Iron Deficiency Anemia In Infants Research Articles

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.

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.

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.

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.

Differences on Brain Connectivity in Adulthood Are Present in Subjects with Iron Deficiency Anemia in Infancy.

Iron deficiency continues to be the most prevalent micronutrient deficit worldwide. Since iron is involved in several processes including myelination, dopamine neurotransmission and neuronal metabolism, the presence of iron deficiency anemia (IDA) in infancy relates to long-lasting neurofunctional effects. There is scarce data regarding whether these effects would extend to former iron deficient anemic human adults. Resting state functional magnetic resonance imaging (fMRI) is a novel technique to explore patterns of functional connectivity. Default Mode Network (DMN), one of the resting state networks, is deeply involved in memory, social cognition and self-referential processes. The four core regions consistently identified in the DMN are the medial prefrontal cortex, posterior cingulate/retrosplenial cortex and left and right inferior parietal cortex. Therefore to investigate the DMN in former iron deficient anemic adults is a particularly useful approach to elucidate de long term effects on functional brain. We conducted this research to explore the connection between IDA in infancy and altered patterns of resting state brain functional networks in young adults. Resting-state fMRI studies were performed to 31 participants that belong to a follow-up study since infancy. Of them, 14 participants were former iron deficient anemic in infancy and 17 were controls, with mean age of 21.5 years (±1.5) and 54.8% were males. Resting-state fMRI protocol was used and the data was analyzed using the seed based connectivity statistical analysis to assess the DMN. We found that compared to controls, former iron deficient anemic subjects showed posterior DMN decreased connectivity to the left posterior cingulate cortex (PCC), whereas they exhibited increased anterior DMN connectivity to the right PCC. Differences between groups were also apparent in the left medial frontal gyrus, with former iron deficient anemic participants having increased connectivity with areas included in DMN and dorsal attention networks. These preliminary results suggest different patterns of functional connectivity between former iron deficient anemic and control young adults. Indeed, IDA in infancy, a common nutritional problem among human infants, may turn out to be important for understanding the mechanisms of cognitive alterations, common in adulthood.

Household Food Security Status Is Associated with Anemia Risk at Age 18 Months among Low-Income Infants in Massachusetts

BackgroundFood insecurity and anemia are prevalent among low-income families and infants. Anemia may reflect iron deficiency anemia (IDA) risk. IDA in infancy and early childhood may have long-lasting developmental effects. Few studies have examined food security status (FSS) as a risk factor for anemia. ObjectiveTo examine the association between household FSS, sociodemographic and health-related variables, and anemia incidence at age 18 months among low-income infants in the Massachusetts Special Supplemental Nutrition Program for Women, Infants, and Children (MA/WIC). Study designThis was a longitudinal study using data from MA/WIC (August 2001 to November 2009) to assess the relationship between household FSS during the 12 months preceding the 1-year visit (age 9 to 15 months) and anemia at age 18 months. Participants/settingsInfants included were not anemic at age 12 months and had complete data on household FSS and the following covariates (N=17,831): race/Hispanic ethnicity, maternal education, breastfeeding duration, household size, and child age. Statistical analyses performedMultiple logistic regression was used to examine the association between household FSS during the prior 12 months and anemia at 18 months, controlling for infant age, sex, and race/Hispanic ethnicity, breastfeeding, maternal education, and household size. ResultsA majority of infants (56%) were nonwhite, and 19.9% lived in food-insecure households (4.8% in very-low food security). Of the infants who were not anemic at age 12 months, 11.7% became anemic by age 18 months. Infants living in low-food-secure households were 42% more likely (adjusted odds ratio 1.42, 95% CI, 1.27-1.60) to develop anemia at age 18 months than were their food-secure counterparts. Nonwhite race, higher household size, and lower maternal education were also associated with an elevated risk of anemia at age 18 months. ConclusionsLow food security appears to be associated with a significant increased risk of anemia, as do nonwhite ethnicity, lower maternal education, and larger household size. Knowledge of these risk factors can be used to design IDA-prevention interventions in this vulnerable population.

