Breast milk iron indicators among anemic and non anemic mothers: interpret with caution
Arun Aggarwal, School of Public Health, PGIMER, Chandigarh, India
2 March 2008
Authors deserve applause for conducting relevant and timely research. Decline in breast milk iron indicators overtime, but no relationship with baby's iron indicators was well understood. However, interpretation with respect to anaemic and non anaemic mothers need to be done with caution. These two groups have been used in the entire presentation. As this was hospital based study, and it was reported that all mothers had normal antenatal history, it is not clear whether haemoglobin was done in the antenatal period or not? Even if it was not done before, then at the time of detection postnataly, whether anaemic mothers were advised therapeutic doses of iron or similar advise was given to both the groups? If anaemic mothers were told about their anaemia, and were advised accordingly to have iron rich foods and therapeutic iron, then their differential intakes would have influenced the breast iron indicators. Thirdly, whether haemoglobin levels of these mothers was also tested at follow-ups? As this is a prospective study, in which critiria for grouping the mothers into two categories is variable, thus same groups cannot be retained without reconfirmation of their haemoglobi status. Fourthly, if mothers who were classified as anaemic at enrollment, continue to be anaemic at 6 months of follow-up, it signifies that their treatment seeking behaviour and compliance to treatment is not satisfactory. In the last it would have been more informative to have mean/ median haemoglobin of both the groups. Overall, study adds to existing knowledge but interpretations with respect to anaemia levels of mothers have to be done with caution.
International Breastfeeding Journal
Breast milk iron indicators among anemic and non anemic mothers: interpret with caution
2 March 2008
Authors deserve applause for conducting relevant and timely research. Decline in breast milk iron indicators overtime, but no relationship with baby's iron indicators was well understood. However, interpretation with respect to anaemic and non anaemic mothers need to be done with caution. These two groups have been used in the entire presentation. As this was hospital based study, and it was reported that all mothers had normal antenatal history, it is not clear whether haemoglobin was done in the antenatal period or not? Even if it was not done before, then at the time of detection postnataly, whether anaemic mothers were advised therapeutic doses of iron or similar advise was given to both the groups? If anaemic mothers were told about their anaemia, and were advised accordingly to have iron rich foods and therapeutic iron, then their differential intakes would have influenced the breast iron indicators. Thirdly, whether haemoglobin levels of these mothers was also tested at follow-ups? As this is a prospective study, in which critiria for grouping the mothers into two categories is variable, thus same groups cannot be retained without reconfirmation of their haemoglobi status. Fourthly, if mothers who were classified as anaemic at enrollment, continue to be anaemic at 6 months of follow-up, it signifies that their treatment seeking behaviour and compliance to treatment is not satisfactory. In the last it would have been more informative to have mean/ median haemoglobin of both the groups. Overall, study adds to existing knowledge but interpretations with respect to anaemia levels of mothers have to be done with caution.
Competing interests
none