My second baby was the picture of health. She was a sweet-natured girl with a killer laugh who slept like a dream. My first daughter had been a bit more high-maintenance: during the first years of her life, she struggled with, among other things, a dairy allergy, eczema, and jaundice. Her baby sister, on the other hand, was like one of those mythical cherubs in the parenting books, who lies down after a good nursing session and drifts off peacefully to sleep.
At 9 months old, my daughter continued to thrive, hitting milestone after milestone. Then her 9-month checkup rolled around, and we found out that there was a problem.
It’s standard practice at the 9-month visit for the doctor to do a quick finger prick to determine if your baby has accurate iron stores. Babies get their iron stores for the first six to eight months of life from their mother in-utero, and delayed cord clamping, or waiting to cut the cord more than a few minutes after birth, is supposed to help that last even longer.
After the finger prick, our doctor came back to give us the news: my daughter was diagnosed with anemia, and I couldn't help but feel like it was all my fault.
Since our baby was a champion breastfeeder, we nursed exclusively. According to my doctors and the internet, I was doing everything right nutrition-wise. Yet her 9-month finger prick came back anemic. The doctor told me not to worry, and that the reading was so low he was convinced it was a faulty test. He asked us to come back in a few days before we tried again.
I thought nothing of it, and a few days later we came back for the doctor to prick our daughter's finger again. He came back a few minutes later looking perplexed. He informed me that the second test had come back anemic as well. It was time to do some more blood work and see what was going on.
We started with a complete blood count (CBC), which analyzed my daughter's red and white blood cells. The experience of being strapped to a table while a doctor stuck a needle in her traumatized her a bit, and it took a while before we could walk into the doctor’s office without her crying and clinging to me. But I reasoned that the answers we’d get would be worth the pain of undergoing the test itself.
The results came back: my daughter was very anemic, and her doctor explained that she was probably not getting enough iron in her diet. He told me breast milk wasn’t high enough in iron, and that we needed to switch to an iron-fortified formula. He explained that once a baby starts eating solid foods, the baby needs iron-rich foods to supplement their diet.
He laid out all of the scary mental and physical problems that can arise for babies with anemia, as well as the symptoms to look out for. Babies with anemia are often pale and lethargic. They have a rapid heartbeat and no appetite, and they’re often irritable. While my daughter didn't have any of these symptoms, he explained that having an iron deficiency could make babies more susceptible to lead poisoning and infection, among other things.
I left the office feeling awful. I had exclusively fed my daughter my own breast milk because I'd thought it was the healthiest choice, yet it was lacking the nutrients she needed to lead a healthy happy life. The way I saw it, I was depriving my child of her health just because it was easier for me than packing up bottles before I left the house. I felt defeated as I went to the store to buy a can of formula.
Unlike many moms who breastfeed, I wasn't against formula, per se. I was exclusively formula-fed as a baby, and I think I’m reasonably intelligent and healthy as a result. My friends successfully formula-fed their extremely smart, beautiful, well-loved healthy babies too. But I enjoyed breastfeeding, and it was so much easier for me than feeding my children formula. I didn’t want to wash the dishes in my sink, let alone add bottles and rubber nipples to the pile.
I was starting to panic a little. Not only was I a shitty mother because my breast milk was nutrient-deficient liquid crap, but I was a bad mom because my daughter was spoiled by breast-feeding.
That afternoon, I tried to give my daughter a bottle of pumped breast milk to ease her into the idea of drinking from something other than the boob. It was a long evening. I tried feeding her the bottle. My husband tried feeding her. We even had our toddler sit on the couch and try giving her the bottle. She wasn’t having it. We tried mixing it with formula, thinking maybe she just didn’t want breast milk out of anything but the tap, but no dice.
I was starting to panic a little. Not only was I a shitty mother because my breast milk was nutrient-deficient liquid crap, but I was a bad mom because my daughter was spoiled by breast-feeding. It was my fault for having been too lazy to try and give her a bottle before she hit the 9-month mark. So now that she couldn’t have breast milk and wouldn’t drink formula, she was going to either drink liquid crap or starve to death.
The next day, I consulted with my doctor. She was a family physician who was about the closest thing to a midwife I’ve ever experienced. She made me feel like She-Ra Princess of Power when she delivered my baby, and she’d helped me through some of my breastfeeding struggles before. She told me to get myself together and start breastfeeding my baby again.
My doctor told me that while it’s true that breast milk typically has less iron than formula, it’s absorbed more efficiently because of higher levels of lactose and Vitamin C in the milk. Furthermore, the lower iron counts serve a purpose: unlike the iron in formula, the iron in breastmilk is escorted through the baby’s system by two fancy proteins called lactoferrin and transferrin. These proteins act as bodyguards against harmful bacteria like E.coli, Salmonella and Staphylococcus, which need to feed on iron as well. The proteins only allow the baby to absorb the iron, thus starving the bacteria trying to mooch on the iron action.
My doctor also noticed that unlike many other anemic babies, who display the classic symptoms of iron deficiency, my baby seemed to be the picture of health. She suggested a specialist, so we paid a quick visit to the hematologist.
The experience gave me the courage to follow my gut and trust my mama instincts. My breast milk wasn't garbage juice after all.
Once again, I was told by the hematologist that my baby was anemic. Yet unlike my other doctor, the hematologist told me my baby wasn’t iron-deficient. He explained that anemia means that your body doesn’t produce enough healthy red blood cells, and the most common cause of anemia is iron deficiency. But for my baby, there was another culprit at play: she had a condition called Thalassemia, which can cause, among other things, fussiness, jaundice, and enlarged organs. As it turned out, my daughter had a very mild, non-scary form called Thalassemia minor, which basically just means she'll be mildly anemic her whole life.
The hematologist warned me that my daughter needed to be aware of her condition later in life, if she decides to have children, as the odds of having a child with Thalassemia major (the more serious version of the condition) goes up if both parents are carriers. But other than that, she’ll have a completely normal, healthy life.
My daughter's diagnosis doesn’t mean that no breastfed baby can ever be iron-deficient, and iron deficiency in babies is certainly nothing to mess with. But the experience did give me the courage to follow my gut and trust my mama instincts: My breast milk wasn’t garbage juice after all, as I'd thought when I left the doctor’s office that day. In our particular case, me — and my breasts — were what was best for my daughter.