Iron Deficiency Anemia In Infants Research Articles

Relationship between Helicobacter pylori infection and iron-deficiency anemia in infants and children

Purpose: To elucidate a potential association between Helicobacter pylori (HP) infection and iron-deficiency anemia (IDA) in infants and children in terms of the other factors related to iron utilization and storage although the association of ferritin was previously studied. Methods: We evaluated 135 infants (aged 6-24 months) admitted at Gyeongsang National University Hospital from 2000 to 2006. Western blot assays using the HP CagA antigen (120 kD) were conducted to identify infections. The concentrations of six parameters were measured: hemoglobin (Hb), serum ferritin, soluble serum transferrin receptors, interleukin-6, prohepcidin, and C-reactive protein. In addition, the infants were classified into IDA, anemia from inflammation (AI), unclassified anemia (UCA), and normal groups on the basis of Hb and ferritin concentrations. Results: In the IDA group (n=20), seven infants were infected with HP, with the other infants showing no evidence of infection. The mean Hb levels in the IDA group were significantly lower in HP-infected infants than those uninfected (7.1 vs. 8.2 g/dL, respectively); the mean ferritin levels were also significantly lower in the infected infants (3.2 vs. 6.8 µg/L). The other four parameters did not differ significantly among the IDA infants. No correlations were found between the six parameters and HP infection status in the other groups. Conclusion: There were no significant differences in the HP infection rates among the study groups. However, in the IDA group, the HP-infected infants had significantly lower serum ferritin and Hb levels than the HP-negative infants (P＜0.05). (Korean J Pediatr 2009;52:544-548)

Iron deficiency anemia in infants aged 12-15 months in Ahwaz, Iran

Iron deficiency anemia (IDA) is one of the most common nutritional problems in the world, especially in developing countries. Infants aged between 4 and 24 months are among the population groups that are most affected by iron deficiency (ID). The aim of this study was to investigate the prevalence of ID and IDA in infants aged 12-15 months, living in Ahwaz, southwest of Iran. One hundred and twenty-six infants participated in the study. The mean corpuscular volume and hemoglobin (Hb), serum ferritin and hematocrit levels were measured. Anemia was defined when Hb < 11 g/dL and ID when ferritin < 12 microg/mL. The prevalence of ID and IDA was 31.7 and 26.2%, respectively. The tendency to have IDA in infants fed with cow's milk and infants who did not receive ferrous sulfate was higher than in the other subjects. ID and IDA are common among infants aged 12-15 months living in Ahwaz, Iran. Maintenance of exclusive breastfeeding up to the 4-6th month of life and iron supplementation for the target group is needed.

Iron Deficiency Anemia in Infancy Is Associated with Altered Temporal Organization of Sleep States in Childhood

Iron Deficiency Anemia in Infancy Is Associated with Altered Temporal Organization of Sleep States in Childhood

Iron deficiency anemia and affective response in rhesus monkey infants

Infant iron deficiency anemia (IDA) occurs spontaneously in monkey populations as it does in humans, providing a model for understanding effects on brain and behavior. A set of 34 monkey infants identified as IDA (hemoglobin <11 g/dl) over a 5-year period at the California National Primate Research Center (CNPRC) was compared to a set of 57 controls (hemoglobin >12 g/dl) matched for age and caging location. The infants had participated in a Biobehavioral Assessment conducted at 3-4 months of age at CNPRC that included measures of behavioral and adrenocortical response to a novel environment. IDA males differed from control males in two factors ("activity," "emotionality") derived from observational data taken on the first and second day of the exposure to the novel environment. In the male infants, IDA was associated with less restriction of activity in the novel environment on both days and less emotionality on the second day (p < .05). IDA males also displayed less response to approach by a human (human intruder test) than did control males. IDA females did not differ from controls. Adrenocortical response was not significantly affected. These findings may be relevant to functional deficits in human infants with IDA that influence later behavior.

