Consumo de leite de vaca e anemia ferropriva na infância

Abstract

Suggested citation: Oliveira MA, Osório MM. Cow's milk consumption and iron deficiency anemia in children. J Pediatr (Rio J). 2005;81: 361-7. AbstractObjective: To thoroughly investigate the association between the consumption of cows milk and anemia in childhood. Sources of data:The information was gathered from papers catalogued in Lilacs and MEDLINE and published during the last two decades, and also from textbooks and publications by international organizations. Summary of the findings:Iron deficiency anemia is a severe public health problem in developing countries. Breast milk contains adequate iron for full term babies in the first 6 months. Thereafter, an additional iron-rich diet becomes essential. In recognition of the importance of the diet in triggering anemia, this paper discusses the relationship in children between a high intake of cows milk and iron deficiency anemia. Gastrointestinal and allergic problems may be caused by early introduction of cows milk or by its substitution for breast milk. Furthermore, cows milk has decreased iron density and bioavailability, excess protein and minerals, notably calcium, and thus interferes in the absorption of iron from other foods, and is also linked to small intestinal hemorrhage in young children. Conclusions:The use of cows milk in lieu of other foods rich in bioavailable iron was shown to be a risk factor for anemia. Exclusive breastfeeding during the first 6 months of life, discretionary weaning only after the 24th month, and a complementary diet rich in iron are highly important to avoid anemia and its consequences.

Diagnosis of iron deficiency anemia in children of Northeast Brazil

“…12,13,17 Another important factor would be the use of in natura cow milk whose iron has low bioavailability and may interfere with iron absorption from other foods due to its direct effect on the intestinal mucosa, which can cause loss of occult blood in feces. 16 The lower prevalence of anemia with iron defi ciency in children aged 24-30 months could be explained by regular consumption of foods in the family diet, characterized by greater diversifi cation and especially higher consumption of foods of animal origin. 9 In this age group, consumption of wheat and maize fl ours, which has been fortifi ed with iron and folic acid in Brazil since 2004, may have also contributed to a greater iron intake.…”

Prevalence of Anemia in Children Three to 12 Months Old in a Health Service in Ribeirão Preto, SP, Brazil

“…The influence of breastfeeding on anemia is better verified in children younger than six months of age, and it is not predictive of iron deficiency after this period (10) . However,…”

“…Several studies agree with the findings of this study in relation to the early introduction of liquid cow's milk and hemoglobin below the recommended level. Casein and whey proteins from cow's milk, which constitute the protein fraction of the majority of infant formulas, and industrialized baby food negatively affect iron absorption, which is aggravated by the increased need for iron imposed by the rapid growth of children (23) .…”

Consumo alimentar de crianças em municípios de baixo índice de desenvolvimento humano no Nordeste do Brasil

“…Nessa idade, a criança torna-se extremamente vulnerável por ser o período de desmame, associado à introdução de leite de vaca, característico de uma dieta monótona que favorece o aparecimento da anemia ferropriva 21 . As demais faixas etárias demonstraram valores de consumo mediano de ferro superiores às DRI, o que na idade de 0 a 6 meses poderia estar relacionado à utilização do leite materno e à introdução precoce de outros alimentos.…”

“…O leite de cabra é especialmente consumido no município de São João do Tigre, por ser produto beneficiado pela cooperativa local e distribuído à população por meio de programa municipal em parceria pelo Governo Federal. Entretanto, o alto consumo de leite de vaca ou de cabra, aliado à pouca adesão de outros alimentos complementares, pode representar risco à população infantil, uma vez que esses alimentos, ricos em proteínas e minerais, em especial o cálcio, interferem na absorção do ferro proveniente do leite materno e de outros alimentos, além de possibilitar ocorrência de micro-hemorragias intestinais 21,28 . Desse modo, as duas populações também podem ter suas prevalências de anemia agravadas por conta desse padrão alimentar.…”