Relationship of Prolonged Exclusive Breastfeeding to Infant Anemia

Background: Anemia can adversely affect cognitive development in infants and children, potentially leading to challenges in cognition, motor control, social interaction, and neurophysiological functioning. Full-term infants do not develop iron deficiency anemia within the first four months of life, as they are born with sufficient iron stores accumulated during their intrauterine life. These stores are usually adequate for four to six months of postnatal life. However, exclusive breastfeeding beyond six months without iron supplementation can increase the risk of iron deficiency anemia, as breast milk does not provide enough iron to meet the growing infant’s demand. The American Academy of Pediatrics, UNICEF, and the World Health Organization (WHO) all recommend that exclusive breastfeeding is the optimal method to feed a newborn during the first six months of life. The aim of the study: This study correlates the association between extended exclusive breastfeeding and anemia in infants under two years of age in Zakho, Iraq, and compares the findings with global studies. Methodology: A cross-sectional study was conducted from October 2023 to February 2024, involving 637 children aged 6 months to 2 years old in Zakho City. Data were obtained through interviews with parents using a validated questionnaire. Anemia was diagnosed based on hemoglobin levels. The study received ethical approval from the University of Zakho’s ethical board. Data were analyzed using SPSS and chi-square tests. Results: The distribution of breastfeeding duration among male and female infants showed no statistically significant difference (p = 0.426). However, a significant association was observed between the mother’s age at delivery and breastfeeding duration (p = 0.007). Similarly, the mother’s occupation demonstrated a significant correlation with breastfeeding duration (p = 0.006), with non-employed mothers being more likely to breastfeed for a longer duration. Among children who were breastfed, 59.8% (128 of 214) were anemic, while 40.2% (86 of 214) were not. Conclusion: Breastfeeding duration is influenced by maternal age, education, and occupation, with more educated mothers tending to breastfeed for longer periods. The percentage of anemia decreases with higher maternal education; however, most anemic children in this study are breastfed. The study’s findings are subject to several limitations, including the small sample size, reliance on maternal self-reports of breastfeeding duration, and infant health history. Future research should incorporate larger sample sizes and a detailed assessment of dietary habits and environmental influences to better understand the relationship between breastfeeding duration and anemia in infants.