Vitafol Fe Plus while Breastfeeding

What is Vitafol Fe Plus used for?

Is Vitafol Fe Plus usage safe while breastfeeding? If a lactating mother is using it can there be any effect on growth or development of infant?

Vitamin a while Breastfeeding

CAS Number: 68-26-8

Retinol is also a name for vitamin A which is a natural component of human milk. Content in the human milk is about 2,800 IU/L (750 μ/L). Infant's recommended dietary daily allowance is 2,000 IU (600 μ/L). Mother's recommended daily allowance is 3,200 IU (950 μ/L). There is a risk for severe intoxication after an isolated dose of 25,000 IU or long-standing daily consumption of 5,000 IU. After a megadose administration of vitamin A increases concentration to a double in the colostrum. Supplementation with vitamin A to breastfeeding mothers or infants does not reduce mortality or morbidity among HIV affected offsprings, instead it increases the likelihood of transmission of HIV or subclinical mastitis in those mothers infected with HIV. Vitamin A is widely distributed in the food of animal or vegetable origin. Except for populations affected with food shortage or nutritionally deficient, those women on a complete and varied diet do not need the intake of vitamin A supplementation The List of Essential Medicines of WHO-2002 classifies it as compatible with breastfeeding.

Ascorbic acid while Breastfeeding

CAS Number: 50-81-7

Vitamin C is abundantly present in food. A balanced and comprehensive diet makes vitamin supplementation useless. Any amount of vitamin C taken by the mother as a supplement does not affect significantly the concentration in breast milk of women who are on a varied and balanced diet.

Vitamin d while Breastfeeding

CAS Number: 67-97-0

Daily allowance of Vitamin D for the breastfeeding woman is still an issue and a matter of disagreement among experts. Vitamin D is hardly found in common food and mostly synthesized by skin under sunlight stimulus. Low concentration in breast milk is thought to be due to deficient levels in the serum of mothers. As high as 6.400 IU daily doses of Vitamin D given to the mother have been required to normalize the infant serum content of 25-OH Vitamin D. Moderate exposure of mothers to sunlight, avoiding any burning, is probably the most cost-effective measure to fight Vitamin D deficiency in the infant. 1 mg = 40.000 IU.

Thiamine while Breastfeeding

CAS Number: 59-43-8

Thiamine or Vitamin B1 is a water soluble vitamin. In addition to Thiamine, other chemical compounds with similar activity: Acetiamine, Benfotiamine, Bisbentiamine, Bisbutiamina, Cetotiamina, Cicotiamina, Cocarboxylase, Fursultiamine, Monofosfotiamina, Octotiamine, Pyrophosphotiamine, Prosultiamine and Sulbutiamine.It is essential for the metabolism of carbohydrate nutrients. Its deficiency causes severe neuromuscular and cardiac symptoms known as Beriberi and Wernicke-Korsakoff disease. Thiamine deficiency is common among disadvantaged populations in Southeast Asia (predominantly consumers of refined rice), other malnourished people (refugees, low socioeconomic status ...) and chronic alcohol consumption. Beriberi of childhood, both infants and children, may arise from breastfeeding by Thiamine deficient mothers. Reportedly, several severe cases have occured after feeding the babies with artificial formulas that were not supplemented with vitamin B1. Daily allowance is higher during pregnancy and lactation (1.5 mg / day) which is readily obtained through a varied diet with adequate content of whole grains, legumes, nuts, eggs and lean meat.Thiamine is excreted in breast milk and gradually increases with time, being lower in colostrum (28 ng / mL) and transitional milk than in mature milk (180 ng / mL). The concentration is lower in milk from mothers of preterm (90 ng / mL). Taking vitamin supplementation is not required if diet and nutritional status are adequate. Supplementation does not increase levels in milk of well-nourished women, but of those with a low nutritional status. The supplementation of group B vitamins and C and E vitamins to HIV positive mothers improves the weight growth of their breasted babies.There is no evidence of their effectiveness in improving athletic performance, lack of appetite, sores, stress, fatigue or aging.Toxicity linked to excessive consumption of thiamine is not known. WHO List of Essential Medicines 2002: compatible with breastfeeding.American Academy of Pediatrics: usually compatible with breastfeeding

Riboflavin while Breastfeeding

CAS Number: 83-88-5

A balanced and comprehensive diet make it vitamin supplementation useless.

