Posted by My OB said WHAT?!?.
Dec
3
Posted by My OB said WHAT?!?.
“You’ll Notice That All Infant Formula Is Fortified With Iron. Breast Milk Needs The Same Thing.”
You’ll notice that all infant formula is fortified with iron. Breast milk needs the same thing.” – Pediatrician to new mother.
There are 32 comments to this post.
I would guess that this mother wasn’t getting enough iron in her diet, therefore baby wasn’t getting enough. Perhaps the doctor is just pointing out the need for mom to have a balanced diet.
Lots of women have low iron–me included.
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Melissa Reply:
December 3rd, 2011 at 8:43 am (Quote)
…how, exactly, would the pediatrician know this, even if it were the case? Seems like that’s working a little too hard to make sense of this nonsense.
This is a pediatrician. He or she should know something about infants. About breastmilk. Maybe even about the new research showing that delayed cord clamping benefits infants’ iron reserves for MONTHS, for example…wouldn’t I love to have a pediatrician check with a mom about when baby’s cord was clamped to get a better idea of the likelihood that the kid will or will not have certain deficiencies early on! He or she should know something about the kind of iron that’s in breastmilk vs the kind that’s in formula…and not assume that because the artificial human milk needs iron as an ingredient, the real deal human milk…what…can’t already have enough and must need extra? Wha…..? The “logic” makes me cringe. My freshman students could do better than this doc, at least on the logic front.
It’s a kind-hearted attempt…but no matter what you do with this statement, it just doesn’t make sense.
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Holly Reply:
December 9th, 2011 at 10:57 pm (Quote)
Low iron in mom has NOTHING to do with it. I was so low that my dr was talking blood transfusions/iron infusions. When I got to the hospital and they looked at my chart they asked “How are you even STANDING here?”. I was LOW. I was so low I could barely stand up out of my chair to make my children food. I was also nursing. (This just happened last month). The day they told me I was so dangerously low I RUSHED my nursling to his ped and had his iron checked. I begged so hard they made a special appt for him and WORKED him into an overbooked afternoon. His iron was the HIGH side of GREAT. He eats very little to no solids even now. I was so worried and they were telling me that my iron didn’t effect him and he was fine and I just needed that confirmation in my time of illness. *Just* because mom is low iron does NOT mean that baby needs iron supplements 
our bodies are AMAZING like that They take care of baby first.
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My story!! This was the way the conversation went”
Pediatrician: “Breastfeeding your baby isn’t enough. He needs an additional iron and vitamin D supplement.”
Mother: “Well, I already take an iron supplement and vitamin D in addition to my prenatal.”
Pediatrician: “It’s still not enough. You’ll notice that all infant formula is fortified with iron. Breast milk needs the same thing.”
It was completely out-of-the-blue. She never asked or knew if I had any deficiencies. Her attitude was more like that formula was the gold standard to which all others are to be compared.
As far as my health goes, I have had 5 kids in 8 years, so I get my levels checked. With my third pregnancy, my iron tested low. Since then I have taken my prenatal and an additional vegan iron supplement. I *know* that my iron level is good because, since that incident, I request lab work to check for deficiencies.
My last labs did show that I was a bit low in vitamin D with a level of 16. Since then (about a year ago) I’ve added a calcium/magnesium/vitamin D supplement. We live in a tropical climate where it is sunny even in the winter time. I really doubt that he deathly *needs* even the vitamin D.
All in all, I like this pediatrician pretty well. She did not brow-beat me when I told her that we fore go vaxxing. I just shrugged off this crazy suggestion.
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Diana Reply:
December 3rd, 2011 at 6:47 am (Quote)
That’s the thing about pediatricians, they think because they have a degree they know everything about your child. You are the mother. You know what’s best. My pediatrician has been so supportive of my breastfeeding. And actually helped to ward off my MIL. But we do differ on some things, like shots. But I still like him.
