>
>
>Then the mother casually mentioned that she is "critically anemic" (her
>words).  Her count was 7.8 after delivery and she was offered a
>transfusion but refused as she did not know that anemia could affect milk
>supply.  Her count is currently 10.2.  She has a condition called
>thalysemmia that she says is hereditary.
>
I know others will give more information about thalassemia (some
websites: http://www.cooleysanemia.org/ http://www.thalassemia.com/
http://www.cariboo.bc.ca/schs/medtech/rice/thalassemia.html) I hope I'm
not being repetitive.

Here is something I can mention: there are two basic types of thal,
major (which, until recently, often led to death long before a mother
could conceive ) and minor (which is just a carrier gene, but can
occasionally affect hemoglobin levels). Many scientists now recognize an
intermediate form. In all cases, but to obviously different degrees, the
red blood cells are small,  immature and unable to carry sufficient
hemoglobin, oxygen etc.

One of the complications is that iron cannot be handled well by people
with thal. For a long time, people died from transfusions containing too
much iron. Even now, many people with thal are advised to not take too
much iron. On the other hand, it is quite common for people with anemia
from the disease to *also* suffer from iron-deficiency anemia.

Here is my own anecdotal evidence: any mother with thal, who has a high
chance of passing on the minor form to her child, has an extra reason to
breastfeed, since the iron levels in breastmilk are ideal for a thal.
baby. I have recounted my personal story here before. We have a son with
minor (but approaching intermediate) thal whose blood levels were tested
on a regular basis between 9 mos (earliest recommended testing) to 3 and
something years old. The very first time that he was iron-deficient
(which meant a lot of fiddling to give him iron supplements, but not too
much) was at the first test post-weaning. And yes, my ped recognized the
eloquence of this testimony to breastfeeding...

Jo-Anne Elder-Gomes

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