Supplemental food may not prevent iron-deficiency anemia in infants

The present study evaluates the role of supplementary food and medicinal iron intake in preventing iron deficiency anemia in children aged between 4 to 6 months. During a case-control study in "Tabriz Children Hospital", nutritional and medicinal-iron intake of 60 consecutively selected patients with iron-deficiency anemia were compared with 60 non-anemic children of similar age and sex distributions. The mean hemoglobin concentration, corpuscular volume and serum iron were 9.11 g/dl, 65.41 fL and 19.33 microg/dl, in case group; and 12.6 g/dl, 75.18 fL and 78.28 microg/dl, in control group, respectively. There was no statistically significant difference between age of case and control groups when complementary-semisolid foods were started (P=0.058), but the mean of received medicinal iron in case group was significantly lower than control group (P<0.001). Supplementary food intake alone is not efficient to prevent iron deficiency anemia since the age of 4-6 months. So, regular administration of medicinal iron is crucial to prevent iron-deficiency anemia in children aged 4-6 months.

Behavioral Effects of Iron Deficiency With and Without Anemia

Although the prevalence of iron deficiency anemia in infants and toddlers in the U.S. has decreased during the past 30 years, poor, minority, and

The Usefulness of the Serum Transferrin Receptor to Serum Ferritin Ratio for Discriminating between Iron Deficiency Anemia and Anemia of Inflammation in Infants

Background: The incidence of iron deficiency anaemia in infants, which is caused by the increased iron demand for rapid growth during this period, is reported to range from 10 to 40%. This age group also suffers from a number of acute illnesses (urinary tract infection, pneumonia and other viral illness). The aim of this study was to evaluate the usefulness of soluble transferrin receptor (sTfR) values and the different methods of calculating the sTfR and serum ferritin (SF) ratio for differentiating anemia of inflammation (AI) from iron deficiency anemia (IDA) or a mixture of these two types of anemia. Methods: 173 infants among all the infants who visited Gyeongsang National University Hospital from 2000 to 2006 were enrolled in this study. The hemoglobin (Hb), SF and sTfR values were checked and the infants were divided into the Al subgroup (Hb ＜11g/dL and SF ＞50Ռg/L), the IDA subgroup (Hb ＜11g/dL and SF ＜12Ռg/L), the normal group (Hb ≥11g/dL and SF ≥12Ռg/L), and the unclassified anemia (UCA) group (Hb ＜11g/dL and SF 12∼50Ռg/L). Results: The mean sTfR and sTfR/Log SF values in the AI group were 3.89 and 10.6Ռg/mL, respectively (P＜0.01). These values in the IDA group were 1.9 and 36.11, respectively (P＜0.01). The mean Log (sTfR/SF) was statistically significant between all the subgroups (1.35 in AI, 3.29 in IDA, 1.76 in Nor and 2.35 in UCA). All the infants in the IDA group had a Log (sTfR/SF) value ＞2.55 whereas all the infants classified in AI group had a Log (sTfR/SF) value ＜2.55. Conclusion: The Log (sTfR/SF) value is a useful criterion for discriminating between AI and IDA.

Occurrence and detection of iron-deficiency anemia in infants and toddlers.

Infants and toddlers are particularly vulnerable to developing iron deficiency, which can cause irreversible deficits in neurodevelopment. Children at highest risk include premature and low birth weight infants, those who are fed cow's milk rather than breast milk or formula prior to age one, and those who drink large amounts of cow's milk as toddlers. It is important to detect iron deficiency before it becomes frank anemia through the use of appropriate laboratory tests. Hemoglobin or hematocrit testing, at around age one, has been the usual screening test. These tests, however, do not become abnormally low until frank anemia has developed. Over the past decade, research has shown the assay for reticulocyte hemoglobin content to be a much earlier indicator of iron deficiency. This article provides an overview of the epidemiology, occurrence, and detection of iron deficiency and iron deficiency anemia in young children as well as a comparison of the utility of various laboratory tests.

Iron deficiency anemia in infancy is associated with altered temporal organization of sleep states in childhood.

The highest prevalence of iron deficiency anemia (IDA) in infancy coincides with a time of rapid changes in sleep organization. Since IDA in infancy is associated with long-lasting neurofunctional effects despite iron treatment, the normal development of sleep patterns might be affected. Night polysomnographic recordings were performed in 55 healthy 4-y-old children (former IDA = 27, nonanemic controls = 28). Both groups were followed from infancy and were similar in background characteristics. The duration of each waking episode was measured, as was the duration of each episode of nonrapid eye movement (NREM) sleep stages 1 (NREM1), 2 (NREM2), and 3-4 (SWS), and rapid eye movement (REM) sleep. The data were analyzed according to the successive thirds of the total sleep time (TST). Relative to controls, former IDA children showed: a) longer duration of REM sleep episodes in the first third and shorter in the last third; b) more REM sleep episodes in the first third and fewer in the second third; and c) shorter latency to the first REM sleep episode and shorter NREM stage 2 and SWS episodes within the first sleep cycle. The results show that early IDA is associated with long-lasting alterations in the temporal organization of sleep patterns.

