{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T21:23:06Z","timestamp":1792790586953,"version":"4.5.0"},"reference-count":60,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2024,4,25]],"date-time":"2024-04-25T00:00:00Z","timestamp":1714003200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Danone Indonesia"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Anemia in breastfeeding women is a neglected global health issue with significant implications for maternal and child health. Despite its widespread occurrence and adverse effects, this problem remains largely unknown and overlooked on the global health agenda. Despite efforts to improve health access coverage and provide iron and folic acid supplementation, anemia persists. This underscores the need for a comprehensive approach to address the problem. Urgent action must be taken to prioritize education and awareness campaigns, ensure access to nutritious food, and enhance healthcare services. Education programs should focus on promoting iron-rich diets, dispelling cultural myths, and providing practical guidance. Improving healthcare services requires increasing availability, ensuring a consistent supply of iron supplements, and providing adequate training for healthcare providers. A successful implementation relies on a strong collaboration between the government, healthcare providers, and community. It is crucial that we acknowledge that high coverage alone is insufficient for solving the issue, emphasizing the importance of targeted interventions and a strategic implementation. By adopting a comprehensive approach and addressing the underlying causes of anemia, Indonesia can make significant progress in reducing its prevalence and improving the overall health of its population, particularly among breastfeeding women.<\/jats:p>","DOI":"10.3390\/nu16091285","type":"journal-article","created":{"date-parts":[[2024,4,26]],"date-time":"2024-04-26T03:23:47Z","timestamp":1714101827000},"page":"1285","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Anemia in Breastfeeding Women and Its Impact on Offspring\u2019s Health in Indonesia: A Narrative Review"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9507-527X","authenticated-orcid":false,"given":"Ray Wagiu","family":"Basrowi","sequence":"first","affiliation":[{"name":"Danone Specialized Nutrition Indonesia, Jakarta 12940, Indonesia"},{"name":"Occupational Medicine Program, Department of Community Medicine, Faculty of Medicine, Universitas Indonesia, Jakarta 12300, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5191-5428","authenticated-orcid":false,"given":"Andy","family":"Zulfiqqar","sequence":"additional","affiliation":[{"name":"Division of Urology, Department of Surgery, Faculty of Medicine, Universitas Gadjah Mada\/Dr. Sardjito Hospital, Yogyakarta 55281, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nova Lidia","family":"Sitorus","sequence":"additional","affiliation":[{"name":"Danone Specialized Nutrition Indonesia, Jakarta 12940, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,4,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"em506","DOI":"10.29333\/ejgm\/13266","article-title":"Factors associated with receiving iron supplements during pregnancy among women in Indonesia","volume":"20","author":"Efendi","year":"2023","journal-title":"Electron. J. Gen. Med."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Sungkar, A., Bardosono, S., Irwinda, R., Manikam, N.R.M., Sekartini, R., Medise, B.E., Nasar, S.S., Helmyati, S., Ariani, A.S., and Nurihsan, J. (2022). A Life Course Approach to the Prevention of Iron Deficiency Anemia in Indonesia. Nutrients, 14.","DOI":"10.3390\/nu14020277"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"33","DOI":"10.25220\/WNJ.V05.S1.0005","article-title":"Optimizing iron adequacy and absorption to prevent iron deficiency anemia: The role of combination of fortified iron and vitamin C","volume":"5","author":"Basrowi","year":"2021","journal-title":"World Nutr. J."},{"key":"ref_4","unstructured":"World Health Organization (2021). Anemia in Women and Children WHO Global Anaemia Estimates, 2021 Edition, World Health Organization."},{"key":"ref_5","unstructured":"Kementrian Kesehatan Republik Indonesia (2018). Laporan Nasional Riskesdas 2018."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"963","DOI":"10.4269\/ajtmh.13-0660","article-title":"Prevalence of anemia and its risk factors among lactating mothers in Myanmar","volume":"90","author":"Zhao","year":"2014","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1111\/nyas.14092","article-title":"Anemia epidemiology, pathophysiology, and etiology in low- and middle-income countries","volume":"1450","author":"Chaparro","year":"2019","journal-title":"Ann. N. Y. Acad. Sci."},{"key":"ref_8","first-page":"S32","article-title":"Non-nutritional anemia: Malaria, thalassemia, G6PD deficiency and tuberculosis in Indonesia","volume":"29","author":"Malik","year":"2020","journal-title":"Asia Pac. J. Clin. Nutr."