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Iron-fortified vs low-iron infant formula: developmental outcome at 10 years

Betsy Lozoff1, Marcela Castillo, Katy M Clark

  • 1Center for Human Growth and Development, Department of Pediatrics and Communicable Diseases, University of Michigan, Ann Arbor, MI 48109-5406, USA. blozoff@umich.edu

Archives of Pediatrics & Adolescent Medicine
|November 9, 2011
PubMed

Insights

Iron-fortified formula may negatively impact long-term child development, especially in infants with high hemoglobin levels. Further research is needed to determine optimal iron levels in infant formula for better developmental outcomes.

Area of Science:

  • Pediatric Nutrition
  • Developmental Psychology
  • Public Health

Background:

  • Infant formula iron fortification is a public health strategy to prevent iron deficiency anemia.
  • The optimal iron concentration in infant formula for long-term neurodevelopmental outcomes remains under investigation.
  • Previous studies have yielded mixed results regarding the effects of formula iron levels on cognitive and motor development.

Purpose of the Study:

  • To evaluate the long-term developmental effects of iron-fortified versus low-iron infant formula.
  • To assess cognitive and motor outcomes at 10 years of age in children who participated in a randomized controlled trial of formula iron levels.

Main Methods:

  • A randomized controlled trial followed 473 children at age 10 years in urban Chile.
  • Participants were previously assigned to receive either iron-fortified (12.7 mg/L) or low-iron (2.3 mg/L) formula from 6 to 12 months of age.
  • Neurodevelopmental assessments included IQ, spatial memory, arithmetic achievement, visual-motor integration, visual perception, and motor functioning, with analyses considering baseline hemoglobin levels.

Main Results:

  • Children receiving iron-fortified formula scored lower on all developmental measures compared to the low-iron group, with significant differences in spatial memory and visual-motor integration.
  • Infants with high baseline hemoglobin levels (>12.8 g/dL) who received iron-fortified formula showed substantially poorer outcomes (10.7-19.3 points lower).
  • Infants with low baseline hemoglobin levels (<10.5 g/dL) showed improved outcomes with iron-fortified formula, though effects were smaller.

Conclusions:

  • High iron content in infant formula may adversely affect long-term neurodevelopment in infants with elevated hemoglobin levels.
  • The findings suggest that current iron fortification levels may not be optimal for all infants.
  • Further research is warranted to determine the ideal iron concentration in infant formula to support optimal child development.
Abstract

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