An important factor that was left out of the iron sufficiency equation.
Research has indicated that introduction of solid foods before age 7
months increases the risk of anemia in exclusively breastfed babies from
0% in those who start solids after 7 months, to 30% in those who start
solids at 5-6 months (Piacane, A et al.: Iron status in breastfed
infants, J Pediatr 127:429-431, 1995.)  This is not surprising in light
of findings that solid foods inhibit the absorbtion of iron from human
milk (Oski, F. and Landau, F.  Inhibition of iron absorbtion from human
milk by baby food.  Am J Dis Child 1980; 134:459-60.)
        It is not a trivial thing to give iron to a breastfeeding baby, as the
exogenous iron saturates lactoferrin, leaving it unable to perform it's
antibacterial functions. (Mevissen-Verhage, EAE, et al.: Effect of iron
on neonatal gut flora during the first three months of life, Eur J Clin
Microbiol 4:273-78, 1985. among others).
        Studies of populations that breastfeed exvlusively without early solids
have not found significant risks of anemia:
McMillan, JA , Landaw, SA, and Oski, FA:  Iron sufficiency in breast-fed
infants and the availability of iron from human milk, Pediatrics
58:686-92, 1976.
Pastel, RA, Howanitz, PJ, and Oski, FA:  Iron sufficiency with prolonged
exclusive breast-feeding in Peruvian infants, Clin Pediatr 20:625-26,
1981.
Woodruff, CW, Latham, C, and McDavid, S: Iron nutrition in the
breast-fed infant, J Pediatr 90:36-38, 1977.
--
Catherine Watson Genna, IBCLC  New York City  mailto:[log in to unmask]

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