title: Comparative analysis of serum iron, serum ferritin and red cell folate levels among breast fed, fortified milk and cow's milk fed infants.
abstract: OBJECTIVE
  Iron and folic acid are essential nutrients needed for hematopoiesis. Infants' diet is commonly deficient in these micronutrients that lead to nutritional anemia. Aim of this study was to determine serum iron, serum ferritin and red cell folate levels among healthy breast fed, fortified milk and cow's milk fed infants.
  
  
  METHODS
  A total of 120 infants of 4-9 months of age were enrolled in this study. It included 40 normal breast fed controls, 40 fortified milk fed (FM) and 40 cow's milk fed (CM) infants. Serum iron, serum ferritin and red cell folate concentrations were determined using colorimetric and enzyme immunoassay techniques.
  
  
  RESULTS
  Mean serum iron, serum ferritin and red cell folate concentrations of breast fed control group were 120.9±68.4µg/dl, 109±71.7ng/ml and 1044.1±409.2ng/ml respectively. Fortified milk (FM) group showed significantly decreased serum iron (p<0.003) as compared with controls whereas serum ferritin and red cell folate values showed insignificant change (p=0.25 and p=0.85 respectively). However serum iron, serum ferritin and red cell folate were significantly decreased in cow's milk fed (CM) group as compared with control subjects (p<0.04, p<0.006, p<0.02 respectively). Comparison of these biochemical parameters between FM and CM groups showed statistically significant difference of serum ferritin and red cell folate among cow's milk group (p<0.0001 and p<0.02) whereas serum iron level showed no significant difference, a p-value being 0.38.
  
  
  CONCLUSIONS
  Healthy breast fed infants do not need any supplementation and fortification of iron and folic acid. Fortified milk appears to be an acceptable alternative in the absence of breast milk whereas cow's milk is a poor source of iron and folic acid in infants.
authors.affiliation: Fatima Qudsia, M.Phil (Hematology). Baqai Institute of Hematology, Baqai Medical University, Karachi, Pakistan.
authors.forename: Fatima
authors.initials: F
authors.lastname: Qudsia
authors.affiliation: Dr. Muhammad Saboor, Ph.D, MT (ASCP ), H (ASCP ). Baqai Institute of Hematology, Baqai Medical University, Karachi, Pakistan.
authors.forename: Muhammad
authors.initials: M
authors.lastname: Saboor
authors.affiliation: Dr. Shafi Muhammad Khosa, MBBS, DCP, M.Phil. Baqai Institute of Hematology, Baqai Medical University, Karachi, Pakistan.
authors.forename: Shafi Muhammad
authors.initials: SM
authors.lastname: Khosa
authors.affiliation: Qamar Ayub, Baqai Institute of Hematology, Baqai Medical University, Karachi, Pakistan.
authors.forename: Qamar
authors.initials: Q
authors.lastname: Ayub
authors.affiliation: Dr. Moinuddin FRCP (C), FRCP (E). Baqai Institute of Hematology, Baqai Medical University, Karachi, Pakistan.
authors.lastname: Moinuddin
keywords: Breast fed; Cow’s milk; Ferritin; Folate; Fortified milk; Iron