A lack of iron intake among young children is very
concerning and there needs to be more education for parents
on how to prepare iron-rich foods, a conference in
Wellington has been told.
This was one of the findings
of the 2021 Australian Feed Infants and Toddlers Study
(OzFITS), the first nationwide survey of the feeding
practices of children under 2 years of age, as presented at
the Infant Nutrition Council’s ‘Feeding the Future’
Conference.
Professor Tim Green and Dr Merryn Netting
of the South Australian Health and Medical Research
Institute presented the findings, which were roughly in line
with some of those that came from the Growing Up in New
Zealand Longitudinal Study.
Iron plays a huge role in
a baby’s development from infancy through childhood. It is
especially important to power a baby’s brain, and
neurological development, and is a key component in helping
red blood cells deliver oxygen from the lungs to the body.
Babies with a deficiency may be less physically active and
develop more slowly, leading to problems concentrating, a
shorter attention span, and poor academic
performance.
Prof Green and Dr Netting said nearly
half of the infants in the study were exclusively breastfed
to four months, and there was a long duration of
breastfeeding, with 68% of infants breastfed to 6 months and
44% breastfed into their second year. Nearly all infants
were introduced to complementary foods at the appropriate
time, between 4 and 6 months.
“We found a mismatch
between the number of recommended servings from each food
group in the Australian Dietary Guidelines and the dietary
intake of toddlers.
“Toddlers [12-24 months]
consumed twice as many fruit servings as recommended and
nearly all of them consumed discretionary foods (snacks),
despite no allowance for these foods. While most consumed
the recommended dairy serves, they consumed half the
recommended serves for other food groups. Infants [6-12
months] and toddlers met their requirements for most
nutrients.
“But one big exception was iron, where
90% of older infants and 25% of toddlers had inadequate iron
intakes. We were surprised by the high prevalence of
inadequate iron intake, especially in older
infants.
“In our study, infant formula and
ironfortified infant cereals were top sources of iron for
infants, although less than one third consumed these
products.” The next top sources were iron-fortified
cereals, breakfast cereals, bread, and meat. For toddlers,
the top five sources were breakfast cereals, infant
formula/toddler milks, bread, meat, and egg.
The study
also showed excessive sodium intake was of concern, with 1
in 3 toddlers exceeding the upper limit of 1000mg per day
– the equivalent of 2.5g of salt. The top five sources of
sodium were bread and rolls, cheese, cow’s milk,
cereal-based mixed dishes, and processed
meat.
“It’s clear from the iron results that there
needs to be more education and information for parents on
how to prepare iron-rich foods. That includes base foods as
well as vegetarian foods that are higher in
iron.
“Iron supplements or more iron-fortified foods
may be needed, with an emphasis on meat.”
Prof Green
and Dr Netting also expressed concerns about the nutritional
value of food pouches and their effect on children’s
development.
In a paper comparing nutritional and
textural properties of commercial infant and toddler foods
available in Australia with established infant feeding
guidelines, they found many of the purees in squeeze pouches
they looked at were inconsistent with guidelines – being
sweet, smooth and low in iron.
Pouches comprised half
of the 414 products they looked at, while one-third were
discretionary foods.
The guidelines recommend “first
foods” be rich in iron with no added sugars and that
nutrient-poor discretionary foods are to be
avoided.
“By sucking from the pouch, children are
using the food more like a drink, rather than moving it
around in their mouth, and learning all the chewing and
swallowing skills. So, if most of their nutrition is coming
from pouches they can miss out on important milestones. Of
the half of our cohort using pouches, half of them were
sucking food directly from the pouch.
“So, there’s
more room to include information about pouches in
information that we hand to parents, because we could do
better for our infants by offering them more nutritious
commercial foods.
“Part of that is a regulatory
issue and part of that is the way the foods are packaged.
Greater regulatory oversight may be needed to better inform
parents and caregivers on this.
“Frequent
consumption of commercial baby foods low in iron may
increase the risk of iron deficiency. And excessive
consumption of purées via squeeze pouches may also have
implications for overweight and obesity risk.”
The
Chief Executive of the INC, Jan Carey, said the findings
showed there is definitely a place for toddler milk in
meeting the requirements for iron in those toddlers whose
diet is inadequate.
“The prevalence of iron
inadequacy is a big concern.
“Experts at the
conference agreed that iron for developing children’s
brains is vital, and it must be comforting to parents to
know these products can do a great job in helping to boost
those
levels.”
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