Clinical and Experimental Pediatrics

The Korean Pediatric Society (대한소아청소년과학회)
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A study on cow's milk and nursing method in relation to iron deficiency

모유 수유아와 생우유를 먹인 아기의 철분결핍에 관한 연구

  • Kang, Ji Ung (Department of Pediatrics, Presbyterian Medical Center) ;
  • Jin, So Hee (Department of Pediatrics, Presbyterian Medical Center) ;
  • Choi, Kyung Dan (Department of Pediatrics, Presbyterian Medical Center) ;
  • Jang, Young Taek (Department of Pediatrics, Presbyterian Medical Center)
  • Received : 2005.09.22
  • Accepted : 2005.10.24
  • Published : 2006.02.15
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Abstract

Purpose : This study investigated the breast-feeding period, the milk bottle-using period, the age of cow's milk, introduced and the amount of cow's milk consumed in relation to anemia. Methods : Over the course of three years, 930 children(12 months to 36 months) who went to the Presbyterian Medical Center, Chonju, Korea were tested for anemia and their parents were surveyed for a history of their children's milk consumption. Results : Anemia appeared more likely between 30 months and 36 months, however, iron-deficiency anemia appeared more likely between 18 months and 23 months. Anemia, low serum ferritin levels and iron-deficiency anemia appeared more likely in children breast fed less than 6 months and greater than 12 months. Although there were survey reports of side effects with cow's milk, including constipation, diarrhea and skin rash, the milk bottle-using period, age of cow's milk introduced and amount of cow's milk consumed had no connection with anemia, serum ferritin levels and irondeficiency anemia. Conclusion : The data showed no correlation between the cow's milk, milk bottle-using period and iron deficiency. But the data revealed that iron deficiency anemia is more likely in children who are breast fed for less than 6 months and over 12 months, so we suggest careful attention during this period to prevent iron deficiency anemia.

목 적 : 모유수유 기간, 우유병 사용 기간, 생우유를 처음 먹인 시기 및 양을 조사하여 빈혈과의 관련을 알아보고자 하였다. 방 법 : 2002년 8월 1일부터 2005년 7월 31일까지 전주예수병원에 입원한 12개월에서 36개월 환아 930명을 대상으로 빈혈검사 및 설문지를 통해 전향적으로 연구하였다. 결 과 : 빈혈이 발생하는 연령은 30-36개월에서 많이 발생하였으나, 철분결핍성 빈혈은 18-23개월에서 많이 발생하였다. 모유수유 기간이 12개월 이상과 6개월 미만 순으로 빈혈이 많고, 혈청 ferritin이 낮고 철분결핍성 빈혈이 많았다. 우유병 사용 기간과 빈혈, 혈청 ferritin, 철분결핍성 빈혈은 차이가 없었다. 생우유를 먹고 난 후에 부작용은 변비, 설사, 피부발진 순으로 나타났다. 생우유를 처음 먹인 시기와 빈혈, 혈청 ferritin, 철분결핍성 빈혈은 차이가 없었다. 하루에 생우유를 먹인 양과 빈혈, 혈청 ferritin, 철분결핍성 빈혈은 차이가 없었다. 결 론 : 생우유와 우유병 사용 기간과 철분결핍은 관계가 없었으며, 모유수유 기간이 12개월 이상과 6개월 이하 순으로 철분결핍이 많았기 때문에, 철분결핍성 빈혈을 예방하기 위해서는, 적절한 모유수유가 중요한 것으로 판단되었다.

