Skip to main content
NCBI home page
Canadian Journal of Public Health = Revue Canadienne de Santé Publique logoLink to Canadian Journal of Public Health = Revue Canadienne de Santé Publique
. 2000 Jul 1;91(4):263–267. doi: 10.1007/BF03404285

Efficacy of Meat and Iron-fortified Commercial Cereal to Prevent Iron Depletion in Cow Milk-fed Infants 6 to 12 Months of Age: A Randomized Controlled Trial

George S Yeung 17,27,37, Stanley H Zlotkin 17,27,37,47,✉
PMCID: PMC6979905  PMID: 10986782

Abstract

Objective: To determine whether utilization of iron from infant cereal and pureed meat was sufficient to prevent iron depletion and/or anaemia in infants 6 to 12 months old fed whole cow milk (WCM) as their primary milk source.

Design: Six-month-old infants were randomized into a treatment group (n=43) receiving iron-fortified infant cereal (10.2 mg iron), pureed meat (0.75–1.7 mg iron) and WCM for six months or a control group (n=54) receiving no dietary intervention. Haemoglobin < 110 g/L or ferritin < 10 μg/L (measured bi-monthly), confirmed in a second blood sample, defined end-points.

Results: Proportion reaching end-point was similar between the treatment (3/43) and control infants (5/54) (p=0.66). Infants not complying with the protocol were at greater risk of reaching end-point (p=0.0002). Change in haemoglobin and ferritin across age was similar in both groups.

Conclusions: Iron deficiency is not a concern in WCM-fed infants after six months of age if iron-containing complementary foods are concurrently ingested.

Footnotes

This research was supported by grants from the Dairy Farmers of Ontario and the Ministry of Agriculture, Food and Rural Affairs Ontario. In-kind support was provided by H. J. Heinz Company of Canada, Nestle Canada Inc., Proctor & Gamble Inc. and Mead Johnson Canada.

