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Full breastfeeding duration and risk for iron deficiency in U.S. infants.
Breastfeed Med. 2007 Jun; 2(2):63-73.BM

Abstract

BACKGROUND

National and international authorities recommend exclusive breastfeeding for an infant's first 6 months. Effects of these recommendations on iron status of U.S. children are unknown.

OBJECTIVE

To ascertain if full breastfeeding for 6 months versus 4 months places U.S. children at greater risk for iron deficiency.

DESIGN/METHODS

Data regarding 2268 children ages 6 to <24 months from NHANES III, a nationally representative cross-sectional survey conducted from 1988-1994, were analyzed. Similar analyses were conducted for 526 children ages 12 to <24 months from NHANES 1999-2002. Anemia (low hemoglobin or history of anemia) and iron status (serum ferritin) were compared for five groups: formula fed only (n = 1142), or full breastfeeding for: 1 month "FullBF<1" (n = 425), 1 to <4 months "FullBF1-3+" (n = 343), 4 to <6 months "FullBF4-5+" (n = 222), and >or= 6 months "FullBF6" (n = 136). Laboratory data were available for children 12 to 24 months (n = 745). SUDAAN software was used to account for the complex sampling design. Logistic regression adjusted for confounding factors.

RESULTS

In unadjusted analyses (NHANES III), 10.0% of "FullBF6+" versus 2.3% of "FullBF4-5+" had a history of anemia (p = 0.007) but unadjusted between group serum ferritin and hemoglobin differences were insignificant in both surveys. Adjusting for birth weight and demography revealed persistently lower risk of history of anemia (NHANES III, odds ratio [OR] 0.20, confidence interval [CI] 0.06, 0.63) and low serum ferritin (NHANES 1999-2002, OR 0.19, CI 0.06, 0.57) but not low hemoglobin at time of survey "FullBF4-5+" versus "FullBF6."

CONCLUSIONS

Young children in the United States fully breastfed for 6 months may be at increased risk of iron deficiency. Adequate iron may not be provided by typical complementary infant foods. Healthcare providers should be vigilant to prevent iron deficiency in this group of infants.

Authors+Show Affiliations

Department of Pediatrics, University of California-Davis Medical Center, Sacramento, California.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17661577

Citation

Chantry, Caroline J., et al. "Full Breastfeeding Duration and Risk for Iron Deficiency in U.S. Infants." Breastfeeding Medicine : the Official Journal of the Academy of Breastfeeding Medicine, vol. 2, no. 2, 2007, pp. 63-73.
Chantry CJ, Howard CR, Auinger P. Full breastfeeding duration and risk for iron deficiency in U.S. infants. Breastfeed Med. 2007;2(2):63-73.
Chantry, C. J., Howard, C. R., & Auinger, P. (2007). Full breastfeeding duration and risk for iron deficiency in U.S. infants. Breastfeeding Medicine : the Official Journal of the Academy of Breastfeeding Medicine, 2(2), 63-73.
Chantry CJ, Howard CR, Auinger P. Full Breastfeeding Duration and Risk for Iron Deficiency in U.S. Infants. Breastfeed Med. 2007;2(2):63-73. PubMed PMID: 17661577.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Full breastfeeding duration and risk for iron deficiency in U.S. infants. AU - Chantry,Caroline J, AU - Howard,Cynthia R, AU - Auinger,Peggy, PY - 2007/7/31/pubmed PY - 2007/9/11/medline PY - 2007/7/31/entrez SP - 63 EP - 73 JF - Breastfeeding medicine : the official journal of the Academy of Breastfeeding Medicine JO - Breastfeed Med VL - 2 IS - 2 N2 - BACKGROUND: National and international authorities recommend exclusive breastfeeding for an infant's first 6 months. Effects of these recommendations on iron status of U.S. children are unknown. OBJECTIVE: To ascertain if full breastfeeding for 6 months versus 4 months places U.S. children at greater risk for iron deficiency. DESIGN/METHODS: Data regarding 2268 children ages 6 to <24 months from NHANES III, a nationally representative cross-sectional survey conducted from 1988-1994, were analyzed. Similar analyses were conducted for 526 children ages 12 to <24 months from NHANES 1999-2002. Anemia (low hemoglobin or history of anemia) and iron status (serum ferritin) were compared for five groups: formula fed only (n = 1142), or full breastfeeding for: 1 month "FullBF<1" (n = 425), 1 to <4 months "FullBF1-3+" (n = 343), 4 to <6 months "FullBF4-5+" (n = 222), and >or= 6 months "FullBF6" (n = 136). Laboratory data were available for children 12 to 24 months (n = 745). SUDAAN software was used to account for the complex sampling design. Logistic regression adjusted for confounding factors. RESULTS: In unadjusted analyses (NHANES III), 10.0% of "FullBF6+" versus 2.3% of "FullBF4-5+" had a history of anemia (p = 0.007) but unadjusted between group serum ferritin and hemoglobin differences were insignificant in both surveys. Adjusting for birth weight and demography revealed persistently lower risk of history of anemia (NHANES III, odds ratio [OR] 0.20, confidence interval [CI] 0.06, 0.63) and low serum ferritin (NHANES 1999-2002, OR 0.19, CI 0.06, 0.57) but not low hemoglobin at time of survey "FullBF4-5+" versus "FullBF6." CONCLUSIONS: Young children in the United States fully breastfed for 6 months may be at increased risk of iron deficiency. Adequate iron may not be provided by typical complementary infant foods. Healthcare providers should be vigilant to prevent iron deficiency in this group of infants. SN - 1556-8342 UR - https://www.unboundmedicine.com/medline/citation/17661577/Full_breastfeeding_duration_and_risk_for_iron_deficiency_in_U_S__infants_ L2 - https://www.liebertpub.com/doi/10.1089/bfm.2007.0002?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -