Hepcidin Status at 2 Months in Infants Fed Breast Milk Compared with Formula

Rebecca Verhaeghe, Kandie George, Mark Westerman, Gordana Olbina, DIane McCann, Nermi Parrow, Elisa Pincus, Tomas Havranek, Robert E. Fleming

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Introduction: The basis for the superior absorption of iron from breast milk compared with infant formulas is unclear. The hormone hepcidin downregulates dietary iron absorption. Hepcidin production increases with increased body iron status (reflected in serum ferritin levels). We hypothesized that serum hepcidin levels are suppressed relative to iron status in infants fed breast milk compared with formula. Methods: Subjects were healthy infants presenting for routine 2-month clinic visit and strictly fed either breast milk or standard infant formula. Urinary hepcidin and ferritin levels (reflective of serum levels) were analyzed and compared across the breast milk- and formula-fed groups. The relationship between urinary hepcidin and ferritin levels within each group was analyzed by linear regression. Results: Twenty-four subjects were enrolled in each group. The median urinary hepcidin level in the group fed breast milk was lower than in formula (130 vs. 359 ng hepcidin/mg creatinine, p < 0.05). However, the median ferritin levels were similar (2.1 vs. 1.9 ng/mL). Within each group, urinary hepcidin correlated with urinary ferritin (r = 0.5, p < 0.05 for each group); however, the slope of the regression line was lower in the group fed breast milk compared with formula (p < 0.005). Conclusion: Despite similar urinary ferritin levels, urinary hepcidin levels are lower at 2 months in infants fed breast milk compared with infants fed formula. Hepcidin levels correlate with iron status in each group; however, this relationship is relatively dampened in infants fed breast milk. We speculate that relatively lower infant hepcidin contributes to the superior efficiency of iron absorption from breast milk.

Original languageEnglish (US)
Pages (from-to)474-479
Number of pages6
Issue number4
StatePublished - Dec 2020
Externally publishedYes


  • Breast milk
  • Ferritin
  • Formula
  • Hepcidin
  • Infant

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Developmental Biology


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