Greer Frank R
Wisconsin Perinatal Center, Meriter Hospital 6-Center, 202 S Park Street, Madison, WI 53715, USA.
Curr Pediatr Rev. 2015;11(4):298-304. doi: 10.2174/1573396311666150731112726.
The iron requirement for breastfed infants remains controversial. Given the impact of iron on neurodevelopmental outcomes and the questionable impact of iron supplements after iron deficiency has occurred, its importance as a nutrient in this population cannot be down played. Infants are born with relatively large body stores of iron that are marginally related to maternal iron status in developed countries. Delayed cord clamping may increase these fetal stores, but at the present time this is only recommended for preterm infants who are born with low iron stores. The diagnosis of iron deficiency (ID) and iron deficiency anemia (IDA) remains problematic though new laboratory tests (measures of reticulocyte hemoglobin concentration and serum transferrin receptor) hold promise in developed countries. The present evidence supports the potential benefits of iron supplementation of exclusively breastfed infants after 4 months of age, by which time the iron stores present at birth are depleted. This deficit cannot be made up even if the small amounts of iron in human milk are completely absorbed.
母乳喂养婴儿的铁需求量仍存在争议。鉴于铁对神经发育结果的影响以及缺铁发生后铁补充剂的影响存疑，其作为该人群营养素的重要性不可忽视。在发达国家，婴儿出生时体内铁储备相对较多，这与母亲的铁状况关系不大。延迟脐带结扎可能会增加这些胎儿储备，但目前仅建议对出生时铁储备低的早产儿采用此方法。尽管新的实验室检测（网织红细胞血红蛋白浓度和血清转铁蛋白受体测量）在发达国家有前景，但缺铁（ID）和缺铁性贫血（IDA）的诊断仍然存在问题。目前的证据支持对4个月龄后的纯母乳喂养婴儿补充铁剂的潜在益处，到这个时候出生时存在的铁储备已耗尽。即使母乳中的少量铁被完全吸收，这种不足也无法弥补。
