Published online February 29, 2008
PEDIATRICS Vol. 121 No. 3 March 2008, pp. e673-e677 (doi:10.1542/peds.2007-1986)

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ARTICLE

Cord Blood and Breast Milk Iron Status in Maternal Anemia

Ashok Kumar, MD^a, Arun Kumar Rai, MD^a, Sriparna Basu, MD^a, Debabrata Dash, MD^b and Jamuna Saran Singh, PhD^c

^a Division of Neonatology, Department of Pediatrics
^b Department of Biochemistry, Institute of Medical Sciences
^c Department of Botany, Faculty of Science, Banaras Hindu University, Varanasi, India

OBJECTIVES. The purpose of this work was to assess the effect of severe maternal iron-deficiency anemia and nutritional status on cord blood and breast milk iron status.

METHODS. We conducted a prospective observational study over a 6-month period in a teaching hospital in central India. The study population consisted of 55 anemic (hemoglobin: <110 g/L) and 20 healthy nonanemic (hemoglobin: 110 g/L) pregnant women who delivered singleton live births at term gestation. We measured hemoglobin, iron, and ferritin levels in paired maternal and cord blood and iron levels in early (day 3 ± 1) and late (day 15 ± 3) transitional milk. Maternal anthropometry, including weight, height, midarm circumference, triceps skinfold thickness, and placental weight, were recorded. The main outcome measure of the study was to find out the relationship of maternal hemoglobin, iron, ferritin, and anthropometry with hemoglobin, iron, and ferritin in cord blood and iron levels in breast milk.

RESULTS. Concentrations of hemoglobin, iron, and ferritin were significantly lower in the cord blood of anemic mothers and showed linear relationships with maternal hemoglobin and ferritin levels. Breast milk iron content was significantly reduced in severely anemic mothers but not in those with mild-to-moderate anemia. Breast milk iron level correlated with maternal hemoglobin and iron levels but not with ferritin levels. Maternal anthropometry had significant correlations with indices of iron nutriture in maternal and cord blood but showed no relationship with breast milk iron content. Placental weight was comparable between anemic and nonanemic mothers.

CONCLUSIONS. Maternal anemia, particularly the severe type, adversely affects cord blood and breast milk iron status. Maternal nutritional status exerts a significant influence on fetal iron status but has little influence on breast milk iron content.

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Key Words: breast milk • cord blood • iron status • maternal anemia • newborn

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Accepted Aug 22, 2007.

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