Effect of Daily Iron Supplementation in Healthy Exclusively Breastfed Infants: A Systematic Review with Meta-Analysis

Cai, Chenxi; Granger, Matthew; Eck, Peter; Friel, James K.

doi:10.1089/bfm.2017.0003

Cited by 20 publications

(18 citation statements)

References 22 publications

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“…Nonetheless, the importance of adequate iron is emphasized by this evidence relative to this vulnerable period in the infant’s and young child’s brain development and likelihood of lasting impairment without adequate iron. Further emphasizing the importance of sufficient iron during this period is a recent systematic review that reports improved psychomotor development in young infants < 6 months exclusively breastfed and supplemented with iron [ 61 ] without improvement of ID, IDA, or SF.…”

Section: U-shaped Risk For Iron Status: Concerns For Pregnant Womementioning

confidence: 99%

“…In contrast, a recent systematic review of iron supplementation of young children (6–24 months) in developed countries found no clear benefit for growth outcomes (5/6 trials) or infant development in the first 12 months (2 trials), inconsistent findings for improvement of hematologic outcomes and no reports in any of the identified studies related to neurodevelopmental delay or improvement of hematologic indicators and clinical outcomes [ 65 ]. As noted previously, the 2017 systematic review [ 61 ] found only four randomized clinical trials (RCTs) on iron supplementation of young exclusively breastfed infants <6 months and reported both benefit in terms of psychomotor development and harm in terms of reduced growth without consistent improvement of iron status in terms of IDA, ID, or SF. In spite of the need for more evidence from well-controlled RCTs especially evaluating non-hematologic health outcomes and the relationship of improved iron status with supplementation and health outcomes, all agree that treatment of ID and IDA during pregnancy and young children is important and warranted.…”

Section: U-shaped Risk For Iron Status: Concerns For Pregnant Womementioning

confidence: 99%

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Iron Supplementation during Pregnancy and Infancy: Uncertainties and Implications for Research and Policy

2017

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Iron is particularly important in pregnancy and infancy to meet the high demands for hematopoiesis, growth and development. Much attention has been given to conditions of iron deficiency (ID) and iron deficient anemia (IDA) because of the high global prevalence estimated in these vulnerable life stages. Emerging and preliminary evidence demonstrates, however, a U-shaped risk at both low and high iron status for birth and infant adverse health outcomes including growth, preterm birth, gestational diabetes, gastrointestinal health, and neurodegenerative diseases during aging. Such evidence raises questions about the effects of high iron intakes through supplementation or food fortification during pregnancy and infancy in iron-replete individuals. This review examines the emerging as well as the current understanding of iron needs and homeostasis during pregnancy and infancy, uncertainties in ascertaining iron status in these populations, and issues surrounding U-shaped risk curves in iron-replete pregnant women and infants. Implications for research and policy are discussed relative to screening and supplementation in these vulnerable populations, especially in developed countries in which the majority of these populations are likely iron-replete.

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Section: U-shaped Risk For Iron Status: Concerns For Pregnant Womementioning

confidence: 99%

Section: U-shaped Risk For Iron Status: Concerns For Pregnant Womementioning

confidence: 99%

Iron Supplementation during Pregnancy and Infancy: Uncertainties and Implications for Research and Policy

2017

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“…Results from a meta-analysis, which included four randomized control trials (RCT) involving 511 infants, supported early iron supplementation [ 45 ]. Current data suggests that though iron supplementation of healthy exclusively breastfed infants may improve their iron status and cognitive development, there may be a delay in their physical growth.…”

Section: Ironmentioning

confidence: 99%

“…Current data suggests that though iron supplementation of healthy exclusively breastfed infants may improve their iron status and cognitive development, there may be a delay in their physical growth. There was no evidence to suggest iron supplementation could cause other adverse effects [ 45 ].…”

Section: Ironmentioning

confidence: 99%

Iron and the Breastfed Infant

2018

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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.

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“…Generally, timely Fe supplementation or complementary feeding with Fe-rich/Fe-fortified foods was necessary for the depletion of infant Fe stores after exclusive breast-feeding for 6 months (26) . However, the results of Fe supplementation trials during infancy on long-term cognitive development are inconsistent and appear to vary by different population (47)(48)(49) . There is also a concern of adverse effects of Fe supplementation, including hampering brain development, due to the excess intake of Fe (50) .…”

Section: Interpretations Of Findings and Implications For Public Healthmentioning

confidence: 99%

Association of infant and young child feeding practices with cognitive development at 10–12 years: a birth cohort in rural Western China

Zhu

Cheng

et al. 2019

Br J Nutr

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We aimed to comprehensively examine the association of breast-feeding, types and initial timing of complementary foods with adolescent cognitive development in low- and middle-income countries. We conducted a prospective cohort study of 745 adolescents aged 10–12 years who were born to women who participated in a randomised trial of prenatal micronutrient supplementation in rural Western China. An infant feeding index was constructed based on the current WHO recommendations. Full-scale intelligence quotient (FSIQ) was assessed and derived by the fourth edition of the Wechsler Intelligence Scale for Children. The duration of exclusive or any breast-feeding was not significantly associated with adolescent cognitive development. Participants who regularly consumed Fe-rich or Fe-fortified foods during 6–23 months of age had higher FSIQ than those who did not (adjusted mean differences 4·25; 95 % CI 1·99, 6·51). For cows’/goats’ milk and high protein-based food, the highest FSIQ was found in participants who initially consumed at 10–12 and 7–9 months, respectively. A strong dose–response relationship of the composite infant feeding index was also identified, with participants in the highest tertile of overall feeding quality having 3·03 (95 % CI 1·37, 4·70) points higher FSIQ than those in the lowest tertile. These findings suggest that appropriate infant feeding practices (breast-feeding plus timely introduction of appropriate complementary foods) were associated with significantly improved early adolescent cognitive development scores in rural China. In addition, improvement in Fe-rich or Fe-fortified foods complementary feeding may produce better adolescent cognitive development outcomes.

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Effect of Daily Iron Supplementation in Healthy Exclusively Breastfed Infants: A Systematic Review with Meta-Analysis

Cited by 20 publications

References 22 publications

Iron Supplementation during Pregnancy and Infancy: Uncertainties and Implications for Research and Policy

Iron Supplementation during Pregnancy and Infancy: Uncertainties and Implications for Research and Policy

Iron and the Breastfed Infant

Association of infant and young child feeding practices with cognitive development at 10–12 years: a birth cohort in rural Western China

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