title: Intestinal blood loss as an aggravating factor of iron deficiency in infants aged 9 to 12 months fed whole cow's milk.
abstract: OBJECTIVE
  To verify the occurrence of occult intestinal blood loss and iron deficiency in infants aged 9 to 12 months.
  
  
  METHODS
  A consecutive sample of 98 infants of the Pediatric Public Health Primary Care Unit in the town of Arapongas, Parana State, Brazil was involved in this cross-sectional study. Dietary history, hemoglobin, serum iron, transferrin saturation, ferritin, and an occult fecal blood loss investigation, by the immune chromatographic method specific for human hemoglobin were performed.
  
  
  RESULTS
  Presence of occult intestinal blood occurred in 8/23 of the breast-fed (plus complementary feed) infants and in 30/64 of the infants who were fed with cow's milk (plus complementary feed) (P=0.449). The comparison of body iron indicators in accordance to positive or negative occult fecal blood, did not show any significant difference in the 23 breast-fed infants. Serum ferritin (median=4.2 ng/mL) was significantly lower (P=0.004) in infants who received whole cow's milk and had positive occult fecal blood, than in those infants who received whole cow's milk but were without occult fecal blood (median=12.1 ng/mL).
  
  
  CONCLUSIONS
  In breast-fed infants with negative occult fecal blood, iron deficiency severity is not greater than in those with positive results. In infants fed whole cow's milk, occult fecal blood loss is an aggravating factor of iron deficiency.
authors.affiliation: Department of Pediatrics, Division of Pediatric Gastroenterology, Federal University of Sao Paulo/Paulista School of Medicine, Sao Paulo, Brazil.
authors.forename: Sandra Maria Rodrigues
authors.initials: SM
authors.lastname: Fernandes
authors.forename: Mauro Batista
authors.initials: MB
authors.lastname: de Morais
authors.forename: Olga Maria Silverio
authors.initials: OM
authors.lastname: Amancio
mesh_terms: D018798:Anemia, Iron-Deficiency / Q000209:etiology*; D000818:Animals; D001942:Breast Feeding; D003430:Cross-Sectional Studies; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000150:complications* / Q000175:diagnosis*; D006801:Humans; D007223:Infant; D008297:Male; D008892:Milk / Q000009:adverse effects*; D009780:Occult Blood