By Titilayo Medunoye
In my years as an International Board-Certified Lactation Consultant, I’ve sat with many mothers like Sola. For her, as a new mum, breastfeeding wasn’t a pleasant journey; it was physically and mentally exhausting. “For my first three months of breastfeeding, I was a shadow of myself,” she recalled. “I was constantly exhausted, fatigued and worn out. When I complained, it was downplayed as just part of the new-mom experience.”
It wasn’t until Sola came to me for a feeding assessment that the pieces came together. The exhaustion she described went well beyond ordinary new-mother tiredness. It was a pattern I’d seen many times. I referred her for bloodwork, and the results confirmed what her symptoms had suggested: severe iron deficiency. As Sola put it, “It wasn’t until then that I learned what was really happening to my body.”
To many, breastfeeding is the easiest and simplest source of nutrition for infants, containing the nutrients required for the first six months of life. While this is true, many are oblivious to the significant nutritional demands this singular act places on mothers’ health. It has been proven repeatedly that breast milk composition is remarkably resilient, but it massively drains the mother’s nutrient stores, like the story of Sola above, if her increased needs are not met accordingly. This explains why the nourishers need to be nourished with postpartum micronutrient supplementation.
It is amazing, however, to note how nature has structured the woman’s anatomy and the release of breast milk, in that even when a mother is undernourished, her body often prioritises milk production to protect her infant. UNICEF discloses in one of its explainers that “even when mothers are malnourished, they can still produce nutritionally adequate breastmilk for their babies,” while stressing that the priority should be supporting both the mother’s nutritional recovery and continued breastfeeding.
Nevertheless, this huge task comes at a cost. During breastfeeding, women’s energy and nutrient requirements increase, and poor nutrition makes it more difficult for mothers to replenish their nutrient stores and meet these additional demands.
This underscores the significant role of micronutrient supplementation in lactating mothers, which is basically not a replacement for normal meals but an augmentation for inadequacy in essential micronutrients like iron, vitamin D, iodine, vitamin B12, folate, zinc, calcium, and DHA/omega. It is also pertinent to note that these nutrients are not for the production of “better” milk, but they are mainly to nourish the nourisher, enhancing her system’s capacity to cope with the responsibility while ensuring both mother and baby are living healthy.
Breastfeeding: A Nutritional Investment
Mrs Ifeoma Isong is a mother-of-three, with varied lactating experiences, but her last baby’s care took a different toll on her. “At the fifth month, I almost stopped breastfeeding my baby because I was drained beyond measure,” she said. “Aside from its reflection on my outlook, I became so physically weak that I contemplated going to stay with my mum for a while to enable me to get some relief from the physical burden of nursing, as well as the nutritional responsibility of breastfeeding.” When Mrs Isong first came to me, she was ready to stop. During our consultation, I assessed how her baby was feeding alongside the toll five months of nursing had taken on her own body. Hers was a clear example of how lactation raises a mother’s requirements for several vitamins and minerals. Without the resources to meet those demands, a mother is left helpless, fatigued and, in most cases, anaemic.
The United Nations Children’s Fund (UNICEF) affirms this in one of its statements, where it explains the scientific process of breastfeeding, describing it as a great nutritional investment of mothers in their infants. “During pregnancy and breastfeeding, energy and nutrient needs increase. Meeting them is critical for women’s health and that of their child,” it stated. This implies that in the postpartum period, hormonal changes trigger lactogenesis, I.e milk production. The special hormones responsible for this process, prolactin and oxytocin, stimulate milk synthesis and milk ejection, respectively. This process ultimately places a special demand on the mother’s body on a daily basis to mobilise energy, protein, water, vitamins and minerals.
However, data from the Nigeria Demographic and Health Survey (NDHS) 2023–24, released in 2025, show that most Nigerian mothers are failing in the hallowed role, as only 29 per cent of infants aged 0- 5 months are found to be exclusively breastfed, which implies that less than 1 in 3 Nigerian babies were exclusively breastfed. The survey also shows that only 23 per cent of Nigerian children enjoy breast milk up to the recommended 24 months. This is a major public health concern, requiring urgent intervention.