Pyridoxine hydrochloride while Breastfeeding

CAS Number: 58-56-0

Concentration of vitamin B6 in the breast milk is directly related to the amount present in diet with the possibility of a high increment by an excessive consumption through the diet. Daily allowance of vitamin B6 ranges from 2 to 3 mg. A balanced and varied diet is enough without a need for extra supplementation with this vitamin. Vitamin B6 deficiency is extremely rare since it is widely distributed in many foods. In those cases where supplementation is required, it is recommended not to exceed 40 mg a-day. There are controversial data on the capacity of a high dose of Pyridoxine to inhibit the secretion of Prolactin and suppress the milk production. The American Academy of Pediatrics rates it as usually compatible with breastfeeding.

Folic acid while Breastfeeding

CAS Number: 59-30-3

Soluble B group vitamin that is very abundant in green vegetables, legumes and fruits (citric fruits). It is actively excreted in breast milk with priority over maternal folate in such extent that may even cause maternal deficit. Exclusive breastfeeding meets the daily allowances of infant folic acid.The concentration is higher in mature milk (85 micrograms / L) than in colostrum and premature breast milk.Administration to nursing mothers increases slightly the usual concentration of folate in breast milk. Folic acid needs are increased during pregnancy and lactation (500-600 micrograms / day) and in case of taking anticonvulsant medication. No harmful effects have been observed by taking folic acid during lactation. Excess of folic acid is eliminated by the kidneys every day. No supplements are needed if diet and nutritional status are adequate. The American Academy of Pediatrics rates it as a mediation usually compatible with breastfeeding.WHO List of Essential Medicines 2002: compatible with breastfeeding.

Cyanocobalamin while Breastfeeding

CAS Number: 68-19-9

Vitamin B12 exists naturally in milk at a concentration of 1 nanogram / mL (range: 0.3 to 3 ng / mL). Maternal supplementation with cyanocobalamin barely increases milk levels in well-nourished women (Sandberg 1981), but it does improve the levels in women of low socioeconomic status (Sneed 1981). The concentration in colostrum is up to 28 times higher than that of mature milk.The daily requirements for Vitamin B12 are 2.4 micrograms and increase to 2.8 micrograms daily during breastfeeding. Foods rich in vitamin B12 are meat, offal, eggs, dairy products, salmon, sardines, clams and fortified cereals. With a varied and balanced diet no vitamin supplements are needed, but B12 deficiency has been observed in the plasma and milk of women with strict vegetarian diets (vegans), malabsorptive diseases (eg, Crohn's disease, celiac disease), bariatric surgery, poor nutritional status, pernicious anemia, low socio-economic status and in cases of natural disasters or wars. There are numerous publications showing that infants of these mothers are at high risk of disease due to vitamin B12 deficiency, which can lead to anemia, stunting and psychomotor retardation. "Flash pasteurization" applied to breast milk of mothers who are HIV+ does not decrease vitamin B12 concentration. American Academy of Pediatrics: medication usually compatible with breastfeeding (AAP 2001).

Iodine while Breastfeeding

CAS Number: 7553-56-2

Disinfectant that contains high amount (2-7%) of Iodine in solution with alcohol or water (Lugol's solution) Not absorbed through intact skin of adults. However, it may trespass the inflamed skin, wounds, mucosa surfaces like vagina, in which case can reach concentration in grams in the human serum (1 g = 1,000 milligrams = 1,000,000 micrograms). Normal daily allowance is considered to be as high as 100 to 150 micrograms that increases to 200 – 300 micrograms in pregnancy or nursing period. The latter means less than one third of a milligram. Iodine is concentrated into breast milk with a level that could reach 20 times higher than the concentration in the blood. It has been found higher levels of Iodine, altered results of neonatal screening test for thyroid function, and, transient hypothyroidism in infants whose mothers were exposed to Iodine Povidone. Use should be avoid in the Delivery Room, Operating Room (C-section), Neonatal Units, Toddler admision areas and during the breastfeeding period. Sporadic or inadvertent use, specially on normal skin, does not require special test or procedures because it does not pose higher risk to the child.

