Anemia In Infants Research Articles

The Relationship Between The Number of Parities and Pregnancy Age with Maternal Anemia

According to the World Health Organization, the anemia prevalence was estimated reach 9% in developed countries, while in developing countries reached 43%. The most-at-risk groups were children and women at fertile age, with an estimated prevalence of anemia in infants at 47%, pregnant women by 42%, and in non-pregnant women t ages 15-49 reached 30%. This was an observational analytic research with cross sectional approach. The purpose was to analyzed the relationship between the number of parity and the pregnancy age with the incidence of maternal anemia. The population in this study were 111 pregnant womens who checked their pregnancy to Public Healt Center (PHC) Kintamani 1 at Bangli regency, the province of Bali. The simple random sampling was used in the research with 87 peoples acted as research sample. Using Rank Spearman Correllation test, it was founded that there was a relationship between the number of parity with the incidence of maternal anemia a low relationship, and there was a relationship between gestational age with maternal anemia incidence with a low degree relationship.

Risk of infant anemia in 3-6 months old babies and its association with maternal anemia

Background: Anemia is a significant health problem in developing countries. Maternal anemia reduces fetal iron stores prior to birth and hence babies born to anemic mothers tend to develop iron deficiency anemia before 6 months which has adverse psychomotor consequences. Objective of this study was to estimate the prevalence of anemia and weight gain pattern in 3 - 6 months old term exclusively breast-fed infants and its association with maternal anemia.Methods: This is a cross - sectional analytical study including 120 babies who are born as term appropriate for gestational age. Preterm and babies with history of bleed or jaundice were excluded from the study. The haemoglobin estimation and weights of these babies was measured after informed consent from parents. Maternal haemoglobin concentration during last trimester was obtained from the maternal records.Results: Seventy-nine (65.8%) out of 120 babies had haemoglobin concentration <11gm/dl, which was significantly associated with maternal anemia (p <0.004, OR 5.9). Thirty-seven (30.8%) babies had low weight for age and were born to anemic mothers and 28% of this variation in weight was contributed by maternal anemia (p = 0.001).Conclusions: Low haemoglobin and poor weight gain in term 3-6 months old babies are significantly associated with maternal anemia in last trimester.

Infant anemia is associated with reduced TLR-stimulated cytokine responses and increased nasopharyngeal colonization with Moxarella catarrhalis

Anemia is a major public health problem in young children. Reports on the role of anemia on infectious diseases remained controversial. We aim to investigate the effect of anemia on innate immunity, nasopharyngeal bacterial colonization, and subsequent infectious outcome. Blood tests were examined at the age of 12 months. TLR-induced cytokine production was assessed by ELISA. Bacteria from nasopharyngeal specimens were identified with traditional culture. Clinical infectious diseases were followed yearly until 3 years of age. Result showed that of the 423 infants, 72 had hemoglobin level ≤ 11 g/dL, among which 55% had normal iron level. There was significant association between hemoglobin level and TLR1–2, and 4 induced IL-6 (p = 0.04, 0.02) and that of TLR4 stimulated TNF-α response (p = 0.04). Children with anemia had higher nasopharyngeal colonization with Moxarella catarrhalis. Clinical analysis did not show anemia to be associated with infectious morbidity. However, children who developed LRTIs had mean lower ferritin levels. We speculated that iron might be the key factor related to infectious morbidity. Thus, to investigate the role of anemia in infectious diseases, it is important to first consider the prevalence of iron deficit, since the incidence of iron deficiency-induced anemia may vary among different regions.

Infant Iron Deficiency and Iron Supplementation Predict Adolescent Internalizing, Externalizing, and Social Problems

To evaluate associations between iron supplementation and iron deficiency in infancy and internalizing, externalizing, and social problems in adolescence. The study is a follow-up of infants as adolescents from working-class communities around Santiago, Chile who participated in a preventive trial of iron supplementation at 6 months of age. Inclusionary criteria included birth weight ≥3.0 kg, healthy singleton term birth, vaginal delivery, and a stable caregiver. Iron status was assessed at 12 and 18 months of age. At 11-17 years of age, internalizing, externalizing, and social problems were reported by 1018 adolescents with the Youth Self Report and by parents with the Child Behavior Checklist. Adolescents who received iron supplementation in infancy had greater self-reported attention-deficit/hyperactivity disorder but lower parent-reported conduct disorder symptoms than those who did not (Ps < .05). Iron deficiency with or without anemia at 12 or 18 months of age predicted greater adolescent behavior problems compared with iron sufficiency: more adolescent-reported anxiety and social problems, and parent-reported social, post-traumatic stress disorder, attention-deficit/hyperactivity disorder, oppositional defiant, conduct, aggression, and rule breaking problems (Ps < .05). The threshold was iron deficiency with or without anemia for each of these outcomes. Iron deficiency with or without anemia in infancy was associated with increased internalizing, externalizing, and social problems in adolescence.

