Do You or Your Infant Need Supplements While Breastfeeding?

Wondering if your breastfed infant needs breastfeeding supplements? hould you continue taking your own supplements as usual? Here’s what you need to know.

Should you and your breastfed infant take supplements?

Human milk provides complete nutrition for infants during their first 6 months and serves as complementary nutrition in the early years. In some cases, it may be necessary to provide additional nutrient supplementation, such as in instances when infants are born preterm, infants have feeding difficulties or where mothers have nutritional deficiencies.

The Academy of Breastfeeding Medicine (ABM) Protocol reviews the evidence on iron, zinc, and vitamin D supplementation for breastfeeding mothers and their infants. Below is a summary of their findings. You can read the full report here: link.

Iron 

For the mother

If blood tests during pregnancy or while breastfeeding show that you have low iron levels (anemia), your doctor or midwife may recommend an iron supplement. Treating low iron levels is essential for both your health and your baby’s development. Iron supplements are relatively safe to take during pregnancy and while breastfeeding, but they may sometimes cause constipation or lead to haemorrhoids. 

However, if you are not anaemic, there is insufficient evidence to prove the benefit of iron supplements for the breastfeeding mother.

For the infant

Research shows that iron supplements for exclusively breastfed infants from birth to 4-months improves blood health of the baby. However, the long-term benefits of iron supplementation between 4 to 6 months is not known.

If you choose to give iron before 6 months, use a dose of 1 mg/kg/day. After 6 months, you can start giving iron-fortified cereals (containing 7–7.5 mg of ferrous sulfate per day) or iron-rich foods like meat, tofu, and beans along with other complementary foods. 

If your breastfed baby has low iron levels, they may require direct treatment and the dosage will be tailored to their needs by the healthcare professional.

Zinc

For mother and infant

Zinc supplements, above dietary intake, have not been proven to improve outcomes in mother or breastfed baby.

Vitamin D

For the mother

For mothers, it’s recommended to take a daily vitamin D supplement of 10 micrograms (mcg) while breastfeeding.  Although vitamin D is present in foods such as oily fish (e.g. salmon, sardines, and mackerel), red meat, and fortified cereals, it can be difficult to get enough from diet alone. Taking a supplement helps ensure you maintain healthy vitamin D levels to support your overall health and your baby’s development.

For the infant

For infants who are exclusively breastfed (without infant formula top-ups), a daily vitamin D supplement of 8.5 to 10 micrograms (mcg) is recommended. Vitamin D is essential for healthy growth and bone development. Severe deficiency can lead to rickets – a condition that has re-emerged amongst exclusively breastfed infants.

Breastfeeding infants should start vitamin D supplementation shortly after birth. It’s best to use cholecalciferol (vitamin D3) for better absorption, although ergocalciferol (vitamin D2) can be used if a plant-based option is preferred.

When there is objection or contraindication to direct infant supplementation, safe vitamin D supplementation may be provided to a nursing mother to achieve healthy vitamin D status in her breastfeeding infant. A maternal dose of 160 micrograms (mcg) per day is suggested in these circumstances.

Should you continue to take your other supplements while you breastfeed?

Breastfeeding mothers who can’t meet their nutritional needs through food alone are often advised to take daily multivitamins or prenatal vitamins.

When it comes to breastfeeding supplements marketed as standalone vitamins or herbal supplements, caution is needed. Unlike medications, the Food and Drug Administration (FDA) doesn’t require supplements to be proven safe before they reach the market. It is therefore important to carefully check the dosage of individual vitamins as well as the other added ingredients in supplements.

Herbal supplements may seem “natural,” but that doesn’t mean they are safe. Most have not been well studied in breastfeeding women or on nursing babies, so their risks are unclear. For these reasons, unregulated medications are best avoided. If you must take one, consult your breastfeeding doctor first in order to determine if supplements are needed and offer strategies to address any challenges in your breastfeeding journey.