The effect of early weaning on iron status among exclusively breastfed infants
Background and objective: Exclusive breastfeeding is recommended for all newborns to gain optimal physical and neurodevelopmental growth. Despite all its advantages, prolonged breastfeeding alone without weaning places the child at risk of iron deficiency and iron deficiency anemia, which is the commonest micronutrient deficiency worldwide among infants. We investigated the effect of early weaning on the iron status of infants.
Methods: We selected 100 infants; all of them were six months old. Fifty of them were exclusively breastfed for four months and started weaning between four to six months while continued to breastfeed till the age of six months (early-weaning group). Another 50 infants were exclusively breastfed for six months without starting weaning (no-weaning group). Then we investigated both groups at the age of six months for both iron and hematological studies.
Results: In the present study, both study groups shared some similarities. In both groups, females accounted for more than half of the cases, the majority of the infants were residing in the urban areas, and most of the infants were delivered by cesarean section. The final result of the iron study and hematological parameters in the no-weaning group was significantly lower as compared to the early-weaning group. Both serum ferritin and serum iron were 7.42 ng/ml and 25.66 µg/dl, respectively, in the no-weaning group and were 23.94 ng/ml and 46.98 µg/dl respectively in the early-weaning group. Hemoglobin level was 10.84 gm/dl in the no-weaning group compared to 11.54 gm/dl in the early-weaning group.
Conclusion: We concluded that early weaning had a great role in the prevention of both iron deficiency and iron deficiency anemia in exclusively breastfed infants.
Lessen R, Kavanagh K. Position of the academy of nutrition and dietetics: promoting and supporting breastfeeding. J Acad Nutr Diet 2015; 115(3):444–9.
Haimi M, Lerner A. Nutritional deficiencies in the pediatric age group in a multicultural developed country, Israel. World J Clin Cases 2014; 2(5):120–5.
Camaschella C. Iron-deficiency anemia. N Engl J Med 2015; 372(19):1832–43.
Berglund S, Domellöf M. Meeting iron needs for infants and children. Curr Opin Clin Nutr Metab Care 2014; 17(3):267–72.
Qasem WA, Friel JK. An overview of iron in term breast-fed infants. Clin Med Insights Pediatr 2015; 9:79–84.
Baker RD, Greer FR. Committee on Nutrition American Academy of Pediatrics. Diagnosis and prevention of iron deficiency and iron-deficiency anemia in infants and young children (0-3 years of age). Pediatrics 2010; 126(5):1040–50.
Hewa FZ, Zangana KO. Influence of iron deficiency anemia on growth: A cross-sectional study. Medical Journal of Babylon 2019; 16(01):335.
Ziegler EE, Nelson SE, Jeter JM. Iron stores of breastfed infants during the first year of life. Nutrients 2014; 6(5):2023–34.
Finkelstein JL, O'Brien KO, Abrams SA, Zavaleta N. Infant iron status affects iron absorption in Peruvian breastfed infants at 2 and 5 months of age. Am J Clin Nutr 2013; 98(6):1475–84.
Burke RM, Rebolledo PA, Aceituno AM, Revollo R, IñiguezV, Klein M, et al. Effect of infant feeding practices on iron status in a cohort study of Bolivian infants. BMC Pediatr 2018; 18(1):107.
Wang F, Liu H, Wan Y, Li J, Chen Y, Zheng J, et al. Prolonged Exclusive Breastfeeding Duration Is Positively Associated with Risk of Anemia in Infants Aged 12 Months. J Nutr 2016; 146(9):1707–13.
Ziegler EE, Nelson SE, Jeter JM. Iron supplementation of breastfed infants. Nutr Rev 2011; 69(s1):S71–7.
Eneroth H, El Arifeen S, Persson LA, Kabir L, Lonnerdal B, Hossain MB, et al. Duration of exclusive breast-feeding and infant iron and zinc status in rural Bangladesh. J Nutr 2009; 139(8):1562–7.
Kim HA, Park SH, Lee EJ. Iron status in small for gestational age and appropriate for gestational age infants at birth. Korean J Pediatr 2019; 62(3):102–7.
Thurnham DI, McCabe LD, Haldar S, Wieringa FT, Northrop-Clewes CA, McCabe GP. Adjusting plasma ferritin concentrations to remove the effects of subclinical inflammation in the assessment of iron deficiency: a meta-analysis. Am J Clin Nutr 2010; 92(3):546–55.
Namaste SM, Rohner F, Huang J, Bhushan NL, Flores-Ayala R, Kupka R, et al. Adjusting ferritin concentrations for inflammation: Biomarkers Reflecting Inflammation and Nutritional Determinants of Anemia (BRINDA) project. Am J Clin Nutr 2017; 106(Suppl 1):359S–71.
Sproston NR, Ashworth JJ. Role of C-reactive protein at sites of inflammation and infection. Front Immunol 2018; 9:754.
Jonsdottir OH, Thorsdottir I, Hibberd PL, Fewtrell MS, Wells JC, Palsson GI, et al. Timing of the introduction of complementary foods in infancy: A randomized controlled trial. Pediatrics 2012; 130(6):1038–45.
Qasem W, Fenton T, Friel J. Age of introduction of first complementary feeding for infants: a systematic review. BMC Pediatr 2015; 15:107.
Krishnaswamy S, Bhattarai D, Bharti B, Bhatia P, Das R, Bansal D. Iron deficiency and iron deficiency anemia in 3-5 months-old, breastfed healthy infants. Indian J Pediatr 2017; 84(7):505–8.
Chen CM, Mu SC, Shih CK, Chen YL, Tsai LY, Kuo YT, et al. Iron status of infants in the first year of life in Northern Taiwan. Nutrients 2020; 12(1):139.
Raj S, Faridi M, Rusia U, Singh O. A prospective study of iron status in exclusively breastfed term infants up to 6 months of age. Int Breastfeed J 2008; 3:3.
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
The copyright on any article published in Zanco J Med Sci is retained by the author(s) in agreement with the Creative Commons Attribution Non-Commercial ShareAlike License (CC BY-NC-SA 4.0).