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Editor,—You have recently published a response by Dr Morley to Dr Stevens concerning our paper on iron status and development.1 We wish to raise two matters not discussed in Dr Morley's letter.
Firstly, when the paper was published, there was prominent media coverage, erroneously concluding that our paper rendered formula unnecessary in the later part of the first year, and that cow's milk was just as satisfactory. We emphasise that the reason for avoiding cow's milk in the first year (in babies not breast fed) is based on several considerations, including suboptimal nutrient content or bioavailability (for example, for vitamins D and C, iron, and copper), unnecessarily high protein content, and, possibly, increased risk of subclinical gastrointestinal bleeding. Our paper does not provide evidence that should change present policy on cow's milk feeding.2
Secondly, the haemoglobin data we included, which were not central to the focus of the paper, were from one centre only and should not be taken as typical of those for the UK population. A more complete presentation of iron status in children in the trial is now published.3
The current evidence on the importance of iron in infancy is much debated and frequently cited in policy documents. We wish the interpretation of our study to be as clear as possible.