Effect of infant feeding practices on iron status in a cohort study of Bolivian infants

Details

• Alternative Title:
  BMC Pediatr
• Personal Author:
  Burke, Rachel M. ; Rebolledo, Paulina A. ; Aceituno, Anna M. ; Revollo, Rita ; Iñiguez, Volga ; Klein, Mitchel ; Drews-Botsch, Carolyn ; Leon, Juan S. ; Suchdev, Parminder S.
• Description:
  Background
  
  Iron deficiency (ID) is the most common micronutrient deficiency worldwide, with potentially severe consequences on child neurodevelopment. Though exclusive breastfeeding (EBF) is recommended for 6 months, breast milk has low iron content. This study aimed to estimate the effect of the length of EBF on iron status at 6 – 8 months of age among a cohort of Bolivian infants.
  
  Methods
  
  Mother-infant pairs were recruited from 2 hospitals in El Alto, Bolivia, and followed from one through 6 – 8 months of age. Singleton infants > 34 weeks gestational age, iron-sufficient at baseline, and completing blood draws at 2 and 6 – 8 months of age were eligible for inclusion (N = 270). Ferritin was corrected for the effect of inflammation. ID was defined as inflammation-corrected ferritin < 12 μg/L, and anemia was defined as altitude-corrected hemoglobin < 11 g/dL; IDA was defined as ID plus anemia. The effect of length of EBF (infant received only breast milk with no other liquids or solids, categorized as < 4, 4 – 6, and > 6 months) was assessed for ID, IDA, and anemia (logistic regression) and ferritin (Fer) and hemoglobin (Hb, linear regression).
  
  Results
  
  Low iron status was common among infants at 6 – 8 months: 56% of infants were ID, 76% were anemic, and 46% had IDA. EBF of 4 months and above was significantly associated with ID as compared with EBF <  4 months (4 – 6 months: OR 2.0 [1.1 – 3.4]; > 6 months: 3.3 [1.0 – 12.3]), but not with IDA (4 – 6 months: OR 1.4 [0.8 – 2.4]; > 6 months: 2.2 [0.7 – 7.4]), or anemia (4 – 6 months: OR 1.4 [0.7 – 2.5]; > 6 months: 1.5 [0.7 – 7.2]). Fer and Hb concentrations were significantly lower with increasing months of EBF.
  
  Conclusions
  
  Results suggest a relationship between prolonged EBF and ID, but are not sufficient to support changes to current breastfeeding recommendations. More research is needed in diverse populations, including exploration of early interventions to address infant IDA.
  
  Electronic supplementary material
  
  The online version of this article (10.1186/s12887-018-1066-2) contains supplementary material, which is available to authorized users.
  
  
• Subjects:
  Anemia, Iron-Deficiency Breast Feeding Developing Countries Female Humans Infant Linear Models Longitudinal Studies Male Risk Factors Time Factors

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• Source:
  BMC Pediatr. 18.
• Pubmed ID:
  29530004
• Pubmed Central ID:
  PMC5848561
• Document Type:
  Journal Article
• Funding:
  HD052460-01/NH/NIH HHS/United States ; 1K01AI087724-01/National Institute of Allergy and Infectious Diseases/International ; K01 AI087724/AI/NIAID NIH HHS/United States ; U19 AI057266/AI/NIAID NIH HHS/United States ; Seed Grants Program/Emory + Children's Pediatric Center/International ; UL1 TR000454/RR/NCRR NIH HHS/United States ; T32 AI074492/AI/NIAID NIH HHS/United States ; UL1 TR000454/TR/NCATS NIH HHS/United States ; U19-AI057266/National Institute of Allergy and Infectious Diseases/International ; T32AI074492/NH/NIH HHS/United States ; T32 HD052460/HD/NICHD NIH HHS/United States
• Place as Subject:
  Bolivia
• Volume:
  18
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:995c0766a0bc59c7e38f1a3e568ce9bdc6d3320060ae20bc36f8ae146ed35cfa
• Download URL:
  https://stacks.cdc.gov/view/cdc/53457/cdc_53457_DS1.pdf
• File Type:
  [PDF - 681.10 KB ]