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Anne Sütü Alan İnfantlarda Demir Takviyesinin Etkisi: Randomize Kontrollü Çalışma

Yıl 2016, Cilt: 6 Sayı: 3, 165 - 172, 19.10.2016
https://doi.org/10.16899/ctd.69667

Öz

Amaç
Bu çalışmanın amacı, çoğunlukla anne sütü alan infantlarda demir eksikliği ve demir eksikliği anemisinden korunmada günlük oral demir takviyesinin etkisini ve demir eksikliği gelişimini etkileyen faktörleri incelemektir.
Metod
Bu çalışma Ocak 2009-Mart 2010 tarihleri arasında, 65 infant (35 demir desteği alan ve 30 destek almayan kontrol grubu) ile yürütülmüştür. Tüm infantlara 4, 6 ve 9. aylarında detaylı fizik muayene yapıldı. Demirden zengin beslenme önerileri infantlar 6 ve 9. ayında iken tüm ailelere verildi. Antropometrik ölçümler, Denver gelişimsel tarama testi, tam kan sayımı ve demir parametreleri değerlendirildi.
Sonuçlar
Demir desteği alan ve kontrol grubu infantlar arasında demir eksikliği ve demir eksikliği anemisi gelişimi yönünden belirgin fark yoktu (31.44%, 46.6% sırasıyla) (p>0,05). Gruplar arasında aynı zamanda, antropometrik ölçümler, hematolojik parametreler, Denver gelişimsel tarama testi sonuçları arasında belirgin fark izlenmedi.
Tartışma
Term, anne sütü alan infantlarda, 4 aylıktan itibaren verilen rutin demir takviyesi ile birlikte demirden zengin ek besinlerin tüketimi demir durumunu düzeltebilir. Diyetle yeterli demir alımı demir eksikliği anemisinden korumada etkin bir yoldur.

