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Breastfeeding and GI Disease and Iron Deficiency
Predominantly Breast-Fed Infants For Six Months Have Fewer Gastrointestinal Infections, but Greater Risk for Iron Deficiency
A study from the Journal of Nutrition found that predominantly breast-fed term infants for the first six months of life are half as likely to have gastrointestinal infections (GI) compared to formula fed (defined as consuming no human milk by three months of age and continued use for formula to at least five months) or partially breast-fed infants (defined as receiving human milk and regular use of formula). These infants, however, had nine times the odds of developing iron deficiency (ID), as measured by serum ferritin and hemoglobin. (ID was defined as having both HB<110 g/L and serum ferritin <12 micrograms/L). No difference between anemia (defined as Hb < 110 g/L) prevalence was observed among the three groups. The authors adjusted all analyses for confounding variables such as maternal education, smoking status, and primipara. The study examined data obtained from term infants born to low-income women in Mexico.
A strength of this study is that it was a prospective study, meaning the authors followed the infants forward in time to measure the development of iron deficiency and GI infections. Limitations of this study include a small sample size, a lack of data on iron status at birth, the potential for recall bias of infant feeding, and the potential for selection bias, due to a high drop out rate of infants initially enrolled in the study.
According to the authors, “our findings add to a small body of literature of the negative association of full breast-feeding to 6 months and infant iron status.” However, the authors conclude that “in this low-income population, our results suggest that predominant breastfeeding should be promoted and the risk for iron deficiency managed using public health and nutrition strategies.”
Monterrosa, E.C., et al., Predominant breast-feeding from birth to six months is associated with fewer gastrointestinal infections and increased risk for iron deficiency among infants. J Nutr, 2008. 138 (8): p. 1499-504.