Carol asks:
>I work on a Neonatal ICU and one of the neonatologists there who is
>breastfeeding her baby and working part time asked me about iron
>deficiency in breastfed babies.
<snip>
>Her concern was
>that mothers might turn to iron supplemented infant formulas once they
>are no longer exclusively breastfeeding their babies. She is reluctant
>to do this as her daughter although born premature has avoided any
>formula so far. If you are no longer exclusively breastfeeding your baby
>how do you ensure an adequate iron intake after six months?
The need for iron has been exaggerated, according to some experts, and
this was the thinking behind the following study which shows that there is
no benefit in growth or development of older babies given iron-fortified
formula - though there was no comparison with breastfed babies. In other
words, yes, these babies' 'iron status' was higher....but so what?
I am in touch with a mother whose little boy was made ill with follow on -
he was extremely consiptated and miserable. She called the manufacturers
who said, yes, it was the follow on, take him off it, and sorry, sorry,
sorry.....sent her a HUGE freebie box of regular formula. She switched him
back to regular formula and he was fine.
There is iron in cereal, whether it is fortified or not, isn't there?
The iron in breastmilk may be small, but its bioavailability is high.
Cynical old moi thinks the anxiety about iron is fuelled by the formula
manufacturers who want to sell iron-fortified formula.
We don't even have it here except as follow on (presumably the formula
tested in this study ).
Arch Dis Child 1999;81:247-252 ( September )
Iron fortified follow on formula from 9 to 18 months improves iron status
but not development or growth: a randomised trial
Ruth Morleyb, Rebecca Abbotta, Susan Fairweather-Taitc, Una MacFadyend,
Terence Stephensone, Alan Lucasa
a MRC Childhood Nutrition Research Centre, Institute of Child Health,
30 Guilford Street, London WC1N 1EH, UK, b Menzies Centre for Population
Health Research, Tasmania and Clinical Epidemiology and Biostatistics Unit,
University of Melbourne Department of Paediatrics, Royal Children's
Hospital, Flemington Road, Parkville, VIC 3052, Australia, c Institute of
Food Research, Norwich Research Park, Colney, Norwich, Norfolk NR4 7UA, UK,
d Stirling Royal Infirmary, Livilands, Stirling FK8 2AV, UK, e Department
of Child Health, Queens Medical Centre, Nottingham NG7 2UH, UK
AIMSIron deficiency anaemia is associated, in observational studies, with
developmental disadvantage. This study tested the hypothesis that feeding
iron supplemented formula from 9 to 18 months of age would improve
developmental performance.
SUBJECTS AND METHODS493 healthy children aged 9 months being fed
pasteurised cows' milk were recruited from three UK centres. They were
randomised to: cows' milk as before, formula containing 0.9 mg/litre iron,
or formula containing 1.2 mg/litre iron, until 18 months of age. Bayley
mental and psychomotor developmental indices were measured at 18 months, as
were growth and haematological indices.
RESULTSChildren fed iron fortified formula had higher plasma ferritin
concentrations, but there were no significant intergroup differences in
development or growth.
CONCLUSIONSThere are no developmental or growth advantages in children
given iron supplemented formula, but a benefit for a minority who were
anaemic, or the possibility that a benefit may emerge at a later age,
cannot be excluded.
Heather Welford Neil
NCT bfc Newcastle upon Tyne UK
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