Iron status of breastfed infants is improved equally by medicinal iron and iron-fortified cereal
Iron status of breastfed infants is improved equally by medicinal iron and iron-fortified cereal
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DOI：
10.3945/ajcn.2008.27350
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发表时间：
2009-07-01
影响因子：
7.1
通讯作者：
Jeter, Janice M.
中科院分区：
文献类型：
--
作者：
Ziegler, Ekhard E.;Nelson, Steven E.;Jeter, Janice M.
背景：虽然不常见，但母乳喂养的婴儿会出现铁缺乏症 (ID)。定期补充铁可以预防智力缺陷。 目的：目的是测试两种为母乳喂养的婴儿提供铁（药用铁或铁强化谷物）的可行性和有效性。该研究测试了这样的假设：定期补充铁可以改善母乳喂养婴儿的铁状态，且不会产生不良影响。设计：在这项前瞻性、随机、开放标签试验中，母乳喂养的婴儿在 4 至 9 个月内定期接受药用铁 (n = 48) 或铁强化水果谷物组合 (n = 45) 或不接受干预（对照组；n = 59）。干预措施提供 7.0-7.5 毫克硫酸亚铁/天。婴儿在 1 个月时入组，并随访至 2 岁。定期测定铁状态指标，记录粪便特征，并监测生长情况。结果：定期补充铁可以改善干预期间和干预后几个月的铁状态。两种铁来源的效果大致相同。铁会影响粪便颜色，但对进食相关行为没有影响。然而，药用铁与长度增加小幅但显着的减少以及体重增加减少的趋势有关。 4 名婴儿（2.3%）观察到 ID 性贫血，其中大多数出生时铁元素水平较低。轻度智力障碍在出生后的第二年很常见。结论：定期提供药用铁或铁强化谷物可以改善母乳喂养婴儿的铁状况，并可能预防智力障碍。两种方法同样有效，但药用铁会导致生长有所减缓。该试验已在临床试验中注册。政府编号为 NCT00760890。美国临床营养杂志 2009；90：76-87。
Background: Although uncommon, iron deficiency (ID) occurs in breastfed infants. The regular provision of iron may prevent ID.Objective: The objective was to test the feasibility and effectiveness of 2 modalities of providing iron (medicinal iron or iron-fortified cereal) to breastfed infants. The study tested the hypothesis that regular provision of iron improves iron status of breastfed infants without adverse effects.Design: In this prospective, randomized, open-label trial, breastfed infants received on a regular basis either medicinal iron (n = 48) or an iron-fortified fruit-cereal combination (n = 45) from 4 to 9 mo or no intervention (control group; n = 59). The interventions provided 7.0-7.5 mg ferrous sulfate/d. Infants were enrolled at 1 mo and were followed to 2 y. Iron-status indicators were determined periodically, stool characteristics were recorded, and growth was monitored.Results: The regular provision of iron led to improved iron status during and for some months after the intervention. Both sources of iron were about equally effective. Iron affected stool color but had no effect on feeding-related behavior. However, medicinal iron was associated with a small but significant reduction in length gain and a trend toward reduced weight gain. ID anemia was observed in 4 infants (2.3%), most of whom had a low birth iron endowment. Mild ID was common in the second year of life.Conclusions: Regular provision of medicinal iron or iron-fortified cereal improves the iron status of breastfed infants and may prevent ID. Both modalities are equally effective, but medicinal iron leads to somewhat reduced growth. This trial was registered at clinicaltrials. gov as NCT00760890. Am J Clin Nutr 2009;90:76-87.