Research Institute of Child Nutrition, Rheinische Friedrich-Wilhelms University of Bonn, Heinstueck 11, D-44225 Dortmund, Germany.
Clin Nutr. 2010 Dec;29(6):773-8. doi: 10.1016/j.clnu.2010.05.002. Epub 2010 Jun 2.
BACKGROUND & AIMS: Breastfed infants may be at particular risk for iron deficiency because breast milk is low in iron. In a secondary analysis of data from a complementary feeding trial, indicators of iron status were examined, with particular focus on the development of iron status in those infants who were fully breastfed during the first 4 months of life.
In this retrospective analysis of data from a randomized controlled trial infants were stratified according to their predominant milk diet during the first 4 months of life, a subgroup of breastfed infants (group BM, n=53) were compared with a subgroup of infants fed (iron-fortified) formula (group F, n=23). Dietary iron intake and indicators of iron status were analysed at 4 months of age (during the full milk feeding period), and during the complementary feeding period at 7 and 10 months of age.
Iron intake was low in the BM group, ranging below the Dietary Reference Intakes throughout the complementary feeding period, with the (estimated) bioavailable iron intake only just achieving the reference requirements. At 4 months, iron deficiency (ID, Ferritin <12.0 ng/mL) was observed in 3 infants in the BM group and in 1 infant in the F group; no infant developed iron deficiency anaemia (IDA, ID and Hb <10.5 g/dl). At 7 and at 10 months of age, iron status was adequate in all infants of the F group. In the BM group, at 7 (10) months of age, ID was diagnosed in 10 (11) infants and IDA was found in 2 (1) infants.
Healthy infants, fully breastfed at 4 months of age, demonstrated ID in about 21% and IDA in up to 6% during the second half of infancy while fed according to the paediatric dietary guidelines. This finding supports the recommendation that supplementation with bioavailable iron via complementary foods should be started early (4-6 months of age) in order to prevent iron deficiency during infancy.
母乳喂养的婴儿可能特别容易缺铁，因为母乳中的铁含量较低。在一项补充喂养试验数据的二次分析中，我们检查了铁状态的指标，特别关注那些在前 4 个月完全母乳喂养的婴儿的铁状态发展情况。
在这项针对随机对照试验数据的回顾性分析中，我们根据婴儿在前 4 个月的主要奶类饮食进行分层，其中一组母乳喂养婴儿（组 BM，n=53）与一组配方奶喂养婴儿（组 F，n=23）进行比较。在 4 个月时（在完全母乳喂养期间）和在 7 个月和 10 个月时的补充喂养期间，分析了膳食铁摄入量和铁状态指标。
BM 组的铁摄入量较低，在整个补充喂养期间均低于膳食参考摄入量，（估计）可利用铁摄入量仅勉强达到参考要求。在 4 个月时，BM 组有 3 名婴儿和 F 组有 1 名婴儿出现缺铁（Ferritin <12.0 ng/mL）；没有婴儿出现缺铁性贫血（ID 和 Hb <10.5 g/dl）。在 7 个月和 10 个月时，F 组所有婴儿的铁状态都充足。在 BM 组，在 7 个月（10 个月）时，10 名（11 名）婴儿被诊断为 ID，2 名（1 名）婴儿被诊断为 IDA。
按照儿科饮食指南，在 4 个月时完全母乳喂养的健康婴儿，在婴儿期的后半段，约有 21%的婴儿出现 ID，多达 6%的婴儿出现 IDA。这一发现支持了以下建议：为了预防婴儿期缺铁，应通过补充食品尽早（4-6 个月）开始补充可利用铁。
