Impact of long-term oral iron supplementation in breast-fed infants

Objective. To weigh benefits of oral iron supplements on infant's growth against its potential hazards. Methods. 248 exclusively breast-fed infants aged 4-6 months were consecutively enrolled and divided into treatment group given iron containing multivitamin (TG = 198) and control group (placebo, PG = 50) given the same multivitamin but without iron. TG is subdivided according to clinical assessment into group A (well nourished) and group B (malnourished); both were further stratified according to basal blood iron status. Assessment was done after 6 and 12 months with concurrent collection of morbidity parameters (diarrhea and fever). Data were normalized and analyzed using SPSS and Eurogrowth softwares. Results. After 6 months treatment, weight and length gain was better in TG compared to placebo especially evident in anemic malnourished infants (P < 0.05, < 0.05 and < 0.01). After 12 months, the same result was obtained with the fading effect of anemia (P for anemic vs. non-anemic subgroups > 0.05). Morbidity risk was linked to immunologic background of infant; odds ratio for diarrhea and fever was higher in malnourished compared to well nourished (P < 0.05) with no special impact for basal iron (P for anemic vs. non-anemic subgroups > 0.05) or iron therapy (P for well-nourished non-anemic treatment vs PG > 0.05). Conclusion. Oral iron supplementation resulted in better effects on growth velocity of breast fed infants especially those who were initially malnourished and anemic or at least iron depleted, with less marked morbidity than in iron replete infants.