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Date: | Tue, 12 Oct 2010 09:02:20 -0400 |
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Dear all:
First a public thanks to the three people who sent me this report. I will continue to read it.
I am dashing off to a consultation so I will just mention was I spotted in my first skim through the first few pages -- the logic behind the blanket recommendation of four months is on page 5. Instead of having clinicians do what they should do -- screen and target earlier supplementation to those at risk -- they simply give a blanket recommendation. In fact, they have no solid evidence to link up supplementation of all infants at four months with better results at nine months. They extrapolate through a series of plausibility arguments. By those same arguments I would argue for screening of those with risk factors and only supplementing those -- BUT I would also argue that they should be conducting clinical trials to prove it. I'll keep reading, but I doubt that there is any clinical trial that actually provides sufficient evidence that this is the best approach.
Also, there is a nice little chart that shows why hemoglobin alone is not sufficient to detect iron deficiency (Table 2 on page 4).
I always think it is important to read through all the details of these types of reports. I learned a lot when I plowed through the entire report of the committee that recommended vitamin D supplementation. It was tough but worth it.
Best, Susan E. Burger, MHS, PhD, IBCLC
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