Accuracy of Different Markers in Diagnosis of Iron Deficiency Anemia in Infants and Young Children

Accuracy of Different Markers in Diagnosis of Iron Deficiency Anemia in Infants and Young Children

Clinical Significance of Hepcidin in the Diagnosis of Infant Iron Deficiency Anemia

To explore the clinical diagnostic value and significance of hepciden level by detecting the expression of serum hepcidin before and after treatment of infant iron deficiency anemia (IDA) with or without vitamin D deficiency. A total of 60 cases of infamt IDA were divided into A and B groups, the group A consisted of 20 IDA infants with vitamin D deficiency, group B consisted of 48 IDA infants without vitamin D deficiency and the control group included 26 healthy infants. Blood examination including HGB, MCV, MCH and MCHC was performed by hematological analyzer, the level of serum ferritin was assayed by chemiluminescence immunoassay, the levels of hepcidin and 25- (OH) D were assayed by ELISA. The levels of serum hepcidin in group A, B and control group before treatment were (29.16 ± 7.50), (27.11 ± 7.10) and (29.25 ± 8.39) ng/ml, respectively (P > 0.05). The level of serum hepcidin in group A and B after treatments was significantly higher than that in control group [ (36.21 ± 5.68) ng/ml vs (29.25 ± 8.39) ng/ml, P < 0.01; (34.16 ± 4.54) ng/ml vs (29.25 ± 8.39) ng/ml, P < 0.01]; but there were no significantly difference between group A and B (P > 0.05). The serum ferritin positively correlated with hepcidin in group B both before and after treatments (r = 0.352 and 0.367, P < 0.05, P < 0.05). The level of serum hepcidin has an important significance in poccess of evaluatng for therapeutic effect in infant iron deficiency anemia, but the interference effect of vitamin D deficience should be eliminated when the expression level of hepcidin is applicated for diagnosis and differential diagnosis.

Evaluation of iron-deficiency anemia in infancy

Objective: The aim of this study was to evaluate iron-deficiency anemia (IDA) in infancy in relation to different patterns of feeding (exclusive breast milk, exclusive cow's milk, and milk fortified with iron). Background: Iron is a component of several metalloproteins and plays a crucial role in vital biochemical activities, such as oxygen sensing and transport, electron transfer, and catalysis. The biological functions of iron are based on its chemical properties. Decreased hemoglobin level and decreased serum ferritin level aid the identification of IDA in infants. Patients and methods: This study included 147 infants with different patterns of feeding (exclusive breast fed, exclusive cow's milk fed, and iron-fortified formula). The studied groups were subjected to a full detailed assessment of history, thorough clinical examination, anthropometric measurements, complete blood count, and determination of serum iron, serum ferritin, and total iron-binding capacity. Results: In our study, the results showed that 84 (57.1%) infants of the total group studied (147 infants) were found to have IDA. According to sex, IDA among girls was 51.2%, which is higher than that found among boys (48.8%). IDA was much higher in cow's milk-fed infants 24 (96%) than exclusively breast milk-fed infants 47 (66.2%), and less in infants receiving mixed feeding with a fortified formula, 13 (25.5%), respectively. Conclusion: Our study found that infants aged 6–24 months represent one of the highest risk groups to develop IDA (57.1%) of the total study. The risk factors for IDA include consumption of cow's milk during the first year, delaying the introduction of solid foods, and lack of fortification of food with iron after 6 months of age.

