Article Text

PDF

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; cc.grantauckland.ac.nz

Abstract

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
View Full Text

Statistics from Altmetric.com

Supplementary materials

  • Online Only Table

    A supplementary table is available as a PDF (printer friendly file).

    Files in this Data Supplement:

    • [View Table] - Table A Nutritional composition of iron fortified follow on infant milk (iron-follow-on) and iron fortified partially modified cow milk (iron-milk) (per 1000 mls).

Footnotes

  • 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

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.