood.
There is some older evidence which suggests a connection between iron deficient anemia and developing low milk supply.
“Anemic mothers reported a higher level of symptomatology associated with insufficient milk and were more frequently classified as having insufficient milk syndrome.”
Insufficient milk syndrome is now frequently referred to as chronic low supply.
“Mothers with the syndrome reported a shorter period of full breastfeeding, and weaned at an earlier age. They identified not having enough milk, baby nursing too often, and baby not gaining enough weight as the main reasons for discontinuing breastfeeding, compared with baby’s disinterest and conflicts with school or work as main reasons among mothers not reporting symptoms related to insufficient milk syndrome.”
While the study is older, knowing how iron deficiency impacts the body and potential milk supply, given the reasons parents gave for cessation, it is reasonable to suspect a potential correlation.
How is Iron Deficient Anemia Managed?
As a CBC, we are not to diagnose, treat, or give medical advice. However, if we are talking with a parent and they mention a history of anemia or concerns we can suggest:
- Reaching out to their doctor or midwife to find out if iron supplements are recommended based on their symptoms and history
- Increasing natural iron in their diet
- Talking with a nutritionist if they are struggling to get enough iron in their diet or if they have absorption concerns
For people with mild to moderate iron deficiency, many doctors will recommend oral iron supplements. However, there is a risk of overconsumption so this is why it is something clients should discuss with their providers. Dietary changes to include more iron are often recommended for all postpartum women to help protect against developing or worsening anemia. If someone has moderate to severe anemia their provider might refer them to a hematologist for more treatment, such as iron infusions.
Our role as a CBC is to simply support clients facing a possible low supply and redirect them to their doctors or midwives with medical concerns. If we are talking with them and find out they might be anemic, or if they report anemia, we can help them understand the potential connection between anemia and milk supply.