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Open AccessArticle

Iron Status of Infants in the First Year of Life in Northern Taiwan

1
Department of Food Science, Nutrition, and Nutraceutical Biotechnology, Shih Chien University, Taipei 10462, Taiwan
2
School of Medicine, Fu-Jen Catholic University, New Taipei City 24205, Taiwan
3
Department of Pediatrics, Shin-Kong Wu Ho-Su Memorial Hospital, Taipei 11101, Taiwan
4
School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, 250 Wu-Hsing Street, Taipei 11031, Taiwan
5
School of Medicine, Taipei Medical University, Taipei 11031, Taiwan
6
Institute of Environmental and Occupational Health Sciences, College of Public Health, National Taiwan University, Taipei 10617, Taiwan
7
Department of Pediatrics, Shuang Ho Hospital, Ministry of Health and Welfare, Taipei Medical University, New Taipei 23561, Taiwan
8
Department of Pediatrics, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan
*
Author to whom correspondence should be addressed.
These authors contributed equally to this work.
Nutrients 2020, 12(1), 139; https://doi.org/10.3390/nu12010139
Received: 3 December 2019 / Revised: 30 December 2019 / Accepted: 31 December 2019 / Published: 3 January 2020
(This article belongs to the Special Issue Nutrition for Anemia)
Iron deficiency (ID) and iron deficiency anemia (IDA) typically occur in developing countries. Notably, ID and IDA can affect an infant’s emotion, cognition, and development. Breast milk is considered the best food for infants. However, recent studies have indicated that breastfeeding for more than six months increases the risk of ID. This study investigated the prevalence of ID and IDA, as well as the association between feeding type and iron nutritional status in northern Taiwan. A cross-sectional study was conducted on infants who returned to the well-baby clinic for routine examination from October 2012 to January 2014. Overall, 509 infants aged 1–12 months completed the iron nutritional status analysis, anthropometric measurement, and dietary intake assessment, including milk and complementary foods. The results revealed that 49 (10%) and 21 (4%) infants in their first year of life had ID and IDA, respectively, based on the World Health Organization criteria. Breastfed infants had a higher prevalence rate of ID and IDA than mixed-fed and formula-fed infants (p < 0.001). Regarding biomarkers of iron status, plasma hemoglobin (Hb), ferritin, and transferrin saturation (%) levels were significantly lower in ID and IDA groups. The prevalence of ID and IDA were 3.7% and 2.7%, respectively, in infants under six months of age, but increased to 20.4% and 6.6%, respectively, in infants above six months of age. The healthy group had a higher total iron intake than ID and IDA groups, mainly derived from infant formula. The total dietary iron intake was positively correlated with infants’ Hb levels. Compared with formula-fed infants, the logistic regression revealed that the odds ratio for ID was 2.157 (95% confidence interval [CI]: 1.369–3.399) and that for IDA was 4.196 (95% CI: 1.780–9.887) among breastfed infants (p < 0.001) after adjusted for all confounding factors (including gestational week, birthweight, sex, body weight percentile, body length percentile, age of infants, mothers’ BMI, gestational weight gain, education level, and hemoglobin level before delivery). In conclusion, our results determined that breastfeeding was associated with an increased the prevalence of ID and/or IDA, especially in infants above six months. This suggests that mothers who prolonged breastfeed after six months could provide high-quality iron-rich foods to reduce the prevalence of ID and IDA. View Full-Text
Keywords: infant; breast milk; formula milk; iron deficiency; iron deficiency anemia infant; breast milk; formula milk; iron deficiency; iron deficiency anemia
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Chen, C.-M.; Mu, S.-C.; Shih, C.-K.; Chen, Y.-L.; Tsai, L.-Y.; Kuo, Y.-T.; Cheong, I.-M.; Chang, M.-L.; Chen, Y.-C.; Li, S.-C. Iron Status of Infants in the First Year of Life in Northern Taiwan. Nutrients 2020, 12, 139.

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