Prevention of iron-deficiency anemia: Comparison of high- and low-iron formulas in term healthy infants after six months of life☆,☆☆,★,★★,♢
Section snippets
Setting
Chile is a South American democracy with a highly literate population and a comprehensive health care system. According to Chilean custom, almost all babies are breast fed in the early months and about 50% continue to breast feed up to 6 months of age. However, unmodified powdered cow's milk is distributed free of charge at all health maintenance visits as part of a long-standing, highly effective program to prevent malnutrition. Routine pediatric care and infant feeding practices in Chile
Results
Eight hundred thirty-five infants completed the trial, randomly assigned to receive low-iron formula (n = 405) or high-iron formula (n = 430). The two groups were similar with respect to demographic characteristics, infant growth, formula consumption, and most measures of breast feeding (Table I).
Empty Cell Low-iron (n = 405) High-iron (n = 430) Demographics Sex (% male) 52 52 Mother's age (yr) 26.4 ± 5.8 26.6 ± 6.1 Mother's education (yr) 9.4 ± 2.7 9.4 ± 0.6 Family members
Discussion
This study shows that newer preparations of low-iron formula are meeting infant iron needs better than expected, even in a developing country where other sources of iron are limited in the first year of life. In this study, low-iron formula was not significantly inferior to iron-fortified formula in the prevention of iron-deficiency anemia. However, iron-deficiency anemia is a late manifestation of iron deficiency. A greater proportion of infants in the low-iron group was iron deficient at 12
Acknowledgements
We are grateful to Angelica Letelier, Marisol Cayazzo, and Pamela Cea for excellent technical assistance, to the project's External Advisory Committee (Peter Dallman, Ernesto Pollitt, Fernando Viteri, and Ray Yip) for expert advice and continued counsel and support, and to the Centers for Disease Control for performing the lead determinations.
References (23)
- et al.
Absorption of fortification iron from milk formulas in infants
Am J Clin Nutr
(1986) - et al.
The influence of feeding regimens on iron status during infancy
Am J Clin Nutr
(1980) - et al.
Iron intake and iron nutritional status of infants fed iron-fortified beikost with meat
Am J Clin Nutr
(1988) - et al.
Iron status with different infant feeding regimens: relevance to screening and prevention of iron deficiency
J Pediatr
(1991) Upper limits of iron in infant formulas
J Nutr
(1989)- et al.
Does iron supplementation compromise zinc nutrition in healthy infants?
Am J Clin Nutr
(1985) - et al.
The absorption of iron as supplements in infant cereal and infant formulas
Pediatrics
(1975) - et al.
Impact on iron status of introducing cow's milk in the second six months of life
J Pediatr Gastroenterol Nutr
(1990) - et al.
Utilization of dietary iron by term infants. A study of 1048 infants from a low socioeconomic population
Am J Dis Child
(1966) - et al.
Comparative hematological response to iron fortification of a milk formula for infants
Pediatrics
(1959)
Iron-fortified infant formulas
Pediatrics
Cited by (99)
Young children formula consumption and iron deficiency at 24 months in the general population: A national-level study
2021, Clinical NutritionCitation Excerpt :This absorption depends notably on the origin of iron (haem or not), the type of other concomitant ingested food and the period of life, notably acceleration of growth [2–4,31,39]. Thus, even a small amount of iron with IFFs could improve iron status [40,41]. Second, another finding helps in understanding how YCF use could help improve iron status: the association observed between increased SF and consumption duration of IFFs since age 6 months (i.e., follow-on formula, then YCF).
Fetal liver hepcidin secures iron stores in utero
2020, BloodCitation Excerpt :Suboptimal iron availability at birth is associated with cognitive, behavioral and motor skill deficits, and increased risk of developing anemia in infancy.1-7 Some of these developmental deficits are not reversible by oral iron therapy in the neonate.8-15 In the first 6 to 9 months of age, the neonate is not fully competent in regulating dietary iron absorption in response to iron needs16,17 and depends on liver iron stores to support its growth and development.18,19
Randomized Controlled Trial of Iron-Fortified versus Low-Iron Infant Formula: Developmental Outcomes at 16 Years
2019, Journal of PediatricsCitation Excerpt :Identical appearing cans were numbered to identify randomization group. The RCT was double blind; whether the infant was receiving iron-fortified or low-iron formula was not disclosed to the families or project personnel.7,9 Continued partial breast feeding was encouraged.
Effects of non-digestive polymers used in iron encapsulation on calcium and iron apparent absorption in rats fed by infant formula
2018, Journal of Trace Elements in Medicine and BiologyPallor and Anemia
2017, Nelson Pediatric Symptom-Based DiagnosisBalancing the benefits and risks of iron fortification in resource-constrained settings
2015, Journal of Pediatrics
- ☆
From the Hematology Unit, Institute of Nutrition and Food Technology (INTA), University of Chile, Santiago, Chile; the Department of Public Health, Faculty of Medicine, University of Chile; and the Center for Human Growth and Development and Department of Pediatrics and Communicable Diseases, University of Michigan, Ann Arbor, Michigan.
- ☆☆
Supported by a grant from the National Institutes of Health (Iron Deficiency Anemia and Infant Behavior, HD 14122, Betsy Lozoff, Principal Investigator).
- ★
The low- and high-iron formulas (Similac) were donated by Abbott-Ross Laboratories, Columbus, Ohio.
- ★★
Reprint requests: Tomas Walter, MD, Hematology Unit, INTA, University of Chile, 5540 Macul, Santiago, Chile 11-138.
- ♢
9/21/85031