Age of introduction of complementary feeding and iron deficiency anemia in breastfed infants

After approximately 6 months of age, term breastfed infants are increasingly depend on other sources of iron to avoid iron deficiency anemia, due to the depletion of the low concentration of iron in human milk. The appropriate complementary feeding must include a balance composition of foods containing an adequate amount of macro- and micronutrients to avoid iron deficiency anemia. This study aimed to compare the risk of iron deficiency and growth in breastfeed infants receiving commercial fortified complementary foods or home-made. A cross-sectional study was held on April-June 2016 to evaluate infants aged 6-24 months with breast feeding intake for 6 month of life. Complementary feeding practices were determined by questionnaire; an unquantified food frequency and feeding practices questionnaire was used to determine usual food intake. Biochemical assessment of haemoglobin (Hb), serum ferritin (SF) and serum iron (SI) level were measured. Anthropometric were assessed using WHO Child Growth Standard 2005. Statistical analysis used were Chi-square Test. Thirty eight infants were enrolled, mean age of 16.2 (SD 10.5) months. 17 infants consumed commercial complementary foods and 21 infants use home-made. Infants with home-made had lower Hb level, SF and SI than those receiving commercial complementary food, and had higher risk of underweight, stunted and wasted. Infants with home-made complementary food had lower haemoglobin, serum feritin and serum iron levels than those in fortified complementary food CF; and a higher risk of stunted and wasted than children with commercial fortified CF.

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Effect of Different Complementary Feeding on Iron Deficiency Anemia and Growth in Breastfed Infants: Home-Made VS Commercial

Folia Medica Indonesiana ◽

10.20473/fmi.v55i2.24594 ◽

2021 ◽

Vol 55 (2) ◽

pp. 112

Author(s):

Roedi Irawan ◽

Nur Aisiyah Widjaja ◽

Meta Herdiana Hanindita

Keyword(s):

Iron Deficiency ◽

Iron Deficiency Anemia ◽

Serum Iron ◽

Complementary Feeding ◽

Feeding Practices ◽

Child Growth ◽

Complementary Food ◽

Deficiency Anemia ◽

Complementary Foods ◽

Breastfed Infants

After approximately 6 months of age, term breastfed infants are increasingly depend on other sources of iron to avoid iron deficiency anemia, due to the depletion of the low concentration of iron in human milk. The appropriate complementary feeding must include a balance composition of foods containing an adequate amount of macro- and micronutrients to avoid iron deficiency anemia. This study aimed to compare the risk of iron deficiency and growth in breastfeed infants receiving commercial fortified complementary foods or home-made. A cross-sectional study was held on April-June 2016 to evaluate infants aged 6-24 months with breast feeding intake for 6 month of life. Complementary feeding practices were determined by questionnaire; an unquantified food frequency and feeding practices questionnaire was used to determine usual food intake. Biochemical assessment of haemoglobin (Hb), serum ferritin (SF) and serum iron (SI) level were measured. Anthropometric were assessed using WHO Child Growth Standard 2005. Statistical analysis used were Chi-square Test. Thirty eight infants were enrolled, mean age of 16.2 (SD 10.5) months. 17 infants consumed commercial complementary foods and 21 infants use home-made. Infants with home-made had lower Hb level, SF and SI than those receiving commercial complementary food, and had higher risk of underweight, stunted and wasted. Infants with home-made complementary food had lower haemoglobin, serum feritin and serum iron levels than those in fortified complementary food CF; and a higher risk of stunted and wasted than children with commercial fortified CF.

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Breastfeeding exclusively and iron deficiency anemia during the first 6 months of age

Revista da Associação Médica Brasileira ◽

10.1590/1806-9282.60.01.006 ◽

2014 ◽

Vol 60 (1) ◽

pp. 18-22 ◽

Cited By ~ 19

Author(s):

Rosa F.S.V. Marques ◽

José A.A.C. Taddei ◽

Fábio A. Lopez ◽

Josefina A.P. Braga

Keyword(s):

Risk Factors ◽

Cohort Study ◽

Iron Deficiency ◽

Iron Deficiency Anemia ◽

Exclusive Breastfeeding ◽

Deficiency Anemia ◽

Term Infants ◽

Breastfed Infants ◽

Growth Development ◽

Associated Risk Factors

Objective The objective was to determine the prevalence of iron deficiency and iron deficiency anemia among exclusively breastfed infants from one to six months of life and to identify associated risk factors. Methods This is a cohort study of the hemoglobin and serum ferritin levels of 102 healthy full-term infants, weighing more than 2500 grams (5.5 pounds) at birth, evaluated for growth development and supported to promote exclusive breastfeeding. Hemoglobin and ferritin levels were measured in the first, fourth, and sixth months of life. The hemoglobin and ferritin levels of the mothers were also measured in the first month postpartum. Results At four months, 5.7% presented iron deficiency and 3.4% had iron deficiency anemia. At six months, the percentage of children with iron deficiency increased more than four times, reaching 26.1%, while iron deficiency anemia was present in 23.9% of the infants studied. Iron deficiency at six months of age was significantly correlated to growth velocity. Conclusion According to the results of this study, exclusive breastfeeding protects infants from iron deficiency and iron deficiency anemia for the first four months of life. After this age, in accordance with the literature, the findings of this study demonstrated an increase in anemia and iron deficiency rates, adding to evidence that supports the monitoring of iron levels in exclusively breastfed children presenting higher weight gains beginning at four months of age.