References

  • 1.Scrimshaw NS. Iron deficiency. Sci Amer. 1991;265:46–52. doi: 10.1038/scientificamerican1091-46. [DOI] [PubMed] [Google Scholar]
  • 2.Longstaffe S, Moffatt MEK, Besant J. Iron-fortified formula and the prevention of siderope-nia in a high risk population. Clin Invest Med. 1993;16:A33. [Google Scholar]
  • 3.Lehmann F, Gray-Donald K, Mongeon M, Di Tommaso S. Iron deficiency anemia in 1-year-old children of disadvantaged families in Montreal. CMAJ. 1992;146:1572–77. [PMC free article] [PubMed] [Google Scholar]
  • 4.Bruner A, Joffe A, Duggan A, et al. Randomized study of cognitive effects of iron supplementation in non-anaemic iron-deficient adolescent girls. Lancet. 1996;348:992–96. doi: 10.1016/S0140-6736(96)02341-0. [DOI] [PubMed] [Google Scholar]
  • 5.Idjradinata P, Pollit E. Reversal of developmental delays in iron-deficient anaemic infants treated with iron. Lancet. 1993;341:1–4. doi: 10.1016/0140-6736(93)92477-B. [DOI] [PubMed] [Google Scholar]
  • 6.Walter T. Early and long-term effect of iron deficiency anemia on child development. In: Fomon SJ, Zlotkin SH, editors. Nutritional Anemias. Vevey: Raven Press; 1992. pp. 81–92. [Google Scholar]
  • 7.Lozoff B, Jimenez MD, Wolf AW. Long-term development outcome of infants with iron deficiency. N Engl J Med. 1991;325:687–94. doi: 10.1056/NEJM199109053251004. [DOI] [PubMed] [Google Scholar]
  • 8.Walter R, De Andraca I, Chadud P, et al. Adverse effect of iron deficiency anemia on infant psychomotor development. Pediatr Res. 1988;23:650–56. doi: 10.1203/00006450-198806000-00044. [DOI] [PubMed] [Google Scholar]
  • 9.Lozoff B, Brittenham GM, Wolf AW, et al. Iron deficiency anemia and iron therapy effects on infant development test performance. Pediatrics. 1987;79:981–95. [PubMed] [Google Scholar]
  • 10.Aukett MA, Parks YA, Scott PH, Wharton BA. Treatment with iron increases weight gain and psychomotor development. Arch Dis Child. 1986;61:849–57. doi: 10.1136/adc.61.9.849. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 11.Canadian Paediatric Society, Dietitians of CanadaHealth Canada. Nutrition for Healthy Term Infants. Ottawa: Minister of Public Works and Government Services; 1998. [Google Scholar]
  • 12.Canadian Paediatric Society Nutrition Committee. Meeting the iron needs of infants and young children: An update. CMAJ. 1991;144:1451–54. [PMC free article] [PubMed] [Google Scholar]
  • 13.Shears E. Meeting the iron needs of infants and young children: An update — a public health response (letter) CMAJ. 1991;145:1558–59. [PMC free article] [PubMed] [Google Scholar]
  • 14.American Academy of Pediatrics Committee on Nutrition. The use of whole cow’s milk in infancy. Pediatr. 1992;89:1105–9. [PubMed] [Google Scholar]
  • 15.Hoag M, Wallerstein R, Pollycovem M. Occult blood loss in iron deficiency anemia of infancy. Pediatrics 1961;27:199–203. [PubMed]
  • 16.Rasch C, Cotton E, Harris J, Griggs R. Blood loss as a contributing factor in the etiology of iron-lack anemia of infancy. Am J Dis Child. 1960;100:627. [Google Scholar]
  • 17.Woodruff CW, Wright SW, Wright RP. The role of fresh cow’s milk in iron deficiency. Am J Clin Nutr. 1972;124:26–30. doi: 10.1001/archpedi.1972.02110130028004. [DOI] [PubMed] [Google Scholar]
  • 18.Fomon S, Ziegler E, Nelson S, Edwards B. Cow milk feeding in infancy: Gastrointestinal blood loss and iron nutritional status. J Pediatr. 1981;98:540–45. doi: 10.1016/S0022-3476(81)80756-1. [DOI] [PubMed] [Google Scholar]
  • 19.Belsten J, Phillips C, Fairweather-Tait S, et al. Endogenous iron losses in 6–12 month old infants. In: Fischer P, L’Abbe M, Cockell K, Gibson R, et al., editors. Proceedings of the Ninth International Symposium on Trace Elements in Man and Animals. Ottawa: NRC Research Press; 1997. pp. 509–11. [Google Scholar]
  • 20.Fuchs G, Farris R, DeWier M, et al. Iron status and intake of older infants fed formula vs cow milk with cereal. Am J Clin Nutr. 1993;58:343–48. doi: 10.1093/ajcn/58.3.343. [DOI] [PubMed] [Google Scholar]
  • 21.Thomas DW, McGilligan KM, Carlson M, et al. Fecal α -anti-trypsin and hemoglobin excretion 1 in healthy human milk-, formula-, or cow’s milk-fed infants. Pediatrics. 1986;78:305–12. [PubMed] [Google Scholar]
  • 22.Zlotkin SH, Ste-Marie M, Kopelman H, et al. The prevalence of iron depletion and iron-deficiency anaemia in a randomly selected group of infants from four Canadian cities. Nutrition Research. 1996;16:729–33. doi: 10.1016/0271-5317(96)00063-2. [DOI] [Google Scholar]
  • 23.Zlotkin S, Beaton G, Tanaka P, et al. Double blind trial of iron fortification of infant cereals: Effect on growth and haematologic status. Pediatr Res. 1993;33:113A. [Google Scholar]
  • 24.Drabkin DL, Austin JH. Spectrophotometric studies: Spectrophotometric constants for common hemoglobin derivatives in human, dog and rabbit blood. J Biol Chem. 1932;98:719–33. [Google Scholar]
  • 25.Mills LE, Lipshitz DA, Bieber CP, Cook JD. Measurement of serum ferritin by a 2-site immunoradiometric method. Anal Biochem. 1974;61:209–24. doi: 10.1016/0003-2697(74)90347-9. [DOI] [PubMed] [Google Scholar]
  • 26.Czajka-Nairns DM, Haddy TB, Kalbn OJ. Nutrition and social correlates in iron deficiency anemia. Am J Clin Nutr. 1978;31:955–60. doi: 10.1093/ajcn/31.6.955. [DOI] [PubMed] [Google Scholar]
  • 27.Dallman PR. Nutritional anemia of infancy: Iron, folic acid, and vitamin B-12. In: Tsang RC, Nichols BL, editors. Infant Nutrition. Philadelphia: Hanley and Belfus Inc.; 1988. pp. 216–35. [Google Scholar]
  • 28.Engelmann MD, Davidsson L, Sandstrom B, et al. The influence of meat on nonheme iron absorption in infants. Pediatr Res. 1998;43:768–73. doi: 10.1203/00006450-199806000-00009. [DOI] [PubMed] [Google Scholar]
  • 29.Walter T, Dallman PR, Pizarro F, et al. Effectiveness of iron-fortified infant cereal in prevention of iron deficiency anemia. Pediatrics. 1993;91:976–82. [PubMed] [Google Scholar]
  • 30.Haschke F, Pietschnig B, Vanura H, et al. Iron intake and iron nutritional status of infants fed iron-fortified beikost with meat. Am J Clin Nutr. 1988;47:108–12. doi: 10.1093/ajcn/47.1.108. [DOI] [PubMed] [Google Scholar]

Articles from Canadian Journal of Public Health = Revue Canadienne de Santé Publique are provided here courtesy of Springer

RESOURCES