Iron Sucrose and Breastfeeding

Summary of use during lactation

Limited data indicate that breastmilk iron is not increased after intravenous infusion of iron sucrose. Amounts of iron ingested by the infant would be normal and are not expected to cause any adverse effects in breastfed infants. The oral form of the drug, called sucroferric oxyhydroxide and used as a phosphate binder, is not orally absorbed and it is unlikely to reach the breastmilk or adversely affect the breastfed infant. No special precautions are required. For additional information on iron use during breastfeeding, see the monograph on Iron Salts.

Drug levels in milk and infant serum

Maternal Levels. Ten mothers who were iron deficient at 2 to 3 days postpartum received a single 100 mg dose of intravenous iron sucrose. The iron concentration in their colostrum was compared to those in 5 similar women who received no iron. Colostrum collected daily for 4 days after the injection contained average iron concentrations between 0.3 and 0.45 mg/kg of milk which is in the low end of the range for postpartum women. No difference in milk iron concentration was found between the treated and control mothers.[1] Infant Levels. Relevant published information was not found as of the revision date.

Effects in breastfed infants

In a study of 104 women with postpartum anemia, 78 women received 300 mg of intravenous iron sucrose over 3 days. All women were breastfeeding and had amenorrhea. No adverse reactions were reported in their infants.[2]

Effects on lactation and breastmilk

Relevant published information was not found as of the revision date.

Alternative drugs to consider

Ferric Carboxymaltose, Ferric Derisomaltose

References

1. Breymann C, von Seefried, B, Stahel M, et al. Milk iron content in breast-feeding mothers after administration of intravenous iron sucrose complex. J Perinat Med 2007;35:115-8.17302514 PubMed
2. Giannoulis C, Daniilidis A, Tantanasis T, et al. Intravenous administration of iron sucrose for treating anemia in postpartum women. Hippokratia 2009;13:38-40.19240819 PubMed