Anemia In Infants Research Articles

Associations between early childhood caries, malnutrition and anemia: a global perspective

BackgroundMalnutrition is the main risk factor for most common communicable diseases. The aim of this study is to determine the relationship between country-level prevalence of early childhood caries (ECC), malnutrition and anemia in infants and preschool children.MethodsMatched country-level ECC, malnutrition and anemia prevalence were generated from databases covering the period 2000 to 2017. Multivariate general linear models were developed to assess the relationship between outcome variables (prevalence of stunting, wasting, overweight, and anemia) and the explanatory variable (ECC prevalence) adjusted for gross national income per capita. Adjusted regression coefficients (B) and partial eta squared were computed.ResultsThe mean (standard deviation (SD)) ECC prevalence was 23.8 (14.8)% for 0–2 year-olds and 57.3 (22.4)% for 3–5-year-olds. The mean (SD) prevalence of wasting was 6.3 (4.8)%, overweight 7.2 (4.9)%, stunting 24.3 (13.5)%, and anemia 37.8 (18.1)%. For 0–2-year-olds, the strongest and only significant association was between the prevalence of ECC and overweight (η2 = 0.21): 1 % higher ECC prevalence was associated with 0.12% higher prevalence of overweight (B = 0.12, P = 0.03). In 3–5-year-olds, the strongest and only significant association was between the prevalence of ECC and anemia (η2 = 0.08): 1 % higher prevalence of ECC was associated with 0.14% lower prevalence of anemia (B = − 0.14, P = 0.048).ConclusionCountry-level prevalence of ECC was associated with malnutrition in 0–2-year-olds and with anemia in 3–5-year-olds. The pathway for the direct relationship between ECC and overweight may be diet related. The pathway for the inverse relationship between ECC and anemia is less clear and needs further investigations.

Prevention of iron deficiency anemia in infants and toddlers.

Anemia, defined as a low blood hemoglobin concentration, is a major global public health problem. Identification of anemia is crucial to public health interventions. It is estimated globally that 273 million children under 5 years of age were anemic in 2011, and about ~50% of those cases were attributable to iron deficiency (Lancet Global Health 1:e16-e25, 2013). Iron-deficiency anemia (IDA) in infants adversely impacts short-term hematological indices and long-term neuro-cognitive functions of learning and memory that result in both fatigue and low economic productivity. IDA contributes to death and disability and is an important risk factor for maternal and perinatal mortality, including the risks for stillbirths, prematurity, and low birth weight (Comparative Quantification of Health Risks: Global and Regional Burden of Disease Attributable to Selected Major Risk Factors. Ch. 3 (World Health Organization, Geneva, 2004)). Reduction in early infantile anemia and newborn mortality rates is possible with easily implemented, low- to no-cost intervention such as delayed cord clamping (DCC). DCC until 1-3 min after birth facilitates placental transfusion and iron-rich blood flow to the newborn. DCC, an effective anemia prevention strategy, requires cooperation among health providers involved in childbirth, and a participatory culture change in public health. Public intervention strategies must consider multiple factors associated with anemia listed in this review before designing intervention studies that aim to reduce anemia prevalence in infants and toddlers. IMPACT: Anemia, defined as a low blood hemoglobin concentration, is a major global public health problem and identification of anemia is crucial to public health interventions. Delayed cord clamping (DCC) until 1-3 min after birth facilitates placental transfusion and iron-rich blood flow to the newborn. Reduction in early infantile anemia and newborn mortality rates is possible with easily implemented, low- to no-cost intervention such as DCC.

