1. Epstein, Linda BSN, RN

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Bottle feeding children beyond the age of 12 months can lead to iron deficiency, according to a recent analysis of data from a large-scale national survey conducted by the National Center for Health Statistics. Mexican American children are at particularly high risk because of a tendency for their parents to bottle feed them well beyond 15 months, the study authors say.


Of the 2,121 children between the ages of one to three years who were included in the sample, 9% were iron deficient. Iron deficiency anemia was found in 2.6% overall: in 5.5% of Mexican American children, 3.5% of black children, and 1.2% of white children. And in all groups, the prevalence of iron deficiency increased the longer the children were bottle fed.


In Mexican American children the prevalence of iron deficiency was 18.5% in those who were bottle fed longer than 12 months. This is significant because 36.8% of the Mexican American children in this study were still bottle fed between the ages of 24 and 48 months, compared with 16.9% of whites and 13.8% of blacks.


Iron deficiency in early childhood and infancy is linked to delayed psychomotor and mental development and behavioral disturbances that can continue through adolescence. Identifying children at risk for iron deficiency can begin by asking parents whether they're still bottle feeding their toddlers. The authors suggest iron supplementation in all children under age two because iron deficiency cannot always be detected. The researchers also suggest that parents be given direction and support to wean infants from the bottle by 15 months.


Brotanek JM, et al. Arch Pediatr Adolesc Med 2005;159(11):1038-42.

FIGURE. Percentage o... - Click to enlarge in new windowFIGURE. Percentage of Bottle-Fed Infants Who Were Iron Deficient