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Supplements while EBF question

Posted by on Mar. 22, 2013 at 11:04 AM
  • 7 Replies

DD2 had her 2 month visit today.  We are trying to EBF for 6 months (my goal).  

DH told the doc that and she said that was great but that we'd need to start an iron supplement and vitamin D supplement later if we didnt' want to do the rice.  

I feel like I've read that the iron in the cereal interferes with her absorption of iron from the BM.  

Yes? No? 

As a side note...should I be taking the DHA supplements that I took during pregnancy?  

(DH and I aren't feeling a need to start the supplements with her, but I wanted concrete info as a reason not to)

by on Mar. 22, 2013 at 11:04 AM
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by on Mar. 22, 2013 at 11:06 AM
Yes you are correct artificial iron can interfere with natural iron absorption.

Do you like in Alaska?

If not just stick baby outside or in the window for 30 minutes a day and you should be good on vitamin d.
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by on Mar. 22, 2013 at 11:09 AM
Vitamin D....a lot of differing opinions there. Many are deficient these days and "15 minutes in the sun" may or may not do the trick. Up to you there.

Iron supplements are simply mal-absorbed into anyone's body. Stupid pointless.

When a doc suggests my baby needs supplements, I require proof. I do give vit d supplements because I simply don't go outside enough right now.
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by Ruby Member on Mar. 22, 2013 at 11:17 AM
Your milk contains everything your baby needs. You can take your prenatals or a good multivitamin if you want to keep your own levels up. And yes, artificial iron binds with the natural iron in breastmilk so that neither is absorbed, leading to anemia. has information on that subject. And the AAP no longer recommends cereal for infants. also has an excellent article on baby-led solids.
Pediatricians receive very little education on breastfeeding, and this one is not even keeping up with the recommendations of hid own professional organization very well.
by on Mar. 22, 2013 at 2:03 PM

You don't need to give iron drops or iron fortified cereal, instead you can give foods that are natrually rich in iron and zinc starting at 6 months.

Here's some info for you:

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

The iron in breastmilk is bound to proteins which make it available to the baby only, thus preventing potentially harmful bacteria (likeE.coli, Salmonella, Clostridium, Bacteroides, Escherichia, Staphylococcus) from using it. These two specialized proteins in breastmilk (lactoferrin and transferrin) pick up and bind iron from baby’s intestinal tract. By binding this iron, they

  1. stop harmful bacteria from multiplying by depriving them of the iron they need to live and grow, and
  2. ensure that baby (not the bacteria) gets the available iron.

The introduction of iron supplements and iron-fortified foods, particularly during the first six months, reduces the efficiency of baby’s iron absorption. As long as your baby is exclusively breastfed (and receiving no iron supplements or iron-fortified foods), the specialized proteins in breastmilk ensure that baby gets the available iron (instead of “bad” bacteria and such). Iron supplements and iron in other foods is available on a first come, first served basis, and there is a regular “free-for-all” in the baby’s gut over it. The “bad” bacteria thrive on the free iron in the gut. In addition, iron supplements can overwhelm the iron-binding abilities of the proteins in breastmilk, thus making some of the iron from breastmilk (which was previously available to baby only) available to bacteria, also. The result: baby tends to get a lower percentage of the available iron.

Supplemental iron (particularly when administered in solution or as a separate supplement rather than incorporated into a meal) can interfere with zinc absorption. In addition, iron supplements and iron-fortified foods can sometimes cause digestive upsets in babies.

A recent study (Dewey 2002) found that routine iron supplementation of breastfed babies with normal hemoglobin levels may present risks to the infant, including slower growth (length and head circumference) and increased risk of diarrhea.

A recent review article on iron (Griffin and Abrams, 2001) indicates that if your baby is basically healthy, iron deficiency in the absence of anemia should not have developmental consequences.

What are some good iron sources?

La Leche League recommends that babies be offered foods that are naturally rich in iron, rather than iron-fortified foods. Read more about when to start solids here: Solid Foods and the Breastfed Baby

Foods that are high in iron include:

  • breastmilk
  • winter squash
  • sweet potatoes
  • prune juice
  • meat & poultry (beef, beef & chicken liver, turkey, chicken)
  • mushrooms
  • sea vegetables (arame, dulse), algaes (spirulina), kelp
  • greens (spinach, chard, dandelion, beet, nettle, parsley, watercress)
  • yellow dock root
  • grains (millet, brown rice, amaranth, quinoa, breads with these grains)
  • blackstrap molasses (try adding a little to cereal or rice)
  • brewer’s yeast
  • dried beans (lima, lentils, kidney)
  • chili con carne with beans
  • tofu
  • egg yolks
  • grains (cooked cracked wheat, cornmeal, grits, farina, bran, breads with these grains)
  • tomato
  • dried fruit (figs, apricots, prunes, raisins)
  • meat (pork)
  • shellfish (clams, oysters, shrimp)
  • tuna, sardines

Warning: Some of the foods listed above are not suitable for babies. Dried fruits should not be given to babies under a year old, due to the choking hazard. Also, pork, fish, shellfish, wheat, citrus fruits and eggs are highly allergenic and may not be suitable for babies who are at high risk for allergies. See Suggested ages for introducing allergenic foods for more information.

Iron in the Vegan Diet by Reed Mangels, Ph.D., R.D. also has some great info on iron-rich foods.

See also Iron Content of Common Foods from British Columbia Ministry of Health

You may wish to give baby foods high in vitamin C along with iron-rich foods, since vitamin C increases iron absorption. Cooking in a cast iron pan also increases iron content of foods. The absorption of iron is also increased by eating green leafy salads or citrus fruits, fruit juices and potatoes (including instant potatoes at meals when consuming iron rich foods).

Here’s a combination to try — Cook brown rice (put in the blender if baby needs a smoother texture) and mix it with stewed iron-containing fruits (apricots, prunes, etc). You can even add a touch of blackstrap molasses for extra flavor and extra iron.

The caffeine/tannin in strong tea, coffee, chocolate and cola drinks interferes with the absorption of iron; avoid having these one hour before and one hour after iron rich foods (this note is for adults and children – none of these things are recommended for babies).

Some vitamin D info:
by on Mar. 22, 2013 at 3:09 PM
You should never give iron supplements to anyone unless their levels have been checked and are low and iron rich foods have been unable to bring the levels up. And vitamin d is debatable. Some people do, some people don't. Depends on how much baby is outside and how much sun your area has.
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by on Mar. 22, 2013 at 3:17 PM

Vitamin D drops also depend upon the amount of melanin in your skin.  The darker your complexion, the more likely you are to be deficient.  Also a very fair person who uses a lot of sunscreen or covers themselves from the sun could be more in need of supplements.

by Group Admin - Amy on Mar. 22, 2013 at 4:52 PM
I would not supplement my baby without a blood test showing a deficiency. Artificial iron is not absorbed well and keeps the natural iron from being absorbed, causing lower iron levels. If you don't get enough sun, giving a vitamin D supplement might be a good idea. You want to look for one that requires only one single drop as the dose and has no added fillers and colors that can disrupt the baby's virgin gut. Just D and Carlson's are the two brands that I know of.
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