Kaynakça

  • Baker RD, Greer FR; Committee on Nutrition American Academy of Pediatrics. Diagnosis and Prevention of Iron Deficiency and Iron-Deficiency Anemia in Infants and Young Children (0 -3 Years of Age). Pediatrics 2010; 126(5): 1040- 1050.
  • Booth IW, Aukett MA: Iron deficiency anemia in infancy and early childhood. Arch Dis Child 1997; 76: 549-554.
  • Iron deficiency anemia: Assessment, prevention and control. Geneva: World Health Organization 2001.
  • Lozoff B, Jimenez E, Hagen J, Mollen E, Wolf AW. Poorer behavioral and developmental outcome more than 10 years after treatment for iron deficiency in infancy. Pediatrics 2000; 105(4)
  • Lozoff B, Jimenez E, Smith JB. Double burden of iron deficiency in infancy and low socioeconomic status: a longitudinal analysis of cognitive test scores to age 19 years. Arch Pediatr Adolesc Med. 2006; 160(11):1108– 1113
  • Oski AF: Iron deficiency in infancy and childhood. N Engl J Med. 1993; 329: 190-193.
  • Infant and young children feeding. Model chapter for text books for medical students and allied health professionals. Geneva, World Health Organization, 2009.
  • AAP section on breastfeeding, Schanler RJ; Executive Committee, Feldman-Winter L, Landers S, Noble L, Szucs KA, Viehmann L. Concerns with early universal iron supplementation of breastfeeding infants. Pediatrics 2011; 127(4): e1097.
  • Hendricks KM, Duggan C: Manual of pediatric nutrition. London, BC Decker, 2005.
  • Gokcay G, Ozden T, Karakas Z, Karabayir N, Yildiz I, Abali S, Sahip Y. Effect of iron supplementation on iron deficiency anemia in breastfed infants. J Trop Pediatr 2012; 58: 481-485.
  • Domellöf M, Cohen RJ, Dewey KG, Hernell O, Rivera LL, Lönnerdal B. Iron supplementation of breast-fed Honduran and Swedish infants from 4 to 9 months of age. J Pediatr 2001; 138(5): 679-687. 12 Ziegler EE, Nelson SE, Jeter JM. Iron supplementation of breastfed infants from an early age. Am J Clin Nutr 2009; 89: 525-532.
  • Friel JK, Aziz K, Andrews WL, Harding SV, Courage ML, Adams RJ. A double masked, randomized control trial of iron supplementation in early infancy in healthy term breast-fed infants. J Pediatr 2003; 143 (5): 582-586.
  • Yurdakok K, Temiz F, Yalcin S, Gümrük F. Efficacy of daily and weekly iron supplementation on iron status in exclusively breast-fed infants. J Pediatr Hematol Oncol 2004; 26(5): 284-288.
  • Chaparro CM. Setting the stage for child health and development: prevention of iron deficiency in early infancy. J Nutr 2008; 138: 2529-2533.
  • Chwang L, Soemantri AG, Polloitt E. Iron supplementation and physical growth of rural Indonesian children. Am J Clin Nutr 1988; 47: 496­501.
  • Tielsch JM, Khatry S. Effect of routine prophylactic supplementation with iron and folic acid on preschool child mortality in southern Nepal. Lancet 2006; 367: 144- 152.
  • Smith AW, Hendrickse RG, Harrison C, Hayes RJ, Greenwood BM. The effects on malaria of treatment of iron deficiency anemia with oral iron in Gambian children. Ann Trop Paediatr 1989; 9: 17­23.
  • Sazawal S, Black RE, Ramsan M: Effect of routine prophylactic supplementation with iron and folic acid on admission to hospital and mortality in preschool children in a high malaria transmission setting: community based randomized placebo controlled trial. Lancet 2006; 367: 133- 143.
  • Gera T, Sachdev HPS: Effect of iron supplementation on incidence of infectious illness in children: systematic review. BMJ 2002; 325: 1142-1151.
  • Aukett MA, Parks YA, Scott PH, Wharton BA. Treatment with iron increases weight gain and psychomotor development. Archives of Disease in Childhood 1986; 61: 849-857.
  • Rosado JL, Lopez P, Munoz E, Martinez H, Allen LH. Zinc supplementation reduced morbidity, but neither zinc nor iron supplementation affected growth or body composition of Mexican preschoolers. American Journal of Clinical Nutrition 1997; 65: 13-19.
  • Majumdar P, Paul P, Talib VH, Ranga S. The effect of iron therapy on the growth of iron-replete and iron- deplete children. Journal of Troph Ped 2003; 49: 84-88.

Effect Of Iron Supplementation In Breastfed Infants: A Randomized Controlled Study

Yıl 2016, Cilt: 6 Sayı: 3, 165 - 172, 19.10.2016
https://doi.org/10.16899/ctd.69667

Öz

Aim
The purpose of this study was to investigate the efficacy of daily iron supplementation for prevention of iron-deficiency and iron-deficiency anemia in healthy exclusively breast-fed infants and the factors affecting development of iron-deficiency anemia.
Methods
This study was conducted with 65 infants (35 in the iron supplemented group and 30 in the non-supplemented controls) between January 2009-March 2010. Detailed physical examination of all infants was carried out at ages 4, 6, and 9 months. Iron-rich complementary feeding recommendations were given to all families when their infants were 6 months and 9 months of age. Anthropometric measurements, Denver developmental screening test, complete blood count and iron parameters were evaluated.
Results
There were no significant differences in terms of having iron-deficiency or iron-deficiency anemia between infants receiving iron supplementation and control group not receiving iron supplementation (31.44% 46.6%, respectively) (p>0,05). There were also no statistically significant differences between supplemented and non-supplemented groups in terms of anthropometric measurements, hematological parameters, Denver developmental screening results.
Conclusion
Consumption of iron rich complementary foods together with routine iron supplementation of term, breast-fed infants from 4 months of age can improve their iron status. Receiving sufficient iron in diet is an effective way prevent iron-deficiency anemia.

