Absorption by 1-year-old children of an iron supplement given with cow's milk or juice

A paucity of data are available on toddlers for the evaluation of optimal strategies of Fe supplementation. In this study, we used a two-tracer stable isotope technique to determine Fe absorption from a 5-mg dose of stable isotopically enriched (57Fe or 58Fe) ferrous sulfate given with cow's milk (CM) compared with the same dose given with apple juice. Ten children (age 13 +/- 1 mo, weight 10.8 +/- 1.1 kg) who had recently discontinued formula feeding and begun on CM were studied. Red blood cell (RBC) iron incorporation of the isotope was determined 14 d after dosing with 57Fe and 58Fe. Fe absorption was calculated based on the assumption that 90% of absorbed Fe is incorporated into RBC. Absorption of Fe was significantly greater (13.7 +/- 6.4%) when given with juice than with milk (5.7 +/- 4.0%), p < 0.01 by paired t tests. Fe absorption from the dose given with juice was significantly negatively correlated with serum ferritin (n = 9, r = -0.70, p < 0.05). These results indicate that 1) a small supplement of Fe is better absorbed when given with juice than with CM, and 2) a large variability in Fe absorption exists in healthy 1-y-old infants, which is related to their existing Fe stores.