Effect of iron supplementation in healthy exclusively breastfed infants: a systematic review and meta-analysis.

IF 2.1 3区医学 Q2 PEDIATRICS

Frontiers in Pediatrics Pub Date : 2025-05-20 eCollection Date: 2025-01-01 DOI:10.3389/fped.2025.1587457

Ke Tian, Wenli Liu, Yi Huang, Rong Zhou, Yan Wang

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引用次数: 0

Abstract

Background and objectives: Exclusively breastfed infants are at risk of iron deficiency due to the low iron content in breast milk. This study aims to evaluate the benefits and risks of daily oral iron supplementation on growth, cognitive outcomes, and hematologic parameters in these infants.

Methods: Data sources include Cochrane Central Register of Controlled Trials, PubMed, and Embase from inception to December, 2024. Randomized controlled trials were included. The Cochrane risk of bias tool was used to assess the methodological quality of included trials. The continuous outcomes were analyzed by calculating the mean difference (MD) and the binary categorical variables were analyzed using relative risk (RR) with 95% confidence intervals (CI).

Results: This study included 8 trials (685 participants) comparing iron supplementation to no iron. At 6 months of age, compared to infants who were exclusively breastfed without iron supplementation, those who received oral iron supplementation showed an increase in hemoglobin (Hb) levels (MD 0.42, 95% CI 0.19-0.66, p < 0.001, I ² = 76%) and a reduction in the incidence of iron deficiency (ID) (RR 0.38, 95% CI 0.15-1.00, p = 0.050, I ² = 29%) and iron-deficiency anemia (IDA) (RR 0.58, 95% CI 0.40-0.84, p = 0.004, I ² = 0). However, by 12 months of age, the supplementation had no effect on Hb levels, ID, the incidence of IDA or mental development index (MDI). Iron supplementation appeared to reduce weight gain (MD = -0.04, 95%CI -0.07 to -0.01, p = 0.004, I ² = 0) and head circumference gain (MD = -0.14, 95% CI -0.18 to -0.09, p < 0.001, I ² = 25%).

Conclusions: Limited available evidence suggests that iron supplementation is beneficial for hematologic parameters and the incidence of IDA in healthy exclusively breastfed infants. However, it may delay weight gain and head circumference growth.

Systematic review registration: https://www.crd.york.ac.uk/prospero/, PROSPERO [CRD42024610082].

查看原文本刊更多论文

补充铁对健康纯母乳喂养婴儿的影响：一项系统回顾和荟萃分析。

背景和目的：由于母乳中铁含量低，纯母乳喂养的婴儿有缺铁的风险。本研究旨在评估每日口服补铁对这些婴儿生长、认知结局和血液学参数的益处和风险。方法：数据来源包括Cochrane Central Register of Controlled Trials， PubMed和Embase，时间从成立到2024年12月。纳入随机对照试验。采用Cochrane偏倚风险工具评估纳入试验的方法学质量。连续结局采用均值差（MD）分析，二元分类变量采用相对危险度（RR）分析，95%置信区间（CI）。结果：这项研究包括8项试验（685名参与者），比较铁补充剂和不铁。相比,在6个月大的婴儿是母乳喂养没有补铁,那些接受口服补铁显示增加血红蛋白(Hb)水平(MD 0.42, 95%可信区间0.19 - -0.66,p我2 = 76%)和减少缺铁性(ID)的发病率(相对危险度0.38,95%可信区间0.15 - -1.00,p = 0.050, 2 = 29%)和缺铁性贫血(IDA)(相对危险度0.58,95%可信区间0.40 - -0.84,p = 0.004, 2 = 0)。然而，到12个月大时，补充剂对Hb水平、ID、IDA发生率或智力发育指数（MDI）没有影响。补充铁可以降低体重增加（MD = -0.04, 95%CI -0.07 ~ -0.01, p = 0.004, i2 = 0）和头围增加（MD = -0.14, 95%CI -0.18 ~ -0.09, i2 = 25%）。结论：有限的现有证据表明，补充铁对健康纯母乳喂养婴儿的血液学参数和IDA发生率有益。然而，它可能会延缓体重增加和头围的增长。系统评价注册：https://www.crd.york.ac.uk/prospero/, PROSPERO [CRD42024610082]。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Frontiers in Pediatrics Medicine-Pediatrics, Perinatology and Child Health

CiteScore

3.60

自引率

7.70%

发文量

2132

审稿时长

14 weeks

期刊介绍： Frontiers in Pediatrics (Impact Factor 2.33) publishes rigorously peer-reviewed research broadly across the field, from basic to clinical research that meets ongoing challenges in pediatric patient care and child health. Field Chief Editors Arjan Te Pas at Leiden University and Michael L. Moritz at the Children''s Hospital of Pittsburgh are supported by an outstanding Editorial Board of international experts. This multidisciplinary open-access journal is at the forefront of disseminating and communicating scientific knowledge and impactful discoveries to researchers, academics, clinicians and the public worldwide. Frontiers in Pediatrics also features Research Topics, Frontiers special theme-focused issues managed by Guest Associate Editors, addressing important areas in pediatrics. In this fashion, Frontiers serves as an outlet to publish the broadest aspects of pediatrics in both basic and clinical research, including high-quality reviews, case reports, editorials and commentaries related to all aspects of pediatrics.