Iron deficiency anemia in infants and toddlers

BackgroundIn Korea, the prevalence of anemia and iron deficiency anemia (IDA) among older infants and young children remains high. To detect IDA early and to reduce its adverse impact, we assessed the characteristics of infants and young children who had IDA or were at risk of developing IDA, or who exhibited characteristics associated with severe anemia.MethodsAmong the 1,782 IDA-affected children aged 6 months to 18 years who visited the hospital, we retrospectively analyzed the medical records and laboratory data of 1,330 IDA-affected children aged 6–23 months who were diagnosed between 1996 and 2013. We excluded patients with a C-reactive protein level ≥5 mg/dL.ResultsIDA was predominant in boys (2.14:1) during infancy and early childhood. The peak IDA incidence was noted among infants aged 9–12 months. Only 7% patients exhibited symptoms of IDA, while 23.6% patients with severe IDA demonstrated classic symptoms/signs of IDA. Low birth weight (LBW) infants with IDA demonstrated low adherence to iron supplementation. In a multivariate analysis, prolonged breastfeeding without iron fortification (odds ratio [OR] 5.70), and a LBW (OR 6.49) were identified as risk factors of severe anemia.ConclusionLBW infants need more attention in order to increase their adherence to iron supplementation. For the early detection of IDA, nutritional status of all infants, and iron batteries of high-risk infants (LBW infants, infants with prolonged breastfeeding, picky eaters, and/or infants with the presence of IDA symptoms) should be evaluated at their health screening visits.

Severe Iron Deficiency Anemia in Infants and Young Children, Requiring Hospital Admission.

Objective. This study evaluated patient characteristics, milk intake, and associated lab findings of children 6 months to 5 years old, admitted to a children’s hospital with severe iron-deficiency anemia (IDA). Methods. A chart review was conducted on patients admitted with microcytic anemia (hemoglobin concentration less than 7 g/dL), accompanied by a low serum ferritin and/or low serum iron level between January 2000 and December 2006. Results. A total of 18 children with severe IDA were evaluated. Many had parents with private insurance and jobs. Almost all children drank >24 ounces of milk daily. Hemoglobin on admission was 3.8 g/dL, and the mean of the patients’ mean corpuscular volume was 52.8 fL. Median iron levels were 4 µg/dL. Conclusions. Severe IDA is still prevalent in children, yet physicians may not perform necessary testing. The devastating long-term effects of severe IDA should prompt clinicians to screen for severe IDA in children regardless of absent risk factors.

Hemin: A Salvage Treatment for a Patient with Severe Auto-Immune Hemolytic Anemia and Reticulocytopenia