Megaloblastic anemia with pancytopenia in infancy:a rare entity

Megaloblastic anemia in infants present with generalized weakness, failure to thrive, or irritability. Diagnosis is usually centered on complete blood count and peripheral smear, which may show macrocytes, hyper segmented neutrophils, reticulocytopenia and a raised mean corpuscular volume (MCV >100 fl). Pancytopenia has also been noted.We report an exclusively breast fed six months old female child who presented with irritability, poor feeding and developmental delay. Her initial blood picture revealed pancytopenia, with normal MCV. Vitamin B12 levels were found to be reduced. Maternal levels of Vitamin B12 were also found to be borderline low. The child was treated as per protocols and improvement was evidenced with return of hematological parameters to normal and gradual advancement of milestones. The authors wish to underscore the importance ofMegaloblastic anemia as an important and rare cause of anemia in infancy. Early recognition and treatment are imperative to prevent catastrophic sequelae.

PROTOCOL: Efficacy and effectiveness of micronutrient supplementation and fortification interventions on the health and nutritional status of children under-five in low and middle-income countries: a systematic review.

PROTOCOL: Efficacy and effectiveness of micronutrient supplementation and fortification interventions on the health and nutritional status of children under-five in low and middle-income countries: a systematic review.

Investigation of the frequency of iron insufficiency among infants in a population in which routine iron supplementation is implemented.

Çullas-İlarslan NE, Günay F, İleri DT, Elhan AH, Ertem M, Arsan S. Investigation of the frequency of iron insufficiency among infants in a population in which routine iron supplementation is implemented. Turk J Pediatr 2018; 60: 22-31. Iron deficiency anemia (IDA) represents the most common cause of anemia worldwide. Because of potential irreversible neurodevelopmental impairment, its prevention during infancy is essential. We aimed to investigate the frequency of iron insufficiency among infants in a population which routine iron supplementation is implemented; and to examine related risks. A total of 501 infants, aged 9-15 months, were screened with complete blood count and serum ferritin. Infants were divided into two groups. [Group 1 (iron insufficient), [Group 1a: Iron deficiency (ID), Group 1b: IDA (IDA)], Group 2 (Iron sufficient (IS)]. Anemia was recognized in 122 (24.3%) infants. Microcytosis was observed in 110 (90.2%) of anemic infants. Group 2 accounted for 49.5% (n=248) whereas 152 (30.3%) and 101 (20.2%) infants belonged to Groups 1a and 1b, respectively. Multiple logistic regression analysis showed that male gender (OR=1.53; 95%CI 1.07 and 2.17), receiving > 500 ml/day cow`s milk (OR=2.77; 95%CI 0.87 and 8.83) and incompliance to iron supplementation (OR=2.51; 95%CI 1.75 and 3.60) were distinctive characteristics of Group 1 while prevalence of iron insufficiency was higher in infants consuming less formula (OR=3.10; 95%CI 2.00 and 4.80). The most frequent reasons for incompliance were consideration of supplementation as unnecessary (n=69, 31.1%) and neglection (n= 59, 26.6%). Our study demonstrated a high frequency of iron insufficiency among infants in a setting utilizing national iron supplementation and `incompliance` to iron as the most evident risk factor for iron insufficiency. Effective counseling of families by health care providers concerning importance of compliance to iron prophylaxis is essential for prevention of iron insufficiency. We also suggest screening of infants for ID as well as IDA in settings with high frequency of iron insufficiency.