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1913","DOI":"10.1007\/s10995-011-0938-y","article-title":"Relationship of maternal knowledge of anemia with maternal and child anemia and health-related behaviors targeted at anemia among families in Indonesia","volume":"16","author":"Souganidis","year":"2012","journal-title":"Matern. Child Health J."},{"key":"ref_10","first-page":"S1","article-title":"Intersectoral and eco-nutritional approaches to resolve persistent anemia in Indonesia","volume":"29","author":"Lukito","year":"2020","journal-title":"Asia Pac. J. Clin. Nutr."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"2123","DOI":"10.1016\/S0140-6736(10)62304-5","article-title":"Anaemia in low-income and middle-income countries","volume":"378","author":"Balarajan","year":"2011","journal-title":"Lancet"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1123","DOI":"10.3797\/scipharm.1304-03","article-title":"Comparison study of oral iron preparations using a human intestinal model","volume":"81","author":"Zariwala","year":"2013","journal-title":"Sci. Pharm."},{"key":"ref_13","first-page":"S55","article-title":"Nutritional anemia: Limitations and consequences of Indonesian intervention policy restricted to iron and folic acid","volume":"29","author":"Nadiyah","year":"2020","journal-title":"Asia Pac. J. Clin. Nutr."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"883","DOI":"10.1111\/1475-6773.13283","article-title":"Food insecurity, health care utilization, and health care expenditures","volume":"55","author":"Dean","year":"2020","journal-title":"Health Serv. Res."},{"key":"ref_15","unstructured":"(2024, January 31). The Use of the Global Food Security Index to Inform the Situation in Food Insecure Countries 2017. Available online: https:\/\/data.europa.eu\/doi\/10.2760\/83356."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1093\/ajcn\/nqz047","article-title":"Micronutrient intakes of lactating mothers and their association with breast milk concentrations and micronutrient adequacy of exclusively breastfed Indonesian infants","volume":"110","author":"Daniels","year":"2019","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1016\/j.jtemb.2005.05.001","article-title":"Macronutrient, mineral and trace element composition of breast milk from Japanese women","volume":"19","author":"Yamawaki","year":"2005","journal-title":"J. Trace Elem. Med. Biol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"272","DOI":"10.1093\/tropej\/fmk004","article-title":"Concentrations of Fe, K, Na, Ca, P, Zn and Mg in maternal colostrum and mature milk","volume":"52","author":"Mastroeni","year":"2006","journal-title":"J. Trop. Pediatr."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"903","DOI":"10.1038\/sj.ejcn.1602398","article-title":"Mother\u2019s iron status, breastmilk iron and lactoferrin--are they related?","volume":"60","author":"Shashiraj","year":"2006","journal-title":"Eur. J. Clin. Nutr."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1007\/s12011-008-8221-9","article-title":"Maternal milk concentration of zinc, iron, selenium, and iodine and its relationship to dietary intakes","volume":"127","author":"Hannan","year":"2009","journal-title":"Biol. Trace Elem. Res."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1007\/s12011-009-8510-y","article-title":"Association between zinc, copper, and iron concentrations in breast milk and growth of healthy infants in Tabriz, Iran","volume":"135","author":"Mahdavi","year":"2010","journal-title":"Biol. Trace Elem. Res."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1193","DOI":"10.1016\/j.foodchem.2011.01.123","article-title":"The chemical composition of human milk from Inner Mongolia of China","volume":"127","author":"Shi","year":"2011","journal-title":"Food Chem."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"64","DOI":"10.4162\/nrp.2017.11.1.64","article-title":"Retinol, \u03b1-tocopherol, and selected minerals in breast milk of lactating women with full-term infants in South Korea","volume":"11","author":"Kim","year":"2017","journal-title":"Nutr. Res. Pract."},{"key":"ref_24","first-page":"S9","article-title":"Nutritional contributors to maternal anemia in Indonesia: Chronic energy deficiency and micronutrients","volume":"29","author":"Lipoeto","year":"2020","journal-title":"Asia Pac. J. Clin. Nutr."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"72","DOI":"10.3148\/67.2.2006.72","article-title":"Is there a link between postpartum anemia and discontinuation of breastfeeding?","volume":"67","author":"Rioux","year":"2006","journal-title":"Can. J. Diet. Pract. Res."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1111\/j.1523-536X.1995.tb00565.x","article-title":"Anemia and insufficient milk in first-time mothers","volume":"22","author":"Henly","year":"1995","journal-title":"Birth"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1039","DOI":"10.1093\/ajcn\/nqaa200","article-title":"Association of maternal diet, micronutrient status, and milk volume with milk micronutrient concentrations in Indonesian mothers at 2 and 5 months postpartum","volume":"112","author":"Gibson","year":"2020","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1223","DOI":"10.3109\/14767058.2013.776529","article-title":"Maternal anemia induces changes in immunological and nutritional components of breast milk","volume":"26","author":"Silva","year":"2013","journal-title":"J. Matern. Fetal Neonatal Med."