Association of maternal BMI during early pregnancy with infant anemia: a large Chinese birth cohort

BackgroundInfant anemia is prevalent in low- and middle-income countries. Maternal body mass index (BMI) is associated with serum ferritin in cord blood, but as yet has not been linked to infant anemia. The objective of this study was to examine the association of maternal BMI during early pregnancy with infant hemoglobin levels and anemia at 6 and 12 months in a Chinese birth cohort.MethodsThe prospective cohort included 17,193 mother-infant pairs. Maternal weight and height prior to 20 gestational weeks as well as infant hemoglobin at 6 and 12 months were measured following standard procedures, and BMI was calculated as weight in kilograms divided by the square of height in meters. Women were categorized into underweight, normal weight (reference), overweight, and obesity. Infant anemia was defined as hemoglobin < 11.0 g/dl. Fractional polynomial regression was used to examine the relation between maternal BMI and infant hemoglobin, joinpoint regression to identify breakpoints, and logistic regression to estimate odds ratios (ORs).ResultsIn the cohort, 1160 (6.8%) were anemic at 6 months and 904 (5.3%) at 12 months. An inverse U-shaped relation of maternal BMI with infant hemoglobin was found at 6 months, at their maximum at maternal BMI of 22.4 kg/m2, and a similar relationship found again at 12 months. Maternal obesity rather than underweight was associated with an increased risk of anemia for infants at 6 months (adjusted OR 1.39, 95% CI 1.02, 1.88), but not at 12 months. Maternal anemia during mid-pregnancy augmented the risk at 6 months (adjusted OR 2.91, 95% CI 1.14, 7.46), but did not mediate the association (Z = − 1.102, P = 0.270).ConclusionsMaternal BMI during early pregnancy is correlated with infant hemoglobin in an inverse U-shaped profile, and obesity increases infant anemia risk that is aggravated by maternal anemia during pregnancy. This study enriched the epidemiological evidence on the adverse effect of high maternal BMI on long-term health of offspring. Optimizing maternal weight in obstetric care is necessary to improve offspring health.

Is Anemia in Low Income Pregnant Women Related to Their Infants' Having Anemia? A Cohort Study of Pregnant Women-Infant Pairs in the United States.

Given evidence that anemia in the first year of life is associated with long-term cognitive, motor, and behavioral deficits, reducing infant anemia is important. The primary objective of this research is to examine whether anemia in low income pregnant women in the United States is associated with anemia in the women's infants. This cohort study linked Centers for Disease Control and Prevention surveillance data on pregnant women with incomes below 185% of the federal poverty level from 2010 and 2011 with data on 6-11month olds from 2011, resulting in a sample of 21,246 uniquely matched mother-infant pairs. We examined bivariate and multivariate relationship between anemia severity in pregnant women and in their infants. Seventeen percent of women had anemia (13.1% mild and 3.9% moderate to severe) and 20.1% infants had anemia (16.4% mild and 3.7% moderate to severe). For both women and infants, blacks had substantially higher anemia rates than whites. In bivariate analysis and multivariate analyses maternal anemia showed a dose-response relationship to infant anemia. In predicted probabilities from the multivariate models, 27.2% of infants born to pregnant women with moderate to severe anemia had anemia, compared to 23.3% for infants whose mothers had mild anemia, and 18.3% for infants whose mothers did not have anemia. This study provides strong evidence of a relationship between maternal and infant anemia in the United States among people with low incomes. Efforts to reduce anemia during pregnancy may be an important strategy for minimizing childhood anemia.

Dose Effect of Bovine Lactoferrin Fortification on Iron Metabolism of Anemic Infants.

To evaluate the effect of iron-fortified formula with different concentrations of bovine lactoferrin (bLF) on improvement of anemic status in term infants who were previously breast-fed. A randomized, controlled, open, and post-market intervention study. A total of 108 infants aged 6-9 mo who were previously breast-fed and weaned were selected. The subjects were divided into three groups with the sequence of outpatient: fortified group 1 (FG1) with a bLF concentration of 38 mg/100 g, FG2 with 76 mg/100 g bLF, FG0 with no bLF. The intervention duration was 3 mo. Weight, height, head circumference and the concentration of hemoglobin (Hb), serum ferritin (SF), serum transferring receptor (sTfR) were measured and sTfR-SF index (TFR-F index) and total body iron content (TBIC) were computed before and after intervention. The primary outcome measures were obtained from 96 infants (35, 33 and 28 for FG0, FG1 and FG2, respectively). After 1 mo of intervention, the changes of Hb level showed no significant difference (p>0.05) among the three groups, however, the Hb level of infants in FG2 were significantly higher than those of infants in the other two groups after 3 mo of intervention (p<0.05). The present data indicated that the formula fortified with 76 mg/100 g bLF positively affected the Hb of anemic infants who were previously breastfed when compared with fortification with 38 mg/100 g bLF and no bLF fortification.

