Iron-Fortified Infant Cereals

Abstract

Infants are particularly susceptible to iron deficiency and related anemia due to their high growth rates and the low iron content of breast milk and most unfortified weaning foods. Cows' milk also is poor in iron, and certain forms of cows' milk cause blood and thus iron loss from the gastrointestinal tract. Iron-fortified cereal-based complementary foods – infant cereals – are recommended to supply the iron needs of older infants. Fortified infant cereals contain much more iron than other fortified cereal products – up to ten or fifteen times as much. Highly or slightly soluble iron salts have excellent bioavailability, but affect color and reduce chemical stability, so these iron salts are not commonly used to fortify infant cereals. Insoluble sources of iron, such as the iron phosphates, were used historically to fortify infant cereals, but these sources have very poor bioavailability. Infants depending on these cereals for iron suffered from high rates of iron deficiency and anemia. Elemental iron of small particle size, particularly electrolytic iron, currently is the generally accepted vehicle for infant cereal fortification. Iron-fortified cereal made with electrolytic iron reduces iron deficiency and related anemia in several settings but unfortunately is not fully protective in all. Ascorbic acid is a known enhancer of iron bioavailability but ascorbic acid is heat-labile and ascorbic activity declines rapidly during storage. Nonetheless, adding ascorbic acid during processing appears to improve the availability of electrolytic iron and thus the reliability of iron-fortified infant cereal as a means of preventing iron deficiency in older infants.