Iron while Breastfeeding

Several ferrous salts of iron (ascorbate, aspartate, citrate, chloride, fumarate, gluconate, lactate, oxalate, succinate, sulfate, glycine sulfate, etc.) are used in oral administration for treating or preventing iron deficiency anemia.Its molecular weight varies from 170 for the fumarate and succinate, and from 280 for lactate and sulfate to 400 for aspartate and ascorbate. Characteristics of iron metabolism in the body make unlikely that it would be excreted in a significant amount into breast milk.It is a medication used for treatment of Neonatal Anemia in premature babies. Iron is excreted in small amounts in human milk, usually being enough for covering the daily needs of infants due to its high bioavailability. There is no correlation between mother's daily intake of iron and its concentration in breast milk.Iron supplementation to the mother does not increase levels of iron in breast milk or infant plasma significantly. Excessive supplementation can reduce the zinc concentration in milk. WHO List of Essential Medicines 2002: compatible with breastfeeding.

Zinc while Breastfeeding

Zinc (Zn) is an essential element for nutrition. It is present in many foods.Recommended daily allowance of Zn is 8 to 15 mg. (Moran Hall 2010). Millions of people worldwide are Zn-deficient.It is used as a treatment for Wilson's disease and Acrodermatitis Enteropathica. Zn is involved in the regulation process of lactation (Lee 2016).Pasteurization of the milk does not affect the concentration of Zn and other trace elements (Mohd Taufek-2016). The average concentration of Zn in breastmilk is 4 to 16 mg / L (Picciano 1976, Hannan 2005, Dórea 2012) which is independent of plasma levels and maternal daily intake (Krebs 1995, Chierici 1999, Hannan 2009).Intestinal absorption of zinc is almost doubled during pregnancy and lactation (Fung 1997).Zinc levels in the infant are dependent on Zinc levels in the breast milk (Dumrongwongsiri 2015)With a varied and balanced diet, an extra intake of minerals is not needed. Excessive intake of Zinc may cause gastrointestinal problems and Pancytopenia (Irving 2003).

Docusate sodium while Breastfeeding

CAS Number: 10041-19-7

Anionic surfactant that acts as an emollient laxative. It is also used to treat the retention of ear cerumen. It is minimally absorbed in the duodenum-jejunum and excreted in the bile. No problems have been observed in infants whose mothers were treated, except one case of diarrhea that was possibly due to other laxative medication took by the mother (Greenhalf 1973). The Institute at the American Gastroenterological Association (AGA) consideres it to be compatible while breastfeeding (Mahadevan 2006).

Vitamin a while Breastfeeding

CAS Number: 68-26-8 79-81-2

Routine, modest daily supplemental vitamin A results in modest increases in milk vitamin A content and appears to be safe for the infant. Vitamin A (retinol) and provitamin A carotenoids are normal components of human milk.[1] The recommend dietary intake in lactating women is 1300 mcg retinol per day, compared to 770 mcg per day during pregnancy. The recommended daily intake for infants aged 6 months or less is 400 mcg. .[2] Lactating mothers may need to supplement their diet to achieve the recommended daily vitamin A intake. Maternal vitamin A supplementation during pregnancy and lactation has not been shown to reduce mortality or the risk of anemia in breastfed infants living in developing regions, but there may be undiscovered benefits related to improved antioxidant capacity and immune function.[3][4][5] Maternal single doses up to 120,000 mcg or daily doses up to 1500 mcg are not expected to harm the breastfed infant. Daily doses above 3,000 mcg should be avoided in the mother. [2] Vitamin A in milk has antioxidant properties.[6] Holder pasteurization (62.5 degrees C for 30 minutes) does not reduce milk antioxidant capacity.[7]

Vitamin d while Breastfeeding

CAS Number: 67-97-0 50-14-6

Vitamin D is a normal component of human milk. Daily maternal vitamin D supplementation in the 400 to 2,000 IU range produces milk concentrations that are inadequate to deliver the daily requirement to an exclusively breastfed infant, and inadequate to correct pre-existing infant vitamin D deficiency through breastfeeding alone. Breastfeeding mothers who take vitamin D supplements in this range should give their infants a daily vitamin D supplement of at least 400 IU to meet pediatric nutritional guidelines.[1][2][3][4][5] Daily maternal vitamin D dosages at or above 4,000 IU achieve milk levels can potentially meet the daily infant goal intake of at least 400 IU, depending on the mother's underlying vitamin D status and daily infant milk intake. Obese mothers may have higher requirements. Holder pasteurization decreased median levels of the major forms of vitamin D in breastmilk by 20% in one study.[6]