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Renai Reply:
December 3rd, 2011 at 7:18 am (Quote)
That doesn’t make sense. Your milk “was” being fortified by the supplements you take. Not that formula has anything over breastmilk. I do the same thing because I know my iron gets a little low sometimes (I take a fluid vegan iron supplement).
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mom of 5 Reply:
December 3rd, 2011 at 10:01 am (Quote)
Just realized I left out some info.
The deal was that she was wanting to prescribe him both an infant iron supplement and an infant vitamin D supplement. I sort of said, “I don’t think that’s really necessary.” That’s when she said that “breastfeeding your baby isn’t enough…”
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Blue Reply:
December 3rd, 2011 at 12:40 pm (Quote)
I generally like my pediatrician, but he did the same thing when my daughter was newborn. Rather than debate with him, however, I just smiled and nodded. He assumes I’m giving them to her. Whatever. My daughter is 13 months, still nursing, still not taking supplements, and has no deficiencies.
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Lisa Reply:
December 3rd, 2011 at 7:09 pm (Quote)
Actually, 16 is more than a “little” low, it’s extremely low. Recent studies are showing that it needs to be closer to 50 in order to transfer adequate amounts through breastfeeding. Breastfeeding mothers should be taking 4000-6000IU of Vitamin D every day, and that’s if you have good levels to start with.
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Heather Reply:
December 4th, 2011 at 11:00 am (Quote)
No, they don’t. While that’s still healthy for you, yes, believe me, as long as you have it in your system, your baby is getting it (and if they’re getting sun, they’re getting more. Yes, it’s good to take a D supplement, but it doesn’t hurt the darn milk NOT to be taking it. And babies don’t get all their D through diet, just like the rest of humanity.
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Lisa Reply:
December 4th, 2011 at 4:15 pm (Quote)
Actually, it does hurt your milk to not have enough D. That’s why drs insist that breastmilk is deficient, because most women are, so their milk is as well. http://compmed.com/family-care/optimum-vitamin-d-level-above-50-ngml/ “Professor Hollis answered that question in his research, finding that when a lactating woman has vitamin D blood levels of 40-50 ng/ml, her breast milk finally has enough vitamin D to support the vitamin D levels of her nursing infant. At levels below 40, the vitamin D content of breast milk becomes unpredictable. ”
And unless you live in areas south of San Francisco, you literally CAN NOT get D from the sun for 4-8 months of the year (depending on how far north you live). In addition, as Jessica said, even if you are getting it from the sun, most people bathe so often they wash it off their skin before it can be absorbed (takes about 3 days)
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IDS Reply:
January 5th, 2012 at 12:28 pm (Quote)
just wanted to add that the whole ‘vitamin D from the sun’ is misunderstood here! It doesn’t ‘stay’ on your skin, you CAN’T ‘wash it off’!!! the sunlight triggers the production of vitamin D INSIDE your body, that’s why it’s supplemented (or should be) in the less sunny locations
Also I’d rather supplement it to myself as nursing mother AND the baby than have a child with week bones and knocked knees! (vitamin D helps to absorb and metabolise Calcium, very important in a growing body)
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Jessica Reply:
December 4th, 2011 at 2:55 pm (Quote)
I was about to say the same thing as Lisa, 16 is EXTREMELY low. My level was 21 this past March, and my doctor immediately put me on a D3 supplement. It is finally up to 50.4. My deficiencies in vitamins D and K while I was pregnant have actually caused issues in my son, including rampant tooth decay at age 2, despite never eating sugar or drinking juice. Nearly everyone DOES need to be supplementing with vitamin D, because we as a population are deficient. My personal theory on why is the overuse of sunblock, and harsh soaps that strip the natural oil from our skin (D is a fat soluble vitamin, so the oils help us absorb it).
To the OP, that pediatrician is unfortunately just spouting what they hear from the formula companies. While breastmilk is low in iron, it is a readily absorbed form, that actually gets BLOCKED when you start supplementing with formula or cereal. I’m glad you get your levels checked regularly, having kids close together can take a lot out of you if you’re not careful to get the nutrition you need!
