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Iron supplementation of iron-replete Indonesian infants is associated with reduced weight-for-age


Torbjörn Lind, Department of Clinical Sciences, Pediatrics, S-901 87 Umeå University, Umeå, Sweden. Tel: +46-90 + 785-2244 | Fax: +46-90-12-37-28 | Email:


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.