Document Detail

Iron-fortified vs low-iron infant formula: developmental outcome at 10 years.
MedLine Citation:
PMID:  22064877     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To assess long-term developmental outcome in children who received iron-fortified or low-iron formula.
DESIGN: Follow-up at 10 years of a randomized controlled trial (1991-1994) of 2 levels of formula iron. Examiners were masked to group assignment.
SETTING: Urban areas around Santiago, Chile.
PARTICIPANTS: The original study enrolled healthy, full-term infants in community clinics; 835 completed the trial. At 10 years, 473 were assessed (56.6%).
INTERVENTION: Iron-fortified (mean, 12.7 mg/L) or low-iron (mean, 2.3 mg/L) formula from 6 to 12 months.
MAIN OUTCOME MEASURES: We measured IQ, spatial memory, arithmetic achievement, visual-motor integration, visual perception, and motor functioning. We used covaried regression to compare iron-fortified and low-iron groups and considered hemoglobin level before randomization and sensitivity analyses to identify 6-month hemoglobin levels at which groups diverged in outcome.
RESULTS: Compared with the low-iron group, the iron-fortified group scored lower on every 10-year outcome (significant for spatial memory and visual-motor integration; suggestive for IQ, arithmetic achievement, visual perception, and motor coordination; 1.4-4.6 points lower; effect sizes, 0.13-0.21). Children with high 6-month hemoglobin levels (> 12.8 g/dL [to convert to grams per liter, multiply by 10]) showed poorer outcome on these measures if they received iron-fortified formula (10.7-19.3 points lower; large effect sizes, 0.85-1.36); those with low hemoglobin levels (< 10.5 g/dL) showed better outcome (2.6-4.5 points higher; small but significant effects, 0.22-0.36). High hemoglobin levels represented 5.5% of the sample (n = 26) and low hemoglobin levels represented 18.4% (n = 87).
CONCLUSION: Long-term development may be adversely affected in infants with high hemoglobin levels who receive 12.7 mg/L of iron-fortified formula. Optimal amounts of iron in infant formula warrant further study.
Betsy Lozoff; Marcela Castillo; Katy M Clark; Julia B Smith
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural     Date:  2011-11-07
Journal Detail:
Title:  Archives of pediatrics & adolescent medicine     Volume:  166     ISSN:  1538-3628     ISO Abbreviation:  Arch Pediatr Adolesc Med     Publication Date:  2012 Mar 
Date Detail:
Created Date:  2012-03-06     Completed Date:  2012-04-24     Revised Date:  2014-09-17    
Medline Journal Info:
Nlm Unique ID:  9422751     Medline TA:  Arch Pediatr Adolesc Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  208-15     Citation Subset:  AIM; IM    
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MeSH Terms
Follow-Up Studies
Food, Fortified*
Hemoglobins / analysis
Infant Formula / chemistry*
Iron, Dietary / administration & dosage*
Motor Skills
Psychomotor Performance
Grant Support
HD14122/HD/NICHD NIH HHS; HD33487/HD/NICHD NIH HHS; R01 HD033487/HD/NICHD NIH HHS; R01 HD033487-03/HD/NICHD NIH HHS; R01 HD033487-03S1/HD/NICHD NIH HHS; R01 HD033487-04/HD/NICHD NIH HHS; R01 HD033487-04S1/HD/NICHD NIH HHS; R01 HD033487-05/HD/NICHD NIH HHS; R01 HD033487-06/HD/NICHD NIH HHS; R01 HD033487-07/HD/NICHD NIH HHS; R01 HD033487-08/HD/NICHD NIH HHS; R01 HD033487-09/HD/NICHD NIH HHS; R01 HD033487-10A2/HD/NICHD NIH HHS; R01 HD033487-11/HD/NICHD NIH HHS; R01 HD033487-12/HD/NICHD NIH HHS; R01 HD033487-13/HD/NICHD NIH HHS; R01 HD033487-14/HD/NICHD NIH HHS
Reg. No./Substance:
0/Hemoglobins; 0/Iron, Dietary
Comment In:
Arch Pediatr Adolesc Med. 2012 Mar;166(3):285-6   [PMID:  22064873 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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