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Effect of Iron Supplementation on Development of Iron Deficiency Anemia in Breastfed Infants

Journal of Tropical Pediatrics ◽

10.1093/tropej/fms028 ◽

2012 ◽

Vol 58 (6) ◽

pp. 481-485 ◽

Cited By ~ 3

Author(s):

G. Gokcay ◽

T. Ozden ◽

Z. Karakas ◽

N. Karabayir ◽

I. Yildiz ◽

...

Keyword(s):

Iron Deficiency ◽

Iron Deficiency Anemia ◽

Iron Supplementation ◽

Deficiency Anemia ◽

Breastfed Infants

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Consumption of Fortified Infant Cereals and Association with Anemia and Growth: Insights from Demographic Health Surveys (DHS) Data Analysis

10.20944/preprints202011.0191.v1 ◽

2020 ◽

Author(s):

Patrick Detzel ◽

Alberto Prieto-Patron

Keyword(s):

Iron Deficiency ◽

Iron Deficiency Anemia ◽

Health Surveys ◽

Household Wealth ◽

Deficiency Anemia ◽

Z Score ◽

Growth Status ◽

Breastfed Infants ◽

Positive Effects ◽

Height For Age

After approximately 6 months of age, term breastfed infants are increasingly depending on other sources of iron to avoid iron deficiency anemia. The appropriate complementary feeding must include a balance composition of foods containing an adequate amount of macro- and micronutrients to reduce the risk of iron deficiency anemia. This study aims to compare the anemia and growth status of infants receiving commercial fortified infant cereals (FIC) with infants not receiving them. We use all complete multiple Demographic Health Surveys (DHS) from 2005 to 2018 to understand global infant feeding patterns. To better control for the strong household wealth effect in nutritional choices and possibly health awareness, we use propensity score technique as applied in outcome research to better control the effect of covariates. After matching and controlling for confounders, we did find a significant association between reduced risk of anemia and consumption of FIC. After matching and adjusting for confounders the small but positive effects of consumption of FIC on Height for age z-score and Weight for Height Z-score are no longer statistically significant.

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The effect of early weaning on iron status among exclusively breastfed infants

Zanco Journal of Medical Sciences ◽

10.15218/zjms.2021.024 ◽

2021 ◽

Vol 25 (2) ◽

pp. 591-598

Author(s):

Kayfi Aziz ◽

Dlair Chalabi

Keyword(s):

Iron Deficiency ◽

Iron Deficiency Anemia ◽

Exclusive Breastfeeding ◽

Urban Areas ◽

Iron Status ◽

Hematological Parameters ◽

Study Groups ◽

Deficiency Anemia ◽

Early Weaning ◽

Breastfed Infants

Background and objective: Exclusive breastfeeding is recommended for all newborns to gain optimal physical and neurodevelopmental growth. Despite all its advantages, prolonged breastfeeding alone without weaning places the child at risk of iron deficiency and iron deficiency anemia, which is the commonest micronutrient deficiency worldwide among infants. We investigated the effect of early weaning on the iron status of infants. Methods: We selected 100 infants; all of them were six months old. Fifty of them were exclusively breastfed for four months and started weaning between four to six months while continued to breastfeed till the age of six months (early-weaning group). Another 50 infants were exclusively breastfed for six months without starting weaning (no-weaning group). Then we investigated both groups at the age of six months for both iron and hematological studies. Results: In the present study, both study groups shared some similarities. In both groups, females accounted for more than half of the cases, the majority of the infants were residing in the urban areas, and most of the infants were delivered by cesarean section. The final result of the iron study and hematological parameters in the no-weaning group was significantly lower as compared to the early-weaning group. Both serum ferritin and serum iron were 7.42 ng/ml and 25.66 µg/dl, respectively, in the no-weaning group and were 23.94 ng/ml and 46.98 µg/dl respectively in the early-weaning group. Hemoglobin level was 10.84 gm/dl in the no-weaning group compared to 11.54 gm/dl in the early-weaning group. Conclusion: We concluded that early weaning had a great role in the prevention of both iron deficiency and iron deficiency anemia in exclusively breastfed infants. Keywords: Exclusive breastfeeding; Early weaning; Iron status.