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1206s","DOI":"10.1093\/ajcn\/81.5.1206","article-title":"Multiple micronutrients in pregnancy and lactation: An overview","volume":"81","author":"Allen","year":"2005","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1030343","DOI":"10.3389\/fnut.2023.1030343","article-title":"Nutrient intakes of pregnant and lactating women in Indonesia and Malaysia: Systematic review and meta-analysis","volume":"10","author":"Agustina","year":"2023","journal-title":"Front. Nutr."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Sunardi, D., Bardosono, S., Basrowi, R.W., Wasito, E., and Vandenplas, Y. (2021). Dietary Determinants of anemia in children aged 6\u201336 months: A cross-sectional study in Indonesia. Nutrients, 13.","DOI":"10.3390\/nu13072397"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"880431","DOI":"10.3389\/fped.2022.880431","article-title":"Iron status of exclusively breastfed low-birth-weight infants born to anemic mothers and effect of maternal iron supplementation for 3 versus 6 months: A randomized double-blind placebo control trial","volume":"10","author":"Fatima","year":"2022","journal-title":"Front. Pediatr."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1199","DOI":"10.1016\/j.mcna.2016.06.004","article-title":"Nutrition Recommendations in Pregnancy and Lactation","volume":"100","author":"Kominiarek","year":"2016","journal-title":"Med. Clin. N. Am."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"O\u2019Toole, F., Sheane, R., Reynaud, N., McAuliffe, F.M., and Walsh, J.M. (2023). Screening and treatment of iron deficiency anemia in pregnancy: A review and appraisal of current international guidelines. Int. J. Gynecol. Obstet., 1\u201314.","DOI":"10.1002\/ijgo.15270"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1365","DOI":"10.4103\/jfmpc.jfmpc_68_19","article-title":"Challenges in supervision, monitoring, and reporting in anemia programme implementation in Odisha, India: A qualitative process documentation","volume":"8","author":"Bhatia","year":"2019","journal-title":"J. Family Med. Prim. Care"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"120","DOI":"10.20473\/amnt.v7i1.2023.120-130","article-title":"Risk Factors of stunting, iron deficiency anemia, and their coexistence among children aged 6\u20139 years in Indonesia: Results from the Indonesian Family Life Survey-5 (IFLS-5) in 2014\u20132015","volume":"7","author":"Utami","year":"2023","journal-title":"Amerta Nutr."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"65","DOI":"10.2223\/JPED.1959","article-title":"Influence of breastfeeding type and maternal anemia on hemoglobin concentration in 6-month-old infants","volume":"86","author":"Lira","year":"2010","journal-title":"J. Pediatr."},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Randell, M., Li, M., Rachmi, C.N., Jusril, H., Fox, O., Wibowo, L., Rah, J.H., Pronyk, P., Harmiko, M., and Phebe, N. (2022). Prevalence of, and factors associated with anaemia in children aged 1\u20133 years in Aceh, Indonesia: A cross-sectional study. Nutr. Health, 2601060221116195.","DOI":"10.1177\/02601060221116195"},{"key":"ref_39","first-page":"13","article-title":"Levels of calcium, aluminium and chromium in serum of exclusively breastfed infants at six months of age in Savannah region of Nigeria","volume":"20","author":"Okolo","year":"2001","journal-title":"West. Afr. J. Med."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"e673","DOI":"10.1542\/peds.2007-1986","article-title":"Cord blood and breast milk iron status in maternal anemia","volume":"121","author":"Kumar","year":"2008","journal-title":"Pediatrics"},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Sudaryati, E., Nasution, E., and Yustina, I. (2016, January 14\u201315). Stunting and anemia in infants among breastfeeding mothers in Binjai city. Proceedings of the 1st Public Health International Conference (PHICo 2016), Jakarta, Indonesia.","DOI":"10.2991\/phico-16.2017.14"},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Rini, S., and Dewi, F.K. (2019, January 26\u201328). Correlation between postpartum anemia and the increase of baby\u2019s weight in Ledug, Kembaran, Banyumas, Indonesia. Proceedings of the 1st International Conference on Community Health (ICCH 2019), Jakarta, Indonesia.","DOI":"10.2991\/ahsr.k.200204.024"},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Aji, A.S., Erwinda, E., Yusrawati, Y., Malik, S.G., and Lipoeto, N.I. (2019). Vitamin D deficiency status and its related risk factors during early pregnancy: A cross-sectional study of pregnant Minangkabau women, Indonesia. BMC Pregnancy Childbirth, 19.","DOI":"10.1186\/s12884-019-2341-4"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1016\/j.jped.2015.11.006","article-title":"Correlation between hemoglobin levels of mothers and children on exclusive breastfeeding in the first six months of life","volume":"92","author":"Taddei","year":"2016","journal-title":"J. Pediatr."