Zinc and Breastfed Infants: If and When is There a Risk of Deficiency?

  • Nancy F. Krebs
  • Jamie Westcott
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 503)


Recent results of randomized controlled zinc supplementation trials in young children have confirmed that globally, zinc deficiency is a major public health problem contributing to significant morbidity and mortality from infectious diseases.1 On the basis of a pooled analysis of the zinc supplementation trials, it is estimated that assuring adequate zinc status may have preventative effects on diarrhea exceeding the effects of clean water and sanitation, as well as those of promotion of breastfeeding. Similarly, the estimated preventive effect of zinc supplementation on pneumonia is similar to that estimated for breastfeeding. Thus there seems little question that zinc deficiency occurs in young infants, including those who are breastfed, but the circumstances are not yet well characterized.


Human Milk Zinc Deficiency Zinc Supplementation Zinc Intake Plasma Zinc 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    . Z.A Bhutta, R.E. Black, and K.H. Brown, et al., Prevention of diarrhea and pneumonia by zin supplementation in children in developing countries: pooled analysis of randomized controlled trials. Zinc Investigators’ Collaborative Group, J Pediatr. 135:689–697 (1999).Google Scholar
  2. 2.
    N. F. Krebs, C.J. Reidinger, S. Hartley, A. D. Robertson, and K. M. Hambidge, Zinc supplementation during lactation: effects on maternal status and milk zinc concentrations, Am. J. Clin. Nutr. 61:1030–1036 (1995).PubMedGoogle Scholar
  3. 3.
    N. F. Krebs, C. J. Reidinger, A. D. Robertson, and K. M. Hambidge, Growth and intakes of energy and zinc in infants fed human milk, J. Pediatr. 124:32–39 (1994).PubMedCrossRefGoogle Scholar
  4. 4.
    R. J. Cousins. A role of zinc in the regulation of gene expression, Proc. Nutr. Soc. 57:307–11 (1998).PubMedCrossRefGoogle Scholar
  5. 5.
    J. C. King, D. M. Shames, and L. R. Woodhouse, Zinc homeostasis in humans, J. Nutr. 130:13605–13665 (2000).Google Scholar
  6. 6.
    N. F. Krebs, C. J. Reidinger, L. V. Miller, and K. M. Hambidge, Zinc homeostasis in breast-fed infants, Pediatr. Res. 39:661–665 (1996).PubMedCrossRefGoogle Scholar
  7. 7.
    N. F. Krebs, C. J. Reidinger, L. V. Miller, and M. W. Borschel, Zinc homeostasis in healthy infants fed a casein hydrolysate formula [see comments], J. Pediatr. Gastroenterol. Nutr. 30:29–33 (2000).PubMedCrossRefGoogle Scholar
  8. 8.
    B. Lonnerdal, Dietary factors influencing zinc absorption, J. Nutr. 130:378S–383S (2000).Google Scholar
  9. 9.
    L. Sian, X. Mingyan, L. V. Miller, L. Tong, N. F. Krebs, and K. M. Hambidge, Zinc absorption and intestinal losses of endogenous zinc in young Chinese women with marginal zinc intakes, Am. J. Clin. Nutr. 63:348–353 (1996).PubMedGoogle Scholar
  10. 10.
    N. F. Krebs, and K. M. Hambidge, Zinc requirements and zinc intakes of breast-fed infants, Am. J. Clin. Nutr. 43:288–292 (1986).PubMedGoogle Scholar
  11. 11.
    N. F. Krebs, Zinc transfer to the breastfed infant, J. Mammary Gland. Biol. Neoplasia 4:259–268 (1999).PubMedCrossRefGoogle Scholar
  12. 12.
    K. M. Hambidge, P. A. Walravens, C. E. Casey, R. M. Brown, and C. Bender, Plasma zinc concentrations of breast-fed infants, J. Pediatr. 94:07–08 (1979).Google Scholar
  13. 13.
