Iron Deficiency & Anemia

Iron's importance extends beyond your well-being and the ability to produce nutritious milk. The body prioritizes critical functions, such as blood cell production, over milk production when resources are scarce. This means addressing iron deficiency is vital for supporting both maternal health and successful lactation.

Lab ranges for lactation are not typically included in analysis and this can impact milk production.  For example, hemoglobin (HGB), which is a measurement of the amount of an iron-rich blood cell, ranges for women are 12-16 g/dL whereas levels below 13.5-14.5 g/dL can impact milk production. Other tests are helpful in interpreting your health, too.

Hematocrit is the percentage of your total blood volume that is made up of red blood cells, which carry oxygen.  Level needed to support lactation is again higher than the range considered normal for women.  Ideally, HCT would range from 40-50%. 

Ferritin is a protein which stores iron and low levels can indicate long term deficiency.  High ferritin is also seen in some inflammatory conditions so it’s best to look at all of these ranges together to create a picture.

In many cases, supporting iron levels through your diet and quality multi-vitamin is sufficient.  For moderate to significant anemia, an iron supplement taken every other day is needed.  Taking the supplement every other day allows for better absorption as a hormone rises after supplementation to prevent the absorption of iron.  Waiting a day to let that fall back to normal levels allows the next supplement to be better absorbed.  Look for bisglycinate or glycinate forms over ferrous sulfate to reduce constipation and increase absorption.

Iron-Rich Foods

Heme Iron (Animal Sources):

Lean red meats: beef, lamb, and pork

Poultry: especially dark meat like thighs and legs

Fish: especially sardines, mackerel, and shellfish

Non-Heme Iron (Plant Sources):

Lentils and beans: kidney beans, chickpeas, and black-eyed peas, Spinach, kale, and other leafy greens Tofu and tempeh, pumpkin seeds and sesame seeds

Note: Iron from animal sources is absorbed more efficiently than iron from plant sources, however, combining plant-based iron foods with vitamin C-rich foods can enhance absorption.

+ Vitamin C: Vitamin C enhances the absorption of non-heme iron. Incorporating vitamin C-rich foods in the same meal as iron-rich foods can be beneficial.

Citrus fruits: oranges, grapefruits, and lemons.  Berries: strawberries, raspberries, and blueberries. Bell peppers, broccoli, and Brussels sprouts Kiwifruit and papaya.

- Limit Calcium Intake During Iron-Rich Meals: While calcium is vital during lactation, it can inhibit iron absorption. Aim to space out calcium-rich foods or supplements from iron-rich meals.

- Avoid Tannins and Phytates During Iron-Rich Meals: These compounds, found in tea, coffee, some grains, and legumes, can inhibit iron absorption. It's advisable to consume these foods or beverages a couple of hours apart from iron-rich meals.

Snacks: Try to have a snack with iron-rich food often.  "Snack when baby eats" is a good way to get in plenty of snacks.

Anemia and mental health: Anemia can also manifest symptoms that resemble anxiety and depression, complicating the postpartum experience. As your anemia status improves, you should also start noticing positive mental health improvements.

National Maternal Mental Health Hotline - call or text 1-833-TLC-MAMA