Occult blood in stool in exclusively formula fed infants versus exclusively breast fed infants in the first six months of life

BackgroundSince most of infant’s formula are based on cow’s milk to which allergy can occur, and considering the neurodevelopmental consequences of iron deficiency during infancy; we aimed to verify the occurrence of occult intestinal blood loss during the first 6 months of life in response to being fed cow’s milk based formula versus breast milk. We also studied the iron status in order to assess prevalence of iron deficiency anemia.MethodsHealthy full term infants from birth to 6 months who were either exclusively breast fed (BF) (n = 50) or formula fed (FF) (n = 50) were considered for enrollment. Detailed questionnaire describing perinatal period was taken from the mothers. Complete blood count, serum iron, total iron binding capacity (TIBC), serum transferrin and occult blood in stool were requested for each infant.ResultsWe reported no significant differences in hemoglobin, hematocrit and MCV between both groups. FF infants had higher levels of TIBC. We found that 4/50 FF infants had positive occult blood in stool; while only 1/50 BF infants was positive. The prevalence of iron deficiency anemia was higher in the FF group (14%) rather than in the BF group (8%).ConclusionAlthough iron content in formula is higher than breast milk, BF infants attained better iron status than FF infants and the prevalence of anemia among the FF group was higher.     

Iron absorption in infants: high bioavailability of breast milk iron as indicated by the extrinsic tag method of iron absorption and by the concentration of serum ferritin

Breast feeding is thought to result in a lower incidence of iron deficiency than does the use of unfortified cow milk forumalas, but there is scant documentation for this belief. The relationship of breast and cow milk feeding to absorption of iron and to iron status was investigated in a total of 45 term infants at about six months of age. Iron absorption was measured by total body counting. Laboratory assessment of iron status was based on the serum ferritin, hemoglobin, mean corpuscular volume, and transferrin saturation. The results indicated that infants fed breast milk during the entire first six to seven months of life attained greater iron stores than did those fed a cow milk formula. Breast-fed infants absorbed an average of 49% of a trace dose of extrinsic iron administered during a breast feeding in contrast to about 10% reported to be absorbed from cow milk under similar conditions. The data indicate that term infants who are breast fed may not require routine administration of supplemental iron.     

Cow milk feeding in infancy: further observations on blood loss from the gastrointestinal tract

Because feeding of cow milk causes normal infants to lose increased amounts of occult blood from the gastrointestinal tract, we conducted a prospective trial to measure intestinal blood loss quantitatively and to monitor iron nutritional status. Fifty-two infants entered the trial at 168 days of age and were assigned at random to receive either cow milk or a milk-based formula. Initially, 31 infants had been breast-fed and 21 had been fed formulas. With the feeding of cow milk, the proportion of guaiac-positive stools increased from 3.0% at baseline to 30.3% during the first 28 days of the trial (p less than 0.01), whereas the proportion of positive stools remained low (5.0%) with the feeding of formula. The proportion of guaiac-positive stools among cow milk-fed infants declined later, but for the entire trial it remained significantly (p less than 0.01) elevated. Stool hemoglobin concentration increased markedly with the introduction of cow milk, rising from a mean (+/- SD) of 622 +/- 527 micrograms/gm dry stool at baseline to 3598 +/- 10,479 micrograms/gm dry stool during the first 28 days of ingestion of cow milk. Among infants fed formula, stool hemoglobin did not increase and was significantly (p less than 0.01) less than in the cow milk group. Among infants fed cow milk, the increase in hemoglobin concentration tended to be greater for those who had initially been fed human milk than for those who had initially been fed formulas. Iron nutritional status was not significantly different between the two feeding groups. However, one infant became iron deficient after 4 weeks of ingesting cow milk. We conclude that cow milk feeding leads to increased intestinal tract blood loss in a large proportion of normal infants and that the amount of iron lost is nutritionally important.     

