BackgroundDespite a World Health Organization recommendation for exclusive breastfeeding of all full-term infants to 6 months of age, it is not clear what the health implications may be. Breast milk alone may not meet the nutrition needs for all growing infants, leaving them at risk for deficiencies. The objective of this study was to investigate the relationship between moderate (4 months) versus late (6 months) introduction of complementary foods to the full-term breastfed infant on iron status and growth.MethodsAn electronic search of peer-reviewed and gray-literature was conducted for randomized control trials (RCTs) and observational studies related to the timing of introduction of complementary foods. Iron status and growth data from the relevant RCTs were analyzed using RevMan 5.2.11.ResultsThree RCTs and one observational study met the inclusion criteria. Meta-analysis showed significantly higher hemoglobin levels in infants fed solids at 4 months versus those fed solids at 6 months in developing countries [mean difference [MD]: 5.0 g/L; 95 % CI: 1.5, 8.5 g/L; P = 0.005]. Meta-anaysis also showed higher serum ferritin levels in the 4-month group in both developed and developing countries [MD: 26.0 μg/L; 95 % CI: -0.1, 52.1 μg/L, P = 0.050], [MD: 18.9 μg/L; 95 % CI: 0.7, 37.1 μg/L, P = 0.040]. Short follow-up periods and small sample sizes of the included studies were the major limitations.ConclusionsRCT evidence suggests the rate of iron deficiency anemia in breastfed infants could be positively altered by introduction of solids at 4 months.Electronic supplementary materialThe online version of this article (doi:10.1186/s12887-015-0409-5) contains supplementary material, which is available to authorized users.
BackgroundThe World Health Organization recommends exclusive breastfeeding until 6 months followed by introduction of iron-rich complementary foods (CFs). The aim of this study was to determine the impact of different iron-rich CFs on infant gut inflammation and microbiota.MethodsEighty-seven exclusively breastfed infants were randomly assigned to receive one of the following as their first CF: iron-fortified cereal (Cer), iron-fortified cereal with fruit (Cer + Fr), or meat (M). Urine and stool samples were collected to assess reactive oxygen species (ROS) generation, gut microbiota and inflammation.ResultsFecal iron differed across feeding groups (p < 0.001); levels were highest in the Cer group and lowest in M group. A significant increase of fecal ROS formation (p < 0.002) after the introduction of CFs was observed, but did not differ across feeding groups. Fecal calprotectin increased within all groups after the introduction of CFs (p = 0.004). Gut microbiota richness increased after introduction of M or Cer + Fr. Regardless of feeding group, Coriobacteriaceae were positively correlated with ROS and Staphylococcaceae were negatively correlated with calprotectin.ConclusionsChoice of first CF may influence gut inflammation and microbiota, potentially due to variations in iron absorption from different foods. Further research is warranted to fully characterize these associations and to establish implications for infant health. This study was registered in the ClinicalTrial.gov registry (Identifier No. NCT01790542).Trial registrationThis study was registered in the ClinicalTrial.gov registry under the name “Assessment of Complementary Feeding of Canadian Infants” (Identifier No. NCT01790542) February 6, 2013.Electronic supplementary materialThe online version of this article (doi:10.1186/s12887-017-0805-0) contains supplementary material, which is available to authorized users.
The first 6 months of life is a crucial time in meeting iron needs. The purpose of this review is to examine iron in mother’s milk and whether or not it meets the physiological needs of the growing infant. Key issues include iron content and iron transport from the mammary gland as well as when and what foods should be added to the solely breastfed infant. We examine these topics in light of new molecular biology findings in the mammary gland.
BACKGROUNDIron is an essential nutrient for normal growth and neurodevelopment of infants. Iron deficiency (ID) remains the most common micronutrient deficiency worldwide. There are convincing data that ID is associated with negative effects on neurological and psychomotor development.OBJECTIVESIn this review, we provide an overview of current knowledge of the importance of iron in normal term breast-fed infants with a focus on recommendations, metabolism, and iron requirements.CONCLUSIONSHealth organizations around the world recommend the introduction of iron-rich foods or iron supplements for growing infants to prevent ID. However, there is no routine screening for ID in infancy. Multicenter trials with long-term follow-up are needed to investigate the association between iron fortification/supplementation and various health outcomes.
Fish meal (FM) has excellent protein and lipid profile. However, FM is losing its acceptability and substituted with plant protein due to FM has high price, high demand, and sustainability issues in global aquaculture production. In this study, experimental diets were prepared by substituting FM with fermented soybean meal (FSM) or normal and untreated soybean meal (SM) to assess the effects on growth, hematology, innate immunity, gut physiology, and digestive enzyme activities in juvenile silver barb, Barbonymus gonionotus. Five diets, that is, 40% FM (FM 40), 20% FM + 20% FSM (FM 20 + FSM 20), 20% FM + 20% SM (FM 20 + SM 20), 40% FSM (FSM 40), and 40% SM (SM 40) were fed to the fish two times daily for 90 days. After 90 days of feeding trial, FM 40, FM 20 + FSM 20, and FM 20 + SM 20 diet groups showed significantly higher weight gain (WG) and specific growth rate (SGR) compared to the FSM 40 and SM 40 diets. Hepatosomatic index (HSI) and viscerosomatic index (VSI) were significantly higher in fish fed with the FSM 40 and SM 40 diets than those of fish fed with the FM 40 diet. Hematocrit, hemoglobin, and erythrocyte count were significantly lower in fish fed with the SM 40 diet compared to fish fed with the FM 40 and FM 20 + FSM 20 diets. Superoxide dismutase and catalase activities in the liver were significantly higher in fish fed with the SM 40 diet compared to fish fed with the FM 40 diet. However, serum thiobarbituric acid reactive substances in fish fed with the experimental diets were unaltered. Fish showed significant reduction of villus height (Vh) in the anterior and posterior intestine of fish fed with the FSM 40 and SM 40 diets, whereas muscular thickness was opposite to the findings of Vh. Digestive enzyme activities in intestine were significantly higher in fish fed with the FM 40 diet compared to those in the SM 40 diet. The results of the present study revealed that the 50% of FM can be replaced by FSM or SM as a source of protein without affecting the growth of juvenile silver barb.
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