Reticulocytopenia concurrent with AIHA is a potentially life threatening condition. It has been described with involvement of certain allo or auto antibodies (Kell; Ge3; U) and parvovirus B19 infection. The hemolysis, uncompensated by reticulocytosis, may require transfusion of multiple RBC units as a supportive measure.We report here the case of a 61-year old woman admitted to a teaching hospital on February 3rd 2014 for the sudden appearance of symptoms and hematological and biochemical markers suggesting hemolytic anemia with reticulocytopenia. The initial serologic workup was negative. No incompatibility has been observed when first RBC units were cross-matched, but hemolysis of transfused red cells was paramount. An intensive immunosuppressive therapy regimen began on day 5.On the 8th day of her hospital stay a significant drop in platelet count was also observed: a bone marrow tap and biopsy were performed and a blood specimen sent to the Hema-Quebec Reference Laboratory. Cytology examination described a hyperplasia of megakaryocytes and erythroid precursors with karyorrhexis. An auto-anti-Ge3 was identified by serology and the Ge3 antigen confirmed by genotyping. At that point in time (day 8) she had received 25 units of Ge3+ red cells to maintain her Hb>4.5gm.On day 10, the hemolytic process began abating without any improvement of reticulocytosis nor Hb level. Six units of rare Ge3 negative blood were found. The survival of the first 5 units after transfusion was better but shorter than expected. With only one unit left we convinced Health Canada to authorize the compassionate use of Normosang (Human Hemin) by referring to an in vitro experiment published in Transfusion, Volume 53, p2134-40 October 2013.The first dose was given on day 26 along with on day 27, the 6th Ge3 negative unit for a Hb level at 4.2gm. No other transfusion had to be administered thereafter. On day 28 the reticulocytes started to increase (along with the platelets and Hb level) and reached above normal levels on day 29, culminating at around 450 on day 35 and remaining elevated as long as hemin therapy was maintained. They dropped abruptly at normal levels 7 days after hemin arrest decided because of important iron accumulation described by MRI in spleen and liver. But cessation of Normosang could put the patient at risk of relapse since the Ab was still detected. In order to minimize this possibility a splenectomy was performed 4 days later and a long-term immunosuppressive drug added. One month after splenectomy the antibody was only weakly detectable in eluate. Thereafter, Hb continued to rise reaching 11.6gm in mid-May and above 13.0 during the summer. Currently she is under a phlebotomy program to reduce her iron stores down to normal values. This would facilitate the use of Normosang again if relapse occurs.Discussion - Previous reports indicated that both auto and allo anti-Ge3 antibodies can cause various degrees of the atypical clinical picture and laboratory abnormalities presented here. Also their capacity to inhibit the differentiation of erythroid precursors and cause reticulocytopenia is probably linked to the position of Ge3 antigen on glycophorin C and D.The monograph of Normosang indicates that exogenous hemin can replace endogenous heme for various biological functions. But its only recognized therapeutic indication is the treatment or prevention of acute attack of hepatic porphyria. With respect to erythropoiesis, studies on cell cultures have shown that human hemin stimulates formation of red blood cell line precursors. The case presented adds information about its in vivo ability of lifting inhibition of erythropoiesis induced by an antibody. The precise pathways involved for those actions remains to be elucidated. But following this case, it seems of interest to study the possibility that this drug could be of value for sparing many transfusions of RBC units used at the present time as a supportive measure not only in certain AIHAs with reticulocytopenia but also during treatment of other hematological conditions (autologous hematopoietic stem cell transplants for instance). Also, its use could be beneficial for prevention or treatment of refractory iron deficiency anemia in infancy due to loss-of-function mutation in the TMPRSS6 gene, as recently described. We are currently discussing with clinicians the modalities of patient recruitment in order to carry out clinical studies on these issues. [Display omitted] DisclosuresOff Label Use: Hemin recognized therapeutic indication is the treatment or prevention of acute attack of hepatic porphyria.

A review of the strategies used to reduce the prevalence of iron deficiency and iron deficiency anaemia in infants aged 6–36 months

AbstractIron deficiency (ID) and iron deficiency anaemia (IDA) are global public health concerns that impact on infants worldwide in low and middle income populations. There is indication that ID affects long‐term neurodevelopment and that these effects could be irreversible. The present study reviews the strategies available to reduce the prevalence of ID and IDA in 6‐12 month‐old infants.A comprehensive review was carried out to identify all relevant studies. Four databases were searched: The Cochrane Library, PubMed/MEDLINE, Leeds Metropolitan Discover and Google Scholar up to 1 November 2014. Randomised controlled trials (RCTs), quasi‐randomised trials and non‐randomised trials investigating the effects of preventative strategies on the prevalence of ID and IDA in infants were included. Primary outcome measures were haemoglobin concentration, anaemia, iron deficiency and iron status. Identified articles were assessed against quality criteria, and a data extraction template was implemented to source all relevant information. A total of 1038 articles were identified by the initial search, with eight trials fitting the criteria for more detailed critical evaluation. Of the final eight articles reviewed, two trials investigated the effect of micronutrient sprinkles, two trials assessed iron‐fortified milk programmes, two trials investigated the effect of iron supplementation, one trial evaluated food‐based strategies, and one trial looked at the efficacy of different strategies to treat ID and IDA. Micronutrient sprinkles proved successful in reducing percentage prevalence of ID by an average of 20% as well as significantly increasing mean haemoglobin levels; additionally, iron‐fortified milk programmes resulted in a significant reduction in percentage prevalence of IDA. Results of the iron supplementation trials were mixed, with one trial showing no difference between intervention and control groups for the incidence of ID and IDA whilst the other trial showed a dose–response effect in the daily supplementation group compared to the control group. Programmes focusing on iron rich food consumption were also unconvincing, with only red meat intake shown to help prevent the decline of iron stores. Results indicate that there are numerous beneficial strategies to reduce ID and IDA in young infants. Larger RCTs of longer duration are needed to determine the effects of timing and dose of these treatments, particularly the use of micronutrient sprinkles which are not commonly used in Europe but show promising results.

