The Role of Fresh Cow's Milk in Iron Deficiency

Woodruff, Calvin W.; Wright, Suzanne W.; Wright, Richard P.

doi:10.1001/archpedi.1972.02110130028004

Cited by 52 publications

(5 citation statements)

References 10 publications

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“…The results of our study are in agreement with those of a cross-sectional study by Thomas et al, who found no increase in fecal hemoglobin by immunoassay or in Hematest-positive stools in older infants fed WCM (4). These re sult s are also in concordance with those of Woodruff et al , who found no difference betwe en formula-fed infant s and WCM -fed infants in guaiac-positive stools (13). Ho wever , unlike the Woodruff study in which most stool specimens from both WCM-fed and formul a-fed infants were guaiac-positive , guaiacpo sitive stools were unusual in any infant from any feeding group in our study.…”

Section: Discussionsupporting

confidence: 92%

Gastrointestinal Blood Loss in Older Infants

Fuchs,

DeWier,

Hutchinson

et al. 1993

J. pediatr. gastroenterol. nutr.

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SummaryConcerns that consumption of whole cow milk (WCM) by older infants may result in excessive gastrointestinal blood loss and subsequent iron deficiency led us to perform a prospective, randomized study in 104 infants. Infants were assigned to receive WCM beginning at 6 months or one of three formulas beginning at 4‐6 months of age and followed until 12 months of age. Gastrointestinal blood loss was similar for all groups, as determined by both qualitative (Hemoccult II) and quantitative testing (HemoQuant). There was no association between concentration of fecal hemoglobin and volume of WCM consumed or iron status by 12 months of age. Of eight infants (seven WCM, one formula) who became iron‐depleted, none had excessive fecal hemoglobin excretion. When pooled and analyzed regardless of feeding group, fecal hemoglobin increased with age and was greater at 11 and 12 months than at younger ages. We conclude that although infants fed WCM are at increased risk of developing iron depletion, the iron insufficiency is not due to gastrointestinal blood loss. We further conclude, based on our sample of normal infants age 4‐12 months, that fecal hemoglobin concentrations of 0.5‐0.8 mg/g stool correspond to the upper limits of normal, values much lower than in adults.

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Section: Discussionsupporting

confidence: 92%

Gastrointestinal Blood Loss in Older Infants

Fuchs,

DeWier,

Hutchinson

et al. 1993

J. pediatr. gastroenterol. nutr.

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“…Should we re-evaluate recommendations regarding the use of cow milk in the second 6 months of life? Of the three other controlled studies that have examined blood loss associated with cow milk feeding in the older infant , two , like the current study, have not found an increase in fecal hemoglobin, while studies by Ziegler et al concluded the opposite (8)(9)(10). Because of different method s used to measure fecal hemoglobin quantitatively and the poor specificity of the guaiac test for occult blood in the stool (11), one cannot yet totally dismiss occult blood loss as a factor contributing to depleted iron stores; however, quantitative information provided in the current study about the mean fecal blood loss across groups is instructive.…”

contrasting

confidence: 47%

Another Look at Cow Milk in the Second 6 Months of Life

Zlotkin

1993

J. pediatr. gastroenterol. nutr.

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“…Since the 1970s, many studies have shown that the feeding of CM to infants (and to young children) is strongly associated with diminished iron stores and an increased probability of ID. Many of these studies were conducted in the United States 1–6 and the United Kingdom, 7–11 but studies have also been reported from Denmark, 12 Australia, 13 Ireland, 14 Sweden, 15 Iceland, 16 and a cross‐section of European countries 17 …”

Section: Cow's Milk and The Occurrence Of Iron Deficiencymentioning

confidence: 99%

“…In most studies, the iron status of infants fed CM was compared with that of infants fed formula, which was usually fortified with iron. However, in two studies the comparison was with formulas that were not fortified with iron 1,2 . Feeding with these formulas still led to better iron nutritional status than feeding with CM.…”

Section: Cow's Milk and The Occurrence Of Iron Deficiencymentioning

confidence: 99%

Consumption of cow's milk as a cause of iron deficiency in infants and toddlers

2011

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Consumption of cow's milk (CM) by infants and toddlers has adverse effects on their iron stores, a finding that has been well documented in many localities. Several mechanisms have been identified that may contribute to iron deficiency in this young population group. The most important of these is probably the low iron content of CM, which makes it difficult for infants to obtain the amounts of iron needed for growth. A second mechanism is the occult intestinal blood loss associated with CM consumption during infancy, a condition that affects about 40% of otherwise healthy infants. Loss of iron in the form of blood diminishes with age and ceases after the age of 1 year. A third mechanism is the inhibition of non-heme iron absorption by calcium and casein, both of which are present in high amounts in CM. Fortification of CM with iron, as practiced in some countries, can protect infants and toddlers against CM's negative effects on iron status. Consumption of CM produces a high renal solute load, which leads to a higher urine solute concentration than consumption of breast milk or formula, thereby narrowing the margin of safety during dehydrating events, such as diarrhea. The high protein intake from CM may also place infants at increased risk of obesity in later childhood. It is thus recommended that unmodified, unfortified CM not be fed to infants and that it be fed to toddlers in modest amounts only.

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The Role of Fresh Cow's Milk in Iron Deficiency

Cited by 52 publications

References 10 publications

Gastrointestinal Blood Loss in Older Infants

Gastrointestinal Blood Loss in Older Infants

Another Look at Cow Milk in the Second 6 Months of Life

Consumption of cow's milk as a cause of iron deficiency in infants and toddlers

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