Home fortification of foods with multiple micronutrient powders for health and nutrition in children under two years of age.

Home fortification of foods with multiple micronutrient powders for health and nutrition in children under two years of age.

Physiological cord clamping: a dawn to halt anemia in infants

All infants immediately following their birth experience a decrease in hemoglobin which result in varying degrees of anemia termed as physiology or early anemia of infancy. Normally after birth hemoglobin values fall from 14.6 to 22.5 g/dl to 10.0 to 12.0 g/dl within 8 to 10 weeks from age, after which the values gradually increase reaching the normal level at the end of 2 years

The development of intestinal dysbiosis in anemic preterm infants.

Objective:Anemia and Proteobacteria-dominant intestinal dysbiosis in very low birth weight (VLBW) infants have been linked to necrotizing enterocolitis, a severe gut inflammatory disease. We hypothesize that anemia of prematurity is related to the development of intestinal dysbiosis.Study Design:342 weekly stool samples collected prospectively from 80 VLBW infants were analyzed for bacterial microbiomes (with 16S rRNA). Linear mixed effects model was used to determine the relationships between the onsets of anemia and intestinal dysbiosis.Results:Hematocrit was associated with intestinal microbiomes, with lower Hct occurring with increased Proteobacteria and decreased Firmicutes. Infants with a hematocrit <30% had intestinal microbiomes that diverged toward Proteobacteria dominance and low diversity after the first postnatal month. The microbiome changes were also related to the severity of anemia.Conclusions:This finding supports a potential microbiological explanation for anemia as a risk factor for intestinal dysbiosis in preterm infants.

Micronutrient-fortified infant cereal improves Hb status and reduces iron-deficiency anaemia in Indian infants: an effectiveness study

Anaemia affects approximately 69 % of Indian children aged 6-12 months, with Fe deficiency (ID) being a common cause. The effectiveness of micronutrient-fortified infant cereal in improving Fe status and neurodevelopment was evaluated in non-anaemic and mildly anaemic Indian infants. An intervention group (IC) enrolled at age 6 months consumed 50 g/d of rice-based cereal providing 3·75 mg Fe/d as ferrous fumarate for 6 months (n 80) and was compared with a matched static cross-sectional control group (CG) without intervention enrolled at age 12 months (n 80). Mean Hb was higher in IC (118·1 (sd 10·2) g/l) v. CG (109·5 (sd 16·4) g/l) at age 12 months (adjusted mean difference: 9·7 g/l; 95 % CI 5·1, 14·3; P < 0·001), while geometric mean serum ferritin tended to be higher (27·0 (-1 sd 13·4, +1 sd 54·4) v. 20·3 (-1 sd 7·5, +1 sd 55·0) ng/ml); P = 0·085) and soluble transferrin receptor was lower (1·70 (-1 sd 1·19, +1 sd 2·43) v. 2·07 (-1 sd 1·29, +1 sd 3·33) mg/l; P = 0·014). Anaemia (23 v. 45 %; P = 0·007) and ID (17 v. 40 %; P = 0·003) were lower in IC v. CG. Bayley Scales of Infant and Toddler Development Third Edition scores for language (P = 0·003), motor development (P = 0·018), social-emotional (P = 0·004) and adaptive behaviour (P < 0·001), but not cognitive development (P = 0·980), were higher in IC v. CG. No significant difference in anthropometric Z-scores was observed between the groups. Consuming a micronutrient-fortified infant cereal daily for 6 months during complementary feeding promoted better Fe status while reducing the risk for anaemia and ID and was associated with superior neurodevelopmental scores.

Long-term impact of fistula status on growth and anemia in infants with congenital anorectal malformations.