Cyanocobalamin while Breastfeeding

CAS Number: 68-19-9

Vitamin B12 is a normal component of human milk.[1] The recommended daily intake in lactating women is 2.8 mcg and for infants aged 6 months or less is 0.4 mcg.[2] Lactating mothers may need to supplement their diet to achieve the recommended daily intake or to correct a known deficiency. Low doses of vitamin B12 found in B complex or prenatal vitamins increase milk levels only slightly. Higher daily doses of 50 to 100 mcg or more are needed in cases of maternal deficiency. The breastfed infant is not exposed to excessive vitamin B12 in such cases, and their vitamin B12 status should improve if it was previously inadequate. Poor health outcomes in infants with vitamin B12 deficiency include anemia, abnormal skin and hair development, convulsions, failure to thrive, and mental developmental delay. One well-recognized at risk group are exclusively breastfed infants of mothers with B12 deficiency due to minimal or no dietary intake of animal products.[3][4][5][6][7][8][9] Infant vitamin B12 status can be improved through maternal B12 supplementation during pregnancy and lactation.[10][11][12][13] Deficient mothers who miss the opportunity to supplement during pregnancy should still be encouraged to supplement during early lactation since infant vitamin B12 status correlates with milk vitamin B12 levels in breastfed infants up to 6 months of age.[14][15][16][17] Although there are cases reported of exclusively breastfed infants with vitamin B12 deficiency having biochemical and clinical improvement through adequate maternal supplementation alone,[3] direct supplementation of the infant is recommended when such treatments are available.[18][19][8] Flash heat pasteurization of breastmilk does not reduce milk vitamin B12 concentration.[20]

Iodine while Breastfeeding

CAS Number: 7553-56-2

Iodine is an essential trace nutrient for all infants that a normal component of breastmilk. Infant requirements are estimated to be 15 mcg/kg daily in fullterm infants and 30 mcg/kg daily in premature infants.[1] Systematic reviews and studies on iodine nutrition found that iodine in breastmilk is adequate in iodine-sufficient countries, but in countries with iodine fortification of foods, many mothers did not obtain adequate iodine and that additional supplementation was desirable.[2][3][4][5] In iodine-deficient areas, supplementation of breastfeeding mothers with iodine appears to be more effective than direct supplementation of the infant in reducing infant iodine deficiency.[6] The American Thyroid Association recommends that breastfeeding women should supplement their diet with a daily oral supplement that contains 150 mcg of iodine, but sustained iodine intake while breastfeeding that exceeds 500 to 1100 mcg daily should be avoided.[7] A survey in the United States between 2011 and 2014 found that only 19% of lactating women used a dietary supplement that contained iodine.[8] The use of excessive amounts of iodine in the mother near term and during breastfeeding (e.g., seaweed soup) can increase breastmilk iodine levels and cause transient hypothyroidism in breastfed infants. The absorption of iodine can be marked after application to open wounds or mucous membranes. Exposure of mothers to unnecessary iodine who are or will be breastfeeding should be avoided or minimized to the extent possible by avoiding its use on maternal mucous membranes (e.g., vaginal use, wound therapy), avoiding prolonged contact time, avoiding repeated applications, and applying it to the smallest possible surface areas of the body. It is possible that maternal exposure to iodine near term could interfere with thyroid studies done as a part of newborn screening tests.

Magnesium while Breastfeeding

CAS Number: 3344-18-1

No information is available on the clinical use of magnesium citrate during breastfeeding. However, other magnesium salts have been studied. Intravenous magnesium sulfate increases milk magnesium concentrations only slightly. Oral absorption of magnesium by the infant is poor, so maternal magnesium citrate is not expected to affect the breastfed infant's serum magnesium. Magnesium citrate supplementation during pregnancy might delay the onset of lactation, but it can be taken during breastfeeding and no special precautions are required.

Docusate sodium while Breastfeeding

CAS Number: 10041-19-7

Docusate is minimally absorbed from the gastrointestinal tract and therefore the drug is unlikely to be found in the maternal serum or breastmilk. Laxatives that are completely unabsorbed may be preferred.[2]

Copper and Breastfeeding

In most cases, it is okay to take mineral supplements like iron, calcium and copper. These have not been known to affect breast milk levels. However, taking large amounts of a dietary supplement while breast-feeding may be harmful to the mother and/or baby and should be avoided.

I already used Vitafol Fe Plus and meanwhile I breastfed my baby should I be concerned?

I am nursing mother and my doctor has suggested me to use Vitafol Fe Plus, is it safe?

If I am using Vitafol Fe Plus, will my baby need extra monitoring?

Who can I talk to if I have questions about usage of Vitafol Fe Plus in breastfeeding?