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This Article Full Text Full Text (PDF) All Versions of this Article: 90/1/76    most recent ajcn.2008.27350v1 Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Citation Map Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Ziegler, E. E Articles by Jeter, J. M PubMed PubMed Citation Articles by Ziegler, E. E Articles by Jeter, J. M Agricola Articles by Ziegler, E. E Articles by Jeter, J. M

Iron status of breastfed infants is improved equally by medicinal iron and iron-fortified cereal^1,2,3

¹ From the Fomon Infant Nutrition Unit, Department of Pediatrics, University of Iowa Iowa City, IA.

² Supported by the National Institutes of Health (grant HD40315), the Gerber Products Company (Fremont, MI) through the donation of the study cereals, and Mead Johnson Nutritionals through the donation of Fer-In-Sol iron drops.

³ Address correspondence to EE Ziegler, Department of Pediatrics, University of Iowa, A136 MTF 2501, Crosspark Road, Coralville, IA 52241. E-mail: ekhard-ziegler{at}uiowa.edu.

Background: Although uncommon, iron deficiency (ID) occurs in breastfed infants. The regular provision of iron may prevent ID.

Objective: The objective was to test the feasibility and effectiveness of 2 modalities of providing iron (medicinal iron or iron-fortified cereal) to breastfed infants. The study tested the hypothesis that regular provision of iron improves iron status of breastfed infants without adverse effects.

Design: In this prospective, randomized, open-label trial, breastfed infants received on a regular basis either medicinal iron (n = 48) or an iron-fortified fruit-cereal combination (n = 45) from 4 to 9 mo or no intervention (control group; n = 59). The interventions provided 7.0–7.5 mg ferrous sulfate/d. Infants were enrolled at 1 mo and were followed to 2 y. Iron-status indicators were determined periodically, stool characteristics were recorded, and growth was monitored.

Results: The regular provision of iron led to improved iron status during and for some months after the intervention. Both sources of iron were about equally effective. Iron affected stool color but had no effect on feeding-related behavior. However, medicinal iron was associated with a small but significant reduction in length gain and a trend toward reduced weight gain. ID anemia was observed in 4 infants (2.3%), most of whom had a low birth iron endowment. Mild ID was common in the second year of life.

Conclusions: Regular provision of medicinal iron or iron-fortified cereal improves the iron status of breastfed infants and may prevent ID. Both modalities are equally effective, but medicinal iron leads to somewhat reduced growth. This trial was registered at clinicaltrials.gov as NCT00760890.