To evaluate the impacts of fistula status over 12 months on growth and development and anemia in infants with anorectal malformation (ARM) and to analyze the effects of comorbidities. The ARM group included infants who suffered from ARM and underwent three operations including colostomy, anoplasty (group A) and fistula closure (group B). The normal group included infants aged approximately 6 months and 12 months who were classified as groups C and D. A 24-h dietary recall questionnaire was completed by the guardians of all the participants. Data on height, weight, hemoglobin (Hb) level and comorbidities were extracted from electronic medical records. Then, we compared the impacts of the 12-month fistula status on growth and development and anemia among the infants. In total, 47 patients in the ARM group and 100 infants in the normal group were included. The height-for-age z-score (HAZ) was lower in group A than in group B. Compared with those in group D, weight, height, the HAZ and the weight-forage z-score (WAZ) were lower in group B. The incidence of anemia was higher in the ARM group than in the normal group. Patients with ARM are at risk for growth problems and anemia. The long-term impacts of fistula status on infant length presented earlier than those associated with other physical indicators. Compared to infants with urogenital comorbidities, those with congenital heart disease (CHD) seemed to be more prone to growth disorders and anemia.

Determination of micro essential element Fe in foodstuffs using instrumental neutron activation analysis (INAA)

Fe is an essential macro element that humans need to carry out their physiological processes. Although many factors that cause stunting cases in Indonesia, Fe anemia in pregnant women, breastfeeding women and infants under two years is believed to be one of the causes of stunting. This study will determine the content of Fe in 73 types of local food from Mamuju Regency, West Sulawesi Province. The information can be useful in preventing stunting, especially stunting caused by iron deficiency. The Fe element is determined using a neutron activation analysis technique that utilizes the G.A. Siwabessy Multipurpose Reactor. The sample irradiation was carried out at a rabbit system that has a thermal neutron flux of about 3.1013 n.cm−2.sec−1. Data acquisition of gamma-ray emitted from target irradiated was performed using gamma-ray spectrometry coupled to the high-resolution detector. Fe concentration in foodstuffs was calculated using the NAA-comparative method. The results showed that green vegetables such as kangkung (Ipomoea Aquatica Forsk), bayam (amaranthus spp), kemangi (ocimum citriodorum), daun pakis (diplazium esculentum), daun katuk (sauropus androgynous), daun seledri (Apium graveolens), daun singkong (cassava leaves), cesim (brassica rapa) and buncis (phaseolus vulgaris) have an elemental content of Fe > 100 mg/kg. Kangkung, bayam, and kemangi are green vegetables that are rich in the element Fe, the concentration of Fe in the vegetables more than 280 mg/kg. Concentrations of Fe minerals in vegetables are higher compared to Fe minerals in beef or other protein sources. The green vegetables are suitable foodstuff to overcome Fe anemia in pregnant women, breastfeeding women and infants under two years.

Blood Smear and Diagnosis of Anaemia in Children: Experience of the Hematology Laboratory of the Avicenna Hospital in Rabat with Review of the Literature

The discovery of anemia in children requires a rigorous approach to determine its etiology. This approach is essentially based on the biological analysis of the haemogram and the blood smear. The aim of our study is to demonstrate the vital interest of the blood smear in the diagnosis of anemia in children and to sensitize clinicians and biologists to the value of an adequate interpretation of the blood count. It is indeed a prospective study conducted at the Department of Pediatrics in collaboration with the Central Hematology Laboratory of the Ibn Sina University Hospital in Rabat, from May to July 2019. This study involved 100 cases of anemic infants and children who underwent a blood count and a blood smear. Childhood anaemia is predominantly male (56%), the most represented age group is between 1 month and 5 years (34%), according to the Hb rate, moderate anaemia is the most frequent (51%), the type of anaemia most found is 10%, the most common hue abnormality is the presence of annulocytes (37%), the anomalies of the are diverse but the most dominant are the presence of schizocytes (81%) followed by elliptocytes (68%), only basophilic wells are present as intraerythrocytic inclusions (1%). Our results are consistent with those in the literature and illustrate the vital interest of the hematologist in the diagnosis of the child.

