Breast Milk and Iron

Using diet to correct anemia in infants requires about one milligram of dietary iron per pound per day.

The level of iron in breastmilk is just where it's meant to be and cannot be changed by mother taking extra iron, unless she is very anemic. Breastmilk possesses a special iron delivery system, known as lactoferrin, which makes iron highly available to baby, but unavailable to intestinal bacteria. Once iron supplements, iron-containing foods, or infant formula are provided to the breastfed baby, this dietary iron binds with lactoferrin, reducing the availability of mother's iron to baby. Additionally, much of this supplementary iron provides nourishment for potentially dangerous intestinal bacteria, promoting their growth, rather than being available for the infant to absorb. Breastfed babies become more susceptible to anemia once iron is introduced to their diets, making them more prone to illness. Their stools become smelly now, representing the growth of adult-type intestinal flora that can be challenging to a young child's health. The infant's potential for diarrhea and illness increases with this flora change.

Because of the risk for anemia during the transition stage when solid foods are introduced, once iron-containing foods become a regular part of baby's diet, efforts should be made to assure that baby is receiving plenty of high-iron foods, or maybe some iron-fortified baby cereal. Good sources of iron for baby include (in order of amount) meats, peas, tofu, beans, dark green vegetables, whole wheat natural baby cereal, avocado, and yam. Vitamin C containing foods assist with iron absorption. Intermediate amounts of iron are found in non-fortified pasta and brown rice, prunes, apricots, and sweet potatoes.

Before getting serious about solid foods, I suggest staying with low-iron foods for playful eating, such as squash, peaches, apples, bananas, and carrots. Feeding cow's milk can cause iron loss due to intestinal bleeding, while cow's milk has very little iron. The overwhelming amount of calcium in cow's milk will bind with iron in baby's diet, making it unavailable.

The causes of anemia development in a breastfed baby include intestinal bleeding from intolerance of cow's milk proteins or other foods in mother's diet, rapid cutting of the umbilical cord during birth, low birth weight, and a smoking parent.

A baby who is shown to be anemic should receive iron supplementation until their blood iron levels reach normal values. Insufficient iron can impair proper neurological development. Symptoms that should evoke a blood test for iron deficiency anemia include paleness of the skin or mucous membranes, frequent illness, increasing irritability, decreased attentiveness, or a decrease in appetite. Some choose to perform a blood test around 6 to 9 months of age, regardless of suggestive symptoms, as early anemia may not easily reveal itself.

It is important to understand that breastfed babies may have low iron stores, by design, but the level of available iron actually circulating in their blood (hemoglobin level) is the measure that counts at this age. Some mothers are told to provide supplements to a breastfed baby when only their iron storage is low. It has been demonstrated that this practice may be detrimental to baby.

The best nutrition assurance for the exclusively breastfed baby is for mother to add a multivitamin-mineral to her own healthy diet. This way mother's body has good availability of nutrients to put into her breastmilk without depleting mother's own nutrient stores.

What is CBC

http://www.webmd.com/a-to-z-guides/complete-blood-count-cbc

A CBC test usually includes:

White blood cell (WBC, leukocyte) count. White blood cells protect the body against infection. If an infection develops, white blood cells attack and destroy the bacteria, virus, or other organism causing it. White blood cells are bigger than red blood cells but fewer in number. When a person has a bacterial infection, the number of white cells rises very quickly. The number of white blood cells is sometimes used to find an infection or to see how the body is dealing with cancer treatment.
White blood cell types (WBC differential). The major types of white blood cells are neutrophils, lymphocytes, monocytes, eosinophils, and basophils. Immature neutrophils, called band neutrophils, are also part of this test. Each type of cell plays a different role in protecting the body. The numbers of each one of these types of white blood cells give important information about the immune system. Too many or too few of the different types of white blood cells can help find an infection, an allergic or toxic reaction to medicines or chemicals, and many conditions, such as leukemia.
Red blood cell (RBC) count. Red blood cells carry oxygen from the lungs to the rest of the body. They also carry carbon dioxide back to the lungs so it can be exhaled. If the RBC count is low ( anemia), the body may not be getting the oxygen it needs. If the count is too high (a condition called polycythemia), there is a chance that the red blood cells will clump together and block tiny blood vessels (capillaries). This also makes it hard for your red blood cells to carry oxygen.
Hematocrit (HCT, packed cell volume, PCV). This test measures the amount of space (volume) red blood cells take up in the blood. The value is given as a percentage of red blood cells in a volume of blood. For example, a hematocrit of 38 means that 38% of the blood's volume is made of red blood cells. Hematocrit and hemoglobin values are the two major tests that show if anemia or polycythemia is present.
Hemoglobin (Hgb). The hemoglobin molecule fills up the red blood cells. It carries oxygen and gives the blood cell its red color. The hemoglobin test measures the amount of hemoglobin in blood and is a good measure of the blood's ability to carry oxygen throughout the body.
Red blood cell indices. There are three red blood cell indices: mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), and mean corpuscular hemoglobin concentration (MCHC). They are measured by a machine and their values come from other measurements in a CBC. The MCV shows the size of the red blood cells. The MCH value is the amount of hemoglobin in an average red blood cell. The MCHC measures the concentration of hemoglobin in an average red blood cell. These numbers help in the diagnosis of different types of anemia. Red cell distribution width (RDW) can also be measured which shows if the cells are all the same or different sizes or shapes.
Platelet (thrombocyte) count. Platelets (thrombocytes) are the smallest type of blood cell. They are important in blood clotting. When bleeding occurs, the platelets swell, clump together, and form a sticky plug that helps stop the bleeding. If there are too few platelets, uncontrolled bleeding may be a problem. If there are too many platelets, there is a chance of a blood clot forming in a blood vessel. Also, platelets may be involved in hardening of the arteries (atherosclerosis).
Mean platelet volume (MPV). Mean platelet volume measures the average amount (volume) of platelets. Mean platelet volume is used along with platelet count to diagnose some diseases. If the platelet count is normal, the mean platelet volume can still be too high or too low.

http://www.nhlbi.nih.gov/health/dci/Diseases/ha/ha_diagnosis.html
http://www.keepkidshealthy.com/welcome/commonproblems/anemia.html