Effect of an iron fortified milk on morbidity in infancy. A field trial

doi:10.1016/S0271-5317(87)80160-4

Nutrition Research

Volume 7, Issue 9, September 1987, Pages 915-922

https://doi.org/10.1016/S0271-5317(87)80160-4 Get rights and content

Abstract

The effect of an iron fortified milk on gastrointestinal and respiratory illness was evaluated in a prospective longitudinal field trial in which infants were provided beginning at 3 and continuing through 15 months of age with, either iron fortified 15 mg Fe/l (n=53) or non fortified (n=47) milk. Gastrointestinal and respiratory symptoms and signs were recorded daily. The mean incidence of diarrhea was 1.1 and 1.2 episodes per year per child in the fortified and non fortified groups, respectively. The figures per child/year for respiratory infections were 3.9 and 3.9 respectively. The results demonstrate that iron fortification at doses sufficient to significantly eradicate iron deficiency anemia is not associated with an increased incidence of gastrointestinal and respiratory illness.

References (19)

MasaweAEJ et al.
Infections in iron deficiency and other types of anaemia in the tropics
Lancet
(1974)
ChandraRK
Trace elements and immune response
Immunol Today
(1983)
RiosE et al.
Evaluation of iron status and prevalence of iron deficiency in infants in Chile
StekelA et al.
Prevention of iron deficiency in infants by milk fortification
HamillPVV et al.
Physical growth: National Center for Health Statistics percentiles
Am J Clin Nutr
(1979)
MacKayHMM
Anemia in infancy: its prevalence and preven tion
Arch Dis Child
(1928)
CantwellRJ
Iron deficiency anemia of infancy
Clin Pediatr
(1972)
BarryDMJ et al.
Increased incidence of gram negative neonatal sepsis with IM iron administration
Pediatrics
(1977)
FarmerK et al.
Administration of parenteral iron to newborn infants
Arch Dis Child
(1976)

There are more references available in the full text version of this article.

Cited by (12)

A randomized trial of two levels of iron supplementation and developmental outcome in low birth weight infants
2001, Journal of Pediatrics
Citation Excerpt :
Nonetheless, there was no evidence of increased lipid peroxidation in the high iron group, which suggests that the enzyme was functioning within normal ranges. The effect of supplemental iron on infection rates is controversial.29,30 In the current study, total respiratory tract infection rates were increased in the high iron group.
Objectives: To investigate the effect of increased iron intakes on hematologic status and cognition in low birth weight infants. Study design: We randomly assigned 58 infants to receive formula with 13.4 mg iron/L (normal iron) or 20.7 mg iron/L (high iron). At baseline, discharge, and at 3, 6, 9, and 12 months’ corrected age, we assessed anthropometry; infections; red blood cell hemoglobin, catalase, glutathione peroxidase, red blood cell fragility (hydrogen peroxide test), and superoxide dismutase values; plasma malondialdehyde, ferritin, iron, transferrin, zinc and copper levels; and diet intake. Griffiths’ Development Assessment was done at 3, 6, 9, and 12 months only. Results: No statistical differences (P <.05) were noted for weight, catalase or malondialdehyde levels, red blood cell fragility, or Griffith’s Development Assessment. Iron intakes were greater in the high iron group except at 12 months. Hemoglobin (high iron, 123 ± 9; normal iron, 118 ± 8) was not different at 3 months (P =.07). Plasma zinc levels (high iron, 70 ± 14; normal iron, 89 ± 27) and copper levels (high iron, 115 ± 26; normal iron, 132 ± 27; P =.06) at 12 months suggested inhibition of absorption by high iron formula. Glutathione peroxidase levels were higher in the high iron group. The total number of respiratory tract infections was greater in the high iron group (3.3 ± 0.9) than in the normal iron group (2.5 ± 0.9). Conclusion: In terms of cognitive outcome, there is no advantage associated with elevated iron intake for low birth weight infants. (J Pediatr 2001;139:254-60)
Impact of iron fortification of milk formulas on infants growth and health
1995, Nutrition Research
The current controversy over the need of iron supplementation lead us to study the growth and health of infants given iron-fortified (6.5mg/l) and non-fortified (0.5mg/l) milk-based formulas during the first six months. The two formulas were identical except for iron content. Healthy, term infants with a mean age of 1.3 months and not being breast-fed were randomly allocated to receive iron-fortified formula (n=164) and non-fortified formula (n=158), being followed up to the age of one year. Data were compiled by health visitors and physicians from their notes and by asking the parents. Our results give no clear evidence of clinical benefit from iron fortification. It is suggested, that iron is not needed in the formula consumed during the first six months of life. Because formulas are widely and increasingly used, further trials of iron fortification in different circumstances are needed.
Iron status with different infant feeding regimens: Relevance to screening and prevention of iron deficiency
1991, The Journal of Pediatrics
The objective of this study was to evaluate the benefit of screening for anemia in infnats in relation to their previous diet. The iron status of 854 nine-month-old infants on three different feeding regimens and on a regimen including iron dextran injection was determined by analysis of hemoglobin, serum ferritin, and erythrocyte protoporphyrin levels and of serum transferrin saturation. Infants were categorized as having iron deficiency if two or three of the three biochemical test results were abnormal and as having iron deficiency anemia if, in addition, the hemoglobin level was <110 gm/L. The prevalence of iron deficiency was highest in infants fed cow milk formula without added iron (37.5%), intermediate in the group fed human milk (26.5%), much lower in those fed cow milk formula with added iron (8.0%), and virtually absent in those injected with iron dextran (1.3%). The corresponding values for iron deficlency anemia were 20.2%, 14.7%, 0.6%, and 0%, respectively. The use of iron supplements is therefore justified in infnats fed cow milk formula without added iron, even when there is no biochemical evidence of iron deficiency. The low prevalence of iron deficiency in the group fed iron-fortified formula appears to make it unnecessary to screen routinely for anemia in such infants. These results also support the recommendation that infants who are exclusively fed human milk for 9 months need an additional source of iron after about 6 months of age.
Nutrient supplementation for prevention of viral respiratory tract infections in healthy subjects: A systematic review and meta-analysis
2022, Allergy: European Journal of Allergy and Clinical Immunology
Effect of iron-fortified foods on hematologic and biological outcomes: Systematic review of randomized controlled trials
2012, American Journal of Clinical Nutrition
Iron fortification of infant formula
2000, Nutrition Research Reviews

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Original article: Studies in humansEffect of an iron fortified milk on morbidity in infancy. A field trial

Abstract

Lancet

Immunol Today

Am J Clin Nutr

Anemia in infancy: its prevalence and preven tion

Arch Dis Child

Iron deficiency anemia of infancy

Clin Pediatr

Increased incidence of gram negative neonatal sepsis with IM iron administration

Pediatrics

Administration of parenteral iron to newborn infants

Arch Dis Child

Original article: Studies in humans
Effect of an iron fortified milk on morbidity in infancy. A field trial