Iron deficiency in breastfed babies - research?

[AislinCarys]

This question came up in a breastfeeding network (mum-to-mum) that I am part of. Ie:

"Will a breastfed baby be anemic if it doesn't get iron-rich or iron-fortified foods after 6 months?"

And I remembered when we were being pushed to make sure our self-feeding (and very much breast-fed) 8-month old ate meat, since we didn't feed her formula or baby rice. I searched for info then, to see where this "fact" came from, but didn't really find anything, was too sleep-deprived and gave up.

Now I'm wondering, does anyone here know of any research about this? I was thinking statistics on the blood tests on babies (as I think American babies are tested - at 9 months or so??? Swedish and New Zealand babies are not - when I suggested testing instead of pressuring parents of babies un-interested in solids, my nurse was horrified, as she thought it would be abusive to test the babies "un-necessarily"). Maybe comparing variables: still exclusively breastfed, ebf till 6 months, then partially breastfed, partially breastfed from the start, eating solids with little or no iron, eating iron-fortified foods, eating iron-rich foods?

Is there any resarch at all? WHO just seem to state the fact.

[hijadelrey3]

I found some good information on iron from this website

http://www.kellymom.com/nutrition/vitamins/iron.html

[tinybutterfly]

Hi! I am moving this out to the general Breastfeeding Forum! It doesn't seem to be a lactivist issue.



tinybutterfly

[Beck024]

All 4 of my kids have had the blood test done at 9 months and they have never shown an iron deficiency. They were all exclusively breastfed until 6 months and slow to start solids - basically still just breasfeeding at 9 months.

[smeep]

I have had many questions on this subject myself. My son (who ate little solids until around 15 months) had "borderline" iron - JUST below the level for "normal." Here are my biggest questions on it.

What study did they use to determine what a "normal" level of iron is for a baby? I would be willing to bet money that it was done similarly to the typical growth charts. The least ideal, but most common, group. For growth charts it was babies who ate too much (formula, early solids, little or no mama milk, high rates of obesity, etc. It is quite likely that the group used for determining the "average" amount of iron could have included babies who intake too much iron with similar nutritional history. Adults also quite often consume too much meat (more than we would if we had to catch and eat our own), nor were we ever meant to consume another mammal's milk, so do we possibly consume too much iron? The same basic question has been raised about the vitamin K shot. They say babies are born with "relatively low" levels of vitamin K. Relative to wom? Adults? Artificially fed babies? How is breastmilk, the food that we survived on for so long, so deficient? If I could find out more about the study, it would shed a lot of light on it.

What did we do in the cave days? We had no pureed foods or ground and iron-fortified cereal. We nursed! When or how much or what types of solids we got is hard to say, but we certainly did not consume the amount that is recommended for nursing babies today.

Introduction of iron-containing supplements (formula, purees, cereal, etc.) decreases the absorption of iron in breastmilk (it breaks the protein-bond that mama milk has which means bacteria eats more and baby gets even less). With iron-containing supplements having such low bioavailability to begin with, then further decreasing what iron they get from mama milk, how is this an improvement at all?

A study showed that leaving the cord intact for just 1-3 minutes considerably increased iron stores in babies compared to those whose cords are cut immediately (as is the case for most infants born in a traditional hospital setting). 1-3 minutes isn't even that long! If we waited until the cord stopped pulsating (as all other mammals do when not interfered with by humans) wouldn't that increase the stores further?

There are so many questions, but those are my biggest ones. My take on it in the meantime? When my child can eat raw (perhaps mashed in my teeth a bit) foods, they are ready. Until then, they're not. (Of course this is what I've learned since DS, and plan to do with this one.) Nature isn't stupid - human milk is for human babies for a reason!

[PatioGardener]

Originally Posted by smeep

A study showed that leaving the cord intact for just 1-3 minutes considerably increased iron stores in babies compared to those whose cords are cut immediately (as is the case for most infants born in a traditional hospital setting). 1-3 minutes isn't even that long! If we waited until the cord stopped pulsating (as all other mammals do when not interfered with by humans) wouldn't that increase the stores further?

I think iron stores have much more to do with pregnancy and birth than breastfeeding. Prematurity or immediate cord clamping puts you at higher risk of anemia - which when severe does have serious health issues. I insisted on waiting until the placenta had detached before clamping for just that reason.

[ClaudiaTh]

Originally Posted by hijadelrey3

I found some good information on iron from this website

http://www.kellymom.com/nutrition/vitamins/iron.html

I love Kelly Mom, let me quote a few things:

Healthy, full-term babies have enough iron stores in their bodies to last for at least the first six months. The current research indicates that a baby's iron stores should last between six and twelve months, depending upon the baby.

Healthy, full-term infants who are breastfed exclusively for periods of 6-9 months have been shown to maintain normal hemoglobin values and normal iron stores. In one of these studies, done by Pisacane in 1995, the researchers concluded that babies who were exclusively breastfed for 7 months (and were not give iron supplements or iron-fortified cereals) had significantly higher hemoglobin levels at one year than breastfed babies who received solid foods earlier than seven months. The researchers found no cases of anemia within the first year in babies breastfed exclusively for seven months and concluded that breastfeeding exclusively for seven months reduces the risk of anemia.

[crunchy_mommy]

smeep, GREAT post. ITA.

Just to add a little personal story (not statistically significant, of course!) DS is 16mos old. His iron was tested at his 12-month appointment. He was 95% BF at that point. He was NOT anemic, not even a trace, but his iron stores were VERY VERY low (almost non-existant). I was very reluctant to supplement though, because I had a hard time believing his low iron stores were really problematic, and thought they might be 'artificially low' because of the test range samples being 'artificially high' if that makes sense! Plus there is research showing that people who consume less/different iron than the SAD (i.e. those on a vegan diet like my family) are able to adapt and continue to produce RBC's well. I really didn't want to interfere with that adaptive response (or maybe natural response?) by supplementing. But after more research we decided to supplement short-term with small, irregular doses of Floradix just to boost his stores because they really were insanely low. I think smeep's post brings closure to our decision -- When DS was born he wasn't breathing & thus the (UAV) doctor decided his cord needed to be cut IMMEDIATELY. I think that was a dumb decision for many reasons but also must have interfered with him building a good iron store. So, we needed to supplement to make up for the early cord-cutting. (I love when things all make sense suddenly )

Sooo next time around, no cord-cutting, and hopefully no iron supplementation!

[Gena 22]

Another anecdote here, to support the theory that what happens in pregnancy and cord clamping has more to do with iron stores than how much iron fortified food a babe gets:

My identical twins were both EBF for the first 6 months, and they ate some food 6-12 months, but not a ton. One twin had lowish iron levels and the other was pretty normal. The twin with the lower level was also a pound smaller at birth: 5.12 as opposed to her sister at 6.11.

I firmly believe that her low birth weight led to the low iron level. I sporadically supplemented with an herbal tonic (yellowroot and dandelion I think), but not much. Both girls were great when tested again later.

No need for rice cereal or formula.