Iron Deficiency Anemia Following Prenatal Nutrition Interventions

Iron deficiency anemia (IDA) during pregnancy and infancy is still common in developed countries, especially in low-income groups. We examined the prevalence of anemia and IDA in healthy low-income pregnant women participating in the Early Childhood Initiatives (ECI) program, and in their infants when they reached six months of age. Pregnant women were recruited by nutritionists. In mothers, hemoglobin (Hb), mean corpuscular volume, and serum ferritin (SF) were measured at 36 +/- 2 weeks of gestation. In infants, Hb, mean corpuscular volume, SF, serum iron, total iron binding capacity (TIBC), and transferrin saturation (TS) were measured at six months of age. Thirty-one mother-infant pairs participated. Among the 31 pregnant women participating in the ECI program, six (19.4%) were anemic (Hb <110 g/L) and five (16.1%) suffered from IDA (Hb <110 g/L and SF <10 microg/L). Among infants, seven of 23 (30.4%) were anemic (Hb <110 g/L) and five of 23 (21.7%) suffered from IDA (Hb <110 g/L plus two of the following: TIBC >60 micromol/L, SF <10 microg/L, serum iron <5.3 micromol/L, TS < or = 15%). The prevalence of anemia in this group of low-income pregnant women is comparable to that in privileged women. The prevalence of IDA in infants is comparable to that observed in other high-risk groups. Effective strategies are needed to prevent IDA in vulnerable groups.

Fetal Alcohol Exposure, Iron-Deficiency Anemia, and Infant Growth

Our goals were to determine whether prenatal alcohol exposure is associated with an increased incidence of iron-deficiency anemia in infancy and to compare effects of fetal alcohol exposure and iron-deficiency anemia on infant growth. We also tested whether effects of fetal alcohol exposure on growth are mediated or moderated by iron-deficiency anemia. A total of 96 infants born to mothers from the Coloured (mixed ancestry) community in Cape Town, South Africa, were recruited prenatally; 42 mothers drank heavily during pregnancy, and 54 abstained or drank small amounts of alcohol. Growth was assessed at birth and 6.5 and 12 months, and iron-deficiency anemia was assessed at 6.5 or 12 months. Infants whose mothers binge drank during pregnancy (> or = 4 drinks per occasion) were 3.6 times more likely to be diagnosed with iron-deficiency anemia at 12 months than were infants whose mothers did not binge drink. Prenatal alcohol exposure was associated with reduced weight at birth, 6.5 months, and 12 months and with shorter length at 6.5 and 12 months. Iron-deficiency anemia was related to reduced 12-month weight and head circumference and to slower growth velocity between 6 and 12 months. The effects of prenatal alcohol on weight were not mediated by iron-deficiency anemia; however, they were seen primarily in infants with iron-deficiency anemia. The association of maternal binge drinking with an increased incidence of iron-deficiency anemia may reflect disruption of accumulation of fetal iron stores or postnatal deficiencies in iron uptake, absorption, or intake. Moreover, iron deficiency seems to exacerbate the prenatal alcohol effects on growth.

Iron-deficiency anemia is associated with altered characteristics of sleep spindles in NREM sleep in infancy.

To determine the effects of iron-deficiency anemia on the development of non-rapid-eye-movement (NREM) sleep stages, as indexed by sleep spindles. Patterns of sleep spindles during NREM sleep stages 2 and 3-4 (slow-wave-sleep, SWS) were compared in 26 otherwise healthy 6-month-old Chilean infants with iron-deficiency anemia and 18 non-anemic control infants. From polygraphic recordings, EEG activity was analyzed for sleep spindles to assess their number (density), duration, frequency, and inter-spindle interval. Iron-deficient anemic infants differed from the control group by having sleep spindles with reduced density, lower frequency, and longer inter-spindle intervals in NREM sleep stage 2 and SWS. These results provide evidence of delayed sleep spindle patterns in iron-deficient anemic infants, suggesting that iron is an essential micronutrient for the normal progression of NREM sleep pattern development in the human.

