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Anaemia is defined as a deficiency of iron in the body that causes low levels of haemoglobin-rich red blood cells and thus, reduced ability of the blood to supply oxygen throughout the body.
Around 50-60 per cent of cases of anaemia is due to iron deficiency, but the rest is also due to the deficiencies of nutrients like vitamin B12, vitamin A, vitamin B6 and folic acid and also due to the presence of some inflammatory and chronic diseases.
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Anaemia affects breastfeeding in many ways and may cause certain growth and development problems in infants. Though iron is found in low amounts in breast milk (around 0.4 mg/L), it can meet an infant's iron requirement for the first four months, says a study. After six months, breast milk may not be sufficient to provide the required amount of iron needed for the baby. 
In this article, we will discuss how iron deficiency anaemia is related to breastfeeding and what causes the condition, its impacts, risk factors, preventions and other details. Take a look.
What Causes Iron-Deficiency Anaemia During Breastfeeding?
The nutrition that pregnant women take during their gestation period is very important. Proper consumption of iron-rich foods or intake of iron supplements (after recommendation by doctors) by the mother help supply enough of the nutrition to the baby's body and store it.
During the breastfeeding period, as aforementioned, the mother's milk may not be able to provide adequate iron supply to a full-term healthy baby after four months. Therefore, it is during this time, when the baby gets the support from iron stored in their body, that helps maintain the iron supply for at least up to six months. 
Iron helps in the proper growth of a newborn's body and mind and also prevents them from getting tired easily. The deficiency of iron in infants can lead to anaemia which may reduce their proper growth and development.
According to the CDC, parents should start on iron supplements after four months, for babies who are only dependent on breast milk. Breast milk followed by formula milk or iron-fortified formula milk is recommended for infants of four months, while iron-rich foods or iron-fortified cereals could be a great option for children above six months. 
Note: Consult healthcare providers before starting ion iron supplements or formula milk for infants.
Impact Of Iron-Deficiency Anaemia In Both Mothers And Newborns
No doubt iron deficiency anaemia affects the well-being of both the mother and the baby. Anaemia may cause breathing difficulties, tiredness, sleep problems, dizziness, high blood pressure, infection and fast heartbeats in affected mothers. 
Another noticeable problem of iron deficiency in mothers is less production of breast milk. This may shorten the breastfeeding period in newborns and put them at risk of complications. 
If the iron deficiency is present during pregnancy itself, it may increase the risk of premature birth, low birth weight and growth retardation in newborns, followed by cognitive impairments and behavioural problems.
Iron deficiency during the first trimester of pregnancy causes more growth and development problems in babies, compared to its deficiency later in pregnancy or during the breastfeeding period.
Studies say that iron deficiency in newborns can be managed by supplements or formula milk, however, if it continues for more than a year, it can affect the brain energy metabolism and functions of neurotransmitters and cause certain long-term impacts related to emotional, language, cognitive, physical and social developments. 
What Are The Risk Factors Of Anaemia During Breastfeeding?
Anaemia during breastfeeding is linked to its deficiency during the pregnancy period, certainly due to factors like:
- Excessive physical activity and less food consumption.
- Being vegan or vegetarian.
- Teenage pregnancy
- Have less period gap between two pregnancies.
- Pregnant with twins or more.
- Less consumption of iron-rich foods.
- History of anaemia in the family
- History of excessive menstrual flow before being pregnant.
How To Prevent Iron Deficiency Anaemia In Newborns?
- Preterm infants or those born before 37 weeks should receive a supplement of iron at 2 mg/kg per day starting from the first month to a year. Standard preterm infant milk formula is also recommended containing around 14.6 mg of iron per litre. 
- Babies who are born healthy and termly are recommended to be breastfed for up to six months.
- Completely avoiding cow's milk in the first year of a baby's life.
- Starting iron supplements or formula-fed for healthy babies after six months of age, after consulting a medical expert.
- For toddlers between the ages of 1-3, the iron requirement is 7 mg/day. It can be met by iron-rich foods such as legumes and iron-fortified cereals, flours, sauce and rice. Vitamin C rich foods are also required as it helps in the absorption of iron by the intestines. Also, foods rich in phytates such as soy should be iron as it reduces iron absorption. 
Points To Remember
- Even if you have iron deficiency anaemia, it is recommended to start breastfeeding your baby. The best way to do so is to consult your medical expert for iron supplements or intravenous infusion of iron.
- Prescribed iron supplements are safe during breastfeeding.
- The dose of iron decreases after pregnancy. Therefore, in many women, the supply of iron can also be met by prenatal multivitamins or iron-rich foods.
- To make sure the baby gets enough iron, add iron-rich or vitamin C rich foods to your baby's diet. 
- If you have problems due to which you are unable to breastfeed your baby, give them iron-fortified formula milk instead of cow's milk.
Iron deficiency anaemia in infants is a worldwide concern, especially in developing countries. Though deficiency of iron can cause long-term problems in infants, its deficiency can easily be managed by supplements, foods or formula milk. It is recommended to never miss routine checkups of babies for early diagnosis and treatment of anaemia.