Table 10.

Summary effect of nutritional minerals supplements on status of Iron human milk composition

First author surname, citation number	Type of Supplement	Characteristics of Participants	Type of study	Aim	Type of Nutrients Evaluated in Milk	Main Findings	Jadad scale points and WHO divisions
Breymann [79]	A single dose of 100 mg intravenous iron sucrose.	Ten healthy lactating mothers with functional iron deficiency 2–3 days after delivery.	Randomized controlled trial	To study the transfer of parenteral iron sucrose into maternal milk in the postpartum period.	Milk iron	No significant difference between the groups was found on any study day as well as in the mean change from baseline over all four days. We could not show transfer of iron-sucorose into maternal milk for the given dosage.	1/5 Europe (EURO)
Holm [80]	Single dose of intravenous 1200 mg iron isomaltoside or oral iron at a mean daily dose of 70.5 mg.	65 women with sufficient breast milk.	Randomized controlled trial	To compare the iron concentration in breast milk after a single high dose of intravenous iron isomaltoside or daily oral iron for postpartum haemorrhage.	Total iron concentration in breast milk	The mean (±SD) iron concentration in breast milk in the intravenous and oral groups was 0.72 ± 0.27 and 0.40 ± 0.18 mg/L at three days (p < 0.001) and 0.47 ± 0.17 and 0.44 ± 0.25 mg/L after one week (p = 0.64).	3/5 Europe (EURO)
Yalcın [81]	80 mg of elementary iron as ferrous sulfate.	47 Healthy mothers were enrolled in the study 10 to 20 days after delivery.	A prospective, placebo controlled, double-blinded, and randomized intervention	To determine the factors that affect milk iron content at the second week of lactation and whether supplementation to lactating mother with iron might increase breast milk iron content between 2 weeks and 4 months postpartum.	Iron and zinc	Iron supplementation to lactating nonanemic mothers did not change milk iron content and the decline in milk iron content and milk-to-serum iron ratio. Milk iron content and milk-to-serum iron ratio of iron could be regulated by active transport in cooperation with maternal iron status.	2/5 Europe (EURO)
zapata [73]	Iron sulfate (FeSO4.7H20) tablets containing 40 mg of Fe each.	Twenty-eight volunteer nursing women Their ages ranged from 19 to 35 years (average of 27);	Randomized controlled trial	To evaluate longitudinally the effect of moderate maternal iron supplementation during the first 3 months of lactation on milk iron levels and iron related milk components.	Concentrations of iron and zinc, lactoferrin, total iron-ligands in milk were measured	Iron supplementation did not alter significantly iron and zinc levels in milk and the low iron to lactoferrin ratio was maintained, thus preserving the important functions of lactoferrin for the infant organism. However, iron supplementation increased total iron ligands in milk as measured by the total iron-binding capacity and increased the proportion of lactoferrin in total protein secreted. Also, lactoferrin levels tended (P = 0.059) to be higher in milk of the supplemented women.	2/5 Americas (AMRO)