Advances on erythropoietin treatment of anemia in prematurity infants

Anemia is one of the common complications in preterm infants.Although there are many factors that can cause anemia of prematurity (AOP), erythropoietin (EPO) deficiency is one of the main causes of AOP.Insufficient EPO levels in premature infants and their mechanisms are the hotspots of AOP research at home and abroad.The rational use of EPO for prevention and treatment of AOP has become an international consensus and significant clinical outcomes have been obtained.The recent progress in the field of AOP, the relationship between EPO and AOP, and the clinical application and efficacy of EPO in the prevention and treatment of AOP in recent 3 to 5 years have been reviewed. Key words: Erythropoietin; Anemia; Infant, preterm; Erythropoiesis stimulating agent; Darepoetin alfa; Treatment

Early anemia and neonatal morbidity in extremely low birth-weight preterm infants

Background Extremely low birth-weight (ELBW) preterm infants remain at high risk for mortality and major morbidities, and nearly all need packed red blood cell transfusions within their first weeks of life. The overall objective of this study was to assess the association between anemia at admission to neonatal intensive care unit (NICU) with the neonatal morbidity and mortality in ELBW infants. Methods This retrospective study was conducted on 106 patients with ELBW admitted at our level III NICU from January 2006 to December 2015. The subjects were divided into two groups: (1) patients with anemia at admission and (2) patients without anemia. Their characteristics and outcomes were compared. Statistical analysis was performed using the Statistical Package for the Social Sciences software, version 24.0 (IBM New York, USA), and a value of p < 0.05 was considered statistically significant. Results Of the 106 ELBW, 34 (32%) presented with anemia at admission and 72 (68%) without anemia. Anemia-naive presented mean hemoglobin at the admission of 12.8 ± 1.5 g/dl and nonanemic 16.8 ± 2.1 g/dl, p < .001). The anemic group presented a lower gestational age (26 ± 2 vs. 27 ± 2 SD weeks, p = .025), greater need for inotropic support (52.9 vs. 31.9%, p = .041), longer period of invasive mechanical ventilation (9 vs. 2 days, p = .012), higher FiO2 need (0.8 vs. 0.4, p < .001), more frequent hemodynamically significant patent ductus arteriosus (HS-PDA) (64.7 vs. 41.7%, p = .006) and severe intra-periventricular hemorrhage (IPVH) (41.2 vs. 16.7%, p = 0.005). The multivariate analysis confirmed an association between anemia at admission and HS-PDA (OR = 3.2; 95% CI: 1.1–9.5, p = 0.044) and severe IPVH (OR = 3.3; 95% CI: 1.0–9.9, p = .038). In anemic infants, ionotropic support and IPVH >2 were considered independent factors for mortality. Conclusion In this ELBW series, the presence of anemia at admission to the NICU was associated with HS-PDA and severe IPVH. Preventive strategies for early anemia must be encouraged.

Hematological Presentation and Change in Clinical Phenotype during Follow-up in Pearson Syndrome

