Maternal Anemia

The recommended daily intake of iron in a breastfeeding mother is 9-10 mg and should not exceed 45 mg daily ^{(NIH 2023, 2022, 2001)}. Supplementation can decrease the concentration of copper and zinc in plasma and breast milk. ^{(Mello 2013, Haidar 2005, Ortega 1998)}

Maternal anaemia must be prevented and treated, but neither the disease nor its treatment contraindicates breastfeeding. 

There is a high prevalence of nutritional anaemia in breastfeeding mothers ^{(Shashiraj 2006)}, which is as high as 47% in mothers of low socio-economic status. ^{(Bodnar 2001)}

During gestation and breastfeeding there is a transfer of iron from mother to child which tends to prevent both iron-mediated infection and oxidative stress and the potential risk of maternal and infant iron deficiency. ^{(Miller 2016)}

Blood loss during childbirth is an important factor in postpartum anaemia ^(Chan2001). Pregnancy during breastfeeding increases the risk of anaemia ^{(Shaaban 2015)}. In contrast, prolonged breastfeeding is a protective factor for anaemia in breastfeeding mothers. ^{(Lakew 2015)}

Iron deficiency anaemia increases the risk of postpartum depression ^{(Azami 2019)} and is a risk factor for early abandonment of breastfeeding ^{(Rioux 2006)}, possibly due to a feeling (real or not) of insufficient milk. ^{(Henly 1995)}

According to some authors, there is a correlation between maternal haemoglobin and that of exclusively breastfed infants in the first 6 months of life ^{(Marques 2016, Teixeira 2010)}, which is why it is necessary to prevent anaemia before conception, during pregnancy and breastfeeding. ^{(Teixeira 2010)}

When maternal anaemia is associated with prolonged breastfeeding, there is an increased risk of anaemia in infants in developing countries ^{(Meinzen 2006)}. But other studies show that iron and lactoferrin levels in milk are independent of maternal plasma iron and haemoglobin levels ^{(Marques 2016, Shashiraj 2006, Murray 1978)} and that exclusively breastfeeding infants have normal plasma iron levels regardless of maternal iron status. ^{(Murray 1978)}

Iron is excreted in small amounts in breast milk by a self-regulating mechanism. There is no correlation between the mother's daily iron intake and its concentration in breast milk ^{(Keikha 2021, Yalçin 2009, Hannan 2009, Muslimatun 2001)}. Maternal iron supplementation does not significantly increase iron levels in breast milk or infant plasma. ^{(Breymann 2007, Baykan 2006)}

Maternal pernicious anaemia due to lack of vitamin B12 absorption or deficient diets such as vegan diets can cause anaemia and severe physical and/or neurological symptoms in the infant. ^{(Lücke 2007, Weiss 2004, Sklar 1986)}

See below the information of these related products:

• Iron Dextran (Safe product and/or breastfeeding is the best option.)
• Iron, ferrous compounds and salts (Safe product and/or breastfeeding is the best option.)
• Vegetarian Diets (Fairly safe. Mild or unlikely adverse effects. Compatible under certain circumstances. Follow-up recommended. Read Commentary.)
• Vitamin B12 Substances (Safe product and/or breastfeeding is the best option.)