Authors of a study of 9-month-old Cree infants living in northern Quebec report that one-third of these children were anemic and that this was more of a problem among breast-fed babies than formula-fed infants. Six Cree communities in the James Bay region introduced a screening program in 1995 to identify anemia in infants. Katherine Gray-Donald and colleagues reviewed the charts of 386 of these children and discovered 31.9% were anemic. To understand the cause of the anemia, Gray-Donald and her colleagues tested the association between hemoglobin (Hb) concentration and mean cell volume at 9 months of age, weight gain between birth and 9 months, and type of milk consumed when the infant visited the 9-month well-baby clinic.
The authors report that babies fed formula at 9 months had a higher mean Hb concentration (118.5 [standard deviation (SD) 9.9] g/L) than those exclusively breast-fed (109.9 [SD 10.0] g/L) or cow's milk (112.5 [SD 10.1] g/L).
Since research shows that iron-deficiency anemia is associated with psychomotor impairment, the authors warn the high prevalence among Cree infants should be considered a serious health problem.
In a related editorial, Dr. John Godel warns this study has important implications for public health and nutrition programs. While stating that "breast is best," he recommends supplying additional sources of iron to breast-fed infants after 6 months of age as a way to avoid the severe neurologic and developmental effects associated with iron-deficiency anemia.
Prevalence of anemia among James Bay Cree infants of northern Quebec by N.D. Willows, J. Morel, K. Gray-Donald
Breast-feeding and anemia: Let's be careful by J.C. Godel
Journal
Canadian Medical Association Journal