Document Detail

Iron and breastfeeding.
MedLine Citation:
PMID:  11339160     Owner:  NLM     Status:  MEDLINE    
Given the importance of iron nutrition during the first year of life, there are surprisingly few true, randomized, controlled studies addressing this issue; however, it seems that iron deficiency is unlikely in full-term, breastfed infants during the first 6 months of life because these infants' body iron stores are sufficient to meet requirements. After this time, many infants exhaust their iron stores and become dependent on a secondary dietary iron supply. Although iron deficiency is a significant nutritional problem worldwide, most of the adverse effects of iron deficiency in this age group are hypothetical and rely on extrapolation from animal studies or studies at different ages. This, however, also is true of most of the adverse effects of iron excess in this age group. Given this uncertainty, it seems prudent to use the lowest dose of iron that prevents iron-deficiency anemia. Currently, the best evidence is that this is achieved by prolonged breastfeeding, avoidance of unfortified formulas and cow's milk, and the introduction of iron-fortified and vitamin C-fortified weaning foods at approximately 6 months of age. Despite much research, there are many areas of uncertainty regarding iron supplementation of infants, including that: 1. The optimal age for introducing iron-fortified supplemental foods is poorly defined and should be further evaluated. 2. The natural history of iron deficiency and iron-deficiency anemia during the first year of life is unclear, as are the possible long-term effects of this, especially on developmental outcome. 3. The biologic variability among infants and among their mothers that allows many infants who do not receive iron-fortified foods to prevent iron deficiency while receiving only human milk throughout the first year of life is intriguing and warrants additional study. 4. The iron requirements of small-for-gestational-age, term infants are unknown. Their iron requirements are likely to be higher than those of average term infants, but whether iron supplements are required is unclear. 5. The optimum amount of dietary iron in the weaning diet needs to be further defined. Similarly, the optimal source and amount of iron in infant formulas given to infants who receive a mixture of human milk and formula is unclear.
I J Griffin; S A Abrams
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Pediatric clinics of North America     Volume:  48     ISSN:  0031-3955     ISO Abbreviation:  Pediatr. Clin. North Am.     Publication Date:  2001 Apr 
Date Detail:
Created Date:  2001-05-07     Completed Date:  2001-05-21     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  0401126     Medline TA:  Pediatr Clin North Am     Country:  United States    
Other Details:
Languages:  eng     Pagination:  401-13     Citation Subset:  AIM; IM    
Department of Pediatrics, Section of Neonatology and US Department of Agriculture/Agricultural Research Service (USDA/ARS) Children's Nutrition Research Center, Baylor College of Medicine, Houston, Texas, USA.
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MeSH Terms
Age Factors
Anemia, Iron-Deficiency / etiology*,  metabolism,  therapy*
Breast Feeding / adverse effects*
Evidence-Based Medicine
Infant Nutritional Physiological Phenomena
Infant, Newborn
Intestinal Absorption
Iron, Dietary / administration & dosage,  metabolism
Nutritional Requirements
Pediatrics / methods
Primary Prevention / methods
Reg. No./Substance:
0/Iron, Dietary

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