Effects of umbilical cord milking compared to differed cord clamping in term infants, a randomized controlled trial

Introduction: Differed cord clamping (DCC) at delivery is currently recommended to increase neonatal haemoglobin levels (Hb) and reduce the risk of infant anemia. It needs waiting for two to three minutes, which is considered to be associated with most of its unwanted effects. An alternative could be umbilical cord milking (UCM) with early clamping. Although effects of UCM have been assessed in preterm neonates such evidence is sparse for term neonates. Objectives: To evaluate whether the effects on Hb, bilirubin and haemodynamic parameters in infants, and blood loss in the mother are better with UCM than with DCC during elective caesarean delivery at term. Methods: Sixty term pregnant mothers undergoing elective caesarean delivery (CD) in Teaching Hospital Kandy, from 1st February to 31st March 2015 were randomized to UCM and DCC. The UCM group had the umbilical cord milked towards the umbilicus of the baby in a standard method soon after delivery. The DCC group had the umbilical cord clamped after two minutes of delivery or once the cord pulsations had ceased. Neonatal Hb, bilirubin and haemodynamic parameters, and maternal blood loss were assessed within 48 hours of delivery. Results: Thirty three participants underwent UCM while 27 participants underwent DCC. Main indications for the CD were past CD (47%), failed induction (12%), past bad obstetric history (10%), maternal medical conditions (8%) and suspected gross cephalo pelvic disproportion (8%). All CD were performed under spinal aneasthesia. There were no significant differences between the UCM and DCC groups with regard to mean neonatal Hb (17.6g/dl, sd 2.0 vs 17.4g/dl, sd 2.4, p=0.67), mean neonatal total bilirubin (111.8 mmol/l, sd 47.6 vs 123.0mmol/l, sd 35.0, p=0.69) and mean maternal decrease in Hb (1.0g/dl, sd 0.7 vs 1.3g/dl, sd 1.0, p=0.37). All the neonates had birth APGAR of 10 at 5 minutes. The volume of blood remaining in the placenta was significantly higher in the UCM group (29.5ml, sd 20.3 vs 19.5ml, sd 13.1, p=0.03). Conclusions: Neonatal and maternal outcomes are not better with UCM than with DCC during elective CD.

Simultaneous determination of Vitamin A, 25-hydroxyl vitamin D3 α-tocopherol in small biological fluids by liquid chromatography-tandem mass spectrometry

A sensitive method for the simultaneous analysis of vitamin A (VA), 25-hydroxyl vitamin D3 (25-OH VD3) and α-tocopherol (VE) in children plasma by liquid chromatography-tandem mass spectrometry (LC–MS/MS) has been developed and validated. Sample preparation chose the solid phase extraction. 100 μL of plasma was mixed with 300 μL ethanol contained 4 μL isotope-labelled analytes. After a series operation, the supernatant was applied to the solid phase extraction (SPE) plate (HLB μElution plate). The eluate was evaporated, and reconstituted in 100 μL methanol. And then, 6 μL reconstituted sample was injected into LC–MS/MS. Quantitative analysis was carried out by multiple reaction monitoring (MRM) with a positive mode electrospray (ESi + ). Separations of VA, 25-OH VD3 and VE were performed on an Acquity UPLC reversed-phase Phenyl-Hexyl analytical column (CSH, 2.1 × 50 mm, 1.7 μm). Gradient elution was used at a flow rate of 0.4 mL/min with a mobile phase consisting of 0.1% formic acid solution and 0.1% formic acid, 5 mM ammonium formate in acetonitrile. The total time of analysis was 10 min. The method had a limit of quantification (LOQ) of 10.03, 1.20, and 0.04 ng/mL for VA, 25-OH VD3 and VE in methanol, respectively. The linear calibration curves were fitted over the range of 0.14–14.32 μg/mL, 1.80–180.29 ng/mL, and 6.03–602.99 ng/mL for VA, 25-OH VD3 and VE in methanol. The correlation coefficients were greater than 0.998 for all analytes. The recoveries for all analytes were between 80 and 120% with the inter- and intra-day precisions (presented as relative standard deviation, RSD%) less than 10.0%. Analysis of VA, 25-OH VD3 and VE in recurrent respiratory tract infection children plasma and anemic infants’ fingertip blood was then carried out using this method and statistical analysis of the data with statistic package for social science 20.0 (SPSS 20.0). Using this method, multiple fat-soluble vitamins could be detected at the same time. Solid phase extraction was used to simplify sample pretreatment. μElution plate used here could reduce the sample volume, only 100 μL sample was used in this method, and 6 μL reconstituted sample was injected into LC–MS/MS. This makes the method appropriate for larger sample pretreatment, and suitable for children, especially infants and newborns’ sample detection, in whom the circulation blood was low.

