Screening for Iron Deficiency.

Abstract

The diagnosis and prevention of iron deficiency and iron deficiency anemia are extremely important to children’s health, as outlined in the 2010 statement by the American Academy of Pediatrics (AAP) Committee on Nutrition.1 Given that Pediatrics is the official journal of the AAP and contains the policy statements of this organization and its committees, it is surprising that the US Preventive Services Task Force (USPSTF) Recommendation Statement2 appears in the journal without comment from the AAP Committee on Nutrition (CON). This statement is even more confusing because the recommendations of the USPSTF disagree with the AAP CON1 and the AAP Bright Futures recommendations.3 In the CON report, universal screening for anemia is recommended at ∼12 months of age with a hemoglobin concentration and assessment of risk factors. Iron deficiency is the most common nutritional deficiency and is seen most frequently in young children and pregnant women.2,4 The Centers for Disease Control and Prevention recommends screening for iron deficiency anemia at 9 to 12 months of age, again at 15 to 18 months, and then yearly until 5 years of age.4 Likewise, the Institute of Medicine recommends screening infants at 9 months of age who are breastfed or not receiving iron-fortified formula.5 In contrast, the USPSTF Recommendation Statement concludes that “the current evidence is insufficient to assess the balance of benefits and harms of screening for iron deficiency anemia in children ages 6–24 months.” They mention that they are aware that their recommendations may differ from those of other professional medical societies.Given this contradictory recommendation about a nutritional deficiency of global importance, we expect and welcome official comment from the AAP CON.