Keywords

References

  1. American Academy of Pediatrics, Committee on nutrition. The use of whole cow's milk in infancy. Pediatrics 1983; 72:53-5
  2. American Academy of Pediatrics, Committee on nutrition. The use of whole cow's milk in infancy. Pediatrics 1992; 89:105-9.
  3. Ahn HS. Characteristics and diagnosis of childhood red blood cell disorders. Korean J Pediatr 2004;47(6 suppl):19S- 23S
  4. Kleinman RE. Pediatric nutrition handbook. 4th ed. Elk Grove, Villag, IL; American Academy of Pediatrics 1998: 233-46
  5. Hong CY. Pediatrics. 7th ed. Seoul : Daehan Printing & Publishing Co, 2001:80-9
  6. Kang HJ, Kwon SW, Ahn HS, Cho HI, Kim JQ. The measurement of iron concentrations in whole milk and powered milk. Korean J Lab Med 1989;9:376-7
  7. Michaelsen KF. Cows milk in complementary feeding. Pediatrics 2000;106:1302-3
  8. American Academy of Pediatrics, Committee on nutrition. Iron fortigication of infant formulas. Pediatrics 1999;104: 119-23 https://doi.org/10.1542/peds.104.1.119
  9. Wang PT, Jeon IS. The impact of prolonged breast milk feeding and large amount of whole cow's milk intake on iron status in early childhood. J Korean Pediatr Soc 1998; 41:437-43
  10. Barton JC, Conrad ME, Parmley RT. Calcium inhibition of inorganic iron absorption in rats. Gastroenterology 1983; 84:90-101
  11. Fomon SJ, Sanders KD, Ziegler EE. Formulas for older infants. J Pediatr 1990;116:690-6. https://doi.org/10.1016/S0022-3476(05)82649-6
  12. Lampe JB, Velez N. The effect of prolonged bottle feeding on cow's milk intake and iron stores at 18 months of age. Clin Pediatr(Phila) 1997;36:569-72 https://doi.org/10.1177/000992289703601003
  13. Woodruff C. Breast-feeding or infant formula should be continued for 12 months. Pediatrics 1983;71:984-5
  14. Wilson JF. Whole cow's milk, age, and gastrointestinal bleeding. Pediatrics 1984;73:879-80
  15. Ziegler EE, Fomon SJ, Nelson SE, Rebouche CJ, Edwards BB, Rogers RR, et al. Cow milk feeding in infancy : further observations on blood loss from the gastrointestinal tract. J Pediatr 1990;116:11-8 https://doi.org/10.1016/S0022-3476(05)82917-8
  16. Fomon SJ, Ziegler EE, Nelson SE, Eewards BB. Cow milk feeding in infancy : Gastrointestinal blood loss and iron nutritional status. J Pediatr 1981;98:540-5 https://doi.org/10.1016/S0022-3476(81)80756-1
  17. Oski FA, Honig AS, Helu B, Howanitz P. Effect of iron therapy on behavior performance in nonanemic, iron-deficient infant. Pediatrics 1983;71:877-80
  18. Lozoff B, Bittenham GM, Wolf AW, McClish DK, Kuhnert PM, Jimenez E, et al. Iron deficiency anemia and iron therapy errects on infant developmental test performance. Pediatrics 1987;79:981-95
  19. Aukett MA, Parks YA, Scott PH. Treatment with iron increases weight gain and psychomotor development. Arch Dis Child 1986;61:849-57 https://doi.org/10.1136/adc.61.9.849
  20. Hurtado EK, Claussen AH, Scott KG. Early childhood anemia and mild or moderate mental retardation. Am J Clin Nutr 1999;69:115-9 https://doi.org/10.1093/ajcn/69.1.115
  21. Halterman JS, Kaczorowski JM, Aligne CA, Auinger P, Szilagyi PG. Iron deficiency and cognitive achievement among school aged children and adolescents in the united states. Pediatrics 2001:6;1381-6
  22. Lozoff B. Jimenez E, Wolf AW. Long-term developmental outcome of infants with iron deficiency. N Engl J Med 1991;325:687-94 https://doi.org/10.1056/NEJM199109053251004
  23. Walter T, Andraca ID, Chadud D, Perales CG. Iron deficiency anemia : adverse effects on infant psychomotor development. Pediatrics 1989;84:7-17
  24. Grantham-McGregor S, Ani C. A review of studies on the effect of iron deficiency on cognitive development in children. J Nutr 2001;131:649-68.
  25. Montalto MB, Benson JD, Martinez GA. Nutrient intakes of formula-fed infants and infants fed cow's milk. Pediatrics 1985:75:343-51
  26. Martinez GA, Ryan AS, Malec DJ. Nutrient intakes of American infants and children fed cow's milk or infant formula. AJDC 1985:139:1010-8
  27. Korean Society of Pediatric Nutrition. Baby food. revised and enlarged ed. Seoul : Eui-Hak Publishing Co, 1994:1-8
  28. Korean Society of Pediatric Nutrition. Infancy and early childhood food. Korean Pediatric Society, 2000:173
  29. Lee JT, Oh KH, Park JO, Shin SM. A survey about the usage of whole cow's milk and commercial baby food in children. J Korean Pediatr Soc 1996;39:1066-74.
  30. Cho SJ, Lee KH, Jang YT. A study of the misinformed method of childcare. J Korean Pediatr Soc 2002;45:24-36