Go read the Disclaimer again. I am not a doctor. This is not medical advice. Seriously.
Iron is toxic to the body, other than the relatively small amounts it needs. It is so toxic the body will take calcium out of the bones to connect to the iron to neutralize it (mostly) and then flush it out in waste. This is part of why iron supplements are so constipating. This is why people who supplement iron or calcium must separate the supplements by as much time as possible. When I was supplementing iron and calcium in the postpartum period for anemia (the result of a C-section in which the cervix tore, after a 40 hour labor during which the cervix bled a fair amount) and hypertension (160/100 with blood tests negative for pre-eclampsia), I took great care to take one in the morning and the other in the evening. It may make sense to supplement iron during pregnancy, although I got enough from food, as the blood supply expands to support the baby. Many women have a diet poor in calcium, or calcium absoroption or both, so it may make sense to supplement calcium. Many books recommend supplementing these, but do not adequately emphasize the need to separate these two in time, in order to get any benefit from them.
A better strategy by far is to get iron and calcium from foods, where for a variety of reasons they interfere with each other less and from which they absorb much better. Dark leafy greens are great for both iron and calcium. Milk products are a poor source for calcium; the high protein content of most milk products tends to leach calcium from the body. Breastfeeding women in particular may have trouble with milk products, as the proteins in them are highly allergenic and are passed through the breast milk to the baby. Some processed foods are quite high in calcium (tomato products, breads, etc.), from the preservative used. You can also try orange juice which has been fortified with calcium and vitamin D.
Floradix makes a variety of liquid supplements including iron and calcium, which taste good, are absorbed well, do not constipate and are, unfortunately, quite expensive.
Tincture of yellow dock root is available at many natural or health food stores, high in iron, seems to absorb well, tastes quite nasty and is not nearly as expensive as Floradix. An herbalist may be able to help you find more options. In addition to dark leafy greens, turkey and red meat are also high in iron, as are iron fortified cereals.
Your health care provider is unlikely to correctly diagnose some of the common indicators of calcium deficiency. If you have bone, joint or muscle pains that are unrelated to an injury or virus, and do not resolve after eating a banana (potassium deficiency), consider calcium deficiency as a possibility. If you have those and your blood pressure is rising for no other known reason, seriously consider a calcium deficiency. You can get a blood test for it, but your health care provider probably does not even know this can happen and may give you some trouble over it.
During the first week or two postpartum, I often fell asleep so fast while nursing it felt like blacking out. I asked my care providers about this, and they kinda laughed and chalked it up to fatigue, prolactin, etc. If this happens to you, and you had a C-section or lost a good amount of blood during your birth, or went into the birth somewhat anemic, you may actually be quite anemic. No one will notice, because they'll tend to attribute your fatigue and instant-sleep to nursing, newborn care, etc. If you pull down your lower eyelid and look at the blood vessels there on the skin, you can get a sense of your iron levels (this works for anyone, not just new mothers). If you are white (on the skin, not the eye), you have problems. See a doctor. If you are barely pink, you probably need a bit more iron. I supplemented with Floradix, tincture of yellow dock root, dark leafy greens and turkey and recovered completely from the anemia by two months post-partum. You can ask your health care provider for a hematocrit test if you want to be sure what is happening.
You do need Vitamin D to absorb calcium, and newer research suggests people supplementing calcium should also supplement magnesium, although the best ratios are still under debate.
In general, during pregnancy and breastfeeding, your body will take second place to nourishing your baby. If your baby is suffering from a deficiency (which is asserted far more often than experienced), you are also suffering from that deficiency and to a far greater degree. The correct solution to a baby suffering a vitamin or mineral deficiency is to help the mother get enough of that vitamin or mineral in her diet or through supplementation or sunlight.
Some people worry about Vitamin D deficiency in breastfed infants.
A lot of people worry about iron deficiency in breastfed infants. Breastmilk contains only a small amount of iron, but it is the right amount of iron in a form highly absorbed. Studies show that breastfed babies do not suffer from iron deficiency unless the mother is or was while pregnant extremely anemic, or the baby suffers from a serious problem that causes bleeding. This has been shown true for every age studied (oldest age studied, I believe, is 9 months). Adding solids actually increases the risk of iron deficiency in the breastfed infant by reducing the consumption of breastmilk and interfering with absorption by changing the gut flora of the infant. Milk products, including formula, tend to disrupt iron absorption, which is, in part, why formula is so heavily supplemented with iron. While the AAP's subcommittee on nutrition continues to sound an alarm about iron deficiency in exclusively breastfed infants from ages 4 months and older, no one, including the AAP as a whole, agrees with them. You can blow them off, too.
Some women worry that breastfeeding might contribute to osteoporosis, because they will be giving up their calcium to their baby in breastmilk. Studies have consistently shown that mothers who breastfed suffer less from osteoporosis than mothers who formula fed.
General Discussion of Supplementation.
Copyright 2006 by Rebecca Allen.
Created January 24, 2006 Updated August 27, 2008