Milk versus medicine for the treatment of iron deficiency anaemia in hospitalised infants.
OBJECTIVE
To compare iron fortified follow-on milk (iron follow-on), iron fortified partially modified cows' milk (iron milk), and iron medicine for the treatment of iron deficiency anaemia (IDA) in hospitalised infants.


METHODS
In a randomised controlled trial, infants aged 9-23 months with IDA and who were hospitalised with an acute illness received iron follow-on (12 mg/l ferrous iron), iron milk (12.9 mg/l ferrous iron), or iron medicine (ferrous gluconate at 3 mg/kg of elemental iron once daily). All interventions were given for three months. Changes in measures of iron status three months after hospital discharge were determined.


RESULTS
A total of 234 infants were randomised. Iron status was measured at follow up in 59 (70%) iron medicine, 49 (66%) iron follow-on, and 54 (70%) iron milk treated infants. There was a significant (mean, 95% CI) increase in haemoglobin (15 g/l, 13 to 16) and iron saturation (9%, 8 to 10) and decrease in ferritin (-53 microg/l, -74 to -31) in all three groups. Mean cell volume increased in iron follow-on (2 fl, 1 to 3) and iron milk (1 fl, 0.1 to 3) treated infants, but not in the iron medicine group (1 fl, -1 to 2). The proportion with IDA decreased in all three groups: iron medicine 93% to 7%, iron follow-on 83% to 8%, and iron milk 96% to 30%. Adverse effects, primarily gastrointestinal, occurred in 23% of the iron medicine, 14% of the iron follow-on, and 13% of the iron milk group.


CONCLUSIONS
Iron fortified follow-on milk, iron fortified partially modified cows' milk, and iron medicine all effectively treat IDA in infancy.
Wall
C R
CR
Massey University, New Zealand.
Grant
C C
CC
Taua
N
N
Wilson
C
C
Thompson
J M D
JM
D018798:Anemia, Iron-Deficiency / Q000097:blood / Q000178:diet therapy* / Q000188:drug therapy*; D000818:Animals; D019587:Dietary Supplements; D005260:Female; D005296:Ferrous Compounds / Q000627:therapeutic use*; D005500:Follow-Up Studies; D005527:Food, Fortified; D006801:Humans; D007223:Infant; D007501:Iron / Q000097:blood; D019266:Iron, Dietary / Q000627:therapeutic use*; D008297:Male; D008892:Milk; D009752:Nutritional Status; D011446:Prospective Studies
D005296:Ferrous Compounds; D019266:Iron, Dietary; D007501:Iron; C011819:ferrous gluconate