I have been fascinated by the discussion of iron metabolism, but I was hoping
that someone much more knowledgeable than I am would address the more basic
issue of the SOURCE of iron. I understand that the bioavailability of iron in
breastmilk makes it a source of iron that is superior to iron supplements
because the infant is actually able to use more of the low amount of iron in
breastmilk. (Of course, most people knowledgeable about breastfeeding are
familiar with this idea.) I also thought I understood that supplements and
artificially fortified baby foods could actually cause a drop in Hct because
the baby would no longer use the breastmilk source of iron properly  (this is
the part that is fuzzy for me) AND the supplement source is not as
bioavailable so the baby would end up with a lower amount of USEABLE iron. I
thought that the main problem with iron supplements for breastfed babies was
not just that they weren't necessary, but that they could actually cause the
problem they were supposed to cure (if it ever existed at all). I think I am
raising an issue that is separate from the issues raised here on LACTNET
about whether or not the body "hides" iron from pathogens as a response to
some infections. (Maybe it is related??)

As for adults, I thought I read that there was a similar problem with simply
taking iron supplements as opposed to eating a varied diet that includes good
food sources of iron. I never took iron supplements during my pregnancies and
my Hct never dropped below 37. I know a lot of women who religiously took
iron supplements and still had low Hcts.  One might be tempted to say - "See,
you really did need an iron supplement." It seems to me that it is more
complex and that supplementing iron using sources that are not very
bioavailable may actually have interfered with the woman's "normal" iron
metabolism. I am not questioning whether or not women need more iron during
their pregnancies, but rather the effacacy of some sources of iron in
correcting the problem.  What is the preferred (most bioavailable) chemical
source of iron for people who aren't getting enough from food sources?
-ferrous- what?

I want to be sure that I understand the more basic questions of the
bioavailability of the source of iron and the percieved need for "extra" iron
for breastfed infants.  Once a breastfed baby has been exposed to an
artificial source of iron, does the way that iron is taken up in the gut
change forever or just while exposed to the supplement? Am I thinking about
this the wrong way? I feel like I'm asking a dumb question, but could someone
who knows more about it address this issue?

I really like the discussion about rethinking the way we control nutrition
(especially iron) for infants and women. More isn't necessarily optimal. I
think it is always healthy to examine assumptions and try to look at things
from a new pwerspective.

Marie of WI LLLL & MOM