Kaynakça

  • Baker RD, Greer FR; Committee on Nutrition American Academy of Pediatrics. Diagnosis and Prevention of Iron Deficiency and Iron-Deficiency Anemia in Infants and Young Children (0 -3 Years of Age). Pediatrics 2010; 126(5): 1040- 1050.
  • Booth IW, Aukett MA: Iron deficiency anemia in infancy and early childhood. Arch Dis Child 1997; 76: 549-554.
  • Iron deficiency anemia: Assessment, prevention and control. Geneva: World Health Organization 2001.
  • Lozoff B, Jimenez E, Hagen J, Mollen E, Wolf AW. Poorer behavioral and developmental outcome more than 10 years after treatment for iron deficiency in infancy. Pediatrics 2000; 105(4)
  • Lozoff B, Jimenez E, Smith JB. Double burden of iron deficiency in infancy and low socioeconomic status: a longitudinal analysis of cognitive test scores to age 19 years. Arch Pediatr Adolesc Med. 2006; 160(11):1108– 1113
  • Oski AF: Iron deficiency in infancy and childhood. N Engl J Med. 1993; 329: 190-193.
  • Infant and young children feeding. Model chapter for text books for medical students and allied health professionals. Geneva, World Health Organization, 2009.
  • AAP section on breastfeeding, Schanler RJ; Executive Committee, Feldman-Winter L, Landers S, Noble L, Szucs KA, Viehmann L. Concerns with early universal iron supplementation of breastfeeding infants. Pediatrics 2011; 127(4): e1097.
  • Hendricks KM, Duggan C: Manual of pediatric nutrition. London, BC Decker, 2005.
  • Gokcay G, Ozden T, Karakas Z, Karabayir N, Yildiz I, Abali S, Sahip Y. Effect of iron supplementation on iron deficiency anemia in breastfed infants. J Trop Pediatr 2012; 58: 481-485.
  • Domellöf M, Cohen RJ, Dewey KG, Hernell O, Rivera LL, Lönnerdal B. Iron supplementation of breast-fed Honduran and Swedish infants from 4 to 9 months of age. J Pediatr 2001; 138(5): 679-687. 12 Ziegler EE, Nelson SE, Jeter JM. Iron supplementation of breastfed infants from an early age. Am J Clin Nutr 2009; 89: 525-532.
  • Friel JK, Aziz K, Andrews WL, Harding SV, Courage ML, Adams RJ. A double masked, randomized control trial of iron supplementation in early infancy in healthy term breast-fed infants. J Pediatr 2003; 143 (5): 582-586.
  • Yurdakok K, Temiz F, Yalcin S, Gümrük F. Efficacy of daily and weekly iron supplementation on iron status in exclusively breast-fed infants. J Pediatr Hematol Oncol 2004; 26(5): 284-288.
  • Chaparro CM. Setting the stage for child health and development: prevention of iron deficiency in early infancy. J Nutr 2008; 138: 2529-2533.
  • Chwang L, Soemantri AG, Polloitt E. Iron supplementation and physical growth of rural Indonesian children. Am J Clin Nutr 1988; 47: 496­501.
  • Tielsch JM, Khatry S. Effect of routine prophylactic supplementation with iron and folic acid on preschool child mortality in southern Nepal. Lancet 2006; 367: 144- 152.
  • Smith AW, Hendrickse RG, Harrison C, Hayes RJ, Greenwood BM. The effects on malaria of treatment of iron deficiency anemia with oral iron in Gambian children. Ann Trop Paediatr 1989; 9: 17­23.
  • Sazawal S, Black RE, Ramsan M: Effect of routine prophylactic supplementation with iron and folic acid on admission to hospital and mortality in preschool children in a high malaria transmission setting: community based randomized placebo controlled trial. Lancet 2006; 367: 133- 143.
  • Gera T, Sachdev HPS: Effect of iron supplementation on incidence of infectious illness in children: systematic review. BMJ 2002; 325: 1142-1151.
  • Aukett MA, Parks YA, Scott PH, Wharton BA. Treatment with iron increases weight gain and psychomotor development. Archives of Disease in Childhood 1986; 61: 849-857.
  • Rosado JL, Lopez P, Munoz E, Martinez H, Allen LH. Zinc supplementation reduced morbidity, but neither zinc nor iron supplementation affected growth or body composition of Mexican preschoolers. American Journal of Clinical Nutrition 1997; 65: 13-19.
  • Majumdar P, Paul P, Talib VH, Ranga S. The effect of iron therapy on the growth of iron-replete and iron- deplete children. Journal of Troph Ped 2003; 49: 84-88.
Toplam 22 adet kaynakça vardır.

