Iron while Breastfeeding | Why it is important

Iron is necessary to make hemoglobin, which carries oxygen in red blood cells to all parts of our body.

Iron also supports neurological development during infancy and early childhood. Nourish yourself and your baby with Iron while breastfeeding

Is breast milk low in iron?

Breast milk naturally contains very little iron.

Considering that human milk is the ideal first food for human babies, the general consensus is that breast milk contains sufficient iron for full term, healthy breastfed infants.

What about iron levels in formula?

Most infant formulas are iron fortified.

This means that babies who are exclusively formula fed get enough iron from formula alone and do not require additional iron supplementation.

Can I increase the iron in breast milk by taking an iron supplement?

Iron supplements do not increase the amount of iron in human milk.

Because maternal iron deficiency anemia can affect the health of both a mother and her baby, iron supplements are commonly recommended in pregnancy.

Iron deficiency during pregnancy can increase the risk of premature birth and low birth weight. These two factors can also contribute to iron deficiency in infants.

Most prenatal vitamins contain iron supplementation. It is safe to continue taking prenatal vitamins while you are breastfeeding. If you have been taking a separate iron supplement throughout your pregnancy, talk to your healthcare provider to find out how long you should continue to take it after giving birth. If you were iron deficient during your pregnancy, it is generally recommended to continue taking iron supplements for 6-12 weeks after your baby is born.

Why not use iron supplements as a protective measure for every baby?

There is no controversy about the fact that breast milk is low in iron; however, there is a level of controversy about whether breast milk has sufficient iron for an exclusively breastfed baby.

This might make you wonder: if there is any controversy about breastfed babies receiving enough iron from breast milk, then why not use iron supplementation as a precautionary measure?

Iron deficiency anemia is uncommon in breastfed babies for several reasons. At birth, a baby’s body iron stores are very high, in both hemoglobin concentrations and liver stores.

We know that the iron content of breast milk is relatively low in comparison with maternal serum ferritin (a blood protein that contains iron); however, it is widely agreed that breast milk has a special form of iron that is highly bioavailable to breast fed infants. This concept has been supported by the discovery of a receptor in the infant gut specifically for lactoferrin-iron.

Giving iron supplements when they are not medically indicated could be dangerous to a newborn baby’s health.

Are all supplements harmful for babies?

Not all supplements are harmful. Most breastfed babies require a vitamin D supplement.

You can read more about this in BellyBelly’s article Vitamin D While Breastfeeding | Why It Is So Important.

Will introducing solid foods earlier help?

In the past there has been conflicting advice about the introduction of solids in relation to a baby’s iron needs. Some suggestions have encouraged the earlier introduction of solid foods at around 4 months of age, when a baby’s iron stores start to deplete naturally.

The current recommendation from the World Health Organization is exclusive breast feeding for the first 6 months of life, with the introduction of solid food from 6 months of age.

In an American study, researchers found that the introduction of solid foods at 4 months, with the intention of increasing iron intake, led to parents offering their babies more iron fortified cereals and less breast milk overall. This did not increase iron levels in breastfed babies, as the iron in baby cereal has a very low bioavailability in comparison with breast milk.

Iron rich foods, such as meat, poultry and fish were not consumed until around 8-9 months of age, regardless of the timing of the introduction of other solid foods.

What are the best iron rich foods?

For babies six months of age and over, offering iron rich foods in addition to breast milk makes sure they are getting enough iron in their diet.

Animal-based food sources of iron include:

• Red meat
• Poultry
• Fish
• Eggs.

Plant-based food sources of iron include:

• Nuts
• Legumes
• Dark, leafy, green vegetables
• Tofu
• Iron fortified cereals.

Eating foods rich in vitamin C can help the body absorb iron more efficiently. Foods that are naturally high in vitamin C include citrus fruits, berries and tomatoes.

You can read more about vitamin C and breastfeeding in BellyBelly’s article Vitamin C While Breastfeeding | Why It Is Important.

Studies show that drinking too much cow’s milk can negatively affect iron absorption. Between the ages of 1 and 5 years, children should drink no more than 700 ml of cow’s milk each day.

Do preterm infants need extra iron?

For infants born prior to 35 weeks gestation, or with a low birth weight, iron supplementation is recommended from 4 weeks until 6 months of age.

This is because infants born prior to full gestation do not have the same high iron levels as full term infants at birth. This means that when the body’s iron stores begin to drop after birth, a premature baby’s iron levels might become too low.

Can a baby have too much iron?

Having too much iron can cause liver damage and viral hepatitis. Interestingly, having too much iron can also affect iron absorption, resulting in iron deficiency.

Breastfed babies born to mothers who are taking iron supplements are not at risk of having too much iron. A breastfed baby who is repeatedly taking a high dose iron supplement, however, might be at risk of too much iron.

Neonatal hemochromatosis is a rare genetic condition that causes the body to store excess iron in the liver and other body tissue of fetuses and infants under 1 month of age.

A baby cannot get hemochromatosis from having oral iron supplements or iron-containing complementary foods.

Iron while breastfeeding: What does the research say?

A prospective study in 2008 evaluated the iron status in exclusively breastfed infants up to 6 months of age.

The study found that exclusively breastfed babies of mothers who either were or were not iron deficient did not develop iron deficiency anemia by 6 months of age.