Intestinal blood loss during cow milk feeding in older infants: quantitative measurements

OBJECTIVE: To determine the response, in terms of fecal hemoglobin excretion and clinical symptoms, of normal 9 1/2-month-old infants to being fed cow milk. DESIGN: Longitudinal (before-after) trial in which each infant was fed formula for 1 month (baseline) followed by 3 months during which cow milk was fed. SETTING: Healthy infants living in Iowa City, Iowa, a town with a population of about 60,000. MAIN OUTCOME MEASURES: Hemoglobin concentration in spot stools, 96-hour quantitative fecal hemoglobin excretion, stool characteristics, feeding-related behaviors, and iron nutritional status. RESULTS: Fecal hemoglobin concentration during formula feeding (baseline) was higher than previously observed in younger infants. Nine of 31 infants responded to cow milk feeding with increased fecal hemoglobin concentration. Fecal hemoglobin concentration (mean +/- SD) of the 9 responders rose from 1,395 +/- 856 microg/g of dry stool (baseline) to 2,711 +/- 1,732 microg/g of dry stool (P=.01). The response rate (29%) was similar to that in younger infants, but the intensity of the response was much less. Quantitative hemoglobin excretion was in general agreement with estimates based on spot stool hemoglobin concentrations. Cow milk feeding was not associated with recognizable changes in stool characteristics, nor were there clinical signs related to fecal blood loss. Iron status was similar, except that after 3 months of cow milk feeding responders showed lower (P= .047) ferritin concentrations than nonresponders. CONCLUSIONS: Cow milk-induced blood loss is present in 9 1/2-month-old infants but is of such low intensity that its clinical significance seems questionable. Nevertheless, infants without cow milk-induced blood loss were in better iron nutritional status than infants who showed blood loss.     

Bioavailability of iron in soy-based formula and its effect on iron nutriture in infancy

Soy products have been reported to inhibit absorption of nonheme food iron and fortification iron. Iron bioavailability from a soy formula (Prosobee-PP 710) (iron added as ferrous sulfate: 12 mg/L; ascorbic acid: 54 mg/L) was examined in 16 adult women using the extrinsic radioactive tag method. The geometric mean absorption from the soy formula was only 1.7%. The effect of this formula on iron nutrition in infants was studied in 47 healthy term infants weaned spontaneously before 2 months of age and who received the formula ad libitum until 9 months of age. For control, 45 infants received a cow's milk formula fortified with ferrous sulfate (iron: 15 mg/L; ascorbic acid: 100 mg/L), which has been shown to be effective in preventing iron deficiency, and 49 additional breast-fed infants were also followed. All babies received solid foods (vegetables and meat) starting at 4 months of age. Iron nutritional status was determined at 9 months. Infants fed soy formula and iron-fortified cow's milk had similar mean values of hemoglobin, mean corpuscular volume, transferrin saturation, free erythrocyte protoporphyrin, and serum ferritin; both formula groups differed significantly (P less than .05) from the breast-fed group in all measurements except free erythrocyte protoporphyrin. Anemia (hemoglobin less than 11 g/dL) was present in only 4.3% and 2.2% of infants receiving the soy and the fortified formulas, respectively, v 27.3% in the breast-fed group. These results indicate that soy formula, in spite of the lower iron bioavailability when measured in adults, is essentially as effective as iron-fortified cow's milk in preventing iron deficiency in infants.     

Vitamin E status in preterm infants fed human milk or infant formula

Vitamin E status was assessed in 36 infants with birth weights less than 1500 gm who were assigned randomly to receive one of three sources of nutrition: milk obtained from mothers of preterm infants (preterm milk), mature human milk, or infant formula. Infants in each dietary group were further assigned randomly to receive iron supplementation (2 mg/kg/day) beginning at 2 weeks or to receive no iron supplementation. All infants received a standard multivitamin, providing 4.1 mg alpha-tocopherol daily. Serum vitamin E concentrations at 6 weeks were significantly related both to type of milk (P less than 0.0001) and to iron supplementation (P less than 0.05). Infants fed preterm milk had significantly higher serum vitamin E levels than did infants fed mature human milk, and both groups had significantly higher levels than did those fed formula. Ratios of serum vitamin E/total lipid were also significantly greater for infants fed human milks than for those fed formula. The addition of iron to all three diets resulted in significantly lower serum vitamin E levels at 6 weeks (P less than 0.05); however, only in the group fed formula was there evidence of vitamin E deficiency. Preterm milk with routine multivitamin supplementation uniformly resulted in vitamin E sufficiency in VLBW infants whether or not iron was administered.     

