Thalassemia and Lactation

The impact of thalassemia on breast milk production and infant feeding.

Thalassemia is an inherited blood disorder. In this condition, hemoglobin—the main oxygen-carrying component of the blood—is not formed properly. As a result, individuals often experience persistent fatigue and recurrent anemia and may require blood transfusions. If not treated in a timely manner, iron accumulates in the body, which can lead to complications affecting the heart, liver, endocrine system, and bones.

In the past, pregnancy and breastfeeding were considered impossible for women with thalassemia. However, with advances in modern medicine, women with thalassemia can now safely conceive, give birth, and even breastfeed their infants. Therefore, studying the effects of thalassemia during pregnancy and lactation is critically important for both maternal health and optimal infant development.

Characteristics of Thalassemia During Pregnancy and Lactation

Since thalassemia is characterized by excessive iron accumulation in the body, the circulatory and hormonal systems of women with the disease become more sensitive during pregnancy. During this period, the demand for blood increases to support fetal development; therefore, blood transfusions are performed more frequently. Routine transfusions may lead to elevated iron levels, which is why careful monitoring of iron overload during pregnancy is of particular importance.

The lactation period, which begins after childbirth, is of enormous significance for both the mother and the infant. During lactation, the hormones prolactin and oxytocin are activated, stimulating milk production. Despite observing hormonal alterations in mothers with thalassemia, studies show that most of them are capable of breastfeeding. Because breast milk contains relatively low levels of iron, it helps prevent excessive iron accumulation in infants with thalassemia and contributes to strengthening immune defense.

The Clinical Significance of Breast Milk in the Nutrition of Infants With Thalassemia

In transfusion-dependent beta-thalassemic infants, the type of feeding (breast milk or formula) has a direct impact on the infant’s iron burden. In beta-thalassemia, the primary pathological mechanism is iron overload in the body, which poses serious risks to the heart, liver, and endocrine system.

One of the studies conducted in this area is a clinical investigation published in the International Breastfeeding Journal (2017). In this study, 60 transfusion-dependent beta-thalassemic infants were divided into three groups: exclusively breastfed infants, infants fed exclusively with formula, and infants receiving mixed feeding. According to the results of the study, serum iron and ferritin levels were lower in exclusively breastfed infants compared with those fed with formula, suggesting that breast milk may help prevent excessive iron accumulation. Although this difference was not statistically significant, the authors reported that breast milk may represent a safer feeding option for infants with beta-thalassemia.

The research findings indicate that breastfeeding by mothers with thalassemia is not only entirely possible but may also have a potentially positive therapeutic effect. Although breast milk contains lower levels of iron, its high bioavailability helps prevent harmful increases in iron overload; therefore, the ability of infants with thalassemia to be breastfed is of significant importance. The data demonstrates that thalassemia requires a specific approach during the lactation period and that encouraging breastfeeding among mothers with thalassemia may provide clinical benefits.

Despite the existence of studies examining the impact of thalassemia on lactation, there remains a need for further medically evidence-based research. Proper management of the lactation process in women with thalassemia makes a substantial contribution both to the preservation of maternal health and to the improvement of the infant’s quality of life. For this reason, encouraging such mothers to breastfeed and ensuring regular medical supervision are essential.

Author: Hajar Piriyeva
Breastfeeding Consultant