title: Duration of exclusive breastfeeding is a positive predictor of iron status in 6- to 10-month-old infants in rural Kenya.
abstract: The prevalence of iron-deficiency anemia (IDA) is high in infants in Sub-Saharan Africa. Exclusive breastfeeding of infants to 6 months of age is recommended by the World Health Organization, but breast milk is low in iron. Some studies suggest exclusive breastfeeding, although beneficial for the infant, may increase risk for IDA in resource-limited settings. The objective of this study was to determine if duration of exclusive breastfeeding is associated with anemia and iron deficiency in rural Kenyan infants. This was a cross-sectional study of 6-10-month-old infants (n = 134) in southern coastal Kenya. Anthropometrics, hemoglobin (Hb), plasma ferritin (PF), soluble transferrin receptor (sTfR), and C-reactive protein were measured. Body iron stores were calculated from the sTfR/PF ratio. Socioeconomic factors, duration of exclusive breastfeeding, nature of complementary diet, and demographic characteristics were determined using a questionnaire. Mean ± SD age of the infants was 7.7 ± 0.8 months. Prevalence of anemia, ID, and IDA were 74.6%, 82.1%, and 64.9%, respectively. Months of exclusive breastfeeding correlated positively with Hb (r = 0.187; p < .05) and negatively with sTfR (r = -0.246; p < .05). sTfR concentrations were lower in infants exclusively breastfed at least 6 months compared with those exclusively breastfed for less than 6 months (7.6 (6.3, 9) vs. 8.9 (6.7, 13.4); p < .05). Controlling for gender, birth weight, and inflammation, months spent exclusively breastfeeding was a significant negative predictor of sTfR and a positive predictor of Hb (p < .05). The IDA prevalence in rural Kenyan infants is high, and greater duration of exclusive breastfeeding predicts better iron status and higher Hb in this age group.
authors.affiliation: School of Public Health, Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya.|International Centre for Behavioural Studies, Mombasa, Kenya.
authors.forename: Mary A
authors.initials: MA
authors.lastname: Uyoga
authors.affiliation: School of Public Health, Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya.
authors.forename: Simon
authors.initials: S
authors.lastname: Karanja
authors.affiliation: Human Nutrition Laboratory, Swiss Federal Institute of Technology, Zürich, Switzerland.
authors.forename: Daniela
authors.initials: D
authors.lastname: Paganini
authors.affiliation: Human Nutrition Laboratory, Swiss Federal Institute of Technology, Zürich, Switzerland.
authors.forename: Colin I
authors.initials: CI
authors.lastname: Cercamondi
authors.affiliation: Kantonsschule Wattwil, Wattwil, Switzerland.
authors.forename: Sophie A
authors.initials: SA
authors.lastname: Zimmermann
authors.affiliation: Centre for Microbiology Research, Kenya Medical Research Institute (KEMRI), Nairobi, Kenya.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Ngugi
authors.affiliation: International Centre for Behavioural Studies, Mombasa, Kenya.
authors.forename: Penny
authors.initials: P
authors.lastname: Holding
authors.affiliation: Human Nutrition Laboratory, Swiss Federal Institute of Technology, Zürich, Switzerland.
authors.forename: Diego
authors.initials: D
authors.lastname: Moretti
authors.affiliation: Human Nutrition Laboratory, Swiss Federal Institute of Technology, Zürich, Switzerland.
authors.forename: Michael B
authors.initials: MB
authors.lastname: Zimmermann
mesh_terms: D018798:Anemia, Iron-Deficiency / Q000097:blood / Q000453:epidemiology*; D001942:Breast Feeding; D002097:C-Reactive Protein / Q000378:metabolism; D003430:Cross-Sectional Studies; D005260:Female; D005293:Ferritins / Q000097:blood; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007223:Infant; D007501:Iron / Q000097:blood*; D007630:Kenya / Q000453:epidemiology; D008297:Male; D015995:Prevalence; D011990:Receptors, Transferrin / Q000097:blood; D012424:Rural Population; D013997:Time Factors
chemical_list: D006454:Hemoglobins; D011990:Receptors, Transferrin; D002097:C-Reactive Protein; D005293:Ferritins; D007501:Iron
keywords: Kenya; anemia; exclusive breastfeeding; infants; iron deficiency; iron deficiency anemia