Nutritional iron status of infants fed according to current recommendations

We examined the iron nutritional status of healthy term infants in a longitudinal study from 15 through 365 days of age. All infants were fed according to the present austrian recommendations. Serum hemoglobin (Hb) decreased from 15 through 122 days of age and remained constant thereafter. At 365 days of age, only 4.7% of the infants had hemoglobin levels below 11 g/dl, which is considered the borderline value for anemia. Mean corpuscular volume (MCV) of erythrocytes was changing during infancy. Free erythrocyte protoporphyrin (FEP) was constant from 122 days through 365 days of age. The upper normal value of 3 micrograms/gHb for infants older than 122 days of age corresponded to that for children older than one year and adults. Serum ferritin (SF) decreased from 15 through 183 days of age and remained constant thereafter. At 365 days of age, only 9.3% of the infants had SF below 10 micrograms/l, which is considered the borderline concentration for depletion of iron stores. We found no differences of iron nutritional status between infants who were breastfed longer than 122 days and infants who were breastfed shorter than 122 days or were fed formula. Our findings indicate that the prevalence of iron deficiency anemia and depletion of the iron stores is lower than in previous studies. Changes in infant nutrition during the last years resulted in higher iron intake and lower prevalence of iron deficiency.     

强化乳铁蛋白配方奶粉对人乳喂养婴儿生长发育和铁代谢影响的前瞻性多中心非随机对照研究

目的 了解添加强化乳铁蛋白(LF)配方奶粉对婴儿生长发育和铁代谢的影响。方法 本研究为前瞻性多中心非随机对照试验,生后以人乳喂养的4~6月龄健康足月儿自愿添加配方奶粉者纳入本研究,按门诊顺序分别纳入强化组(LF 38 mg·100 g-1 ,铁元素4 mg·100 g-1)和对照组(LF 0,铁元素4.2 mg·100 g-1,其余成分与强化组相同)。两组干预时间均为3个月。两组婴儿在干预前后分别测定身长、体重、头围、Hb、血清铁蛋白(SF)、血清转铁蛋白受体(sTfR);同时计算TFR-F指数、机体总铁含量(TBIC)、年龄别身高Z评分(HAZ)、年龄别体重Z评分(WAZ)、身高别体重Z评分(WHZ),比较上述指标的干预前后和组间差异。结果 213名婴儿完成了研究,强化组115名,对照组98名。强化组和对照组婴儿人均日摄入配方奶粉量(94.3±9.8) vs (88.2±8.7) g, P>0.05;人均日铁剂摄入量(3.8±0.4) vs (3.7±0.6) mg, P>0.05。强化组人均日LF摄入量为(35.8±3.7) mg。强化组与对照组干预后各指标改变值比较,体重：(2 213±82) vs (2 033±77) g, WAZ: (0.82±0.22) vs (-0.05±0.01), WHZ: (0.74±0.32) vs (0.20±0.06), Hb: (13.9±4.1) vs (7.2±1.8) g·L-1, SF: (1.37±0.08) vs (0.55±0.04) μg·L-1, TFR-F指数：(0.86±0.11) vs (0.39±0.05),TBIC: (19.4±8.8) vs (9.1±3.4) mg·kg-1, P均<0.05。同时干预后强化组贫血、铁缺乏和缺铁性贫血检出率均显著低于对照组,贫血： 4.1% vs 7.5%,铁缺乏：13.9% vs 24.4%,缺铁性贫血：1.7% vs 8.2%,P均<0.05。结论 添加强化LF配方奶粉干预可以显著改善人乳喂养婴儿生长发育以及铁营养状况     

Treatment of iron deficiency anemia and associated protein-losing enteropathy in children

PURPOSE: The aims of this study were to evaluate the response of oral iron treatment in children with iron deficiency anemia (IDA) fed whole cow's milk (WCM) or soy formula; to compare the incidence of fecal blood loss in infants fed WCM and soy formula; and to evaluate the incidence and relation of protein-losing enteropathy (PLE) and IDA by testing serum albumin, fecal blood loss, and fecal alpha1-antitrypsin (alpha1AT). METHODS: Twenty-four children with nutritional IDA were randomly assigned to receive either 16 oz WCM or soy formula daily. Both groups were treated with daily therapeutic oral iron during 12 weeks. Stool specimens for hemoglobin losses were collected at weeks 0, 3, 6, and 12. Levels of serum albumin and fecal alpha1AT were tested at diagnosis and when IDA was corrected. RESULTS: Anemia was corrected in 21 of the 24 children by week 6 or 12. Median fecal hemoglobin losses were not increased in either group at diagnosis or during treatment. Seven of 24 children had PLE at diagnosis with elevated fecal alpha1AT levels of 72 to 381 mg/dL that returned to normal after correction of IDA. Their initial fecal alpha1AT levels averaged 170 mg/ dL at diagnosis and 21 mg/dL after the IDA was corrected. Excessive WCM intake of 30 oz/day or more was present in 63% of the infants. CONCLUSIONS: Treatment of nutritional IDA with oral iron was just as effective with a limited quantity of either WCM or soy formula. Fecal hemoglobin losses were uncommon and did not differ in children at diagnosis or during treatment of IDA. PLE associated with IDA resolves when the IDA is corrected, but differences between children fed WCM or soy formula could not be detected.     

