Effect of breastfeeding versus infant formula on iron status of infants with beta thalassemia major

Effect of breastfeeding versus infant formula on iron status of infants with beta thalassemia major

Thalassemia major or Cooley's anemia is the most severe form of beta thalassemia in which the complete lack of beta protein in the hemoglobin causes a life-threatening anemia requiring regular blood transfusions and extensive ongoing medical care. These extensive, lifelong blood transfusions le...

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Bibliographic Details
Published in:International breastfeeding journal Vol. 12; no. 1; p. 18
Main Authors: El Safy, Usama Roshdy, Fathy, Manar Mohamed, Hassan, Tamer Hasan, Zakaria, Marwa, Al Malky, Mohamed Abdel Kader, Arafa, Mohamed, El Sayed, Hany, Al Ghobashy, Ashgan, Zaho, Boshra, Wahab, Attia Abdel, Mourad, Mohamed Hosam
Format: Journal Article
Language:English
Published: England BioMed Central Ltd 17-04-2017
BioMed Central
BMC
Subjects:
Age
Anemia
Babies
Baby foods
Beta protein
Beta thalassemia
Bioavailability
Blood transfusion
Body weight
Breast feeding
Breastfeeding
Breastfeeding & lactation
Care and treatment
Chelation
Family medical history
Feeding
Ferritin
Health aspects
Hemoglobin
Infants
Iron
Iron overload
Metabolism
Milk
Patient outcomes
Pediatrics
Socioeconomic factors
Statistical analysis
Thalassemia
Variance analysis
Iron overload
Breastfeeding
Thalassemia
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Summary:Thalassemia major or Cooley's anemia is the most severe form of beta thalassemia in which the complete lack of beta protein in the hemoglobin causes a life-threatening anemia requiring regular blood transfusions and extensive ongoing medical care. These extensive, lifelong blood transfusions lead to iron-overload that must be treated with chelation therapy to prevent early death from organ failure. We compared serum iron and ferritin levels amongst infants aged up to one year with beta thalassemia major according to their feeding types, including exclusively breastfed, exclusively formula fed and combined (both breast and formula) fed types. Sixty out of 176 screened infants with transfusion dependant beta thalassemia major were recruited from the outpatient clinic of thalassemia at Zagazig University Hospital in Egypt, between 2007 and 2014. Patients were classified into three groups (20 patients per group) according to type of feeding. Group 1: exclusive breastfeeding, around 6-8 feeds per day; group 2: exclusive infant formula feeding, 120-150 ml of formula per kilogram of body weight per day divided into 6-8 feeds and group 3: combined breastfeeding and formula per day. Serum iron and ferritin levels were lower in group 1 compared to groups 2 and 3. The mean serum iron for group 1 was 73, 87 and 96 ug/dl at 6, 9 and 12 months respectively, while that for group 2 was 85, 99 and 112 ug/dl at 6, 9 and 12 months respectively and for group 3 was 78, 92 and 99 ug/dl at 6, 9 and 12 months respectively. The mean serum ferritin for group 1 was 283, 327 and 497 ng/ml at 6, 9 and 12 months respectively, while that for group 2 was 310, 389 and 591 ng/ml at 6, 9 and 12 months respectively and for group 3 was 291, 345 and 515 ng/ml at 6, 9 and 12 months respectively. The differences were not statistically significant. Breastfed infants with beta thalassemia major may accumulate less iron than infants fed iron fortified formula anticipating later onset of iron overload in the breastfed infants. Larger studies are needed to support these findings.
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ISSN:1746-4358
1746-4358
DOI:10.1186/s13006-017-0111-3