Breastfeeding, Mixed, or Formula Feeding at 9 Months of Age and the Prevalence of Iron Deficiency and Iron Deficiency Anemia in Two Cohorts of Infants in China

Clark, Kathy; Li, Ming; Zhu, Bingquan; Liang, Fanrong; Shao, Jie; Zhang, Yueyang; Ji, Chaofan; Zhao, Zhiyuan; Kaciroti, Niko; Lozoff, Betsy

doi:10.1016/j.jpeds.2016.10.041

Cited by 42 publications

(40 citation statements)

References 40 publications

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“…An extensive study examining Filipino infant and child feeding (6-23 months of age) in urban areas reported that children who are breastfed were more likely to be anaemic or iron de cient after 6 months of age than those receiving forti ed foods [7]. This is similar to results reported in other countries including India, China and Japan [22][23][24]. Forti ed young child beverages provide a source of iron among Filipino infants (6-11.9mo) and toddlers (12-23.9mo), respectively [5].…”

Section: Discussionsupporting

confidence: 76%

Complementary feeding patterns of Filipino infants and toddlers lack diversity, especially among children from poor households

Jacquier

Angeles‐Agdeppa

Lenighan

et al. 2020

Preprint

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Consumption of nutritionally adequate complementary foods is essential for optimal growth and development of infants and toddlers, particularly in developing countries. The aim of this study was to describe percentages of consumption, energy contribution (6-23.9mo), and usual nutrient intakes (12-23.9mo) from complementary foods among Filipino infants and toddlers stratified by household wealth. Data from 1087 infants and toddlers from the 2013 National Nutrition Survey were included. Dietary intake data was assessed using a 24Hr recall and population food intakes were stratified into pre-defined wealth categories. Breast milk, infant formula, powdered milk and rice were the most commonly consumed foods and beverages across the age groups. Several differences in complementary feeding by wealth status were observed. Infants and toddlers from poor households reported significantly greater consumption of human milk, in comparison to those from the rich households who reported a significantly greater consumption of infant/toddler formula (P>0.05). A higher percentage of toddlers from rich households consumed protein-containing foods, cookies and cakes. There was no difference in fruit and vegetable consumption between wealth groups in 6-11.9mo and 18-23.9mo children. Human milk and formula were the top contributors to energy in 6.11.9mo and 12-17.9mo children, while rice was the top energy contributor in 18-23.9mo children. Intakes of protein, fat, vitamin C, B vitamins, vitamin D, vitamin E, iron and calcium were higher in 12-23.9mo children from rich households. Interventions are required to enable caregivers of young Filipino children to provide complementary foods of high nutritional quality, particularly among children from the poor households.

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Section: Discussionsupporting

confidence: 76%

Complementary feeding patterns of Filipino infants and toddlers lack diversity, especially among children from poor households

Jacquier

Angeles‐Agdeppa

Lenighan

et al. 2020

Preprint

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“…Among 619 Korean infants aged 8-15 months old, ID and IDA were diagnosed in 174 (28.1%) and 87 infants (14.0%), respectively [26]. The prevalence of ID and IDA in two cohorts of infants aged nine months old in China was 2.8% and 20.7% and 12.0% and 31.2%, respectively [27]. The prevalence of ID and IDA in infants above six months of age in our study was concordant with that observed in China and Korea.…”