IRON ABSORPTION FROM INFANT MILK FORMULA AND THE OPTIMAL LEVEL OF IRON SUPPLEMENTATION

Abstract. Thirty healthy infants, aged 11–13 months, were studied with regard to the iron absorption from proprietary milk formula. The infants were divided into three groups (I-III) depending on the concentration of iron in the formula: 0.8 (I), 6.8 (II), and 12.8 (III) mg/1, respectively. The calculated amount of iron absorbed per test dose of SO ml of milk averaged 5 μg (I), 32 μg (II), and 43 μg (III). Group I differed significantly from groups II and III. No correlation was found between iron absorption and hemoglobin, MCV, serum transferrin saturation or serum ferritin within the range of normal values. Our findings suggest that at least 7 mg of iron as ferrous sulphate per litre of formula is required to prevent iron deficiency.     

Iron absorption from infant milk formula and the optimal level of iron supplementation

Thirty healthy infants, aged 11-13 months, were studied with regard to the iron absorption from proprietary milk formula. The infants were divided into three groups (I-III) depending on the concentration of iron in the formula: 0.8 (I), 6.8 (II), and 12.8 (III) mg/l, respectively. The calculated amount of iron absorbed per test dose of 50 ml of milk averaged 5 microgram (I), 32 microgram (II), and 43 microgram (III). Group I differed significantly from groups II and III. No correlation was found between iron absorption and hemoglobin, MCV, serum transferrin saturation or serum ferritin within the range of normal values. Our findings suggest that at least 7 mg of iron as ferrous sulphate per litre of formula is required to prevent iron deficiency.     

Iron status and infant feeding practices in an urban ambulatory center

The relationship of infant feeding practices to iron status was examined in a group of 280 infants, 9 to 12 months of age, attending a "well-baby" clinic. Of this group, 7.6% were found to be iron depleted, 19.7% were iron deficient without anemia, and 8.2% were iron deficient with anemia. The incidence of iron-deficiency anemia was significantly greater in the black infants than the white infants (14.3% v 2.7%). The introduction of whole cow's milk into the diet had occurred prior to 6 months of age in 29.2% of the infants, and 62.1% of these infants had laboratory evidence of nutritional iron inadequacy, as contrasted with only 21.8% of those with iron deficiencies fed cow's milk after 6 months of age. Of the 21 infants with iron-deficiency anemia, 19 (90.5%) had been fed whole cow's milk prior to 6 months of age. Iron deficiency remains a nutritional problem for infants in an urban setting and is largely a result of the early introduction of whole cow's milk into the diet.     

Nutritional anemia and its control

Available studies on prevalence of nutritional anemia in India show that 65% infant and toddlers, 60% 1–6 years of age, 88% adolescent girls (3.3% had hemoglobin < 7.0 g/dl; severe anemia) and 85% pregnant women (9.9% having severe anemia) were anemic. The prevalence of anemia was marginally higher in lactating women as compared to pregnancy. The commonest is iron deficiency anemia. National programmes to control and prevent anemia have not been successful. Experiences from other countries in controlling moderately-severe anemia guide to adopt long-term measures i.e. fortification of food items like milk, cereal, sugar, salt with iron. Use of iron utensils in boiling milk, cooking vegetables etc may contribute significant amount of dietary iron. Nutrition education to improve dietary intakes in family for receiving needed macro/micro nutrients as protein, iron and vitamins like folic acid, B₁₂, A and C etc. for hemoglobin synthesis is important. As an immediate measure medicinal iron is necessary to control anemia. Addition of folate with iron controls anemia and is neuroprotective. Evidence in early childhood suggests vitamin B₁₂ deficiency anemia; thus it may also be given alongwith iron and folate.     

Bone mineral metabolism in full-term infants fed human milk, cow milk-based, and soy-based formulas.

