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Effect of Daily Iron Supplementation in Healthy Exclusively Breastfed Infants: A Systematic Review with Meta‐Analysis
Author(s) -
Cai Chenxi,
Friel James
Publication year - 2016
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.30.1_supplement.673.6
Subject(s) - medicine , pediatrics , breastfeeding , randomized controlled trial , bayley scales of infant development , anemia , ferritin , iron deficiency , meta analysis , mean corpuscular volume , adverse effect , psychomotor learning , hemoglobin , cochrane library , cognition , psychiatry
Background Maintaining adequate iron is critical to infants’ physical and neurological development. The literature on iron requirements of exclusively breastfed infants contains conflicting data and contrary views. We summarized the evidence for benefits and risks of daily oral iron supplementation with regard to hematologic, growth, cognitive parameters and adverse effects in exclusively breastfed infants. Methods Structured electronic searches were conducted until August 26, 2015. We searched PubMed, Cochrane Library databases and Google Scholar for randomized controlled trials (RCTs) involving daily iron supplementation in healthy term, exclusively breastfed infants. Random‐ and fixed‐effects models were used to calculate the pooled estimates. Heterogeneity was assessed by Q‐test. Results Four RCTs with 511 infants were included in the meta‐analysis. Iron interventions had no significant effect on iron deficiency and iron deficiency anemia (OR=0.56; 95% CI, 0.23–1.33), serum ferritin level, or hemoglobin level. Iron interventions did result in a significant increase in Bayley psychomotor developmental indexes in later life (MD= 7.00, 95% CI, 0.99 to 13.01) and mean corpuscular volume (MD=2.17 fL; 95% CI, 0.99–43.5 fL). Iron supplementation was associated with slower growth in the exclusive breastfeeding period, but its long‐term effect is unclear. Conclusions Limited available evidence suggests that daily iron supplementation has beneficial effects on the hematologic parameter and later cognitive development, but delays the physical growth in healthy term, exclusively breastfed infants. There was no evidence to suggest iron supplementation could cause adverse effects.