Iron Requirements for Infants with Cow Milk Protein Allergy

H istorically, cow milk has been used as a major source of protein and balanced nutrition for infants and children in resource-rich and resource-constrained countries. It is a rich source of energy, protein, and calcium. It is also an important source of fat; many of its fatty acids are readily metabolized to essential omega-3 fatty acids. Regular consumption of milk during childhood has been shown to enhance bone density later in life. However, reliance upon whole pasteurized cow milk as the sole or major source of nutrition for infants during the first year of life can increase the risk for iron deficiency and, in extreme cases, iron-deficient anemia (IDA) for a number of reasons. In 1972, Woodruff et al showed that 7 of 12 infants (ages 7-17 months) with IDA who ingested between 720 and 1920 mL whole milk daily had higher albumin turnover rates than a group of 5 normal infants. Parenteral iron had no effect on albumin turnover, but replacing whole milk with reconstituted evaporated milk or soy formula decreased the high albumin turnover rates to normal levels, suggesting that large amounts of cow milk protein could result in iron and protein loss in the gastrointestinal tract. Cow milk contains low levels of ascorbic acid, a factor that increases iron absorption, and certain proteins that negatively impact iron absorption. Cow milk contains about 4 times more calcium than human milk, and calcium negatively impacts iron absorption. Furthermore, cow milk has a higher protein concentration than human milk, and ingestion of large amounts can lead to metabolic and fluid imbalances, particularly in children with febrile illnesses. Thus, several entities have recommended against whole cow milk ingestion until 9-12 months and then, only when given in moderate amounts in conjunction with appropriate complementary foods.

High prevalence of iron deficiency anemia in infants attending a well-baby clinic in northwestern Saudi Arabia.

Objectives:To determine the prevalence of iron deficiency anemia (IDA) in infants aged 6-24 months attending the well-baby clinic in primary health care centers (PHCCs).Methods:This cross-sectional epidemiological study was conducted in the Northwestern region of Saudi Arabia from April 2013 to January 2014 in 5 randomly selected PHCCs. The sample size comprised 500 infants, with 100 infants screened from each PHC. Blood samples were obtained for estimation of hemoglobin and serum ferritin levels.Results:Out of 500 infants, 246 (49%) cases had IDA with a mean age of 15.4 ± 6.5 months, with 130 (53%) males, and 116 (47%) females (p=0367). Out of 274 Saudi infants, 126 (51%) cases were diagnosed as IDA.Conclusion:Iron deficiency anemia is very common in Saudi infants aged 6-24 months. A national program directed for primary prevention and early discovery of IDA in Saudi infants is recommended at PHCCs system. Iron supplementation is to be given at early infancy with universal screening of hemoglobin and ferritin estimation to all infants at 12 months of age.

Contemporary views concerning the necessity, age of indication and duration of iron administration to prevent deficiency and to treat iron-deficiency anemia in infants