    N. F. Michaelsen, G. Samuelson, T. W. Graham, and B. Lonnerdal, Zinc intake, zinc status and growth in a longitudinal study of healthy Danish infants, Acta Paediatr. 83:1115–1121 (1994).PubMedCrossRefGoogle Scholar
  14. 14.
    L. Salmenpera, J. Perheentupa, V. Nanto, and M. A. Sumes, Low zinc intake during exclusive breast-feeding does not impair growth, J. Pediatr. Gastroenterol. Nutr. 18:361–370 (1994).PubMedCrossRefGoogle Scholar
  15. 15.
    P. Hemalatha, P. Bhaskaram, P. A. Kumar, M. M. Khan, and M. A. Islam, Zinc status of breastfed and formula-fed infants of different gestational ages, J. Trop. Pediatr. 43:52–54 (1997).PubMedCrossRefGoogle Scholar
  16. 16.
    K. H. Brown, Effect of infections on plasma zinc concentration and implications for zinc status assessment in low-income countries, Am. J. Clin. Nutr. 68:425S–429S (1998).PubMedGoogle Scholar
  17. 17.
    M. J. Heining, K. H. Brown, B. Lonnerdal, and K. G. Dewey, Zinc supplementation does not affect growth, morbidity, or motor development of U.S. breastfed infants at 4–10 months, FASEB J. 12:A970 (1998).Google Scholar
  18. 18.
    N. F. Krebs, J. E. Westcott, and N. Butler-Simon, Effect of zinc supplement on growth of normal breastfed infants, FASEB J. 10:A230 (1996).Google Scholar
  19. 19.
    P. A. Walravens, A. Chakar, R. Mokni, J. Denise, and D. Lemonnier, Zinc supplements in breastfed infants [see comments], Lancet 340:683–685 (1992).PubMedCrossRefGoogle Scholar
  20. 20.
    S. A.Abrams, K.O. O’Brien, J. Wen, L. K. Liang, and J. E. Stuff, Absorption by 1-year-old children of an iron supplement given with cow’s milk or juice, Pediatr. Res. 41:171–175 (1997).CrossRefGoogle Scholar
  21. 21.
    R. S. Gibson, E. L. Ferguson, and J. Lehrfeld, Complementary foods for infant feeding in developing countries: their nutrient adequacy and improvement, Eur. J. Clin. Nutr. 52:764–770(1998).Google Scholar
  22. 22.
    M. D. Engelmann, B. Sandstrom, and K. F. Michaelsen, Meat intake and iron status in late infancy: an intervention study, J. Pediatr. Gastroenterol. Nutr. 26:26–33 (1998).PubMedCrossRefGoogle Scholar
  23. 23.
    M. D. Engelmann, B. Sandstrom, T. Walczyk, R. F. Hurrell, and K. F. Michaelsen, The influence ofmeat on nonheme iron absorption in infants, Pediatr. Res. 43:768–773 (1998).PubMedCrossRefGoogle Scholar
  24. 24.
    J. Westcott, N. B. Simon, and N. F. Krebs, Growth, zinc and iron status, and development of exclusively breastfed infants fed meat vs cereal as a first weaning food, FASEB J 12:A487 (1998).Google Scholar
  25. 25.
    S. Jalla, J. Westcott, M. Steirn, L. V. Miller, and N. F. Krebs. Zinc absorption and exchangeable zinc pool sizes in breastfed infants fed meat or cereal as first complementary food, J. Pediatr. Gastroenterol. Nutr. Submitted for publication (2000).Google Scholar
  26. 26.
    L. A. Persson, M. Lundstrom, B. Lonnerdal, and O. Hernell, Are weaning foods causing impaired iron and zinc status in 1-year-old Swedish infants? A cohort study, Acta Paediatr. 87:618–622 (1998).CrossRefGoogle Scholar
  27. 27.
    M. Umeta, C. E. West, J. Haidar, P. Deurenberg, and J. G. Hautvast, Zinc supplementation and stunted infants in Ethiopia: a randomised controlled trial, Lancet 355:2021–2026 (2000).PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2002

Authors and Affiliations

  • Nancy F. Krebs
    • 1
  • Jamie Westcott
  1. 1.University of Colorado, School of MedicineDenverUSA

Personalised recommendations