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1093\/jn\/136.2.452","article-title":"Risk of infant anemia is associated with exclusive breast-feeding and maternal anemia in a Mexican cohort","volume":"136","author":"Guerrero","year":"2006","journal-title":"J. Nutr."},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Reinbott, A., Jordan, I., Herrmann, J., Kuchenbecker, J., Kevanna, O., and Krawinkel, M.B. (2016). Role of breastfeeding and complementary food on hemoglobin and ferritin levels in a cambodian cross-sectional sample of children aged 3 to 24 months. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0150750"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"2007","DOI":"10.4314\/ahs.v20i4.59","article-title":"A systematic review and meta-analysis of the prevalence and predictors of anemia among children in Ethiopia","volume":"20","author":"Gebrie","year":"2020","journal-title":"Afr. Health Sci."},{"key":"ref_48","first-page":"18","article-title":"Breastfeeding exclusively and iron deficiency anemia during the first 6 months of age","volume":"60","author":"Marques","year":"2014","journal-title":"Rev. Assoc. M\u00e9dica Bras. 1992"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"5975","DOI":"10.3390\/nu6125975","article-title":"Anemia and feeding practices among infants in rural Shaanxi Province in China","volume":"6","author":"Luo","year":"2014","journal-title":"Nutrients"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"338","DOI":"10.3177\/jnsv.55.338","article-title":"Nutritional status of lactating mothers and their breast milk concentration of iron, zinc and copper in rural Vietnam","volume":"55","author":"Nakamori","year":"2009","journal-title":"J. Nutr. Sci. Vitaminol."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"8","DOI":"10.4103\/0970-0218.80786","article-title":"Nutritional anemia in young children with focus on Asia and India","volume":"36","author":"Kotecha","year":"2011","journal-title":"Indian. J. Community Med."},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Ha, E.K., Lee, S.W., Kim, J.H., Lee, E., Cha, H.R., Han, B.E., Shin, J., and Han, M.Y. (2023). Associations between delayed introduction of complementary foods and childhood health consequences in exclusively breastfed children. Nutrients, 15.","DOI":"10.3390\/nu15153410"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"787","DOI":"10.1111\/jhn.13098","article-title":"Association between complementary food introduction before age 4 months and body mass index at age 5-7 years: A retrospective population-based longitudinal cohort study","volume":"36","author":"Ha","year":"2023","journal-title":"J. Hum. Nutr. Diet."},{"key":"ref_54","doi-asserted-by":"crossref","unstructured":"Friel, J., Qasem, W., and Cai, C. (2018). Iron and the Breastfed Infant. Antioxidants, 7.","DOI":"10.3390\/antiox7040054"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1093\/tropej\/fms055","article-title":"Iron supplementation in pregnancy and breastfeeding and iron, copper and zinc status of lactating women from a human milk bank","volume":"59","author":"Oshiiwa","year":"2013","journal-title":"J. Trop. Pediatr."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"146","DOI":"10.15537\/smj.2015.2.10289","article-title":"The impact of maternal iron deficiency and iron deficiency anemia on child\u2019s health","volume":"36","author":"Jan","year":"2015","journal-title":"Saudi Med. J."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1162\/adev_a_00158","article-title":"What\u2019s happened to poverty and inequality in Indonesia over half a century?","volume":"38","author":"Hill","year":"2021","journal-title":"Asian Dev. Rev."},{"key":"ref_58","first-page":"604","article-title":"Iron-deficiency anemia in pregnant women in Bali, Indonesia: A profile of risk factors and epidemiology","volume":"33","author":"Suega","year":"2002","journal-title":"Southeast Asian J. Trop. Med. Public. Health"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"e06348","DOI":"10.1016\/j.heliyon.2021.e06348","article-title":"The impact of nutrition education on knowledge, attitude, and practice regarding iron deficiency anemia among female adolescent students in Jordan","volume":"7","author":"Eyadat","year":"2021","journal-title":"Heliyon"},{"key":"ref_60","first-page":"S1","article-title":"The clinical nutrition research agenda in Indonesia and beyond: Ecological strategy for food in health care delivery","volume":"26","author":"Lukito","year":"2017","journal-title":"Asia Pac. J. Clin. Nutr."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/16\/9\/1285\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T14:33:11Z","timestamp":1760106791000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/16\/9\/1285"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,25]]},"references-count":60,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2024,5]]}},"alternative-id":["nu16091285"],"URL":"https:\/\/doi.org\/10.3390\/nu16091285","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4,25]]}}}