Section: Discussionmentioning

confidence: 99%

Iron Status of Infants in the First Year of Life in Northern Taiwan

Chen

Shih

et al. 2020

Nutrients

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Iron deficiency (ID) and iron deficiency anemia (IDA) typically occur in developing countries. Notably, ID and IDA can affect an infant’s emotion, cognition, and development. Breast milk is considered the best food for infants. However, recent studies have indicated that breastfeeding for more than six months increases the risk of ID. This study investigated the prevalence of ID and IDA, as well as the association between feeding type and iron nutritional status in northern Taiwan. A cross-sectional study was conducted on infants who returned to the well-baby clinic for routine examination from October 2012 to January 2014. Overall, 509 infants aged 1–12 months completed the iron nutritional status analysis, anthropometric measurement, and dietary intake assessment, including milk and complementary foods. The results revealed that 49 (10%) and 21 (4%) infants in their first year of life had ID and IDA, respectively, based on the World Health Organization criteria. Breastfed infants had a higher prevalence rate of ID and IDA than mixed-fed and formula-fed infants (p < 0.001). Regarding biomarkers of iron status, plasma hemoglobin (Hb), ferritin, and transferrin saturation (%) levels were significantly lower in ID and IDA groups. The prevalence of ID and IDA were 3.7% and 2.7%, respectively, in infants under six months of age, but increased to 20.4% and 6.6%, respectively, in infants above six months of age. The healthy group had a higher total iron intake than ID and IDA groups, mainly derived from infant formula. The total dietary iron intake was positively correlated with infants’ Hb levels. Compared with formula-fed infants, the logistic regression revealed that the odds ratio for ID was 2.157 (95% confidence interval [CI]: 1.369–3.399) and that for IDA was 4.196 (95% CI: 1.780–9.887) among breastfed infants (p < 0.001) after adjusted for all confounding factors (including gestational week, birthweight, sex, body weight percentile, body length percentile, age of infants, mothers’ BMI, gestational weight gain, education level, and hemoglobin level before delivery). In conclusion, our results determined that breastfeeding was associated with an increased the prevalence of ID and/or IDA, especially in infants above six months. This suggests that mothers who prolonged breastfeed after six months could provide high-quality iron-rich foods to reduce the prevalence of ID and IDA.

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“…Iron deficiency increases the risk of preterm childbirth and low weight in newborns. In fact, in low weight and premature infants, hematocrit levels are decreased 31 . On the other hand, in women with high parity, natural childbirth or Csection is accompanied by less stress, in comparison to nulliparous women, because of previous childbirth experience and short deliveries.…”

Section: Introductionmentioning

confidence: 99%

The effect of delivery type on neonatal blood indices in an Iranian population

et al. 2018

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Background: Generally, there are two methods for childbirth: normal vaginal and cesarean section (C-section). Each method has advantages and complications. In this study, we investigated the effects of type of delivery on hematological parameters in healthy full-term neonates in an Iranian population, from 2016-2017. Materials: Three hundred pregnant women, along with their healthy and term babies, were studied. According to the route of delivery, the neonates were divided into two groups: vaginal (n=150) and C-section (n=150). Complete blood count (CBC) and peripheral blood smear (PBS) were performed on the neonates from umbilical cord blood immediately after birth. Data were analyzed by using SPSS v. 22 and statistical analyses were done by student's t-test and correlation tests, with P-value < 0.05 set as the lowest limit of significance. Results: We observed a significant increase in hematologic parameters, such as red blood cell (RBC) count, hemoglobin, hematocrit, red cell distribution width (RDW), platelets, total leukocyte count and neutrophil count, in full-term neonates who delivered vaginally compared to those delivered by cesarean section (p<0.001). However, there was no significant difference between the delivery types in terms of mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), mean platelet volume (MPV), platelet distribution width (PDW), eosinophil count, lymphocyte count, or monocyte count. Conclusion: According to our study, the mode of delivery influences the hematological parameters in full-term neonates; thrombocytopenia and anemia in neonates were associated with cesarean section delivery. Thus, we recommend that pregnant women do not deliver by C-section unless in emergency situations.

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Breastfeeding, Mixed, or Formula Feeding at 9 Months of Age and the Prevalence of Iron Deficiency and Iron Deficiency Anemia in Two Cohorts of Infants in China

Cited by 42 publications

References 40 publications

Complementary feeding patterns of Filipino infants and toddlers lack diversity, especially among children from poor households

Complementary feeding patterns of Filipino infants and toddlers lack diversity, especially among children from poor households

Iron Status of Infants in the First Year of Life in Northern Taiwan

The effect of delivery type on neonatal blood indices in an Iranian population

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