Pediatr Blood Cancer 2012 58 233 238 Cord Blood Iron Profi le and Breast Milk Micronutrients in Maternal Iron Defi ciency Anemia Rania Ali El Farrash MD 1Eman Abdel Rahman Ismail MD 2 and Ahmed Shafi k Nada MD3 INTRODUCTION The nutritional status of mothers is an important factor both prenatally and after birth Prenatal maternal nutritional status affects birth weight neonatal morbidity and mortality and the micronutrient status of newborns while postnatal maternal status can affect the quality of breast milk and thus the nutrient intake of infants 1 2 Micronutrient defi ciencies are still a major public health problem in many developing countries with pregnant women and infants especially at risk 2 4 Pregnant women are particularly vulnerable to nutritional defi ciencies because of the increased metabolic demands imposed by pregnancy involving a growing placenta fetus and maternal tissues coupled with associated dietary risks 5 There are several biological strategies that impose on the mineral status of the mother for meeting the extra demands that pregnancy and lactation 6 Infants warrant extra concern because they require extra micronutrients to main tain optimal growth and development 2 Most public health and nutrition programs focus on one micro nutrient only whereas several micronutrients can be expected to be defi cient at the same time 2 Micronutrient defi ciencies tend to coexist in impoverished settings because of uniformly low consumption of foods rich in multiple micronutrients 7 Iron defi ciency is the most important cause of nutritional anemia and is the most common micronutrient defi ciency worldwide especi ally in developing countries 2 8 The competing demands of mother and fetus may disturb the normal maternal fetal iron homeostasis 9 11 Exclusive breastfeeding is considered adequate to meet the nutrient needs of normal term infants for approximately the fi rst 6 months of life 12 13 The micronutrient composition of human milk is generally considered to be more resistant to differences in maternal dietary intake 13 however there is considerable inter individual variation in breast milk mineral secretion 6 Little is known about the mechanisms regulating the concentration of micronutrients in breast milk although the proteins transporting these minerals across the mammary gland epithelium were recently characterized in animal studies 14 Moreover nutri tional composition of breast milk in developing countries especi ally among malnourished women has not been fully investigated nor have the factors that account for these inter individual differ ences 13 15 Some studies have reported that breast milk iron status may be infl uenced by maternal anemia but the high bioavailability of iron in breast milk partly compensates for its low concentrations 7 16 17 In mild to moderate maternal anemia there are bio logical adaptive mechanisms that ensure adequate iron transfer to the fetus and breast milk 18 19 However in severe maternal anemia these protective mechanisms might fail leading to insuf fi cient iron supply to the fetus and breast milk 9 Other studies found that fetal iron status may be independent of maternal iron status 20 22 Therefore the present analysis aimed to assess the effect of maternal nutritional status and iron defi ciency anemia IDA as a potential risk factor for neonatal IDA as well as to evaluate the impact of this maternal anemia on breast milk mineral content MATERIALS AND METHODS Materials This study was conducted in Gynecology and Obstetrics Hos pital Ain Shams University Egypt between January 2009 and Background Micronutrient defi cienciesamongpregnant women are widespread in low income countries including Egypt Iron defi ciency anemia IDA is the most frequent nutritional defi ciency during pregnancy with an impact on maternal and fetal morbidity and mortality We aimed to evaluate the effect of maternal IDA and nutritional status on birth anthropometry cord blood iron profi le and breast milk micronutrients in 50 anemic hemoglobin 11 g dl and30healthypregnantwomen Procedure Maternal and neonatal anthropometric measures were recorded Hemoglobin red blood cell RBC indices and indices of iron nutriture were measured in maternal and cord blood Breast milk minerals iron copper zinc calcium and magnesium were assessed Results Hemoglobin RBC indices and iron profi le showed signifi cant differences in the neonates born to anemic mothers compared to controls particularly in moderate to severe anemia and linear correlations with maternal hemoglobin iron and ferritin levels were found P 0 01 Anthropometric measure ments of anemic mothers and their neonates were positively corre lated P 0 05 Breast milk micronutrients were signifi cantly reduced in all anemic mothers showing signifi cant relations with maternal serum iron P 0 01 Conclusions Maternal IDA wields a signifi cant infl uence on maternal and fetal nutritional status IDA during pregnancy adversely affects both cord blood iron