Katy M Clark1, Ming Li2, Bingquan Zhu3, Furong Liang2, Jie Shao3, Yueyang Zhang2, Chai Ji3, Zhengyan Zhao3, Niko Kaciroti1, Betsy Lozoff4. 1. Center for Human Growth and Development, University of Michigan, Ann Arbor, MI. 2. Department of Pediatrics, Peking University First Hospital, Beijing, China. 3. Department of Child Health Care, Zhejiang University Children's Hospital, Hangzhou, China. 4. Center for Human Growth and Development, University of Michigan, Ann Arbor, MI; Department of Pediatrics and Communicable Diseases, CS Mott Children's Hospital, University of Michigan, Ann Arbor, MI.
Abstract
OBJECTIVE: To assess associations between breastfeeding and iron status at 9 months of age in 2 samples of Chinese infants. STUDY DESIGN: Associations between feeding at 9 months of age (breastfed as sole milk source, mixed fed, or formula fed) and iron deficiency anemia (IDA), iron deficiency, and iron sufficiency were determined in infants from Zhejiang (n = 142) and Hebei (n= 813) provinces. Iron deficiency was defined as body iron < 0 mg/kg, and IDA as iron deficiency + hemoglobin < 110 g/L. Multiple logistic regression assessed associations between feeding pattern and iron status. RESULTS: Breastfeeding was associated with iron status (P < .001). In Zhejiang, 27.5% of breastfed infants had IDA compared with 0% of formula-fed infants. The odds of iron deficiency/IDA were increased in breastfed and mixed-fed infants compared with formula-fed infants: breastfed vs formula-fed OR, 28.8 (95% CI, 3.7-226.4) and mixed-fed vs formula-fed OR, 11.0 (95% CI, 1.2-103.2). In Hebei, 44.0% of breastfed infants had IDA compared with 2.8% of formula-fed infants. With covariable adjustment, odds of IDA were increased in breastfed and mixed-fed groups: breastfed vs formula-fed OR, 78.8 (95% CI, 27.2-228.1) and mixed-fed vs formula-fed OR, 21.0 (95% CI, 7.3-60.9). CONCLUSIONS: In both cohorts, the odds of iron deficiency/IDA at 9 months of age were increased in breastfed and mixed-fed infants, and iron deficiency/IDA was common. Although the benefits of breastfeeding are indisputable, these findings add to the evidence that breastfeeding in later infancy identifies infants at risk for iron deficiency/IDA in many settings. Protocols for detecting and preventing iron deficiency/IDA in breastfed infants are needed. TRIAL REGISTRATION: ClinicalTrials.gov: NCT00642863 and NCT00613717.
OBJECTIVE: To assess associations between breastfeeding and iron status at 9 months of age in 2 samples of Chinese infants. STUDY DESIGN: Associations between feeding at 9 months of age (breastfed as sole milk source, mixed fed, or formula fed) and iron deficiency anemia (IDA), iron deficiency, and iron sufficiency were determined in infants from Zhejiang (n = 142) and Hebei (n= 813) provinces. Iron deficiency was defined as body iron < 0 mg/kg, and IDA as iron deficiency + hemoglobin < 110 g/L. Multiple logistic regression assessed associations between feeding pattern and iron status. RESULTS: Breastfeeding was associated with iron status (P < .001). In Zhejiang, 27.5% of breastfed infants had IDA compared with 0% of formula-fed infants. The odds of iron deficiency/IDA were increased in breastfed and mixed-fed infants compared with formula-fed infants: breastfed vs formula-fed OR, 28.8 (95% CI, 3.7-226.4) and mixed-fed vs formula-fed OR, 11.0 (95% CI, 1.2-103.2). In Hebei, 44.0% of breastfed infants had IDA compared with 2.8% of formula-fed infants. With covariable adjustment, odds of IDA were increased in breastfed and mixed-fed groups: breastfed vs formula-fed OR, 78.8 (95% CI, 27.2-228.1) and mixed-fed vs formula-fed OR, 21.0 (95% CI, 7.3-60.9). CONCLUSIONS: In both cohorts, the odds of iron deficiency/IDA at 9 months of age were increased in breastfed and mixed-fed infants, and iron deficiency/IDA was common. Although the benefits of breastfeeding are indisputable, these findings add to the evidence that breastfeeding in later infancy identifies infants at risk for iron deficiency/IDA in many settings. Protocols for detecting and preventing iron deficiency/IDA in breastfed infants are needed. TRIAL REGISTRATION: ClinicalTrials.gov: NCT00642863 and NCT00613717.
Authors: Tsunenobu Tamura; Robert L Goldenberg; Jinrong Hou; Kelley E Johnston; Suzanne P Cliver; Sharon L Ramey; Kathleen G Nelson Journal: J Pediatr Date: 2002-02 Impact factor: 4.406
Authors: Jie Shao; Jingan Lou; Raghavendra Rao; Michael K Georgieff; Niko Kaciroti; Barbara T Felt; Zheng-Yan Zhao; Betsy Lozoff Journal: J Nutr Date: 2012-09-26 Impact factor: 4.798
Authors: D B Hipgrave; X Fu; H Zhou; Y Jin; X Wang; S Chang; R W Scherpbier; Y Wang; S Guo Journal: Eur J Clin Nutr Date: 2014-06-04 Impact factor: 4.016