Ayrıntılar

Konular Sağlık Kurumları Yönetimi
Bölüm Orjinal Çalışma
Yazarlar

Şeyma Kayalı

Nilgün Caylan Bu kişi benim

Gonca Yılmaz Bu kişi benim

Selim Gökçe Bu kişi benim

Candemir Karacan Bu kişi benim

Yayımlanma Tarihi 19 Ekim 2016
Yayımlandığı Sayı Yıl 2016 Cilt: 6 Sayı: 3

Kaynak Göster

APA Kayalı, Ş., Caylan, N., Yılmaz, G., Gökçe, S., vd. (2016). Anne Sütü Alan İnfantlarda Demir Takviyesinin Etkisi: Randomize Kontrollü Çalışma. Çağdaş Tıp Dergisi, 6(3), 165-172. https://doi.org/10.16899/ctd.69667
AMA Kayalı Ş, Caylan N, Yılmaz G, Gökçe S, Karacan C. Anne Sütü Alan İnfantlarda Demir Takviyesinin Etkisi: Randomize Kontrollü Çalışma. J Contemp Med. Eylül 2016;6(3):165-172. doi:10.16899/ctd.69667
Chicago Kayalı, Şeyma, Nilgün Caylan, Gonca Yılmaz, Selim Gökçe, ve Candemir Karacan. “Anne Sütü Alan İnfantlarda Demir Takviyesinin Etkisi: Randomize Kontrollü Çalışma”. Çağdaş Tıp Dergisi 6, sy. 3 (Eylül 2016): 165-72. https://doi.org/10.16899/ctd.69667.
EndNote Kayalı Ş, Caylan N, Yılmaz G, Gökçe S, Karacan C (01 Eylül 2016) Anne Sütü Alan İnfantlarda Demir Takviyesinin Etkisi: Randomize Kontrollü Çalışma. Çağdaş Tıp Dergisi 6 3 165–172.
IEEE Ş. Kayalı, N. Caylan, G. Yılmaz, S. Gökçe, ve C. Karacan, “Anne Sütü Alan İnfantlarda Demir Takviyesinin Etkisi: Randomize Kontrollü Çalışma”, J Contemp Med, c. 6, sy. 3, ss. 165–172, 2016, doi: 10.16899/ctd.69667.
ISNAD Kayalı, Şeyma vd. “Anne Sütü Alan İnfantlarda Demir Takviyesinin Etkisi: Randomize Kontrollü Çalışma”. Çağdaş Tıp Dergisi 6/3 (Eylül 2016), 165-172. https://doi.org/10.16899/ctd.69667.
JAMA Kayalı Ş, Caylan N, Yılmaz G, Gökçe S, Karacan C. Anne Sütü Alan İnfantlarda Demir Takviyesinin Etkisi: Randomize Kontrollü Çalışma. J Contemp Med. 2016;6:165–172.
MLA Kayalı, Şeyma vd. “Anne Sütü Alan İnfantlarda Demir Takviyesinin Etkisi: Randomize Kontrollü Çalışma”. Çağdaş Tıp Dergisi, c. 6, sy. 3, 2016, ss. 165-72, doi:10.16899/ctd.69667.
Vancouver Kayalı Ş, Caylan N, Yılmaz G, Gökçe S, Karacan C. Anne Sütü Alan İnfantlarda Demir Takviyesinin Etkisi: Randomize Kontrollü Çalışma. J Contemp Med. 2016;6(3):165-72.