title: Breastfeeding exclusively and iron deficiency anemia during the first 6 months of age.
abstract: OBJECTIVE
  The objective was to determine the prevalence of iron deficiency and iron deficiency anemia among exclusively breastfed infants from one to six months of life and to identify associated risk factors.
  
  
  METHODS
  This is a cohort study of the hemoglobin and serum ferritin levels of 102 healthy full-term infants, weighing more than 2500 grams (5.5 pounds) at birth, evaluated for growth development and supported to promote exclusive breastfeeding. Hemoglobin and ferritin levels were measured in the first, fourth, and sixth months of life. The hemoglobin and ferritin levels of the mothers were also measured in the first month postpartum.
  
  
  RESULTS
  At four months, 5.7% presented iron deficiency and 3.4% had iron deficiency anemia. At six months, the percentage of children with iron deficiency increased more than four times, reaching 26.1%, while iron deficiency anemia was present in 23.9% of the infants studied. Iron deficiency at six months of age was significantly correlated to growth velocity.
  
  
  CONCLUSIONS
  According to the results of this study, exclusive breastfeeding protects infants from iron deficiency and iron deficiency anemia for the first four months of life. After this age, in accordance with the literature, the findings of this study demonstrated an increase in anemia and iron deficiency rates, adding to evidence that supports the monitoring of iron levels in exclusively breastfed children presenting higher weight gains beginning at four months of age.
authors.affiliation: Pediatrician, Professor, Department of Integral Health, State University of Pará, Pará, Brazil.
authors.forename: Rosa F S V
authors.initials: RF
authors.lastname: Marques
authors.affiliation: Associate Professor, Department of Pediatrics, Escola Paulista de Medicina, Federal University of São Paulo, São Paulo, SP, Brazil.
authors.forename: José A A C
authors.initials: JA
authors.lastname: Taddei
authors.affiliation: Full Professor, Department of Pediatrics, Escola Paulista de Medicina, Federal University of São Paulo, São Paulo, SP, Brazil.
authors.forename: Fábio A
authors.initials: FA
authors.lastname: Lopez
authors.affiliation: Adjunt Professor, Department of Pediatrics, Escola Paulista de Medicina, Federal University of São Paulo, São Paulo, SP, Brazil.
authors.forename: Josefina A P
authors.initials: JA
authors.lastname: Braga
mesh_terms: D000367:Age Factors; D018798:Anemia, Iron-Deficiency / Q000097:blood / Q000453:epidemiology*; D001938:Brazil / Q000453:epidemiology; D001942:Breast Feeding / Q000706:statistics & numerical data*; D002657:Child Development; D015331:Cohort Studies; D005260:Female; D005293:Ferritins / Q000097:blood; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007223:Infant; D007501:Iron / Q000097:blood; D000090463:Iron Deficiencies; D008297:Male; D015995:Prevalence; D012307:Risk Factors; D015430:Weight Gain
chemical_list: D006454:Hemoglobins; D005293:Ferritins; D007501:Iron