Related Experiment Video
Updated: Oct 9, 2025
Author Spotlight: Developing a Point-of-Care Hemoglobin Estimation Method for Anemia Management
Published on: January 19, 2024
Association of Infant Feeding Practices with Iron Status and Hematologic Parameters in 6-Month-Old Infants
Chayatat Ruangkit1, Nawapat Prachakittikul2, Nutthida Hemprachitchai2
1Ramathibodi Medical School, Chakri Naruebodindra Medical Institute, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bang Phli 10540, Samut Prakan, Thailand.
Insights
Breastfeeding without iron supplementation increases infant anemia risk. Iron supplements for breastfed infants at 4 months significantly reduce iron deficiency anemia (IDA) incidence by 90%.
Area of Science:
- Pediatrics
- Hematology
- Nutrition
Background:
- Infant feeding practices in early life are crucial for iron status.
- Limited research exists on the association between infant feeding and hematologic parameters.
- Understanding these associations can inform public health guidelines.
Purpose of the Study:
- To evaluate the association between infant feeding practices and iron status at 6 months.
- To compare the incidence of anemia, iron deficiency (ID), and iron deficiency anemia (IDA) across different feeding groups.
Main Methods:
- Retrospective chart review of 403 infants screened for anemia at 6 months.
- Infants categorized into four feeding groups: breastfed (BF), breastfed with iron (BI), mixed-fed (MF), and formula-fed (FF).
- Comparison of hematologic parameters and incidence of anemia, ID, and IDA.
Main Results:
- The BF group showed the highest incidence of anemia (38.1%), ID (28.6%), and IDA (17.1%).
- Compared to BF infants, BI, MF, and FF infants had significantly decreased risks of IDA (90.4%, 97.5%, and 96.9%, respectively).
- Iron supplementation starting at 4 months in BF infants substantially lowered ID and IDA rates.
Conclusions:
- Breastfeeding alone is associated with higher rates of anemia, ID, and IDA at 6 months.
- Early iron supplementation (from 4 months) is effective in mitigating iron deficiency in breastfed infants.
- Feeding practices significantly impact infant iron status, highlighting the importance of targeted interventions.
Background:
Infants' feeding practices in the first 6 months of life and their association with iron status and hematologic parameters has not been well studied. We aim to evaluate this association.
Methods:
In a retrospective chart review, we identified 403 infants who received laboratory screening for anemia at 6-month visits. Infants were categorized into four groups according to feeding practices. Hematologic parameters and incidence of anemia, iron deficiency (ID), and iron deficiency anemia (IDA) were compared.
Results:
In total, 105 infants were breastfed (BF), 78 were breastfed with iron supplementation starting at 4 months (BI), 109 were mixed-fed (breast milk and formula) with or without iron supplementation (MF), and 111 were formula-fed (FF). The BF group had the highest incidence of anemia (38.1%), ID (28.6%), and IDA (17.1%) when compared with the other groups (p < 0.001). In multivariate logistic regression, BI, MF, and FF infants had 90.4%, 97.5%, and 96.9% decreased risk of IDA, respectively, with BF infants as a reference group.
Conclusion:
The incidence of anemia, ID, and IDA at age 6 months was higher in BF than FF or MF infants. However, iron supplements in BF infants starting at 4 months significantly reduced their ID and IDA incidence.
