Comparative Prevalence of Iron Deficiency Anemia in Exclusively Breastfed Versus Exclusively Cow Milk-Fed Infants: A Cross-Sectional Study

INTRODUCTION: Anemia has long been a major public health issue worldwide and continues to be the most common type of micronutrient deficiency. Iron deficiency anemia (IDA) represents a major health challenge during infancy and early childhood. Children in Pakistan suffering from IDA often experience stunted growth, cognitive delays, and decreased physical activity. METHODOLOGY: This cross-sectional study was conducted from October 2024 to February 2025 in the Pediatric Department of Lady Reading Hospital, Peshawar, to assess the prevalence of IDA in term infants up to 12 months of age who were either breastfed or fed cow's milk. Using non-probability purposive sampling, 340 eligible infants visiting the outpatient department or admitted to the pediatrics ward were included. Infants with hemoglobin <9.5 g/dL and mean corpuscular volume <70 fL were labeled as having IDA. Ethical approval and informed consent were obtained prior to data collection. RESULTS: ​In our study of 340 infants (mean age: 3.71 ± 1.84 months), 127 (37.4%) were diagnosed with IDA. A significant association was found between exclusive cow's milk feeding and IDA (p < 0.001), with 92 (72.44%) of IDA cases occurring in cow's milk-fed infants. No significant link was observed between the frequency of pediatric check-ups and IDA prevalence. Additionally, parental confidence in understanding their infant's nutritional needs was significantly related to IDA occurrence (p = 0.05). CONCLUSION: The study's findings indicate a significant association between exclusive cow's milk feeding and the development of IDA in infants, underscoring the importance of appropriate infant feeding practices. No significant link was observed between the frequency of pediatric check-ups and IDA prevalence. Additionally, parental confidence in understanding their infant's nutritional needs was significantly related to IDA occurrence. These results highlight the need for targeted nutritional education for parents to prevent IDA in infants.