Anemia and Extended BF'ing

[yummeecookee]

My LO just turned 1 over the weekend.  We nurse 2-3x/day and he gets BM in his sippy cups at DC.  He has always been a little on the light side as far as weight (lower 40s percentile), but at his 12mo appt, the bloodwork was showing signs of anemia.  I just feel really gutted about the whole thing, like I failed him. Like wtf am I doing as his mother that has now led him to become iron deficient? Maybe I nursed him too much and didnt let him try enough foods.  I am starting to question whether I should be nursing him anymore and maybe I should be trying out some of those toddler formulas that would be iron fortified.  He eats 3 meals a day and snacks but does eat like a little bird.  My pedi said to start him on poly-vi-sol and to nurse him only after he has eaten his meals.

Sorry, I think this is more of a vent than a real question here. But if anyone else has any insight or thoughts on anemia and extended BF'ing, I am all ears.

[melody330]

Have you been giving him a vitamin supplement at all?

You did not fail him. This is easily fixed.

I gave DS1 poly-vi-sol starting around 6 months, and NOD until he was 25 months. I don't see why you need to only nurse after meals if you're going to start the vitamins.

[yummeecookee]

I had been giving him the vit D drops. I'm hoping the poly vit fixes this.

My pedi said that milk inhibits iron absorption so she wanted him to be full from food before he started filling up on milk.

[vvvvvfee]

hugs! this is not your fault, and not only that, it's easily remedied. my DS1 was anemic at 9 months, too. we pushed iron-rich foods and gave him supplements (most of which he spit out) and his levels were fine at 12 months. don't stop nursing! yes, maybe you want to feed LO solids sometimes before nursing, if you feel like it's filling him up, but breast milk has so many other benefits for your LO. also, many kids who have been EBF will reject formula if it's offered after their early months because it kinda tastes gross.

focus on including iron-rich foods-- find something that LO likes and then give him lots of it! good iron sources include: ground beef, ground turkey, dark meat chicken, lentils and beans, and dark green leafy vegetables (although the iron in meat is most easily absorbed). look for iron-fortified cereals, too-- you can buy plain instant oatmeal packets, which are usually iron fortified. top with blackstrap molasses and raisins (2 more good sources of iron). if you cook food in a cast-iron skillet, you will get a little more iron in that way, too. keep in mind that vitamin c helps boost iron absorption, which calcium interferes with it. so try to give LO foods rich in vitamin C along with the iron-rich foods (citrus fruits, bell peppers, strawberries, broccoli, tomatoes), and try to space out LO's dairy intake to avoid the iron-rich foods. (this article lists more foods and has some tips- scienceofmom.com/2011/08/31/practical-ways-to-increase-iron-in-your-baby%e2%80%99s-diet/ )

poly-vi-sol tastes unbelievably gross. i would recommend novaferrum brand drops instead-- they're not great-tasting, but aremuch less offensive than poly-vi-sol (i have sampled both!).

[billyhorrible]

I think more babies are anemic than not (formula or breast fed) so don't beat yourself up. There's less iron in breastmilk, but it's more easily absorbed, so it's really a wash.

Iron rich foods and supplements well clear this right up.

[emmyg65]

Your doctor should have told you to start giving iron drops or fortified cereal around 4-6 months of age, so if anyone has failed, it's the doc.

Cow's milk does inhibit iron absorption. Breast milk is not as bad—it's pretty low in iron, but the iron is absorbed more efficiently. You have a couple options. You can give iron drops. You can give fortified cereal. You can feed iron-rich foods like meat and broccoli. We liked to give Cheerios as finger food.

You should continue breastfeeding and just supplement with one/all of the above. There's no need to fill him up! Breast milk carries many awesome benefits, even if it's relatively low in iron and Vitamin D.

You have not failed. Mild anemia has a very easy fix and you caught it early!

ETA: Almost all formula is iron-fortified, so FF babies don't generally have issues with anemia. But that's not a reason to not BF! 

[yummeecookee]

Thank you for such great tips vvvvvfee!

[yummeecookee]

I feel so much better. You guise are great!

[emmyg65]

This is useful too: scienceofmom.com/2013/04/22/breastfeeding-a-toddler-should-you-be-concerned-about-iron-deficiency/

[aves0708]

You have great advice already. I just wanted to add that I have a close friend who FF her baby and she was still anemic. There is more iron in formula than BM but it's not as easily absorbed, so definitely don't stop BFing if you don't want to! Our pedi instructed us to start the poly-vi-sol with iron at 6 months and I usually give it to her every other day and her iron has been fine. It's definitely not great tasting and it stains clothes so I usually give it to her while she's in the bathtub. She didn't like it at first, but now she's gotten used to the taste and takes it really easily. You've done an awesome job BFing your little guy for as long as you have and have nothing to feel guilty about!