Low doses of iron do not benefit breastfeeding infants
Last reviewed: 14.06.2024
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The American Pediatric Association recommends iron supplementation for all healthy infants who are breastfed for more than four months, while its European counterpart, the Society of Gastroenterology, Hepatology and Nutrition, makes no such recommendation.
These various recommendations prompted the researchers to design a new study. Breastfeeding is highly recommended and the proportion of children breastfed in the first months of life is high. The researchers wanted to determine whether infants could benefit from extra iron.
The purpose of the SIDBI study was to compare recommendations based on the effects of iron supplementation on psychomotor development in children.
SIDBI stands for Supplementing Iron and Development in Breastfed Infants and was a randomized, placebo-controlled trial conducted from December 2015 to May 2020, with follow-up until May 2023. This was an international collaboration between the Medical University of Warsaw and the University of Umeå, and children were recruited in both Poland and Sweden.
A total of 221 infants were recruited. If the child was exclusively breastfed at four months, he or she was randomly assigned to receive either iron 1 mg/kg or placebo once daily from 4 to 9 months. Participants then completed psychological assessments at 12, 24, and 36 months. Cognitive, motor and language abilities were studied, as well as behavioral problems.
"We saw no significant differences in psychomotor development between children receiving supplemental iron and children receiving placebo," says Ludwig Svensson, a graduate student involved in the SIDBI study. "In other words, there was no developmental benefit from iron supplementation. More children in the placebo group were found to be iron deficient, but the difference was not significant.
"Our results provide high-quality evidence in an area where randomized trials have previously been lacking. They support European recommendations against recommending iron supplementation for all healthy infants. We are proud to publish the results in JAMA Pediatrics and hope there will be great interest in the study." "
Ludwig looks forward to analyzing the remaining data from the SIDBI study.
"Among other things, we will be looking at behavioral problems at age 3. It will be very interesting to see whether the iron has an impact on behaviors associated with ADHD or autism spectrum disorder."
The results were published in the journal JAMA Pediatrics.