Evaluation of Iron Deficiency Anemia in a Pediatric Clinic in the Dominican Republic

BackgroundIron deficiency and iron deficiency anemia affect billions of people worldwide. Infants and young children are the most vulnerable. The Niños Primeros en Salud pediatric clinic aims to follow the American Academy of Pediatrics (AAP) recommendation to screen all children at 12 months of age, a vital period for development and the time of greatest risk. ObjectivesTo evaluate the clinic's performance screening for, diagnosing, and treating iron deficiency anemia; and to describe the prevalence and severity of anemia in infants and children attending a perirural clinic in the Dominican Republic. MethodsA total of 293 charts were reviewed for hemoglobin tests performed between 9 and 15 months of age. If a hemoglobin screening was performed, then sociodemographic characteristics, medical history, and laboratory data were collected. If blood tests revealed anemia, then the presence or absence of documented anemia diagnosis as well as the presence or absence of documented provision of iron therapy were recorded. FindingsLess than one-third (87, 29.7%) of patients had a documented hemoglobin test performed in this age range. Of these, 89.6% indicated anemia and nearly half (48.6%) revealed moderate anemia. One-third (34%) of hemoglobin results revealing anemia were not accompanied by a documented diagnosis. The vast majority (86.5%) of results indicated microcytosis, yet just more than half (50.8%) of anemic patients received iron therapy. ConclusionsMany children at the clinic were not screened for iron deficiency anemia during the period of highest risk. In the participants screened, iron deficiency anemia was underdiagnosed and often untreated. Anemia is a significant burden in this community—one demanding reliable screening and universal supplementation.

Excess iron intake as a factor in growth, infections, and development of infants and young children

The provision of iron via supplementation or the fortification of foods has been shown to be effective in preventing and treating iron deficiency and iron deficiency anemia in infants and young children. However, iron is a pro-oxidative element and can have negative effects on biological systems even at moderate amounts. An increasing number of studies have reported adverse effects of iron that was given to infants and young-children populations who initially were iron replete. These effects include decreased growth (both linear growth and weight), increased illness (usually diarrhea), interactions with other trace elements such as copper and zinc, altered gut microbiota to more pathogenic bacteria, increased inflammatory markers, and impaired cognitive and motor development. If these results can be confirmed by larger and well-controlled studies, it may have considerable programmatic implications (e.g., the necessity to screen for iron status before interventions to exclude iron-replete individuals). A lack of understanding of the mechanisms underlying these adverse outcomes limits our ability to modify present supplementation and fortification strategies. This review summarizes studies on the adverse effects of iron on various outcomes; suggests possible mechanisms that may explain these observations, which are usually made in clinical studies and intervention trials; and gives examples from animal models and in vitro studies. With a better understanding of these mechanisms, it may be possible to find novel ways of providing iron in a form that causes fewer or no adverse effects even when subjects are iron replete. However, it is apparent that our understanding is limited, and research in this area is urgently needed.

Wait a minute? An observational cohort study comparing iron stores in healthy Swedish infants at 4 months of age after 10-, 60- and 180-second umbilical cord clamping

Background and objectiveUmbilical cord blood (UCB) is a valuable stem cell source used for transplantation. Immediate umbilical cord (UC) clamping is widely practised, but delayed UC clamping is increasingly advocated...

Improving Rates of Screening for Anemia in Infancy.

In 2010, the American Academy of Pediatrics recommended universal screening for anemia at approximately 1 year of age. This quality improvement study sought to improve anemia screening in an ambulatory setting. In a large university-based setting, a best practice alert (BPA) was placed within the electronic health record. The primary outcome was overall screening rate in ambulatory family medicine (DFM) and pediatrics (PEDS) clinics. From 2545 pre-BPA clinic visits over a 12-month period, the screening rate was 48.2%. Among 2186 post-BPA clinic visits over an 8-month period, the screening rate improved to 72.7%, P < .0001. Follow-up over a second 7-month period demonstrated sustained improvements (70.8%) but was not higher after educational sessions between the periods. Screening rates were higher in PEDS than DFM at each time point; P < .0001. This technology-based intervention increased and maintained higher screening rates for anemia at 1 year, with higher rates in PEDS.