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Heather P had this to say,
Dec 3, 2011 @ 9:03 am (Quote)
Infant cereal is fortified with iron as well. The first time I have my exclusively breastfed baby her cereal she gobbled it up. Then screamed for two days because all the iron made her constipated. She didn’t get any more of that stuff. I didn’t care what the ped had to say about it.
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KristinG Reply:
December 4th, 2011 at 12:01 pm (Quote)
Make your own, take uncooked rice, pulverize it in the blender, while mixing start water boiling, boil the rice powder for a few minutes until cooked/soft, let cool. No artificial crap
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Heather P Reply:
December 7th, 2011 at 9:26 am (Quote)
We only gave rice cereal once because our ped recommended adding it to her diet. We completely gave up on rice cereal after that. Rice is just starch, not much nutritional value anyway. Fresh squash was a much better first food than rice. . We didn’t give jarred baby food either. We made our own.
Plus, my baby that I’m talking about is now four years old.
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road2vba2c had this to say,
Dec 3, 2011 @ 9:36 am (Quote)
Have you ever thought, doc, that formula *has* to be fortified because it’s a breastmilk *replacement* and therefore an inferior product? If you were to make artificial blood, you would have to “fortify” it with red blood cells, plasma, etc. from another source because the replacement product is inferior and thus needs fortification. Just a thought.
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Jess Reply:
December 3rd, 2011 at 1:17 pm (Quote)
Exactly! Infant formula has to be fortified with basically EVERYTHING because it’s ARTIFICIAL! Good Lord.
Infant formula doesn’t just have to be fortified with iron. It’s a protein base that has to be fortified with carbohydrates, fats, vitamins, minerals, nucleotides, etc….EVERYTHING has to be added to it. Because t’s ARTIFICIAL!
So if you were trying to make a point with that comparison, Doc, you failed. Miserably. And it mainly bothers me because most of your other patients probably take you seriously when you say half-witted things like that.
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My husband is in the military so we see quite a few doctors and almost everyone one of them says that we need to be giving any breastfed babies extra iron. I hadn’t done much research on it the first time through, but I still knew that sounded wrong. After some research, when asked now if I give them vitamins, I say that I do. I take my vitamins and give them a portion through my milk.
My kids have always had extremely good iron levels.
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Lora Reply:
December 3rd, 2011 at 12:59 pm (Quote)
Exactly. My understanding is that breastfed babies “sometimes” have low vitamin D levels (this study http://pediatrics.aappublications.org/content/118/2/603.long found about 25% of breastfed babies who were not supplemented with vitamins or formula were vitamin D deficient). This becomes more of an issue the more north you live (we are up in New York and have to watch this) and the darker your skin is (darker skin produces less D with the same amount of sunlight- hey, my pastiness is worth something!).
So, some babies can benefit from supplementation of either the mother or the baby. Most pediatricians think that breastmilk does not have sufficient vitamin D to support the baby and prescribe supplements. That isn’t true, it’s just that many mothers have low levels of D themselves so it looks like it doesn’t transfer. If mom’s levels are high, baby gets plenty, but if Mom’s levels are low, baby will be low. Supplementation of mother with 400 IU (recommendation by FDA) is often not sufficient to support D levels in baby, but higher amounts will do it. (http://www.liebertonline.com/doi/abs/10.1089/bfm.2006.1.59) and DOES NOT need to be given vitamins. There are other studies, but this one had a fairly simple abstract.
I have chronically low levels of D and heavily supplement myself to manage that. My breastfed babies vitamin D levels are beautiful. I lie to the ped when he asks if we are giving the recommended vitamin d supplement to the baby. He doesn’t believe that vitamin D can transfer to breastmilk, and I got tired of arguing (I see this so often on this site and I HATE that I contribute to it by just lying. It’s just simpler…). Even if I did not have low D without supplementation, I would probably supplement myself because I would rather give the vitamin to me than to my baby who has such a young and sensitive tummy.
