Supplements during lactation

Peer reviewed / Manuskript (original) submitted: 10 October 2022 / Revision accepted: 08 February 2023

The more the merrier?

Introduction

The market for dietary supplements (DS) is vast and confusing with products being sold in a variety of locations including pharmacies, drugstores, discount stores, and online. Advertising addresses a wide variety of target groups and their needs, including lactating mothers.

During this vulnerable phase, lactating individuals are dual providers and it’s crucial to ensure adequate nutrient supply for the wellbeing of the mother as well as optimal infant health and development. Manufacturers of DS take advantage of a mother's basic emotional need to provide her child with all the required nutrients by addressing precisely these maternal wishes and concerns in the advertising of their products. They use statements such as “For the special needs of you and your baby during lactation [Femibion Stillzeit]“, “Only the best for you and your child [Eucell natal]“, and “comprehensively supplied [Abtei Vita Mama]“ in flyers, brochures, or on the internet. Advertising statements like these can lead lactating mothers to believe that they are not providing enough nutrients for their child without taking similar DS. Manufacturers often add a wide range of vitamins and minerals in various dosages to their products. To the best of our knowledge, there is currently no overview of the various DS available to breastfeeding women in Germany. Furthermore, data on the included micronutrients as well as their dosage is lacking, a research gap we could like to close with this work.

Abstract

The German “Healthy Start – Young Family” network (Gesund ins Leben), affiliated with the Federal Center for Nutrition (Bundeszentrum für Ernährung, BZfE), recommends iodine supplementation during lactation, as well as docosahexaenoic acid (DHA) intake for breastfeeding women with low fish consumption. But what do dietary supplements (DS) for breastfeeding women contain and in what dosage? We investigated 50 supplements and compared their iodine and DHA dosage to the recommendations set by the “Healthy Start – Young Family” network.
10% of the DS contained iodine according to the supplementation recommendation, while 72% exceeded and 4% fell short. 14% of the investigated DS did not contain iodine at all. In the case of DHA, 32% contained exactly the recommended amount, while 24% of the preparations exceeded and 2% fell short of this recommendation. 42% of the supplements did not contain any DHA.
Our analysis shows that many DS do not meet the supplementation recommendations for iodine and DHA in the lactation period. In addition, all the investigated DS contained a large number of nutrients, some of which exceed the maximum levels proposed by the German Federal Institute for Risk Assessment (Bundesinstitut für Risikobewertung, BfR). A reformulation of the preparations by the manufacturer, taking into account the recommendations as well as the proposed upper limits by the BfR, is desirable.

Keywords: dietary supplements, lactation, multinutrient supplements, DHA, iodine, n-3 fatty acids, supplements

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