OBJECTIVE--To study the hypothesis that ingestion of a modified soy-based formula with an improved mineral suspension system may result in bone mineral content similar to that observed in infants fed human milk or cow milk-based formulas. DESIGN--Prospective, self-selected group of infants fed human milk randomized between the two formula-fed groups. SETTING--University-based hospital nursery and follow-up. PARTICIPANTS--Fifty-six normal, healthy, full-term infants, free of major malformations or disorders, including 17 infants fed human milk, 19 infants fed a cow milk-based formula, and 20 infants fed a soy protein formula were followed up to 6 months' postnatal age. The soy-based formula studied was modified to improve the suspendability of the minerals. INTERVENTIONS--Infants were fed human milk or the study formula for the first 4 months, at which time beikost was permitted. Infants fed human milk received vitamin supplementation to provide 400 IU of vitamin D per day. MEASUREMENTS--Anthropometric variables, serum calcium, magnesium, phosphorus, alkaline phosphatase, and parathyroid hormone levels were measured at enrollment, and at 8, 16, and 24 to 26 weeks' postnatal age. Bone mineral content at the distal third radius site was measured with single photon absorptiometry at these times. Growth in the infants did not differ significantly among the groups. There was no significant difference in serum calcium, magnesium, alkaline phosphatase, or parathyroid hormone concentrations among the infants during the study. Serum phosphorus was significantly lower at 8 weeks in the group fed human milk than in that fed the cow milk-based formula. Bone mineral content at 16 and 24 to 26 weeks was higher in the group fed the soy-based formula than in that fed human milk, and bone width was also higher at 16 weeks in the infants fed the soy-based formula. CONCLUSIONS--Improving the suspendability of the mineral system in the soy formula results in bone mineralization in infants fed the soy-based formula similar to that measured in infants fed human milk and cow milk-based formula. We suggest that the suspendability of the minerals used is an important variable in the interpretation of the effect of feedings on the bone mineral status of infants.     

Type of milk feeding affects hematological parameters and serum lipid profile in Japanese infants

Background: Type and volume of infant feeding determines infant growth, hematological parameters, and serum lipids. Methods: Study subjects consisted of 103 infants who were born vaginally at term, with birthweight >2200 g. Milk feeding amount, type, and anthropometry were measured at 1 and 6 months. Hematological tests and serum lipid profile were assessed at 1 and 6 months. Thirty‐four infants were breast‐fed and 36 were formula‐fed at 6 months. Results: Breast‐fed infants demonstrated similar growth patterns compared with partially breast‐fed or formula‐fed infants, despite the lower milk intake. Infants with higher breast milk intake at 6 months, however, tended to have lower hemoglobin levels. In contrast, higher formula intake at 6 months was related to lower serum total cholesterol. Conclusions: Japanese breast‐fed infants were more likely to be anemic at 6 months, while formula‐fed infants were likely to have low serum lipid levels. Iron‐fortified infant foods may be useful to prevent anemia in breast‐fed infants. Fat quality of infant formulas should be improved to enhance lipid status of formula‐fed infants.     

Red blood cell indices and iron status according to feeding practices in infants and young children

With the electronic counters routinely used, it has become practical to determine the concentration of hemoglobin, red cell indices, and RDW concurrently in association with transferrin saturation and ferritin in accordance with feeding practices. The 1028 infants and children aged 6 to 24 months, who had been mainly admitted with acute infectious or inflammatory diseases, were divided into three groups, i.e., children who were exclusively breast-fed more than 6 months (group A), those who had been given iron-fortified formula milk since birth (group B), and those who had been given breast milk for 5–6 months and then switched to the iron-fortified formula (group C). Children with anemia comprised 34.8% (104/299) of group A, significantly more than 5.6% (34/608) of group B and 6.6% (8,/121) of group C ( p < 0.001, respectively). Children with MCV < 70 fl comprised 39.5% (118/299) of group A, significantly more than 7.1% (43/608) of group B and 13.2% (16/121) of group C. Out of the total 146 patients with anemia, 82.2% ( n = 120) had laboratory evidence of iron deficiency, which was mostly suggested by a dietery history. The sensitivity of MCV values < 70 fl in IDA patients was 90.0%; specificity was 53.8%. The sensitivity of RDW values ≥ 15% was 83.3%; specificity was 57.7%. The positive predictive value could be increased to 97.8% by combining MCV < 70 fl and RDW ≥ 15%. The sensitivity of serum ferritin concentrations < 10ng/ml was 62.4% and specificity was 100%. The sensitivity of transferrin saturation < 12% was 72.3% and specificity was 81.3%. By combining the hemoglobin with MCV and RDW in screening for iron deficiency, the diagnostic accuracy of IDA can be increased. We support the use of appropriately iron-fortified weaning foods or the routine iron supplement starting at 6 months of age in exclusively breast-fed infants.     