Ingesta de una fórmula láctea suplementada con hierro como medida preventiva del déficit de hierro en niños de 1 a 3 años de edad

Low iron status is a well known risk factor for iron deficiency anemia in infants and young children. The aim of the present study was to evaluate the influence of an iron-fortified toddler formula on iron status in 1-3 year-olds.Thirty-three healthy infants and young children were assigned to two groups that received 500 mL/day of and iron-fortified toddler formula or 500 mL/day of unmodified cow's milk for 4 months. Allocation was random and double-blind. Daily dietary intake was calculated by dietary evaluation, and iron nutritional status was assessed (hemoglobin, hematocrit, mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, serum iron, ferritin, and transferrin).At enrollment, no anemia was found in either group, although hemoglobin concentration and hematocrit were significantly lower in the toddler formula group than in the unmodified cow's milk group. However, these differences disappeared at the end of the intervention period. After 4 months, the toddler formula group showed significantly higher serum ferritin and lower serum transferrin concentrations than the cow's milk group.Intake of iron-supplemented toddler formula for 4 months in 1-3 year-olds is more effective in maintaining iron nutritional status than cow's milk.

Preschool-Aged Children with Iron Deficiency Anemia Show Altered Affect and Behavior ,

This study compared social looking and response to novelty in preschool-aged children (47–68 mo) with or without iron deficiency anemia (IDA). Iron status of the participants from a low-income community in New Delhi, India, was based on venous hemoglobin, mean corpuscular volume, and red cell distribution width. Children’s social looking toward adults, affect, and wary or hesitant behavior in response to novelty were assessed in a semistructured paradigm during an in-home play observation. Affect and behavior were compared as a function of iron status: IDA (n = 74) vs. nonanemic (n = 164). Compared with nonanemic preschoolers, preschoolers with IDA displayed less social looking toward their mothers, moved close to their mothers more quickly, and were slower to display positive affect and touch novel toys for the first time. These results indicate that IDA in the preschool period has affective and behavioral effects similar to those reported for IDA in infancy.

Diagnosis of Iron Deficiency in Infants

The assessment of iron deficiency anemia in infants is a clinical challenge because of the high requirements for iron to support expansion of the blood volume during rapid growth and development. Infants are endowed with only adequate storage iron to support this iron requirement for the first 4 to 6 months of life and premature infants even less than that. Hemoglobin is a measure of anemia but is not specific to iron deficiency, which requires the additional measurement of ferritin, soluble transferrin receptor, and protoporphyrin levels to assess iron nutrition. Premature infants that receive transfusion or erythropoietin therapy are special diagnostic challenge. An accurate classification of iron status requires multiple biomarkers of iron storage and transport adequacy and in the absence of standardized assay material for several tests, becomes quite problematic.

Iron Deficiency in Infancy and Mother-Child Interaction at 5 Years

Five-year-old Costa Rican children, who had either chronic, severe iron deficiency or good iron status in infancy, were observed with their mothers during a structured interaction task in a laboratory setting and everyday interactions in their home. Child affect and behavior as well as the quality of mother-child interaction of the formerly chronic iron-deficient children (n = 40) were compared to those with good iron status in infancy (n = 102). Children who had chronic iron deficiency in infancy were more likely to display lower levels of physical activity, positive affect, and verbalization during the structured task at 5 years, despite iron therapy that corrected their iron deficiency anemia in infancy. Mother-child reciprocity during the structured task (e.g., eye contact, shared positive affect, turn taking) was more likely to be lower in the chronic iron deficiency group compared to the good iron group. Mothers of children in the chronic iron deficiency group showed less responsivity in both settings. These results show that children with chronic, severe iron deficiency in infancy continue at behavioral disadvantage relative to their peers at school entry. Sustained differences in mother-child interaction might contribute to the long-lasting behavioral and developmental alterations reported in children with chronic, severe iron deficiency in infancy.

