The feeding of cow’s milk has adverse effects on iron nutrition in infants and young
children. Several different mechanisms have been identified that may act synergistically.
Probably most important is the low iron content of cow’s milk. It makes it difficult
for the infant to obtain the amounts of iron needed for growth. A second mechanism is
the occult intestinal blood loss, which occurs in about 40% of normal infants during
feeding of cow’s milk. Loss of iron in the form of blood diminishes with age and ceases
after 1 year of age. A third factor is calcium and casein provided by cow’s milk in high
amounts. Calcium and casein both inhibit the absorption of dietary nonheme iron.
Infants fed cow’s milk receive much more protein and minerals than they need. The
excess has to be excreted in the urine. The high renal solute load leads to higher urine
concentration during the feeding of cow’s milk than during the feeding of breast milk
or formula. When fluid intakes are low and/or when extrarenal water losses are high,
the renal concentrating ability of infants may be insufficient for maintaining water balance
in the face of high water use for excretion of the high renal solute. The resulting
negative water balance, if prolonged, can lead to serious dehydration. There is strong
epidemiological evidence that the feeding of cow’s milk or formulas with similarly high
potential renal solute load places infants at an increased risk of serious dehydration.
The feeding of cow’s milk to infants is undesirable because of cow’s milk’s propensity
to lead to iron deficiency and because it unduly increases the risk of severe dehydration.
Copyright / Drug Dosage
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