Splanchnic-Cerebral Oxygenation Ratio Decreases during Enteral Feedings in Anemic Preterm Infants: Observations under Near-Infrared Spectroscopy

Background: Anemia is common in premature infants. Due to risks with red blood cell transfusions, many anemic infants are not transfused. The implications of this pathophysiologic status, especially at times of increased metabolic demand (enteral feedings), is not well understood. Near-infrared spectroscopy (NIRS) allows for the noninvasive determination of regional oxygen saturations (rSO2) in tissues such as the brain and mesentery, giving insight into their oxygen sufficiency. Objective: We tested the hypothesis that during enteral feedings very low birth weight (VLBW) infants with a hematocrit ≤28% will experience a decrease in splanchnic rSO2 and splanchnic-cerebral oxygenation ratio (SCOR). Methods: This prospective, observational, 2-centered study included VLBW infants receiving full enteral feedings with a hematocrit ≤28%. Cerebral and splanchnic rSO2 were monitored via NIRS for 24 h. Average values were calculated for periods immediately preceding, during, and after each feeding. SCOR was calculated from these values (rSO2 splanchnic/rSO2 cerebral), and data were analyzed using a linear mixed effect model. Results: Fifty neonates with a median gestational age of 28 weeks (range 23-32), a birth weight of 1,118 ± 284 g (mean ± SD), and a hematocrit of 26 ± 2% (mean ± SD) were studied. During feedings, SCOR decreased significantly from baseline (0.72 ± 0.17 to 0.69 ± 0.17, p = 0.043). With feedings, there was a trend of decreased splanchnic rSO2 (47 ± 11 to 45 ± 10, p = 0.057) and no change in cerebral rSO2 (66 ± 8 to 66 ± 7, p = 0.597). Conclusions: VLBW infants with a hematocrit ≤28% had a decrease in SCOR and a trend towards decreased splanchnic rSO2 with enteral feedings.

Iron therapy substantially restores qEEG maturational lag among iron-deficient anemic infants

Objective: To use quantitative electroencephalography (qEEG) to assess the impact of iron-deficiency anemia on central nervous system maturation in the first year of life.Method: Twenty-five infants (3–12 months old) presenting ferropenic anemia (IDA) and 25 healthy controls (CTL1), matched by age/gender with the former, were studied in two stages. Electroencephalogram during spontaneous sleep was recorded from all participants; the fast Fourier transform was calculated to obtain absolute power (AP) and relative power (RP) qEEG measures. In the first stage, a qEEG comparison between CTL1 and IDA was performed. Second stage consisted in comparing qEEG of the IDA infants before and after supplementation with iron (IDA-IS group), and comparing qEEG of the IDA-IS group with another control age-matched group (CTL2). Non-parametric multivariate permutation tests (NPT) were applied to assess differences between CTL1 and IDA groups, as well as IDA vs. IDA-IS, and IDA-IS vs. CTL2.Results: More power in slow frequency bands and less power in fast frequency bands in 64% of IDA babies were observed. NPT evinced higher alpha AP and RP (P < 0.001), less theta AP, and less delta and theta RP in CTL1 than in IDA. After iron-restoration therapy, alpha AP and RP increased while theta AP and theta and delta RP decreased, reaching almost normal values.Discussion: This work reveals CNS developmental delay through the study of qEEG (less rapid and more slow frequencies) which recovered significantly with iron supplementation. It is concluded that IDA constitutes a high risk factor for a lag of CNS maturation.

Iron deficiency anaemia

Abstract Iron deficiency anaemia is a global heath issue in children and adults alike with the health burden being increased as there is some evidence that iron deficiency anaemia in infants and toddlers can lead to potentially irreversible long-term neurodevelopmental sequelae. In developed nations, there is a strong association with administration of inappropriate amounts of cow's milk. The onus is on healthcare professionals and paediatricians to combat iron deficiency anaemia in their patients.

Prebiotic galacto-oligosaccharides mitigate the adverse effects of iron fortification on the gut microbiome: a randomised controlled study in Kenyan infants

ObjectiveIron-containing micronutrient powders (MNPs) reduce anaemia in African infants, but the current high iron dose (12.5 mg/day) may decrease gut Bifidobacteriaceae and Lactobacillaceae, and increase enteropathogens, diarrhoea and respiratory tract...

