Relationship between nutrient intake and iron levels of foremilk and hindmilk in breastfeeding mothers

Dewi Ratnasari* -  Department of Nutrition Science, Faculty of Medicine, Diponegoro University, Semarang
Ani Margawati -  Department of Nutrition Science, Faculty of Medicine, Diponegoro University, Semarang
Mohammad Zen Rahfiludin -  Department of Nutrition Science, Faculty of Medicine, Diponegoro University, Semarang
Infants who are not exclusively breastfed are at a risk of iron deficiency. Iron deficiency affects motor development, intelligence, and endurance. Adequate nutrient intake can increase breast milk iron levels, because maternal food intake greatly affects the amount of iron in breast milk. This study aimed to determine the relationship between maternal nutrient intake and iron levels in the breast milk. This study used a cross-sectional approach from October to December 2024. The subjects were 90 mothers who breastfed babies aged 2-24 weeks, with a probability proportional to size. Nutrient intake and breast milk iron stage were the variables that were studied. Data were analyzed using the Pearson’s correlation test and multiple linear regression analysis. Results showed that foremilk iron levels ranged from 60,62 µg/dL to 632,94 µg/dL, while hindmilk iron levels varied from 127,44 µg/dL to 680,38 µg/dL. Iron intake was measured between 13,17 g and 115,6 g, showing a significant correlation between nutrient intake and breast milk (p < 0,05). In addition, it was found that breastfeeding mothers' iron intake was the most influential factor on the breast milk iron stage. In conclusion, maternal iron intake significantly affects breast milk iron levels. Ensuring adequate maternal iron intake, supported by vitamin C consumption, can help increase the availability of iron in breast milk, thereby benefiting infant growth and development.

