Factors influencing iron nutrition among one-year-old healthy children in Sweden.

AIMS AND OBJECTIVES: To describe possible social, nutritional and biological factors influencing iron intake and iron status among healthy one-year-old children in southern Sweden. BACKGROUND: Iron deficiency is one of the most important nutritional disorders and increases the risk of delayed mental and motor development. Children are at risk because of rapid growth, which entails relatively high requirements of iron. DESIGN: A prospective study using survey methods. METHOD: Randomly selected one-year-old children (n = 90) and their parents participated. Parents answered a questionnaire enquiring about demographic data and the child's feeding and health during the first year. The child's total food intake and blood samples (haemoglobin, mean corpuscular volume, S-ferritin and transferring receptor) were obtained. Results. Twenty-seven per cent of the children had an iron intake below the Nordic Nutrition Recommendations of 8 mg/day (NNR 2004). Follow-on formula and iron-fortified porridge contributed to 64% of the child's total iron intake. Partial breastfeeding and low maternal education correlated negatively with iron intake from complementary food. In total, 10·3% (n = 9) of the children were found to be iron-depleted (S-ferritin ≤ 12 µg/l), and 2·3% (n = 2) had iron deficiency with or without anaemia (Hb ≤ 100 g/l). CONCLUSIONS: One-year-old children in Sweden may be at risk of developing iron deficiency, but information about iron-rich food can improve iron status. RELEVANCE TO CLINICAL PRACTICE: Knowledge about factors influencing children's iron intake and iron status may improve the nutritional advice and education from the Child Health Services to prevent or detect iron deficiency.

Feeding preterm infants after hospital discharge: a commentary by the ESPGHAN Committee on Nutrition.

Survival of small premature infants has markedly improved during the last few decades. These infants are discharged from hospital care with body weight below the usual birth weight of healthy term infants. Early nutrition support of preterm infants influences long-term health outcomes. Therefore, the ESPGHAN Committee on Nutrition has reviewed available evidence on feeding preterm infants after hospital discharge. Close monitoring of growth during hospital stay and after discharge is recommended to enable the provision of adequate nutrition support. Measurements of length and head circumference, in addition to weight, must be used to identify those preterm infants with poor growth that may need additional nutrition support. Infants with an appropriate weight for postconceptional age at discharge should be breast-fed when possible. When formula-fed, such infants should be fed regular infant formula with provision of long-chain polyunsaturated fatty acids. Infants discharged with a subnormal weight for postconceptional age are at increased risk of long-term growth failure, and the human milk they consume should be supplemented, for example, with a human milk fortifier to provide an adequate nutrient supply. If formula-fed, such infants should receive special postdischarge formula with high contents of protein, minerals and trace elements as well as an long-chain polyunsaturated fatty acid supply, at least until a postconceptional age of 40 weeks, but possibly until about 52 weeks postconceptional age. Continued growth monitoring is required to adapt feeding choices to the needs of individual infants and to avoid underfeeding or overfeeding.