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Iron fortified follow on formula from 9 to 18 months improves iron status but not development or growth: a randomised
R Morley1, R Abbott, S Fairweather-Tait
1Menzies Centre for Population Health Research, Tasmania and Clinical Epidemiology and Biostatistics Unit, University of Melbourne Department of Paediatrics, Royal Children's Hospital, Parkville, VIC 3052, Australia. morleyr@cryptic.rch.unimelb.edu.au
Insights
Iron supplementation in formula for infants aged 9 to 18 months did not improve overall development or growth. Higher plasma ferritin was observed, but no significant developmental benefits were found in this study.
Area of Science:
- Pediatric Nutrition
- Developmental Pediatrics
- Iron Metabolism
Background:
- Iron deficiency anemia is linked to developmental disadvantages in children.
- Early iron supplementation is a common strategy to mitigate these risks.
Purpose of the Study:
- To investigate if iron-fortified formula improves developmental outcomes in infants.
- To assess the impact of different iron fortification levels on infant development and growth.
Main Methods:
- Randomized controlled trial involving 493 healthy 9-month-old infants.
- Infants received standard cow's milk, or formula with 0.9 mg/L or 1.2 mg/L iron until 18 months.
- Developmental indices (Bayley Scales), growth, and hematological markers were assessed at 18 months.
Main Results:
- Infants fed iron-fortified formula showed higher plasma ferritin levels.
- No significant differences in mental or psychomotor developmental indices were observed between groups.
- No significant differences in growth parameters were found across the study groups.
Conclusions:
- Iron-fortified formula does not confer developmental or growth advantages in healthy infants from 9 to 18 months.
- Potential benefits for a subgroup of anemic infants or later developmental emergence cannot be ruled out.
Aims:
Iron deficiency anaemia is associated, in observational studies, with developmental disadvantage. This study tested the hypothesis that feeding iron supplemented formula from 9 to 18 months of age would improve developmental performance.
Subjects And Methods:
493 healthy children aged 9 months being fed pasteurised cows' milk were recruited from three UK centres. They were randomised to: cows' milk as before, formula containing 0.9 mg/litre iron, or formula containing 1.2 mg/litre iron, until 18 months of age. Bayley mental and psychomotor developmental indices were measured at 18 months, as were growth and haematological indices.
Results:
Children fed iron fortified formula had higher plasma ferritin concentrations, but there were no significant intergroup differences in development or growth.
Conclusions:
There are no developmental or growth advantages in children given iron supplemented formula, but a benefit for a minority who were anaemic, or the possibility that a benefit may emerge at a later age, cannot be excluded.
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