福建省儿童铁缺乏症流行病学调查报告

目的 　了解我省儿童铁营养的现状 ,为使儿童缺铁性贫血的患病率在 2 0 0 0年的基础上下降 1 / 3掌握基数。方法 　在全省范围分三个层次九个流调点对 2 584名儿童作Hb(血红蛋白 )、ZPP(锌原卟啉 )及SF(血清铁蛋白 )的测定。结果 　我省儿童总的铁缺乏症发生率 37 2 3% ;铁减少发生率 2 2 87% ;缺铁性贫血发生率 1 4 36 %。结论 　铁缺乏、铁减少及缺铁性贫血的发生率 ,与饮食的合理性有密切关系。     

Soy infant formula: is it that bad?

The objective of this study is to review the indications of soy infant formula (SIF). Structured review of publications is made available through standard search engines (Pubmed,…). The medical indications for SIF are limited to galactosaemia and hereditary lactase deficiency. In the treatment of cow’s milk allergy, SIF is used for economic reasons, as extensive hydrolysates are expensive. SIF is dissuaded mainly because of its phytooestrogen content. Isoflavone serum levels are much higher in SIF‐fed infants than in breastfed or cow milk formula–fed infants. Administration of pure isoflavones to animals causes decreased fertility, but clinically relevant adverse effects of SIF in infants are not reported. Conclusion: Soy infant formula remains an option for feeding of term born infants if breastfeeding is not possible and if standard infant formula is not tolerated.     

Effect of micronutrient sprinkles on reducing anemia: a cluster-randomized effectiveness trial

OBJECTIVE To evaluate the effectiveness of Sprinkles alongside infant and young child feeding (IYCF) education compared with IYCF education alone on anemia, deficiencies in iron, vitamin A, and zinc, and growth in Cambodian infants. DESIGN Cluster-randomized effectiveness study. SETTING Cambodian rural health district. PARTICIPANTS Among 3112 infants aged 6 months, a random subsample (n?=?1350) was surveyed at baseline and 6-month intervals to age 24 months. INTERVENTION Daily micronutrient Sprinkles alongside IYCF education vs IYCF education alone for 6 months from ages 6 to 11 months. MAIN OUTCOME MEASURES Prevalence of anemia; iron, vitamin A, and zinc deficiencies; and growth via biomarkers and anthropometry. RESULTS Anemia prevalence (hemoglobin level <11.0 g/dL [to convert to grams per liter, multiply by 10.0]) was reduced in the intervention arm compared with the control arm by 20.6% at 12 months (95% CI, 9.4-30.2; P?=?.001), and the prevalence of moderate anemia (hemoglobin level <10.0 g/dL) was reduced by 27.1% (95% CI, 21.0-31.8; P?<?.001). At 12 and 18 months, iron deficiency prevalence was reduced by 23.5% (95% CI, 15.6-29.1; P?<?.001) and 11.6% (95% CI, 2.6-17.9; P?=?.02), respectively. The mean serum zinc concentration was increased at 12 months (2.88 μg/dL [to convert to micromoles per liter, multiply by 0.153]; 95% CI, 0.26-5.42; P?=?.03). There was no statistically significant difference in the prevalence of zinc and vitamin A deficiencies or in growth at any time. CONCLUSIONS Sprinkles reduced anemia and iron deficiency and increased the mean serum zinc concentration in Cambodian infants. Anemia and zinc effects did not persist beyond the intervention period. TRIAL REGISTRATION anzctr.org.au Identifier: ACTRN12608000069358.     

Iron deficiency in hospitalized infants: study of the incidence of the nutritional factor]

We report an investigation on the iron status of 209 hospitalized 3-month--2-year-old infants over a 6-month period. Hematological parameters and infant feeding practice were determined: a total of 105 infants (50.2%) were found to be iron-depleted, with (24.8%) or without (25.4%) anemia. The mode of lactation appeared to be the main determining factor in iron deficiency, as shown by the fact that during the first months, breast feeding and consumption of an iron-fortified milk formula were 50% less frequent and of shorter duration in infants with iron deficiency than in normal infants. Incorrect diet was also more frequent in iron-deficient infants. It is concluded that iron deficiency in infants could be prevented by better informing mothers in order to encourage breast-feeding and develop the use of an iron-fortified milk formula until the infant reaches the age of one year.