Résumé
The present study included fifty apparently healthy infants attending the outpatient pediatric clinic of Assiut University Hospital for preventive medicine. They were 25 breast-fed infants [15 males and 10 females], aged 6-12 months with mean age 9.1 +/- 1.73 months and 25 cow's milk-fed infants [12 males and 13 females], their age ranged from 6-12 months, mean age 8.46 +/- 1.76 months. Infants with protein energy malnutrition [PEM] and chronic diseases were excluded from the study. Peripheral hemogram, serum iron, serum ferritin, transferrin saturation percentage and fecal occult blood testing were done for all studied infants. The mean hemoglobin [Hb] and hematocrit [Hct] values were significantly lower in cow's milk-fed infants than in breast-fed ones. At a cut-off value of 11 gm/dl for Hb and 34% for Hct, significantly higher number of infants showed lower Hb [< 11 gm/dL] and lower Hct [<34%] in cow's milk- fed group than in breast-fed one. Furthermore, at a cut-off value of 70 fL [femtolitre] for mean corpuscular volume and 23 pg/cell for mean corpuscular hemoglobin [MCH], the number of infants with lower levels was significantly higher in the former than in the latter group. Serum iron, ferritin and transferrin saturation percentages were significantly lower in cow's milk feeders than in breast-fed ones. At a cut-off value of 22 micro g/dL for serum iron, 10 ng/ml for ferritin and 16% for transferrin saturation percentage, significantly larger number of cow's milk-fed infants showed lower values than breast-fed ones. On the other hand, high total iron binding capacity [> 400 micro g/dL] was more frequent in the former than in the latter group [P<0.1]. Occult blood in stools was detected with significantly higher frequency in cow's milk than in breast milk-fed group
Conclusion: iron deficiency is more common in cow's milk-fed infants than in breast-fed ones and it may be attributed to increased occult blood loss and decreased iron bioavailability in cow's milk group. If non-mother milk is mandatory to be given before 1 year of age for any reason, it is to be fortified with iron