Iron supplementation of iron-replete Indonesian infants is associated with reduced weight-for-age
Article first published online: 14 APR 2008
©2008 The Author(s)/Journal Compilation ©2008 Foundation Acta Pædiatrica/Acta Pædiatrica
Volume 97, Issue 6, pages 770–775, June 2008
How to Cite
Lind, T., Seswandhana, R., Persson, L.-Å. and Lönnerdal, B. (2008), Iron supplementation of iron-replete Indonesian infants is associated with reduced weight-for-age. Acta Paediatrica, 97: 770–775. doi: 10.1111/j.1651-2227.2008.00773.x
- Issue published online: 15 APR 2008
- Article first published online: 14 APR 2008
- Received 14 January 2008; accepted 4 March 2008.
- Iron replete;
- Iron supplementation
Background: General iron supplementation to prevent iron deficiency in infants who are iron sufficient when starting supplementation may adversely affect their health.
Objective: A secondary analysis to explore the effect of iron supplementation on iron-replete (IR; Hb ≥113 g/L and S-ferritin ≥33 μg/L) or non-iron-replete 6-month-old Indonesian infants participating in a large, randomized trial on iron and zinc supplementation.
Results: Among the iron-supplemented IR (Fe-IR, n = 80) infants S-ferritin was, compared to non-iron-supplemented (NS) IR infants (NS–IR, n = 74), significantly higher (47.5 vs. 20.7 μg/L, p = 0.04), and S-zinc significantly lower (9.7 vs. 10.5 μmol/L, p = 0.04). Haemoglobin concentration (Hb) did not differ between the Fe-IR and NS–IR groups. Change in weight-for-age z-score (WAZ) from 6 to 12 months and mean WAZ at 12 months was lower in the Fe-IR group compared to the NS-IR group (−1.45 vs. −1.03, p < 0.001 and −1.97 vs. −1.60, p < 0.001, respectively). There was no difference in morbidity between groups. Iron supplementation of non-iron-replete infants increased Hb and S-ferritin, but did not affect S-zinc or anthropometrical indices.
Conclusion: In our study, iron supplementation of IR infants affected WAZ adversely, whereas iron supplementation to non-iron-replete infants did not affect growth. These results support a cautious approach to iron supplementation of IR infants.