1. 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
- Author
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Furong Liang, Zhengyan Zhao, Betsy Lozoff, Yueyang Zhang, Katy M. Clark, Bingquan Zhu, Ming Li, Jie Shao, Niko Kaciroti, and Chai Ji
- Subjects
Male ,0301 basic medicine ,China ,Pediatrics ,medicine.medical_specialty ,Iron ,Breastfeeding ,Risk Assessment ,Article ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,Formula feeding ,hemic and lymphatic diseases ,030225 pediatrics ,Confidence Intervals ,Odds Ratio ,Prevalence ,medicine ,Humans ,Trial registration ,Randomized Controlled Trials as Topic ,030109 nutrition & dietetics ,Anemia, Iron-Deficiency ,business.industry ,Infant ,Feeding Behavior ,Iron deficiency ,medicine.disease ,Infant Formula ,Breast Feeding ,Logistic Models ,Iron-deficiency anemia ,Pediatrics, Perinatology and Child Health ,Female ,Hemoglobin ,Iron status ,business ,Formula fed - Abstract
To assess associations between breastfeeding and iron status at 9 months of age in 2 samples of Chinese infants.Associations between feeding at 9 months of age (breastfed as sole milk source, mixed fed, or formula fed) and iron deficiency anemia (IDA), iron deficiency, and iron sufficiency were determined in infants from Zhejiang (n = 142) and Hebei (n= 813) provinces. Iron deficiency was defined as body iron 0 mg/kg, and IDA as iron deficiency + hemoglobin 110 g/L. Multiple logistic regression assessed associations between feeding pattern and iron status.Breastfeeding was associated with iron status (P .001). In Zhejiang, 27.5% of breastfed infants had IDA compared with 0% of formula-fed infants. The odds of iron deficiency/IDA were increased in breastfed and mixed-fed infants compared with formula-fed infants: breastfed vs formula-fed OR, 28.8 (95% CI, 3.7-226.4) and mixed-fed vs formula-fed OR, 11.0 (95% CI, 1.2-103.2). In Hebei, 44.0% of breastfed infants had IDA compared with 2.8% of formula-fed infants. With covariable adjustment, odds of IDA were increased in breastfed and mixed-fed groups: breastfed vs formula-fed OR, 78.8 (95% CI, 27.2-228.1) and mixed-fed vs formula-fed OR, 21.0 (95% CI, 7.3-60.9).In both cohorts, the odds of iron deficiency/IDA at 9 months of age were increased in breastfed and mixed-fed infants, and iron deficiency/IDA was common. Although the benefits of breastfeeding are indisputable, these findings add to the evidence that breastfeeding in later infancy identifies infants at risk for iron deficiency/IDA in many settings. Protocols for detecting and preventing iron deficiency/IDA in breastfed infants are needed.ClinicalTrials.gov: NCT00642863 and NCT00613717.
- Published
- 2017