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Effectiveness of iron-fortified infant cereal in prevention of iron deficiency anemia.
Pediatrics. 1993 May; 91(5):976-82.Ped

Abstract

BACKGROUND

Iron deficiency continues to be a common problem among infants throughout the world. Iron-fortified formula is effective in preventing iron deficiency but the benefit of iron-fortified cereal is controversial.

METHODS

We compared iron-fortified rice cereal to unfortified rice cereal in infants who were exclusively breast-fed for more than 4 months and to iron-fortified formula in infants who were weaned to formula before 4 months of age. The design was double blind in respect to the presence or absence of fortification iron in the cereal or formula and included 515 infants who were followed on the protocol from 4 to 15 months of age. Rice cereal was fortified with 55 mg of electrolytic iron per 100 g of dry cereal and infant formula with 12 mg of ferrous sulfate per 100 g of dry powder, levels approximating those in use in the United States. Measures of iron status were obtained at 8, 12, and 15 months. Infants with hemoglobin levels of < 105 g/L were excluded from the study and treated.

RESULTS

Consumption of cereal reached plateaus at means of about 30 g/d after 6 months of age in the formula-fed groups and 26 g/d after 8 months in the breast-fed groups; these amounts are higher than the 19-g/d mean intake by the 73% of infants who consume such cereal in the United States. Among infants weaned to formula before 4 months, the cumulative percentages of infants excluded for anemia by 15 months were 8%, 24%, and 4%, respectively, in the fortified cereal, unfortified cereal and formula, and fortified formula groups (P < .01 unfortified vs either fortified group; the difference between the two fortified groups was not significant). In infants breast-fed for more than 4 months, the corresponding values were 13% and 27%, respectively, in the fortified and unfortified cereal groups (P < .05). Mean hemoglobin level and other iron status measures were in accord with these findings.

CONCLUSION

Iron-fortified infant rice cereal can contribute substantially to preventing iron deficiency anemia.

Authors+Show Affiliations

Hematology Unit, Instituto de Nutricion y Technologia de los Alimentos, Universidad de Chile, Santiago.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Controlled Clinical Trial
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

8474819

Citation

Walter, T, et al. "Effectiveness of Iron-fortified Infant Cereal in Prevention of Iron Deficiency Anemia." Pediatrics, vol. 91, no. 5, 1993, pp. 976-82.
Walter T, Dallman PR, Pizarro F, et al. Effectiveness of iron-fortified infant cereal in prevention of iron deficiency anemia. Pediatrics. 1993;91(5):976-82.
Walter, T., Dallman, P. R., Pizarro, F., Velozo, L., Peña, G., Bartholmey, S. J., Hertrampf, E., Olivares, M., Letelier, A., & Arredondo, M. (1993). Effectiveness of iron-fortified infant cereal in prevention of iron deficiency anemia. Pediatrics, 91(5), 976-82.
Walter T, et al. Effectiveness of Iron-fortified Infant Cereal in Prevention of Iron Deficiency Anemia. Pediatrics. 1993;91(5):976-82. PubMed PMID: 8474819.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effectiveness of iron-fortified infant cereal in prevention of iron deficiency anemia. AU - Walter,T, AU - Dallman,P R, AU - Pizarro,F, AU - Velozo,L, AU - Peña,G, AU - Bartholmey,S J, AU - Hertrampf,E, AU - Olivares,M, AU - Letelier,A, AU - Arredondo,M, PY - 1993/5/1/pubmed PY - 1993/5/1/medline PY - 1993/5/1/entrez SP - 976 EP - 82 JF - Pediatrics JO - Pediatrics VL - 91 IS - 5 N2 - BACKGROUND: Iron deficiency continues to be a common problem among infants throughout the world. Iron-fortified formula is effective in preventing iron deficiency but the benefit of iron-fortified cereal is controversial. METHODS: We compared iron-fortified rice cereal to unfortified rice cereal in infants who were exclusively breast-fed for more than 4 months and to iron-fortified formula in infants who were weaned to formula before 4 months of age. The design was double blind in respect to the presence or absence of fortification iron in the cereal or formula and included 515 infants who were followed on the protocol from 4 to 15 months of age. Rice cereal was fortified with 55 mg of electrolytic iron per 100 g of dry cereal and infant formula with 12 mg of ferrous sulfate per 100 g of dry powder, levels approximating those in use in the United States. Measures of iron status were obtained at 8, 12, and 15 months. Infants with hemoglobin levels of < 105 g/L were excluded from the study and treated. RESULTS: Consumption of cereal reached plateaus at means of about 30 g/d after 6 months of age in the formula-fed groups and 26 g/d after 8 months in the breast-fed groups; these amounts are higher than the 19-g/d mean intake by the 73% of infants who consume such cereal in the United States. Among infants weaned to formula before 4 months, the cumulative percentages of infants excluded for anemia by 15 months were 8%, 24%, and 4%, respectively, in the fortified cereal, unfortified cereal and formula, and fortified formula groups (P < .01 unfortified vs either fortified group; the difference between the two fortified groups was not significant). In infants breast-fed for more than 4 months, the corresponding values were 13% and 27%, respectively, in the fortified and unfortified cereal groups (P < .05). Mean hemoglobin level and other iron status measures were in accord with these findings. CONCLUSION: Iron-fortified infant rice cereal can contribute substantially to preventing iron deficiency anemia. SN - 0031-4005 UR - https://www.unboundmedicine.com/medline/citation/8474819/Effectiveness_of_iron_fortified_infant_cereal_in_prevention_of_iron_deficiency_anemia_ L2 - http://pediatrics.aappublications.org/cgi/pmidlookup?view=long&amp;pmid=8474819 DB - PRIME DP - Unbound Medicine ER -