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Predominantly breast-fed infants experience fewer gastrointestinal infections but a higher incidence of iron deficiency |
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Although it is well known that breast-feeding protects infants from infections and promotes optimal growth and development, total iron concentration in human milk is low. |
Iron deficiency (ID) can occur when there is not enough iron in the diet to produce hemoglobin, the component of red blood cells that circulates oxygen. For infants, long-term health consequences associated with ID include diminished cognitive, motor, and behavioral functioning. Factors that contribute to ID include poor maternal iron status during pregnancy, early consumption of cow milk, rapid infant growth, low socioeconomic status, and providing low-iron weaning foods. In the August 2008 issue of The Journal of Nutrition, Monterrosa et al. provides evidence that human milk is best for infants, particularly for those living in disadvantaged environments. A prospective study of infants born at a public hospital in Guadalajara, Mexico was conducted to assess the relationship between infant feeding practices, iron status, and likelihood of a gastrointestinal (GI) infection during the first 6 months of life. |
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To test
the hypothesis that predominantly breast-fed infants experience fewer GI
infections but are at increased risk of ID or anemia compared with infants who
were regularly fed iron-fortified formula, 357 healthy mothers were asked to
participate in the study. Of the 250 women who enrolled, 154 (62%) completed
the entire 6 mo study period. Infant feeding practices were assessed and
infants were grouped by the amount of human milk received throughout the 6 mo
period. The formula-fed group (n = 50) received very little human milk; the
partially breast-fed group (n = 55) received moderate amounts of human milk
along with formula; and the predominantly breast-fed group (n = 49) received
substantial amounts of human milk for at least 5 mo with small amounts of
formula. All infant formulas were iron fortified (8-12 mg/L).
Iron status (hemoglobin and serum ferritin
concentration) was assessed at 6 mo. Infant weight and length were recorded
monthly.
Episodes of GI infections were determined by asking mothers if in the previous
month the infant had at least 2 of the following symptoms with a minimum
duration of 2 days: fever, decreased stool consistency, increased stool
frequency, or vomiting.
As predicted, infants in the
formula-fed group
had a lower incidence of ID and a higher incidence of GI infection. Hemoglobin
and serum ferritin concentrations were significantly higher in the
formula-fed group
(122 g/L and 52
mg/L,
respectively) than the partially
breast-fed (119 g/L and 45
mg/L,
respectively) and predominantly
breast-fed (116 g/L and 26
mg/L,
respectively) groups. Approximately 17% of formula-fed infants had one or more
GI infection during the 6 mo study period, compared with 33% and 34% of
partially breast-fed
and predominantly breast-fed
infants, respectively. Results of this study support the
hypothesis that human milk protects against gastrointestinal infections, but may
increase the risk of developing ID. It is recommended that public health
policies encourage breast-feeding, while assuring adequate iron status through
prenatal, perinatal, and postnatal nutrition strategies.
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| Source: http://jn.nutrition.org/ |
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