Association 'tween total duration of BF and Iron Deficiency

[@llli*free2beme]

Stumbled across this, and didn't really know what to make of it!! Was wondering what you people thought, and if you knew what the cause could be.

http://pediatrics.aappublications.or...6-f125abe5b888

A comment on the study made mention of the fact that delayed cord clamping can have an effect on iron stores.

All 3 of my boys had very delayed cord clamping.

Any thoughts?

[@llli*lllkaren]

Hm, I'm not really sure what to make of it either...

It sounds like they're saying that the babies who were breastfed longer were more likely to have low iron, but they were NOT more likely to become anemic.

I know we have some scientist moms around here... I'd be interested in hearing their take on it.

[@llli*mommal]

Unless you subscribe to Pediatrics, all you can see is the abstract. Unless someone has access to the full text? I don't really want to comment just based on an abstract... Although I do note that the P value for the association between breastfeeding duration and lower serum ferritin was just P = 0.0015, which if I remember my biostatistics class correctly, is a very weak association. The usual value for determining statistical significance is generally set at P = 0.05.

[@llli*sonogirl]

Although I do note that the P value for the association between breastfeeding duration and lower serum ferritin was just P = 0.0015, which if I remember my biostatistics class correctly, is a very weak association. The usual value for determining statistical significance is generally set at P = 0.05.

I think it is the opposite, actually--the smaller the P value, the less likely the result is due to chance. So P=0.0015 means there is only a 15/10,000 chance the result is just chance.

That said, it is still hard to draw conclusions without access to the full paper.

[@llli*mommal]

Argh! This is why I only got a B in that class... Thanks for the correction!

[@llli*free2beme]

I agree the small exerpt is quite frustrating, as it does not give a conclusion. I think from memory it said something about iron decreasing a certain amount for every extra month breastfed.

As all my 3 boys have been breastfed 4 yrs plus, I was thinking "geez, should I get their Iron tested??"

Mind you, I get low in Iron sometimes, and know how it makes me feel and behave, none of my boys act remotely lacking in energy!!

[@llli*free2beme]

The relationship between total breastfeeding duration and iron deficiency anemia did not meet statistical significance.

This was part of the result, so does that mean that the study actually did not find any signigicant association after all?

[@llli*bfwmomof3]

The study looked at the association between breastfeeding duration and serum ferritin, a marker of iron stores (lower ferritin suggests lower iron stores, though it is not a perfect measure). It did find a statistically significant association between longer duration of breastfeeding and lower serum ferritin, but not with iron deficiency anemia (ie, low hemoglobin/hematocrit as a result of low iron stores). Interestingly, the strongest association was with daily cow's milk intake - ie, more cow's milk intake, lower serum ferritin - drinking more cow's milk had a far bigger effect on ferritin than longer breastfeeding! For every additional month of breastfeeding, serum ferritin decreased by 0.24 micrograms/L, whereas drinking more cow's milk decreased ferritin by 1.85 micrograms/L (I believe this is for each additional cup of milk per day, it's not totally clear). And, they state, "Additional exploration identified an association between greater daily cow’s milk consumption and both shorter total breastfeeding duration and lower serum ferritin." They tried to deal with this statistically in their adjusted model, and found that prolonged breastfeeding still was associated with lower ferritin after adjustment, but as with any observational study, it is quite possible that there are other confounders that they didn't adjust for and that could be causing the association, rather than breastfeeding itself. Also, one thing to keep in mind is that they lumped all breastfeeding together, exclusive and non-exclusive, and they don't actually provide any information about the extent to which the breastfed infants were breastfed vs received other forms of nutrition.

All in all? Something to keep an eye on, certainly NOT a reason to curtail breastfeeding!

[@llli*free2beme]

Thanks for that. Very interesting, and relieving!!

[@llli*kayla9214]

People who actually know what they are talking about, please rebut what I'm about to say, if necessary:

A baby who isn't bf is more likely to be given iron-fortified foods, like formula and those cutesy baby cereals. That type of iron isn't used as well in a human's body as the smaller amounts of iron naturally found in bm and, you know, real food.

So, couldn't the higher iron blood levels be because the iron is hanging around in the system, instead of getting used?

I'm always impressed (sarcasm) by studies that twist things around and make the bf group look special or different, when really bf groups should be your control group. They want you to think, "What us wrong with bf that it makes you have low iron?" Instead, You should say, "Hmmm...what is wrong with the non-bf group? Why do they have elevated iron levels?"