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Consumption of cow's milk as a cause of iron deficiency in infants and toddlers.

Abstract

Consumption of cow's milk (CM) by infants and toddlers has adverse effects on their iron stores, a finding that has been well documented in many localities. Several mechanisms have been identified that may contribute to iron deficiency in this young population group. The most important of these is probably the low iron content of CM, which makes it difficult for infants to obtain the amounts of iron needed for growth. A second mechanism is the occult intestinal blood loss associated with CM consumption during infancy, a condition that affects about 40% of otherwise healthy infants. Loss of iron in the form of blood diminishes with age and ceases after the age of 1 year. A third mechanism is the inhibition of non-heme iron absorption by calcium and casein, both of which are present in high amounts in CM. Fortification of CM with iron, as practiced in some countries, can protect infants and toddlers against CM's negative effects on iron status. Consumption of CM produces a high renal solute load, which leads to a higher urine solute concentration than consumption of breast milk or formula, thereby narrowing the margin of safety during dehydrating events, such as diarrhea. The high protein intake from CM may also place infants at increased risk of obesity in later childhood. It is thus recommended that unmodified, unfortified CM not be fed to infants and that it be fed to toddlers in modest amounts only.

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  • Publisher Full Text
  • Authors+Show Affiliations

    Fomon Infant Nutrition Unit, Department of Pediatrics, University of Iowa, Iowa City, Iowa, USA. ekhard-ziegler@uiowa.edu

    Source

    Nutrition reviews 69 Suppl 1: 2011 Nov pg S37-42

    MeSH

    Anemia, Iron-Deficiency
    Animals
    Calcium, Dietary
    Caseins
    Child Nutritional Physiological Phenomena
    Child, Preschool
    Food, Fortified
    Humans
    Infant
    Infant Formula
    Infant Nutritional Physiological Phenomena
    Intestinal Mucosa
    Iron, Dietary
    Milk
    Milk, Human
    Nutritional Status
    Obesity
    Occult Blood

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    22043881

    Citation

    Ziegler, Ekhard E.. "Consumption of Cow's Milk as a Cause of Iron Deficiency in Infants and Toddlers." Nutrition Reviews, vol. 69 Suppl 1, 2011, pp. S37-42.
    Ziegler EE. Consumption of cow's milk as a cause of iron deficiency in infants and toddlers. Nutr Rev. 2011;69 Suppl 1:S37-42.
    Ziegler, E. E. (2011). Consumption of cow's milk as a cause of iron deficiency in infants and toddlers. Nutrition Reviews, 69 Suppl 1, pp. S37-42. doi:10.1111/j.1753-4887.2011.00431.x.
    Ziegler EE. Consumption of Cow's Milk as a Cause of Iron Deficiency in Infants and Toddlers. Nutr Rev. 2011;69 Suppl 1:S37-42. PubMed PMID: 22043881.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Consumption of cow's milk as a cause of iron deficiency in infants and toddlers. A1 - Ziegler,Ekhard E, PY - 2011/11/3/entrez PY - 2011/11/9/pubmed PY - 2012/3/1/medline SP - S37 EP - 42 JF - Nutrition reviews JO - Nutr. Rev. VL - 69 Suppl 1 N2 - Consumption of cow's milk (CM) by infants and toddlers has adverse effects on their iron stores, a finding that has been well documented in many localities. Several mechanisms have been identified that may contribute to iron deficiency in this young population group. The most important of these is probably the low iron content of CM, which makes it difficult for infants to obtain the amounts of iron needed for growth. A second mechanism is the occult intestinal blood loss associated with CM consumption during infancy, a condition that affects about 40% of otherwise healthy infants. Loss of iron in the form of blood diminishes with age and ceases after the age of 1 year. A third mechanism is the inhibition of non-heme iron absorption by calcium and casein, both of which are present in high amounts in CM. Fortification of CM with iron, as practiced in some countries, can protect infants and toddlers against CM's negative effects on iron status. Consumption of CM produces a high renal solute load, which leads to a higher urine solute concentration than consumption of breast milk or formula, thereby narrowing the margin of safety during dehydrating events, such as diarrhea. The high protein intake from CM may also place infants at increased risk of obesity in later childhood. It is thus recommended that unmodified, unfortified CM not be fed to infants and that it be fed to toddlers in modest amounts only. SN - 1753-4887 UR - https://www.unboundmedicine.com/medline/citation/22043881/full_citation L2 - https://academic.oup.com/nutritionreviews/article-lookup/doi/10.1111/j.1753-4887.2011.00431.x DB - PRIME DP - Unbound Medicine ER -