Trajectory of vitamin D, micronutrient status and childhood growth in exclusively breastfed children

Sci Rep. 2019 Dec 13;9(1):19070. doi: 10.1038/s41598-019-55341-1.

Abstract

This study aimed to compare the trajectory of serum 25(OH)D, micronutrient levels, and anthropometric measurements between exclusively breastfed and mixed-fed children. This is a prospective cohort study. Anthropometric measurements of the children were obtained during scheduled clinical visits. Tests for 25(OHD), ferritin, zinc and complete blood count were performed yearly until 3 years of age. Clinical records and questionnaires on dietary habits were obtained. The results showed that despite official recommendations on vitamin D/iron supplements for breastfed children, less than 10% of our exclusively breastfed children received regular supplements. Thus, after 1 year, the odds for having iron deficiency anemia and vitamin D insufficiency were 9 [95% CI, 4-19] and 6 [95% CI, 2-16], respectively. Longitudinal follow-up showed the prevalence of iron deficiency to decrease from 34% at 1 year to 2% at age 3 years. However, the prevalence of vitamin D insufficiency remained persistently high throughout the first three years of life (60% at 1 to 44% at 3 years). Very few children had zinc deficiency. Anthropometric measurements showed exclusively breastfed children to have lower mean z-scores for body weight and height when compared to mixed-fed children after 12 months. In conclusion, children who were exclusively breastfed for longer than 4 months without proper supplement were more likely to have transient iron deficiency anemia and persistent vitamin D insufficiency. Their growth became relatively slower after infancy. Whether this was associated with underlying inadequate serum vitamin D and iron level remains an important issue to be explored.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Blood Cell Count
  • Body Mass Index
  • Breast Feeding*
  • Child
  • Child Development*
  • Child, Preschool
  • Female
  • Ferritins / blood
  • Hemoglobins / metabolism
  • Humans
  • Infant
  • Iron Deficiencies
  • Male
  • Micronutrients / blood*
  • Vitamin D / blood*
  • Zinc / blood

Substances

  • Hemoglobins
  • Micronutrients
  • Vitamin D
  • Ferritins
  • Zinc