title: Prevention of iron-deficiency anemia: comparison of high- and low-iron formulas in term healthy infants after six months of life.
abstract: OBJECTIVE
  For bottle-fed babies or nursing infants who receive milk supplements, the American Academy of Pediatrics recommends the use of iron-fortified infant formula. Because these recommendations have not been universally adopted, the hematologic effects of currently available low-iron formulas need to be determined.
  
  
  METHODS
  Healthy Chilean 6-month-old infants (without iron-deficiency anemia, born at term weighing > or 3.0 kg) who were totally or partially weaned from the breast were randomly allocated in a double-blind fashion to receive high-iron (n = 430) or low-iron formula (n = 405), containing an average of 12.7 mg/L or 2.3 mg/L, respectively, of elemental iron as ferrous sulfate. Iron status was determined at 12 months.
  
  
  RESULTS
  The prevalence of iron-deficiency anemia was not different in the high- and low-iron groups (2.8% versus 3.8%, p = 0.35). Nevertheless, infants receiving high-iron formula had somewhat higher levels of hemoglobin and serum ferritin, greater mean cell volumes, and lower erythrocyte protoporphyrin levels (p < 0.005).
  
  
  CONCLUSIONS
  Although high-iron formulas are more efficacious in improving iron status, currently available low-iron formulas may prevent iron-deficiency anemia in selected healthy, term infant populations with otherwise poor sources of dietary iron after 6 months of life. Formulas with relatively small amounts of iron appear to prevent iron-deficiency anemia. We speculate that the optimal level of iron fortification likely lies somewhere between the current levels in high- and low-iron formulas.
authors.affiliation: Hematology Unit, Institute of Nutrition and Food Technology (INTA), University of Chile, Santiago, Chile.
authors.forename: T
authors.initials: T
authors.lastname: Walter
authors.forename: P
authors.initials: P
authors.lastname: Pino
authors.forename: F
authors.initials: F
authors.lastname: Pizarro
authors.forename: B
authors.initials: B
authors.lastname: Lozoff
mesh_terms: D018798:Anemia, Iron-Deficiency / Q000453:epidemiology / Q000517:prevention & control*; D001903:Bottle Feeding; D002677:Chile / Q000453:epidemiology; D004311:Double-Blind Method; D005260:Female; D005296:Ferrous Compounds / Q000008:administration & dosage*; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007225:Infant Food; D008297:Male; D015995:Prevalence
chemical_list: D005296:Ferrous Compounds; C020748:ferrous sulfate