by Amy Spangler
July 15, 2007

A group of researchers whose data were recently published in the June 2007 issue of Breastfeeding Medicine, the official journal of the Academy of Breastfeeding Medicine investigated breastfeeding duration and the risk of iron deficiency anemia in five groups of infants: exclusively formula-fed; exclusively breastfed for less than 1 month; exclusively breastfed for at least 1 month but less than 4 months; exclusively breastfed for at least 4 months but less than 6 months; and exclusively breastfed for 6 months or more.

The authors concluded that, “Young children in the United States fully breastfed for 6 months may be at increased risk of iron deficiency.” In addition, they noted that, “Adequate iron may not be provided by typical complementary infant foods. Health care providers should be vigilant to prevent iron deficiency in this group of infants.”

When research results reinforce strongly held beliefs, health professionals are quick to embrace the data. But when results contradict current thinking, there is a tendency to question the validity of the data.

According to Ruth Lawrence, Editor-in-Chief of Breastfeeding Medicine, “The article was carefully reviewed by expert reviewers, who acknowledged the work as valid, the report as accurate, and recommended publication.”

Dr. Lawrence added, “The significance of the finding is not completely clear. The authors refer to the reports of long-term cognitive deficits associated with iron deficiency. Among these reports, the ones with the most concerning outcomes do not mention breastfeeding or any feeding details. They do not mention time of cord clamping at birth or any cause of the iron deficiency.”

One obvious limitation of the study was the fact that history of anemia was reported by survey respondents (usually parents) but no medical records were reviewed. In addition, because children fully breastfed for 6 months or more are at greater risk for iron deficiency, perhaps their hemoglobin was checked more often, increasing the likelihood of diagnosis.

The fact remains that full or exclusive breastfeeding for 6 months or more provides greater protection against respiratory and gastrointestinal infections, and should continue to be recommended.

Healthy, term infants born to well-nourished mothers typically have iron stores that last 6 months. The iron in breast milk is more bio-available than iron in fortified infant formula. However, the overall amount is still quite low. The importance of iron-rich complementary foods cannot be overstated. Even though meat and liver are known to be better sources of iron and zinc than fortified cereals, meat is seldom introduced before a baby is 8 months old, and more often after 10 months.

As was suggested in a previous post on baby gooroo, perhaps it’s time to pass the meat in addition to the breast milk.