Abstract
AIMS—Iron deficiency anaemia is associated, in observational studies, with developmental disadvantage. This study tested the hypothesis that feeding iron supplemented formula from 9 to 18 months of age would improve developmental performance. SUBJECTS AND METHODS—493 healthy children aged 9 months being fed pasteurised cows' milk were recruited from three UK centres. They were randomised to: cows' milk as before, formula containing 0.9 mg/litre iron, or formula containing 1.2 mg/litre iron, until 18 months of age. Bayley mental and psychomotor developmental indices were measured at 18 months, as were growth and haematological indices. RESULTS—Children fed iron fortified formula had higher plasma ferritin concentrations, but there were no significant intergroup differences in development or growth. CONCLUSIONS—There are no developmental or growth advantages in children given iron supplemented formula, but a benefit for a minority who were anaemic, or the possibility that a benefit may emerge at a later age, cannot be excluded.
Full Text
The Full Text of this article is available as a PDF (92.9 KB).
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Ashby D. Can iron supplementation improve cognitive functioning? Lancet. 1996 Oct 12;348(9033):973–973. doi: 10.1016/S0140-6736(05)64919-7. [DOI] [PubMed] [Google Scholar]
- Aukett M. A., Parks Y. A., Scott P. H., Wharton B. A. Treatment with iron increases weight gain and psychomotor development. Arch Dis Child. 1986 Sep;61(9):849–857. doi: 10.1136/adc.61.9.849. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Beard J. L., Connor J. R., Jones B. C. Iron in the brain. Nutr Rev. 1993 Jun;51(6):157–170. doi: 10.1111/j.1753-4887.1993.tb03096.x. [DOI] [PubMed] [Google Scholar]
- Bruner A. B., Joffe A., Duggan A. K., Casella J. F., Brandt J. Randomised study of cognitive effects of iron supplementation in non-anaemic iron-deficient adolescent girls. Lancet. 1996 Oct 12;348(9033):992–996. doi: 10.1016/S0140-6736(96)02341-0. [DOI] [PubMed] [Google Scholar]
- Connor J. R., Benkovic S. A. Iron regulation in the brain: histochemical, biochemical, and molecular considerations. Ann Neurol. 1992;32 (Suppl):S51–S61. doi: 10.1002/ana.410320710. [DOI] [PubMed] [Google Scholar]
- Connor J. R., Menzies S. L. Altered cellular distribution of iron in the central nervous system of myelin deficient rats. Neuroscience. 1990;34(1):265–271. doi: 10.1016/0306-4522(90)90320-4. [DOI] [PubMed] [Google Scholar]
- Cook J. D. Iron-deficiency anaemia. Baillieres Clin Haematol. 1994 Dec;7(4):787–804. doi: 10.1016/s0950-3536(05)80124-6. [DOI] [PubMed] [Google Scholar]
- Daly A., MacDonald A., Aukett A., Williams J., Wolf A., Davidson J., Booth I. W. Prevention of anaemia in inner city toddlers by an iron supplemented cows' milk formula. Arch Dis Child. 1996 Jul;75(1):9–16. doi: 10.1136/adc.75.1.9. [DOI] [PMC free article] [PubMed] [Google Scholar]
- DeMaeyer E., Adiels-Tegman M. The prevalence of anaemia in the world. World Health Stat Q. 1985;38(3):302–316. [PubMed] [Google Scholar]
- Hertrampf E., Olivares M., Pizarro F., Walter T., Cayazzo M., Heresi G., Llaguno S., Chadud P., Stekel A. Haemoglobin fortified cereal: a source of available iron to breast-fed infants. Eur J Clin Nutr. 1990 Nov;44(11):793–798. [PubMed] [Google Scholar]
- Idjradinata P., Pollitt E. Reversal of developmental delays in iron-deficient anaemic infants treated with iron. Lancet. 1993 Jan 2;341(8836):1–4. doi: 10.1016/0140-6736(93)92477-b. [DOI] [PubMed] [Google Scholar]
- Idjradinata P., Watkins W. E., Pollitt E. Adverse effect of iron supplementation on weight gain of iron-replete young children. Lancet. 1994 May 21;343(8908):1252–1254. doi: 10.1016/s0140-6736(94)92151-2. [DOI] [PubMed] [Google Scholar]
- Knobloch H., Pasamanick B., Sherard E. S., Jr A developmental screening inventory for infants. Pediatrics. 1966 Dec;38(6 Suppl):1095–1108. [PubMed] [Google Scholar]
- Logan S. Commentary: iron deficiency and developmental deficit-the jury is still out. BMJ. 1999 Mar 13;318(7185):697–698. [PubMed] [Google Scholar]
- Lozoff B., Jimenez E., Wolf A. W. Long-term developmental outcome of infants with iron deficiency. N Engl J Med. 1991 Sep 5;325(10):687–694. doi: 10.1056/NEJM199109053251004. [DOI] [PubMed] [Google Scholar]
- Lozoff B., Wolf A. W., Jimenez E. Iron-deficiency anemia and infant development: effects of extended oral iron therapy. J Pediatr. 1996 Sep;129(3):382–389. doi: 10.1016/s0022-3476(96)70070-7. [DOI] [PubMed] [Google Scholar]
- Lucas A., Cole T. J., Morley R., Lucas P. J., Davis J. A., Bamford M. F., Crowle P., Dossetor J. F., Pearse R., Boon A. Factors associated with maternal choice to provide breast milk for low birthweight infants. Arch Dis Child. 1988 Jan;63(1):48–52. doi: 10.1136/adc.63.1.48. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Marder E., Nicoll A., Polnay L., Shulman C. E. Discovering anaemia at child health clinics. Arch Dis Child. 1990 Aug;65(8):892–894. doi: 10.1136/adc.65.8.892. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Marx J. J. Iron deficiency in developed countries: prevalence, influence of lifestyle factors and hazards of prevention. Eur J Clin Nutr. 1997 Aug;51(8):491–494. doi: 10.1038/sj.ejcn.1600440. [DOI] [PubMed] [Google Scholar]
- Moffatt M. E., Longstaffe S., Besant J., Dureski C. Prevention of iron deficiency and psychomotor decline in high-risk infants through use of iron-fortified infant formula: a randomized clinical trial. J Pediatr. 1994 Oct;125(4):527–534. doi: 10.1016/s0022-3476(94)70003-6. [DOI] [PubMed] [Google Scholar]
- Roncagliolo M., Garrido M., Walter T., Peirano P., Lozoff B. Evidence of altered central nervous system development in infants with iron deficiency anemia at 6 mo: delayed maturation of auditory brainstem responses. Am J Clin Nutr. 1998 Sep;68(3):683–690. doi: 10.1093/ajcn/68.3.683. [DOI] [PubMed] [Google Scholar]
- Stevens D., Nelson A. The effect of iron in formula milk after 6 months of age. Arch Dis Child. 1995 Sep;73(3):216–220. doi: 10.1136/adc.73.3.216. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Walter T. Impact of iron deficiency on cognition in infancy and childhood. Eur J Clin Nutr. 1993 May;47(5):307–316. [PubMed] [Google Scholar]
- Williams J., Wolff A., Daly A., MacDonald A., Aukett A., Booth I. W. Iron supplemented formula milk related to reduction in psychomotor decline in infants from inner city areas: randomised study. BMJ. 1999 Mar 13;318(7185):693–697. doi: 10.1136/bmj.318.7185.693. [DOI] [PMC free article] [PubMed] [Google Scholar]