Introduction: Pearson syndrome (PS) was originally reported as a sideroblastic anemia in infancy with vacuolization of marrow precursors and exocrine pancreas dysfunction. It is now recognized as a fatal multisystem mitochondrial disorder caused by single mitochondrial DNA deletions (SLSMDs) presenting with anemia. PS, Kearns-Sayre Syndrome (KSS) and progressive external ophthalmoplegia (PEO) form a continuous spectrum of disease associated with SLSMDs. There have been only a few systematic studies on PS. Methods: We retrospectively reviewed hematological features and clinical course of 25 children with PS diagnosed between 1987 and 2019. Results: Patients presented with normo/macrocytic transfusion-dependent anemia (n=25), failure to thrive (n=3), diarrhea (n=1), acidosis (n=1) and/or omphalocele/esophageal atresia (n=1) at a median age of 5 (0-31) months. A median hemoglobin, platelet count and neutrophil count were 6.5 (1.9-9.8) g/dl, 104 (31-300) G/L, and 0.9 (0.1-2.4) G/L, respectively. Bone marrow (n=24) was normo- (n=15) or hypocellular (n=9). Vacuoles in erythroid and myeloid precursors were observed in all patients, but ring sideroblasts were present in only 16 of 23 patients examined. Morphology can resemble Diamond-Blackfan anemia (DBA) because of erythroid hypoplasia (15/21). Dysplastic features are often observed including micromegakaryocytes. Lactic acid was elevated in most patients examined (14/18). Exocrine pancreas insufficiency at diagnosis was documented in 5 patients only. The detection of SLSMDs confirmed the diagnosis of PS in all patients. The median age at the time of the last follow-up was 47 (7 - 183) months. Among 11 patients with hematological follow-up for more than 3 years after diagnosis, 8 had spontaneous resolution of anemia at a median age of 28 (12-67) months, and 3 died at the age of 3, 6 or 8 years without hematological recovery. Clinical course was highly heterogeneous and various organ dysfunctions appeared. Renal tubulopathy/Fanconi syndrome (n=7) and cardiomyopathy/arrhythmia (n=5) were often fatal complications which developed at the median age of 32 and 45 months, respectively. Failure to thrive/short stature (n=13) and muscle hypotonia (n=9) were commonly observed. Other complications included pancreas insufficiency (n=7), liver dysfunction (n=4), endocrine dysfunctions (n=7), hearing loss (n=1), ophthalmoplegia (n=1), retinitis pigmentosa (n=1), cataract (n=1), ataxia (n=2) and encephalopathy (n=1). Thirteen patients died of acute metabolic acidosis with/without other complications (n=7), arrhythmia (n=2), respiratory failure (n=3) and liver/renal failure (n=1) at the median age of 50 (14-183) months. Two patients developed KSS and PEO-like phenotypes at the age 92 months and 19 months, respectively. Summary: Anemia is generally the only presenting syndrome of PS. While the bone marrow morphology can resemble DBA or myelodysplastic syndrome, recognition of vacuolated myeloid/erythroid precursors lead to the correct diagnosis of PS in all cases. Other classical signs of PS, ring-sideroblasts and pancreas insufficiency, are often missing. Anemia spontaneously resolves in most patients surviving early childhood. However, PS is unexceptionally fatal (Figure), most patients succumb to metabolic acidosis and various forms of multi-organ failure. Since there is no effective therapy, the diagnosis of PS is one of the saddest news that pediatric hematologists have to break to parents of an anemic infant. Figure Disclosures Niemeyer: Celgene: Consultancy.

Study of anemia in hospitalised infants with special reference to its risk factors

Background: Anemia is a major nutritional problem in India. Anemia in infancy and early childhood affects growth and development and is associated with increased morbidity and mortality. The aim of this study was to determine the prevalence, severity and types of anemia and study the risk factors for anemia in hospitalised infants. Methods: A prospective study was conducted at a tertiary care hospital in Western India from July 2016 to December 2017. Complete hemogram of all hospitalised infants between 6-12 months of age was done and those with haemoglobin levels<11g/dl were considered anemic. Results: Out of 206 hospitalised infants,131(63.6%) had anemia. Male: female ratio was1.3:1. The most common illness for which they were admitted was respiratory tract infections.35.1% of the anemic infants had low birth weight, 19.1% were born prematurely and 59.5% had a history of maternal anemia. Only 42% were exclusively breast fed till 6 months of age and improper complementary feeding practices was observed in 61.8% of infants. Mild, moderate and severe anemia was seen in 41.2%, 50.4% and 8.4% infants respectively. The most common type of anemia was microcytic hypochromic anemia (67.2%). Conclusion: Anemia is a major problem in infants with a high prevalence. Most infants have mild to moderate anemia and the most common type is microcytic hypochromic anemia most likely due to iron deficiency. Preterm gestation, absence of exclusive breastfeeding, consumption of cow’s milk, improper complementary feeding practices and presence of maternal anemia were the risk factors found to be associated with development of anemia in the present study.

Management of anaemia in pre-term infants.

