Childhood Obesity and Iron Deficiency Anemia Linked to Prolonged Bottle Feeding

According to a 2003 survey and study conducted by Karen A. Bonuck, Ph.D., and Richard Kahn, M.S., of the Montefiore Medical Center/Albert Einstein College of Medicine, children who are bottle fed for a prolonged period of time may be at higher than normal risk of developing iron-deficiency anemia or becoming obese.

The study was supported by the Agency for Healthcare Research and Quality (AHRQ) and included 95 children, most of whom were Hispanic or black and from lower income families. They ranged in age from 18 to 56 months, with the average age being 36 months. The children's caretakers were given the survey when they reported for re-certification at several Bronx, N.Y., Women's, Infants & Children (WIC) supplemental feeding programs.

The doctors found the following:

Based on their BMI, 50 percent of the children were overweight; 36 percent were obese.

Based on their blood test results, 21 percent of the children met the criteria for anemia, as set by the Centers for Disease Control and Prevention.

Caregivers reported that 63 percent of the children were given daily bottles of milk or sweet liquids such as juice; each child was given anywhere from three to 10 bottles each day.

The researchers concluded that use of the bottle did not seem to be significantly associated with a child being overweight, but both obesity and iron-deficiency anemia were significantly linked to a child's bottle use.

Although iron deficiency is common in children, iron-deficiency anemia has been associated with delayed mental and psychomotor development. Children who either don't eat enough or eat foods that are poor sources of iron are at greatest risk of developing iron-deficiency anemia. According to KidsHealth.com, poverty has been found to also be a contributing factor to iron-deficiency anemia because children of poor families often don't get enough iron-rich foods.

Interestingly, the American Academy of Pediatrics recommends that infants be introduced to drinking from a cup by six months of age; they recommend a child be completely weaned from the bottle by 15 months. However, 20 percent of children two years old and nine percent of children three years old are still using a baby bottle. Further, babies who are more likely to stay on the bottle the longest are from poor, urban, less-educated and minority parents.

According to Drs. Bonuck and Kahn, children who aren't weaned by the recommended time often become habituated to drinking milk or sweet liquids throughout both day and night, rather than drinking water. Cow's milk is low in the iron needed for growth and development, and it also decreases the absorption of iron. Further, drinking milk and sweet liquids can also discourage a child's taste for other food, as well as for a more balanced diet.

Resources:

AHRQ; http://www.ahrq.gov/research/feb03/0203RA5.htm

KidsHealth; http://www.kidshealth.org/parent/medical/heart/ida.html

American Academy of Pediatrics