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Effectiveness of Starting Weaning at 4 Months Compared to 6 Months to Reduce Anemia among Infants: An Evidence-Based Case Report

World Nutrition Journal ◽

10.25220/wnj/v02.i1.0005 ◽

2018 ◽

Vol 2 (1) ◽

pp. 32

Author(s):

Nadya Johanna ◽

Taufik MS ◽

Maulana MS ◽

Samban JLT ◽

Nurul Ratna Manikam

Keyword(s):

Iron Deficiency ◽

Risk Reduction ◽

Iron Deficiency Anemia ◽

Complementary Feeding ◽

Absolute Risk ◽

Hemoglobin Concentration ◽

Absolute Risk Reduction ◽

Deficiency Anemia ◽

Number Needed To Treat ◽

Significant Difference

Aim: Comparing the effectiveness of introducing complementary foods at four months of age compared to six months of age to reduce the incidence of iron-deficiency anemia among healthy full-term infants.Methods: A systematic search was conducted on PubMed, EBSCO, and Cochrane on 28th September 2017. After the selection of title and abstract was done using the predefined inclusion and exclusion criteria. Twelve original articles were found, but after full-text assessment, only two studies were considered relevant. These two studies were further critically appraised for its validity, importance, and applicability to measure its usability degree in this study.Results: These two included studies showed no significant difference of iron-deficiency anemia incidence between the two complementary feeding groups. This can be shown by the absolute risk reduction which varied from -3.1% to 13.4%, relative risk reduction which varied from -22.8% to 18.4%, and number needed to treat which varied from -33 to 8. Both studies found that the ferritin was significantly different between both groups. However, the hemoglobin concentration was significantly higher in the complementary fed group in only one study.Conclusion: The introduction of complementary feeding at 4 months of age is not effective to reduce the incidence of iron-deficiency anemia.

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Effectiveness of Starting Weaning at 4 Months Compared to 6 Months to Reduce Anemia among Infants: An Evidence-Based Case Report

World Nutrition Journal ◽

10.25220/wnj.v02.i1.0005 ◽

2018 ◽

Vol 2 (1) ◽

pp. 32

Author(s):

Nadya Johanna ◽

Taufik MS ◽

Maulana MS ◽

Samban JLT ◽

Nurul Ratna Manikam

Keyword(s):

Iron Deficiency ◽

Risk Reduction ◽

Iron Deficiency Anemia ◽

Complementary Feeding ◽

Absolute Risk ◽

Hemoglobin Concentration ◽

Absolute Risk Reduction ◽

Deficiency Anemia ◽

Number Needed To Treat ◽

Significant Difference

Aim: Comparing the effectiveness of introducing complementary foods at four months of age compared to six months of age to reduce the incidence of iron-deficiency anemia among healthy full-term infants.Methods: A systematic search was conducted on PubMed, EBSCO, and Cochrane on 28th September 2017. After the selection of title and abstract was done using the predefined inclusion and exclusion criteria. Twelve original articles were found, but after full-text assessment, only two studies were considered relevant. These two studies were further critically appraised for its validity, importance, and applicability to measure its usability degree in this study.Results: These two included studies showed no significant difference of iron-deficiency anemia incidence between the two complementary feeding groups. This can be shown by the absolute risk reduction which varied from -3.1% to 13.4%, relative risk reduction which varied from -22.8% to 18.4%, and number needed to treat which varied from -33 to 8. Both studies found that the ferritin was significantly different between both groups. However, the hemoglobin concentration was significantly higher in the complementary fed group in only one study.Conclusion: The introduction of complementary feeding at 4 months of age is not effective to reduce the incidence of iron-deficiency anemia.

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PROPHYLAXIS OF IRON DEFICIENCY ANEMIA IN INFANTS AND TODLLERS: A MULTIDISCIPLINARY APPROACH (LITERATURE REVIEW)

Medicinos teorija ir praktika ◽

10.15591/mtp.2015.009 ◽

2014 ◽

Vol 21 (1) ◽

pp. 65-72

Author(s):

Audronė Mulevičienė ◽

Lina Ragelienė

Keyword(s):

Iron Deficiency ◽

Iron Deficiency Anemia ◽

Iron Homeostasis ◽

Deficiency Anemia ◽

Important Place ◽

Iron Supplements ◽

Breastfed Infants ◽

Cord Clamping ◽

Infancy And Childhood ◽

Umbilical Cord Clamping

Iron deficiency is one of the most common micronutrient deficiency in infancy and childhood. The main long lasting effect of iron deficiency anemia in infancy is poor neurocognitive development. Despite early treatment with iron supplements, lower cognitive performance remains even after reaching adulthood. Therefore iron deficiency anemia should be regarded not only as a haematological problem, but as a result of imperfections in the social system. Preventive strategies occupie most important place ensuring the normal development of the child. The main recommendations regarding iron deficiency prophylaxis are as follows: delayed umbilical cord clamping, exclusive breastfeeding until 6 months of age, iron fortified formula for non-breastfed infants, iron supplements for infants with risk factors, complementary feeding starting at 6 months of age, avoiding cow‘s milk until 12 months of age and restriction of intake to less than 500 ml per day for toddlers. The article analyzes iron deficiency impact on the development of central nervous system, the characteristics of iron homeostasis in children, iron deficiency anemia causes and pathophysiological mechanisms. Based on the latest scientific literature iron deficiency prevention strategies and practical recommendations are provided.

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