As for iron, breastmilk has very little iron but it is VERY easily absorbed. Breastfed babies do not need supplementation because they have enough iron stores to last at least 6 months, some research suggests much longer, as long as they are also breastfed and, therefore, receiving that little bit of easily absorbed iron from Mom. But, a ped who is used to formula might not know that. (I’ve run out of time to find primary sources, so check this nice summary by KellyMom. http://kellymom.com/nutrition/vitamins/iron.html
Incidentally, my pro-Vitamin-D Pediatrician understands that breastfed babies don’t need iron. He recently explained to me (unnecessarily) that formula-fed babies benefit from cereal earlier than breastfed babies because they need the additional iron.
Of course, that begs the question, as mentioned above, how long would it take the baby to use his iron stores if delayed cord-clamping was done? Enough rambling for now.
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Jess Reply:
December 3rd, 2011 at 1:24 pm (Quote)
I’m so glad you mentoned the connection between ron and delayed cord clamping. I’ve always believed there was a huge connection between the two…..it’s only logical. Most people suffer low iron after considerable blood loss. Consider early coed clamping a considerable loss of their intended blood volume. The blood will replenish itself in a fairly short time, but original iron stores would have to be replaced….the body can’t make more iron liek it can make more blood. So it maes sense that in a culture where most babies lose a significant percentage of their blood volume at birth, that smae culture also sees tone of babies with low iron levels by 6 months of age.
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Out of three kids, for the first time EVER, the pediatrician who checked my now 12-day-old at the hospital rolled his eyes at these recommended supplements for a breastfeeding baby. Especially the vitamin d since we live in the tropics. He basically said that he was giving me the prescription because he had to, but that he didn’t think it was necessary, and it was up to me whether or not I give them to LO. I don’t
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Formula and baby cereal are fortified with iron because babies are often deficient. However they are deficient because they are deprived of 30-40% of the blood they are supposed to get by early cord clamping. It causes a whole host of other problems too: http://web.me.com/len15/INFANT_ANEMIA,_HYPOVOLEMIA,_THE_CORD_CLAMP,_AUTISM_AND_NEONATAL_BRAIN_INJURY__A_Survey_of_Related_Factors_in_235,215_Michigan_Births/George_Malcolm.html
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Formula is also made up primarily of things like corn syrup solids and canola oil. Does that mean I should add some deep fried gummy bears to her breastmilk too, since it is obviously deficient in important nutrients like corn syrup and rancid seed oil?
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Our pediatrician said the same thing and told me it was because that’s what the current guidelines are, but that she didn’t feel like it was necessary.
So the nurse gave me a vitamin sample and a formula sample anyway and when I handed it back to her, she said that the vitamins were because my breast milk wasn’t good enough and the formula was because “everyone quits breastfeeding, it’s just too hard”. I said “not everyone, my older child never got any formula and I don’t intend to give this baby any”. She just rolled her eyes.
Every time we go in, we have the same nurse and she asks us the same thing, “how much formula every day?” and I say none and she says “what do you feed him?” in a panicky tone.
I wrote a letter to the lead pediatrician about the blatant formula favoritism and didn’t hear anything back. Sigh….thankfully, they’re really good about everything else, so I hesitate to change.
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Formula has probably got artificial color in it too. Breast milk doesn’t need that.
Maybe, just maybe, breast milk isn’t fortified with iron because it doesn’t need to be…? And maybe because the iron in breast milk is very easily absorbed by the infant gut, so there doesn’t need to be a lot of it…?
Or am I talking sense here?
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Angelica Reply:
December 3rd, 2011 at 9:22 pm Angelica(Quote)
I said the same thing! They tried to tell me my daughter needed poly-vi-sol immediately after they praised me for giving her “the very best start” in life. XD
“Breastmilk is the perfect food, but it’s low in iron.”
“So does that mean that babies just don’t need all that iron?”
“No! You need to supplement her right away!”
*facepalm*
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