50 Years Ago in The Journal of Pediatrics: Intramuscular iron for the treatment of iron deficiency anemia in infants

50 Years Ago in The Journal of Pediatrics: Intramuscular iron for the treatment of iron deficiency anemia in infants

Community-based communication strategies to promote infant iron nutrition in northern Canada

Objectives. To evaluate innovative communication strategies promoting iron nutrition for infants at risk for iron deficiency anemia (IDA) in a northern Aboriginal community.Study Design. A prospective process evaluation.Methods. A social marketing approach was used in the development, implementation and evaluation of the communication strategies. A post-intervention questionnaire was administered to a sample (n = 45) to evaluate reach and exposure of the strategies, and sales of iron-rich infant foods were examined pre-and post-intervention.Results. Multiple communication channels were associated with an increased awareness of IDA and an increased self-reported use of iron-rich infant food. Radio was the most successful channel for reach and exposure of messages. Iron-rich infant food sales increased from pre-to post-intervention (p & 0.05). Breadth of exposure to cooking activity was more limited; however, participants reported increased confidence in preparing homemade baby food.Conclusions. Communication strategies are a promising strategy for infant IDA prevention where appropriate food is available.

Behavioral consequences of developmental iron deficiency in infant rhesus monkeys

Human studies have shown that iron deficiency and iron deficiency anemia in infants are associated with behavioral impairment, but the periods of brain development most susceptible to iron deficiency have not been established. In the present study, rhesus monkeys were deprived of iron by dietary iron restriction during prenatal ( n = 14, 10 μg Fe/g diet) or early postnatal ( n = 12, 1.5 mg Fe/L formula) brain development and compared to controls ( n = 12, 100 μg Fe/g diet, 12 mg Fe/L formula) in behavioral evaluations conducted during the first four months of life in the nonhuman primate nursery. Iron deficiency anemia was detected in the pregnant dams in the third trimester and compromised iron status was seen in the prenatally iron-deprived infants at birth, but no iron deficiency was seen in either the prenatally or postnatally iron-deprived infants during the period of behavioral evaluation. Neither prenatal nor postnatal iron deprivation led to significant delays in growth, or gross or fine motor development. Prenatally deprived infants demonstrated a 20% reduced spontaneous activity level, lower inhibitory response to novel environments, and more changes from one behavior to another in weekly observation sessions. Postnatally deprived infants demonstrated poorer performance of an object concept task, and greater emotionality relative to controls. This study indicates that different syndromes of behavioral effects are associated with prenatal and postnatal iron deprivation in rhesus monkey infants and that these effects can occur in the absence of concurrent iron deficiency as reflected in hematological measures.

Iron deficiency anemia in infants. Preliminary development results at five years

Research, mostly conducted in developing countries, have suggested short and long term developmental delay in children who had iron-deficiency anemia (IDA) in their early life. This study aims to evaluate the development of 5-years old children who were diagnosed IDA at 9 months of age. 27 children with IDA diagnosed at 9 months of age and 28 non-anemic controls were followed-up until they were 5 years old. At 9 months of age and at 5 years of age, blood samples were collected for blood count, iron, transferrin and ferritin. Children with hemoglobin < 110 g/l and ferritin < 12 ng/ml were diagnosed with IDA and received iron treatment for IDA correction. C Reactive Protein and antibody to hepatitis A virus were also studied at 5 years of age. At this age, children's motor and cognitive development were accessed using Griffith's test. At 9 months of age, IDA children had [mean (SD)] 102.5 g/ l (5.9) g/l of hemoglobin and 5.6 ng/l (3.1) ng/ml of ferritin. At 5 years of age all children were healthy and without anemia. One child had positive antibody to hepatitis A virus. The results of Griffith's test at five years--anemic/non-anemic at 9 months of age. The mean (sd)-p: general coefficient--100.8 (6.6)/99.5 (7.1)-0.48; locomotor 110.2 (6.9)/109.3 (6.5)-0.62; personal-social--99.1 (11.4)/95.7(11.6)-0.28; hearing-speech--93.8 (9.1)/95.3 (13.7)-0.64; hand-eye--98.2 (13.2)/99.1 (14.3)-0.79; performance--97.5 (17.6)/96.9 (13.6)-0.88; practical reasoning--89.8 (9.1)/86.3(7.1)-0.21. As only one child had positive antibody to hepatitis A virus, the study population may be considered as belonging to a developed region. These results suggest that, at least in developed regions, infants who receive an early treatment for their mild IDA may not be affected in global development at the age of five.