Promoting Early Child Development With Interventions in Health and Nutrition: A Systematic Review

Although effective health and nutrition interventions for reducing child mortality and morbidity exist, direct evidence of effects on cognitive, motor, and psychosocial development is lacking. To review existing evidence for health and nutrition interventions affecting direct measures of (and pathways to) early child development. Reviews and recent overviews of interventions across the continuum of care and component studies. We selected systematic reviews detailing the effectiveness of health or nutrition interventions that have plausible links to child development and/or contain direct measures of cognitive, motor, and psychosocial development. A team of reviewers independently extracted data and assessed their quality. Sixty systematic reviews contained the outcomes of interest. Various interventions reduced morbidity and improved child growth, but few had direct measures of child development. Of particular benefit were food and micronutrient supplementation for mothers to reduce the risk of small for gestational age and iodine deficiency, strategies to reduce iron deficiency anemia in infancy, and early neonatal care (appropriate resuscitation, delayed cord clamping, and Kangaroo Mother Care). Neuroprotective interventions for imminent preterm birth showed the largest effect sizes (antenatal corticosteroids for developmental delay: risk ratio 0.49, 95% confidence interval 0.24 to 1.00; magnesium sulfate for gross motor dysfunction: risk ratio 0.61, 95% confidence interval 0.44 to 0.85). Given the focus on high-quality studies captured in leading systematic reviews, only effects reported within studies included in systematic reviews were captured. These findings should guide the prioritization and scale-up of interventions within critical periods of early infancy and childhood, and encourage research into their implementation at scale.

Iron in Micronutrient Powder Promotes an Unfavorable Gut Microbiota in Kenyan Infants.

Iron supplementation may have adverse health effects in infants, probably through manipulation of the gut microbiome. Previous research in low-resource settings have focused primarily on anemic infants. This was a double blind, randomized, controlled trial of home fortification comparing multiple micronutrient powder (MNP) with and without iron. Six-month-old, non- or mildly anemic, predominantly-breastfed Kenyan infants in a rural malaria-endemic area were randomized to consume: (1) MNP containing 12.5 mg iron (MNP+Fe, n = 13); (2) MNP containing no iron (MNP−Fe, n = 13); or (3) Placebo (CONTROL, n = 7), from 6–9 months of age. Fecal microbiota were profiled by high-throughput bacterial 16S rRNA gene sequencing. Markers of inflammation in serum and stool samples were also measured. At baseline, the most abundant phylum was Proteobacteria (37.6% of rRNA sequences). The proteobacterial genus Escherichia was the most abundant genus across all phyla (30.1% of sequences). At the end of the intervention, the relative abundance of Escherichia significantly decreased in MNP−Fe (−16.05 ± 6.9%, p = 0.05) and CONTROL (−19.75 ± 4.5%, p = 0.01), but not in the MNP+Fe group (−6.23 ± 9%, p = 0.41). The second most abundant genus at baseline was Bifidobacterium (17.3%), the relative abundance of which significantly decreased in MNP+Fe (−6.38 ± 2.5%, p = 0.02) and CONTROL (−8.05 ± 1.46%, p = 0.01), but not in MNP-Fe (−4.27 ± 5%, p = 0.4445). Clostridium increased in MNP-Fe only (1.9 ± 0.5%, p = 0.02). No significant differences were observed in inflammation markers, except for IL-8, which decreased in CONTROL. MNP fortification over three months in non- or mildly anemic Kenyan infants can potentially alter the gut microbiome. Consistent with previous research, addition of iron to the MNP may adversely affect the colonization of potential beneficial microbes and attenuate the decrease of potential pathogens.

Parents’ Knowledge and Practice of Iron Therapy for Anemic Infants in Primary Health Care in Bahrain

BACKGROUND: Anemia in children aged less than five years is a common medical problem worldwide. Iron deficiency anemia is the most prevalent anemia in infants and has been shown to be a public health problem. Many studies have been conducted on anemia among infants but the scope of the conducted studies was focused on the prevalence of anemia with less emphasis on the knowledge and parental practice of anemia and its treatment. Providing infants with iron supplements and simultaneously ensuring their compliance has shown an improvement in hemoglobin levels, along with a significant reduction in the prevalence of iron deficiency anemia (IDA).OBJECTIVE: To explore the level of parental knowledge and practice towards iron syrup.METHODS: A Cross- sectional study was carried out from 21st June to 2nd July, 2015 in ten Primary Health Care centers in Bahrain. During the study period, a phone survey was conducted using a self-constructed questionnaire. The response rate was 98%.RESULTS: In this study, the prevalence of anemia in infants is 45%. 58.4% of parents did not give the offered iron for their infants or stopped it within the first week of use. Overall, around 70% of parents correctly answered half or more of the knowledge questions regarding iron syrup side effects but only 32.5% of parents correctly answered half or more of the questions regarding IDA complications.CONCLUSION: Anemia is prevalent among 9 months old infants with considerable gaps in knowledge and practices of parents.