Role of Fortified Cereals as Supplementary Food During the Complementary Feeding Period for Infants and their Impact on Iron Deficiency Status: A Retrospective Case Series with a Follow-up of 6 Months

This case report assessed eleven (11) Indian infants selected from published data to evaluate the effect of nutrient-fortified (rice-based) supplementation from six months of age for a 6-month weaning period. Anthropometric measurements (weight and length/height) and Body Mass Index (BMI) based on the Z-score were evaluated at four-time points at 6-weeks intervals and correlated with nutrient intake (energy, fat, carbohydrates, protein, iron, and vitamin A), haemoglobin, serum ferritin, and serum soluble Transferrin Receptor (sTfR). Of the 11 subjects, 5 were exclusively breastfeeding and 6 were on mixed feeding. On enrolment, all patients presented the following characteristics: mild/borderline anaemia (Hb at 10.3 g/dL ± 1.55 g/dL); mean gestational age of 36.45 ± 1.57 weeks, mean birth weight was 2.72 kg ± 0.31 kg, and male-to-female distribution was 6:5. Post 6-months follow-up with the multi-nutrient fortified feeds including iron, the Hb concentration increased to 11.5 µg/dL ± 1.3 µg/dL at 12-months. There was a significant correlation between Hb and serum ferritin, soluble transferrin receptor, and mean corpuscular volume. The individual composite score on the Bayley-III assessment (including cognitive and motor function) showed that 27% of the infants (3/11) at 6-months were below average [mean score: ≤ 70] and at 12-months all the infants were found to be average [mean score:100]. While supplementation is used for therapeutic purposes where anaemia has progressed to the severity necessitating treatment, fortified cereals are used to prevent the risk. Thus, good nutritional fortified feeds are of profound importance during the rapid growth and development of infants.