Prevention of Iron Deficiency by Milk Fortification

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Abstract
Olivares, M., Walter, T., Hertrampf, E., Pizarro, F. and Stekel, A. (Hematology Unit, Institue of Nutrition and Food Technology, University of Chile, Santiago, Chile). Prevention of iron deficiency by milk fortification. The Chilean experience.A large proportion of the milk consumed by infants in Chile is distributed by a National Food Supplementary Program. Efforts to prevent iron deficiency by milk fortification started several years ago. Initially a field study involving the simple addition of ferrous sulfate to a low‐fat powdered milk was only partially successful due to the relatively low iron absorption from this product. Following the observation that the enrichment of milk with ascorbic acid markedly improved iron bioavailability, a new fortified formula was developed and has been tested in the field since 1976. This is powdered full‐fat milk, biologically acidified and fortified with 15 mg Fe, as ferrous sulfate, and 100 mg ascorbic acid per 100 g powder. In a pilot study, 276 infants spontaneously weaned before 3 months of age received the fortified milk, and 278 infants receiving unfortified milk served as controls. At the end of the study (15 months of age) anemia (Hb <11 g/dl) was present in 25.7 % of unfortified infants comped with only 2.5 % in those fortified. Saturation of Transferrin <9 % was present in 33.8 % and serum ferritin <10 μg/I in 39.1 % of the nonfortMed infants. The figures for the fortified group were 7 % and 8.5 % respectively. Acceptance of the fortified formula was good. Following these observations, and as a previous step to the use of the fortified milk in the national program, the formula was tested in 7 National Health Service inner city community clinics under regular milk distribution. Survey data in 1 655 infants and laboratory studies in 200 infants at 9 and 15 months of age confirmed the good acceptance of this milk and the fact that iron deficiency anemia in infancy could be essentially eradicated by the use of milk fortified with iron and ascorbic acid.