Pre-term infants have one of the highest transfusion requirements within the hospital-setting. The vast majority of blood transfusions performed in Neonatal Intensive Care Units (NICUs) are for medically stable pre-term infants with anaemia of prematurity, with the aim of improving oxygen delivery to the vital organs during the crucial phase of growth and development. However, despite the frequency of transfusion in this population, the potential benefits and harms of 'top up' transfusion are not fully understood, leading to practice variation between clinicians, institutions and countries. Significant advances have been made in the prevention of anaemia of prematurity, with recent emphasis on optimising infants' circulatory volume at birth via placental transfusion and preserving infants' own blood volume through innovative minimal sampling techniques. More research is urgently needed to establish optimal transfusion thresholds for these high-risk pre-term infants, for whom benefits as well as adverse outcomes may have consequences that extend for decades throughout the recipients' life-course. In this review, we will discuss some of the consensus and controversies regarding optimal management of anaemia in pre-term infants and highlight potential areas for future research.

EFEKTIFITAS METODE LOTUS BIRTH TERHADAP KEJADIAN ANEMIA DEFISIENSI ZAT BESI PADA BAYI

&lt;pre&gt;&lt;em&gt;The controversy over the Lotus Birth method for general application is still being debated, but the consensus to delay cord clamping and cutting has been agreed and agreed by WHO that the umbilical cord is clamped after stopping to beat to allow increased blood flow to the baby to prevent anemia. The objective of the research was to find effectiveness of the lotus birth method for the incidence of anemia in infants. The research is done by using quasy experiment with sample infants born spontaneously, having 38-40 weeks of pregnancy and without complications using the lotus birth method (15 people) and the control group not using the lotus birth method (15 people). Analysis method of data uses independent t-test. The result of the research showed no Effectiveness of the lotus birth method for the incidence of iron deficiency anemia in infants at the Klinik Pratama Sejahtera (p=0, 865).&lt;/em&gt; &lt;em&gt;The conclusion in this study is no Effectiveness of the lotus birth method for the incidence of iron deficiency anemia in infants at the Klinik Pratama Sejahtera. It is expected that pregnant women should prepare themselves in the face of childbirth by increasing knowledge about how to maintain health and care for babies to avoid the occurrence of iron deficiency anemia.&lt;/em&gt;&lt;/pre&gt;

Early life risk factors of motor, cognitive and language development: a pooled analysis of studies from low/middle-income countries

ObjectiveTo determine the magnitude of relationships of early life factors with child development in low/middle-income countries (LMICs).DesignMeta-analyses of standardised mean differences (SMDs) estimated from published and unpublished data.Data sourcesWe searched...

Iron supplementation in preterm and low-birth-weight infants: a systematic review of intervention studies.

ContextEnteral iron supplementation in preterm infants is recommended to supply sufficient iron for growth and development without increasing the risk of iron overload. However, the current recommendations date from 2010 and are based on limited evidence.ObjectiveThis systematic review aimed to investigate the effects of enteral iron supplementation on iron status, growth, neurological development, and adverse clinical outcomes in preterm (<37 weeks’ gestation) and low-birth-weight (LBW, <2500 g) infants.Data sourcesThe PubMed/Medline and Cochrane Library databases were searched to 31 October 2018.Data extractionOf the 684 records identified, 27 articles, describing 18 randomized controlled trials (RCTs) plus 4 nonrandomized interventions, were included. Using the Cochrane Collaboration’s criteria, study quality was found to be poor to fair overall.ResultsMost articles (23/27) reported iron status indices; supplementation for ≥8 weeks resulted in increased hemoglobin and ferritin concentrations and a reduction in iron deficiency and anemia. No article reported on iron overload. Growth-related parameters reported in 12 articles were not affected by supplementation. Among the 7 articles on neurological development, a positive effect on behavior at 3.5 and 7 years was observed in one Swedish RCT. No association was found between supplementation and adverse clinical outcomes in the 9 articles reporting on studies in which such data was collected.ConclusionsLong-term iron supplementation appears to result in improved iron status and a reduction in iron deficiency and anemia in preterm and LBW infants. However, high-quality evidence regarding the long-term effects of supplementation on functional health outcomes is lacking. Iron overload has largely been ignored. Well-designed, long-term, dose-response RCTs are required to ascertain the optimal dose and delivery method for the provision of dietary iron in preterm infants, with consideration of short- and long-term health effects.Systematic Review RegistrationPROSPERO registration no. CRD42018085214.