Understanding Maternal Micronutrient Needs
Micronutrients are essential vitamins and minerals that the body needs in small amounts, but that play vital roles in energy metabolism, immune function, tissue repair, bone health, hormone production, and neurological function. Studies have shown that vitamins and minerals such as iron, iodine, vitamin D, vitamin B12, folate, calcium, zinc, and vitamin A are very crucial for mothers during the postpartum period. Some of the nutrients primarily help restore and protect the mother’s health, while others contribute to maintaining adequate levels of these nutrients in breast milk, particularly when maternal intake is insufficient.
The World Health Organisation (WHO) affirms that breastfeeding increases women’s nutritional requirements and recommends that postpartum and lactating women consume a balanced, healthy diet to meet these needs. However, rising food insecurity brought about by climate change and insurgency has made it increasingly difficult for most lactating mothers to have adequate dietary intake, which reaffirms their needs for micronutrient supplementation. Again, situations surrounding their delivery, as seen in many cases where mothers experience huge hemorrhage at birth, postpartum bleeding, pre-existing nutrient deficiencies, dietary restrictions, closely spaced pregnancies, or limited access to diverse foods, subject this set of mothers to a mandatory need for micronutrient supplementation.
In a chat with a Consultant Public Health Physician, Dr Francis Ohanyido, he corroborated the need for micronutrient supplements for pregnant and lactating mothers to prevent malnutrition in infants and mothers. He said” Micronutrient supplements help in terms of the nutrient level for the mother that has gone through pregnancy. It has been observed that a lot of women going through pregnancy in Nigeria, especially in sub-communities, are malnourished. So it’s very important that we introduce micronutrient supplements and put them out in a way that is accessible to pregnant and breastfeeding women in any community in Nigeria”.
Ohanyido further decried the impacts of poor maternal nutrition, saying it has dire consequences for women and children, as micronutrient deficiencies can have lifelong impacts on a child’s physical, mental, and emotional development. He listed some of the essential micronutrients for women and children to include iron, vitamin B6, vitamin C, vitamin E, magnesium, zinc, and iodine, among others.
Supporting the Mother to Sustain the Baby
Mrs Isong, in her concluding narration, disclosed how she lodged complaints in her clinic, and she was adequately diagnosed and recommended the appropriate micronutrient supplement, which aided her recovery journey from micronutrient deficiency. “When the situation became overwhelming for me then, I was forced to complain to my doctor at the clinic, who prescribed a supplement for me. Subsequently, after a few weeks, there was great improvement in my system, and I resumed normal breastfeeding of my baby.”
Fatigue is indeed one of the most obvious symptoms of iron deficiency and iron-deficiency anaemia in lactating mothers. Other symptoms as established by experts include weakness, shortness of breath, dizziness, headaches, difficulty concentrating and pale skin. While fatigue alone cannot disrupt lactation, other factors including inadequate nutrition, thyroid disorders, or postpartum depression can hamper the frequency of breastfeeding in a nursing mother.
In supporting the mother to support the baby, experts recommend the use of appropriate micronutrient supplements after clinical assessment to elevate the inadequacy in the mother’s nutritional system, thereby strengthening the baby’s supply system for continuous supply of breast milk to the baby. Additionally, assessment of practical breastfeeding skills is crucial in addressing poor milk transfer or ineffective feeding methods, in ensuring that optimal milk release is not disrupted in any way. The WHO emphasises that mothers require skilled support to initiate and sustain breastfeeding, including guidance on positioning, addressing breastfeeding difficulties, advising on optimal nutrition, and understanding the physiological and emotional needs of the mother, which is the work I do as a Lactation Consultant.
As it is often said, breastfeeding is a natural gift nursing mothers bestow on their children, but sustaining that gift through the first 24 months of a child’s life requires the mother to be nourished herself and cared for. When required, micronutrient supplementation is not a luxury nor substitute for a balanced diet, adequate breast-feeding practise or skilled lactation support. It is rather a part of the multifactorial approach to protect and preserve mothers’ health during the critical period of breastfeeding. When the nourishers are nourished, the foundation of healthier mothers is enhanced for continued effective and adequate breastfeeding.
Medunoye is an International Board certified Lactation Consultant (IBCLC) and Founder, Milky Express.