Keywords : Iron sufficiency, iron, breastmilk iron, foremilk, and hindmilk

  1. Achebe, M. M., & Gafter-Gvili, A. (2017). How I treat anemia in pregnancy: iron, cobalamin, and folate. Blood, 129(8), 940–949. https://doi.org/10.1182/blood-2016-08-672246
  2. Atkins, L. A., McNaughton, S. A., Campbell, K. J., & Szymlek-Gay, E. A. (2016). Iron intakes of Australian infants and toddlers: findings from the Melbourne Infant Feeding, Activity and Nutrition Trial (InFANT) Program. British Journal of Nutrition, 115(2), 285–293. https://doi.org/10.1017/S0007114515004286
  3. Bzikowska-Jura, A., Sobieraj, P., Michalska-Kacymirow, M., & Wesołowska, A. (2021). Investigation of Iron and Zinc Concentrations in Human Milk in Correlation to Maternal Factors: An Observational Pilot Study in Poland. Nutrients, 13(2), 303. https://doi.org/10.3390/nu13020303
  4. Choi, Y. K., Kim, J.-M., Lee, J.-E., Cho, M. S., Kang, B. S., Choi, H., & Kim, Y. (2016). Association of Maternal Diet With Zinc, Copper, and Iron Concentrations in Transitional Human Milk Produced by Korean Mothers. Clinical Nutrition Research, 5(1), 15. https://doi.org/10.7762/cnr.2016.5.1.15
  5. Daniels, L., Gibson, R. S., Diana, A., Haszard, J. J., Rahmannia, S., Luftimas, D. E., Hampel, D., Shahab-Ferdows, S., Reid, M., Melo, L., Lamers, Y., Allen, L. H., & Houghton, L. A. (2019). Micronutrient intakes of lactating mothers and their association with breast milk concentrations and micronutrient adequacy of exclusively breastfed Indonesian infants. The American Journal of Clinical Nutrition, 110(2), 391–400. https://doi.org/10.1093/ajcn/nqz047
  6. Demmelmair, H., Prell, C., Timby, N., & Lönnerdal, B. (2017). Benefits of Lactoferrin, Osteopontin and Milk Fat Globule Membranes for Infants. Nutrients, 9(8), 817. https://doi.org/10.3390/nu9080817
  7. Dror, D. K., & Allen, L. H. (2018). Overview of Nutrients in Human Milk. Advances in Nutrition, 9, 278S-294S. https://doi.org/10.1093/advances/nmy022
  8. El‐Farrash, R. A., Ismail, E. A. R., & Nada, A. S. (2019). Cord blood iron profile and breast milk micronutrients in maternal iron deficiency anemia. Pediatric Blood & Cancer, 58(2), 233–238. https://doi.org/10.1002/pbc.23184
  9. Flora, R. et al. (2022). Perbandingan Kadar Zat Besi Dan Vitamin C Pada Ibu Hamil Anemia Dan Tidak Anemia Di Kabupaten Seluma. Jurnal Pengabdian Masyarakat, 5, 887–894.
  10. Hanim, B. (2020). Faktor Yang Memengaruhi Status Gizi Balita Di Wilayah Kerja Puskesmas Sidomulyo Kota Pekanbaru. JOMIS (Journal of Midwifery Science), 4(1), 15–24. https://doi.org/10.36341/jomis.v4i1.1118
  11. Hardinsyah dan Dewi. (2019). Kecukupan Mineral: Besi, Seng, Mangan,Flour, Kalsium,Kromium, Selenium, Kalium, Natrium, Klor, Iodium, Fosfor, Magnesium dan Tembaga. In Widya Karya Nasional Pangan dan Gizi XI.
  12. Henjum, S., Manger, M., Skeie, E., Ulak, M., Thorne-Lyman, A. L., Chandyo, R., Shrestha, P. S., Locks, L., Ulvik, R. J., Fawzi, W. W., & Strand, T. A. (2018). Iron deficiency is uncommon among lactating women in urban Nepal, despite a high risk of inadequate dietary iron intake. British Journal of Nutrition, 112(1), 132–141. https://doi.org/10.1017/S0007114514000592
  13. Hernell, O., Fewtrell, M. S., Georgieff, M. K., Krebs, N. F., & Lönnerdal, B. (2015). Summary of Current Recommendations on Iron Provision and Monitoring of Iron Status for Breastfed and Formula-Fed Infants in Resource-Rich and Resource-Constrained Countries. The Journal of Pediatrics, 167(4), S40–S47. https://doi.org/10.1016/j.jpeds.2015.07.020
  14. Holm, C., Thomsen, L. L., Norgaard, A., Markova, V., Michaelsen, K. F., & Langhoff_Roos, J. (2017). Iron concentration in breast milk normalised within one week of a single high_dose infusion of iron isomaltoside in randomised controlled trial. Acta Paediatrica, 106(2), 256–260. https://doi.org/10.1111/apa.13681
  15. Lönnerdal, B. (2020). Bioactive Proteins in Human Milk: Mechanisms of Action. The Journal of Pediatrics, 156(2), S26–S30. https://doi.org/10.1016/j.jpeds.2009.11.017
  16. Novia Three Rahmadani, Rostika Flora, Indah Purnama Sari, Fatria Harwanto, Mohammad Zulkarnain, Hamzah Hasyim, Nur Alam Fajar, Nurmalia Ermi, Annisah Biancika Jasmine, Aguscik, Ikhsan, Nurlaili, Samwilson Slamet, Yetti Purnama, & Neshy Sulung. (2023). Pengaruh Defisiensi Zat Besi Terhadap Kadar Zat Besi ASI Pada Ibu Menyusui di Kabupaten Seluma. 4(1), 92–99.
  17. Pasricha, S.-R., Tye-Din, J., Muckenthaler, M. U., & Swinkels, D. W. (2021). Iron deficiency. The Lancet, 397(10270), 233–248. https://doi.org/10.1016/S0140-6736(20)32594-0
  18. Pluymen, L. P. M., Wijga, A. H., Gehring, U., Koppelman, G. H., Smit, H. A., & van Rossem, L. (2018). Early introduction of complementary foods and childhood overweight in breastfed and formula-fed infants in the Netherlands: the PIAMA birth cohort study. European Journal of Nutrition, 57(5), 1985–1993. https://doi.org/10.1007/s00394-018-1639-8
  19. Rodríguez, J. M., Fernández, L., & Verhasselt, V. (2021). The Gut‒Breast Axis: Programming Health for Life. Nutrients, 13(2), 606. https://doi.org/10.3390/nu13020606
  20. Sánchez, C., Fente, C., Barreiro, R., López-Racamonde, O., Cepeda, A., & Regal, P. (2020). Association between Breast Milk Mineral Content and Maternal Adherence to Healthy Dietary Patterns in Spain: A Transversal Study. Foods, 9(5), 659. https://doi.org/10.3390/foods9050659
  21. Vir, S. C. (2011). Public health in developing countries. Woodhead Publishing Limited. https://doi.org/10.1533/9780857093905
  22. W. Basrowi, R., & Dilantika, C. (2021). Optimizing iron adequacy and absorption to prevent iron deficiency anemia: The role of combination of fortified iron and vitamin C. World Nutrition Journal, 5(S1), 33–39. https://doi.org/10.25220/WNJ.V05.S1.0005
  23. Zare, S., Miri, M., & Amini, M. (2019). Effect of Maternal Iron Intake on Breast Milk Iron Content: A Systematic Review. Journal of Clinical Nutrition, 39(4), 339–346.

Open Access Copyright (c) 2025 Dewi Ratnasari, Ani Margawati, Mohammad Zen Rahfiludin
Creative Commons License
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

AcTion: Aceh Nutrition Journal
Published by: Department of Nutrition at the Health Polytechnic of Aceh, Ministry of Health.
Soekarno-Hatta Street, No. 168. Health Polytechnic of Aceh, Aceh Besar, 23352. Telp/Fax: 0651 46126 / 0651 46121.
Website: https://gizipoltekkesaceh.ac.id/
E-mail: jurnal6121@gmail.com

e-issn: 2548-5741, p-issn: 2527-3310

All content is licensed under a: Creative Commons Attribution ShareAlike 4.0 International License

View My Stats

Get a feed by atom here, RRS2 here and OAI Links here