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Milk versus medicine for the treatment of iron deficiency anaemia in hospitalised infants
  1. C R Wall1,
  2. C C Grant2,
  3. N Taua2,
  4. C Wilson3,
  5. J M D Thompson2
  1. 1Massey University, New Zealand
  2. 2University of Auckland, New Zealand
  3. 3Starship Children’s Hospital, Auckland District Health Board, New Zealand
  1. Correspondence to:
    Prof. Associate C Grant
    Department of Paediatrics, Faculty of Medicine and Health Sciences, University of Auckland, Private Bag 92019, Auckland, New Zealand;


Aims: To compare iron fortified follow-on milk (iron follow-on), iron fortified partially modified cows’ milk (iron milk), and iron medicine for the treatment of iron deficiency anaemia (IDA) in hospitalised infants.

Methods: In a randomised controlled trial, infants aged 9–23 months with IDA and who were hospitalised with an acute illness received iron follow-on (12 mg/l ferrous iron), iron milk (12.9 mg/l ferrous iron), or iron medicine (ferrous gluconate at 3 mg/kg of elemental iron once daily). All interventions were given for three months. Changes in measures of iron status three months after hospital discharge were determined.

Results: A total of 234 infants were randomised. Iron status was measured at follow up in 59 (70%) iron medicine, 49 (66%) iron follow-on, and 54 (70%) iron milk treated infants. There was a significant (mean, 95% CI) increase in haemoglobin (15 g/l, 13 to 16) and iron saturation (9%, 8 to 10) and decrease in ferritin (−53 μg/l, −74 to −31) in all three groups. Mean cell volume increased in iron follow-on (2 fl, 1 to 3) and iron milk (1 fl, 0.1 to 3) treated infants, but not in the iron medicine group (1 fl, −1 to 2). The proportion with IDA decreased in all three groups: iron medicine 93% to 7%, iron follow-on 83% to 8%, and iron milk 96% to 30%. Adverse effects, primarily gastrointestinal, occurred in 23% of the iron medicine, 14% of the iron follow-on, and 13% of the iron milk group.

Conclusions: Iron fortified follow-on milk, iron fortified partially modified cows’ milk, and iron medicine all effectively treat IDA in infancy.

  • ID, iron deficiency
  • IDA, iron deficiency anaemia
  • MCV, mean cell volume
  • RDW, red cell distribution width
  • anaemia
  • iron deficiency
  • iron
  • randomised controlled trials

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  • Funding: this research was supported by research grants from the former New Zealand Dairy Board, now the Fonterra Co-operative Group which includes New Zealand Milk Limited. Dr Wilson was supported by a grant from the Auckland Savings Bank.

  • Competing interests: none

  • Published Online First 14 June 2005