Does Taking Iron While Breastfeeding Affect the Baby?

If you have questions about taking iron supplements while breastfeeding, you're likely in good company: Between 10 and 30 percent of postpartum parents experience anemia (low iron), per the World Health Organization.

Postpartum anemia can make you feel weak, dizzy and exhausted, per the National Heart, Lung, and Blood Institute, which can make it challenging to take care of your baby and yourself. That's why it's important to treat the condition, which may include taking iron supplements if recommended by your health care provider.

If you have anemia, you might be asking: "Can I take iron pills while breastfeeding?" You might want to know whether your supplements will negatively affect your baby and whether it's possible to take too much iron.

You also may have questions about your own baby's iron needs, including whether there's iron in breastmilk and whether you need to take supplements to increase iron levels in your milk.

The topic of iron supplements and how they affect babies can be confusing, but we've got you covered. We reached out to experts to answer parents' most pressing questions about taking iron supplements while breastfeeding.

The short answer is yes, you can take iron supplements while breastfeeding, but it's only necessary in certain cases.

"It is a very good idea for parents to take iron while breastfeeding if they have been diagnosed with iron-deficiency anemia," Kyle Graham, MD, a board-certified ob-gyn at Pediatrix Medical Group in San Jose, California, tells LIVESTRONG.com.

Anemia is a common problem in lactating parents. According to an April 2015 study in ‌BMJ Open‌, it is most commonly caused by iron depletion in pregnancy or blood loss after childbirth.

While breastfeeding itself doesn't cause low iron, breastfeeding people who don't get enough nutrients during breastfeeding might develop anemia. If you are anemic, you should make sure you are taking the right amount of iron supplement for you.

"It is possible to take too much iron, so you'll want to take the medication as prescribed by your doctor," Dr. Graham says.

Taking too much iron can lead to digestive symptoms like gas and constipation, he says.

"The iron in your breastmilk is more bioavailable than in supplements, including formula, so you should feel confident that your baby is getting what they need."

As for whether you need to take iron for the sake of your baby, the Academy of Breastfeeding Medicine notes that taking iron supplements yourself doesn't affect the amount of iron in your breastmilk.

"Iron content of breastmilk is consistent and does not vary with maternal intake," says Cinthia Scott, RD, IBCLC, registered dietitian and international board-certified lactation consultant with The Baby Dietitian. In other words: "Iron supplements do not pass through human breastmilk to babies."

You can rest assured, though, that there ‌is‌ iron in your breastmilk, says Nicole Peluso, IBCLC, international board-certified lactation consultant and manager of lactation services and education at Aeroflow Breastpumps.

"The iron in your breastmilk is more bioavailable [easily absorbed] than in supplements, including formula, so you should feel confident that your baby is getting what they need," Peluso says.

Not only that, but your baby builds up iron stores during the third trimester of pregnancy, and these stores should last them about six months after birth, per Peluso and the Centers for Disease Control and Prevention (CDC).

Delaying the clamping of the umbilical cord for at least 30 to 60 seconds after birth can increase the amount of iron stored as well, according to the American College of Obstetricians and Gynecologists.

However, certain things may affect your baby's iron stores, such as premature birth, low birth weight or pregnancy complications like diabetes, according to the American Academy of Pediatrics (AAP). So if you're wondering whether breastfed babies need iron supplements, the answer is that it depends.

The CDC recommends talking to your child's doctor about whether they need an iron supplement before they're 6 months old, which is typically when they can start getting their iron from solid foods.

What about iron and milk supply? Does low iron affect milk supply?

There's not enough research to say for sure, Scott says.

"Currently we do not have any clear research on whether iron deficiency directly correlates to low milk supply or if the symptoms of iron deficiency like exhaustion and fatigue are the main contributors to poor milk supply in an iron-deficient mother," Scott explains. "This is an area that needs more research and evaluation to make broad recommendations."

If you've taken them, you're likely aware of some of the potentially unpleasant side effects of iron supplements, such as digestive upset and black-colored stool.

And you might be wondering: "Can taking iron while breastfeeding cause my baby to be gassy or constipated?"

There is limited research on this question, but according to Peluso, babies sometimes get upset tummies when their breastfeeding parent takes iron pills.

"Iron supplements can cause babies gastric upset," Peluso says.

But that doesn't mean you should stop taking iron altogether if you're anemic.

"If you are taking an iron supplement and see signs in your baby that may look like an upset stomach or baby is constipated, it's best to find another form of iron to take," she says.

Again, you only need to take iron supplements while breastfeeding if you are anemic, and you should do so under the supervision of your health care provider. Usually, your provider can recommend a few supplements for you.

"I always recommend patients choose an iron supplement that has the USP Verified Mark," Dr. Graham says. "Products with this label ensure the product was made according to the FDA's Good Manufacturing Practices."

Usually the biggest issue with iron supplements is that they can cause you to have an upset stomach, including gas, bloating, stomach pain and constipation. That's why many people look for more stomach-friendly iron supplements.

Bethany Ferguson, RD, IBCLC, registered dietitian and international board-certified lactation consultant at Nourishing Babes, says you can start by continuing to take the prenatal vitamin you took during pregnancy, especially if you found that one to be tolerable.

As for other brands, she recommends any iron supplement that is third-party tested and contains a source of vitamin C to help with absorption. In particular Thorne Iron Bisglycinate ($14, Thorne) is a third-party tested supplement that she's found to be gentle on her client's stomachs.

For parents who find that most iron pills cause significant GI effects, an iron infusion might be a good alternative, Peluso says.

"Iron infusions must be prescribed by a physician and are often administered in cancer centers where other intravenous therapies are administered," she says. "It only takes a few minutes per session and can make a dramatic difference in how you feel with no gastrointestinal side effects."

Peluso personally benefited from an iron infusion after trying many iron pills that didn't help increase her iron levels and also caused stomach pain.

"The infusion option was a lifesaver for me," she says. "I only needed to do it twice and then everything got back on track."

It's important to make sure you are getting enough iron, both during pregnancy and while breastfeeding, Scott says.

"Making sure our nutrient stores are sufficient can provide us with adequate energy even during the sleepless newborn days," she says.

She recommends you focus on a balanced diet full of all food groups, including the most iron-rich foods: beef, chicken, eggs, liver, seafood and pork.

It's also important to keep in mind that there are two types of iron-rich foods: heme iron foods and non-heme iron foods.

"Heme iron comes from animal sources like meat and fish and is most easily absorbed," says Ferguson. "Non-heme iron comes from plant sources like grains, vegetables, fruits and nuts."

Non-heme iron sources are a good source of iron, but they aren't absorbed in the body as easily. As such, it's recommended that you pair non-heme iron sources with vitamin C-rich foods (citrus fruits, tomatoes, peppers) for maximum absorption.

According to the National Institutes of Health, Office of Dietary Supplements, foods with the most plentiful amounts of heme iron are seafoods and lean meats. Non-heme sources of iron include:

• Beans (white beans, lentils, kidney beans, chickpeas, tofu)
• Veggies (spinach, tomatoes, green peas)
• Nuts (cashews, pistachios)
• Fortified grain products such as some breads and breakfast cereals

Taking iron while breastfeeding and how it might affect your baby is a complex topic. In a nutshell, you only need to take iron supplements while breastfeeding if you are anemic.

If you do need to take iron supplements, you can feel confident that they are safe for your baby. Either way, your breastmilk should provide all the iron your baby needs until they are about 6 months old.

If you have further questions about taking iron while breastfeeding, reach out to a lactation consultant or ask your health care provider, who can also recommend an iron supplement that will work best for you.