Latent Iron Deficiency at Birth Doubles Risk in Breastfed Infants by 6 Months: Study Finds

The prospective cohort study was conducted at a tertiary care center in southern India. It included neonates born at more than 34 weeks of gestation. Based on cord serum ferritin levels at birth, infants were classified into two groups: those with NIS (ferritin levels greater than 75 ng/mL) and those with LID (ferritin levels between 11–75 ng/mL).

Out of 559 neonates enrolled in the study, 45 were categorized as having LID and 514 as having NIS. At the six-month follow-up, iron status was reassessed in 272 infants—33 from the LID group and 239 from the NIS group—by measuring hemoglobin and serum ferritin levels.

The study revealed the following findings:

• 48.5% of infants with latent iron deficiency (LID) at birth developed iron deficiency by six months.
• 24.7% of infants with normal iron status (NIS) at birth developed iron deficiency by six months.
• Infants with LID had a relative risk of 2.3, indicating more than double the risk compared to those with NIS.
• Average hemoglobin levels at six months were similar between groups: 10.21 g/dL in the LID group and 10.48 g/dL in the NIS group.
• These comparable hemoglobin levels suggest that hemoglobin alone may not reliably detect emerging iron deficiency.
• The overall incidence of iron deficiency among the study cohort was 27.6%.
• Despite the advantages of exclusive breastfeeding, the findings highlight the need to reassess iron supplementation strategies in early infancy.
• Special attention is warranted for infants predisposed to low iron stores at birth to prevent early iron deficiency.

The authors stress the importance of early screening for latent iron deficiency and recommend timely intervention through iron supplementation for at-risk infants. This approach may help reduce the burden of iron deficiency during the critical window of early childhood development, a period essential for cognitive and physical growth.

The authors concluded, "With iron deficiency remaining a leading cause of anemia in infancy, the study adds valuable insight into the early identification and prevention of the condition, especially in resource-limited settings where routine screening may not be standard practice."

Reference:

Babu, P. A., Garg, A. K., Patnaik, S. K., & John, B. M. Risk of iron deficiency at 6 months in predominantly breastfed infants with normal iron status and latent iron deficiency at birth. Journal of Pediatric Gastroenterology and Nutrition. https://doi.org/10.1002/jpn3.70116