CONSUMPTION OF UNMODIFIED COW’S MILK AND THE RISK OF IRON DEFICIENCY ANEMIA IN INFANTS AND TODDLERS AND ITS MANAGEMENT

Early introduction of complementary foods (weaning) before 4 to 6 months of age and unmodified cow’s milk before age 12 months are associated with several health risks in children. Too early introduction of unmodified cow’s milk and milk products to infants and toddlers has adverse effects on their iron stores. Children can develop iron-deficiency anemia from chronic enteric blood loss even when occult blood is not found in stools on random testing. Several mechanisms have been identified that may contribute to iron deficiency anemia in young population group. The most important of these is probably the low iron content of Cow’s Milk. Other risks in association to the consumption of unmodified cow’s milk in infants include increased renal solute load; increased blood loss from the gastrointestinal tract, chronic constipation, and anal fissures; and an increased risk for subsequent type 1 and type 2 diabetes. Evidence is now also growing to show that iron deficiency anemia is associated with developmental delay, and that the association is causal. Breastfed infants may also be still at particular risk for iron deficiency anemia because breast milk by itself has low iron content. Conclusion: iron deficiency anemia is readily preventable, even in a profoundly socially disadvantaged population, by the provision of an iron supplemented formula in place of unmodified cow’s milk. Regular provision of medicinal iron or iron-fortified cereal improves the iron status of breastfed infants.