title: Predominant breast-feeding from birth to six months is associated with fewer gastrointestinal infections and increased risk for iron deficiency among infants.
abstract: Iron deficiency (ID) is prevalent among infants world-wide and may be more likely among infants born to women living in disadvantaged environments. A strategy to address ID in this context is to feed iron-fortified formula, but this may create risk for gastrointestinal (GI) infection. Our objective was to investigate the relationship between infant feeding practices, iron status, and likelihood of a GI infection in the first 6 mo of life. We conducted a prospective study at a public hospital in Guadalajara, Mexico. Healthy women who gave birth to a healthy term infant were eligible to participate. Each month, mothers (n = 154) provided information on infant feeding methods and symptoms of GI infection. At 6 mo of age, infants' iron status was assessed [hemoglobin (Hb) and serum ferritin concentration]. When compared with nonpredominantly breast-fed [partially breast-feeding (PBF) and formula feeding (FF) combined], predominantly breast-fed (PRBF) infants to 6 mo had a lower incidence of GI infection from 0-6 mo [18 vs. 33%; P = 0.04; adjusted odds ratio (OR) = 0.4; 95% CI = 0.2, 1.0] but a higher risk for ID (serum ferritin < 12 microg/L) at 6 mo (22 vs. 4%; P = 0.001; adjusted OR = 9.2; 95% CI = 2.3, 37.0). Anemia (Hb < 110 g/L) prevalence did not differ among feeding groups (13% for PRBF, 19% for PBF, and 4% for FF; P = 0.09). In this low-income population, our results suggest that PRBF should be promoted and the risk for ID managed using public health and nutrition strategies.
authors.affiliation: Department of Agricultural, Food, and Nutritional Sciences, University of Alberta, T6G 2P5 Edmonton, Canada.
authors.forename: Eva C
authors.initials: EC
authors.lastname: Monterrosa
authors.forename: Edward A
authors.initials: EA
authors.lastname: Frongillo
authors.forename: Edgar M
authors.initials: EM
authors.lastname: Vásquez-Garibay
authors.forename: Enrique
authors.initials: E
authors.lastname: Romero-Velarde
authors.forename: Linda M
authors.initials: LM
authors.lastname: Casey
authors.forename: Noreen D
authors.initials: ND
authors.lastname: Willows
mesh_terms: D000328:Adult; D018798:Anemia, Iron-Deficiency / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D001942:Breast Feeding / Q000009:adverse effects; D005260:Female; D005767:Gastrointestinal Diseases / Q000517:prevention & control*; D006801:Humans; D007223:Infant; D041943:Infant Formula / Q000737:chemistry; D007227:Infant Nutritional Physiological Phenomena; D007231:Infant, Newborn; D019266:Iron, Dietary / Q000008:administration & dosage; D008297:Male; D008800:Mexico / Q000453:epidemiology; D011203:Poverty; D011446:Prospective Studies; D012307:Risk Factors
chemical_list: D019266:Iron, Dietary