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R.J. Adams, A. Setliff, W. Andrews, K. Aziz, M.L. Courage, J. Friel; Iron Supplementation and Visual and Neurobehavioural Functioning in Breast–Fed Human Infants: Do the Effects Persist Beyond Infancy? . Invest. Ophthalmol. Vis. Sci. 2006;47(13):3157.
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© ARVO (1962-2015); The Authors (2016-present)
Although considered to be optimal, human breast milk contains relatively low iron (Fe) content, thus breast–fed infants are at some risk for iron deficiency and iron deficiency anemia. It is well known that within the visual system, iron is essential for photoreceptoral development and for normal neurotransmitter functioning within the developing geniculostriate pathway. It is also critical within other neural systems that subserve motor and cognitive development. In previous work (ARVO, 2003), we reported that, compared to controls, early Fe supplementation (7.5 mg/day for 3 to 6 mo) enhanced hematological status (hemoglobin, mean corpus vol) , visual acuity, and motor (but not cognitive) development in 12–mo–old breast–fed infants. Here we test whether these early advantages persist by following up both placebo and Fe supplemented children at 3.5 years.
36 of the 47 children (19 Fe suppl and 17 placebo) tested originally, returned at 3.5 years and were assessed with the Teller acuity cards, modified Pease–Allen color cards, SureSight autorefraction, and the Bayley mental and motor scales. Evaluation was conducted by examiners masked to group assignment.
At 3.5 years, there were no differences between the placebo and iron supplemented children on any of the measures of visual development or on the Bayley scales. (all p > 0.05). Moreover, all children scored within the normal range on all tests
Although there may be some early hematological, sensory and neurobehavioral advantages to iron supplementation in breast–fed infants during the first year of life, these do not persist into the preschool years. Thus, despite early differences, it can be assumed that the post–breast feeding iron content in food equalizes or normalizes visual and neural development, at least in normally developing infants and children. Whether this is the case for nutritionally–, visually–, or neurologically–at risk patients awaits further study.
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