Breastfeeding exclusively and iron deficiency anemia during the first 6 months of age

Abstract

Conflict of interest: noneObjective: The objective was to determine the prevalence of iron deficiency and iron deficiency anemia among exclusively breastfed infants from one to six months of life and to identify associated risk factors. Methods: This is a cohort study of the hemoglobin and serum ferritin levels of 102 healthy full-term infants, weighing more than 2500 grams (5.5 pounds) at birth, evaluated for growth development and supported to promote exclusive breastfeeding. Hemoglobin and ferritin levels were measured in the first, fourth, and sixth months of life. The hemoglobin and ferritin levels of the mothers were also measured in the first month postpartum. Results: At four months, 5.7% presented iron deficiency and 3.4% had iron deficiency anemia. At six months, the percentage of children with iron deficiency increased more than four times, reaching 26.1%, while iron deficiency anemia was present in 23.9% of the infants studied. Iron deficiency at six months of age was significantly correlated to growth velocity. Conclusion: According to the results of this study, exclusive breastfeeding protects infants from iron deficiency and iron deficiency anemia for the first four months of life. After this age, in accordance with the literature, the findings of this study demonstrated an increase in anemia and iron deficiency rates, adding to evidence that supports the monitoring of iron levels in exclusively breastfed children presenting higher weight gains beginning at four months of age.

Early deterioration of iron status among a cohort of Bolivian infants

“…Even in well-resourced populations (e.g., USA, Denmark, and Norway), Fer has been shown to decrease from birth through at least 6 months of age, as birth iron stores run out faster than they are replenished through diet (Hay et al, 2007; Kling, Roberts, & Widness, 1998; Michaelsen et al, 1995; Ziegler et al, 2014). Nonetheless, the (Fer-defined) ID prevalence observed in our cohort was higher than that observed in other Latin American populations (32% in 5-month-old Peruvian infants (Finkelstein et al, 2013); 26% in 6-month-old Brazilian infants (Marques et al, 2014)), although comparable with some other developing-country settings (59% in Nigerian 6-month-olds (Preziosi et al, 1997)). Among Latin American countries in a recent review, Bolivia has the highest national prevalence of anemia among preschoolers (6–59-month-olds; 61%; Mujica-Coopman et al, 2015), and so it is perhaps not surprising that our study also showed an extremely high prevalence of anemia in infants, despite our adjustment for the high altitude of the study setting.…”

“…However, the size of these stores at birth can vary, and given the low intake of iron through breast milk in the first months of life, birth stores may be an important determinant of later risk of iron deficiency (Burke et al, 2014). Although multiple studies have gathered data on iron status on infants at different ages (Capozzi, Russo, Bertocco, Ferrara, & Ferrara, 2010; Domellof, Dewey, Lonnerdal, Cohen, & Hernell, 2002; Finkelstein, O’Brien, Abrams, & Zavaleta, 2013; Marques, Taddei, Lopez, & Braga, 2014; Michaelsen, Milman, & Samuelson, 1995; Olaya, Lawson, & Fewtrell, 2013; Preziosi et al, 1997; Sherriff, Emond, Hawkins, & Golding, 1999), few have provided data for healthy infants followed from breastfeeding age through complementary food introduction and up to 1 year of life (Hay et al, 2007; Willows, Dewailly, & Gray-Donald, 2000; Ziegler, Nelson, & Jeter, 2014). These published studies suggest that iron status declines significantly over the first year of life, leading to ID in vulnerable populations.…”

Stunting and Anemia in Infants Among Breastfeeding Mothers in Binjai City

“…The prevalence is almost similar to that of other studies that is 3.4% of infants at four months had iron deficiency anemia, and at six months of age 26.1% anemic, while iron deficiency anemia was present in 23.9% of the infants studied. Iron deficiency at six months of age was significantly correlated to growth velocity [19].…”

Prevalence of iron-deficiency anemia in children aged less than 60 months: A population-based study from the state of Minas Gerais, Brazil

“…Important for preventing childhood anemia, breastfeeding for more than six months increases the risk of anemia since 90.0% of the iron requirement of the child comes from complementary foods 25 . A recent study on exclusive breastfeeding and iron-deficiency anemia found that 26.1% of the breastfed children were iron deficient, and 23.9% had iron-deficiency anemia 26 . Improving the iron reserves of the mother is an alternative to improve the iron reserves of breastfed children.…”