Nowadays deficiency of micronutrients leading to the development of serious disorders in the human organism remains an important problem to be solved in the world. Anemia is considered to be one of such problems which is an indicator of the quality of diet and the sate of human heath. About 70-80% cases of diagnosed anemia are connected with iron deficiency. Iron-deficiency anemia may occur in any place, season of the year and age. Although pregnant women and newborns, especially preterm ones are the most susceptible to the development of anemia. The article specifies explanations concerning the importance of iron intake by the fetus in the III trimester of pregnancy and the importance of iron effect upon an adequate development of fetus and babies in the first 2 years of life. Perinatal risk factors are indicated which cause 20% of development of iron-deficiency conditions and pathophysiological reasons of a negative influence of these conditions on the CNS. Using the findings of the unified protocol project “Enteral Feeding of Preterm Infants” and results of the studies investigating the influence of iron preparations upon the development of infants, CNS state, hematological status, the age to indicate iron preparations, daily doses and duration of their administration are discussed.Attention is focused on the advantages to administer oral forms of ferric iron (drops, syrup “Maltofer”) for infants. The method to calculate a daily amount of iron preparation is demonstrated individually for every child, being aware of a therapeutic dose of an elementary iron in 1 ml of preparation. The analysis of the studies existed from 1960-2010 enables to conclude that administration of iron preparations in newborns and infants of various gestational age improve the indices of iron hematological status and reduce the frequency of development of iron deficiency and iron-deficiency anemia. Till now there is a necessity to conduct randomized controlled trials with the aim to get essential evidence concerning the consequences of iron preparation effect upon the development of the nervous system or occurrence of unfavourable effects in preterm newborns, especially in infants with very low body weight at birth.The optimum dose, the term of the beginning and duration of the administration of ferric iron use indicated for intravenous injection are defined: gestational age of a baby, hematological indices (the level of hemoglobin, serum ferritin, mean corpuscular volume), the aim achieved (prevention of iron deficiency or treatment of iron-deficiency anemia).

Прогнозування ризику формування анемії у дітей грудного віку

Прогнозування ризику формування анемії у дітей грудного віку

Syrup versus Drops of Iron III Hydroxide Polymaltose in the Treatment of Iron Deficiency Anemia of Infancy

Background: Iron deficiency anemia in infants is the most common micronutrient deficiency worldwide. The main cause is low iron intake in the presence of accelerated physiologic growth rate. Objective: The current study aimed at prospectively comparing the efficacy of iron III hydroxide polymaltose syrup (IPS) versus iron III hydroxide polymaltose drops (IPD) in treating iron deficiency among infants attending the hematology outpatient clinic. Our hypothesis was that IPS would be less effective possibly related to the difficulty of giving the medication. Methods: Participants diagnosed with iron deficiency anemia between 11-24 months were randomly assigned to receive either IPS or IPD for 3 months. The main outcome parameter was hemoglobin blood level, while the secondary outcome parameters were: 1) iron; 2) ferritin; 3) transferrin (i.e. total iron binding capacity); 4) mean corpuscular volume; and 5) red blood cell distribution width. Results: Out of the 104 recruited infants, 55 (52%) completed the study: 29 in the IPS group and26 inthe IPD group. There was no significant difference in the main outcome parameter at either 1 or 3 months of treatment: mean hemoglobin was 10.5 versus 10.7 g/dL within a 1 month treatment, P = 0.4; mean hemoglobin was 11.0 versus 11.1 g/dL within a 3 months of treatment, P = 0.59. Likewise, no significant differences were found with respect to the occurrence of side effects. Conclusion: Oral IPD and IPS are equally effective in treating iron deficiency anemia in infants aged 11 - 24 months.

PROPHYLAXIS OF IRON DEFICIENCY ANEMIA IN INFANTS AND TODLLERS: A MULTIDISCIPLINARY APPROACH (LITERATURE REVIEW)

Iron deficiency is one of the most common micronutrient deficiency in infancy and childhood. The main long lasting effect of iron deficiency anemia in infancy is poor neurocognitive development. Despite early treatment with iron supplements, lower cognitive performance remains even after reaching adulthood. Therefore iron deficiency anemia should be regarded not only as a haematological problem, but as a result of imperfections in the social system. Preventive strategies occupie most important place ensuring the normal development of the child. The main recommendations regarding iron deficiency prophylaxis are as follows: delayed umbilical cord clamping, exclusive breastfeeding until 6 months of age, iron fortified formula for non-breastfed infants, iron supplements for infants with risk factors, complementary feeding starting at 6 months of age, avoiding cow‘s milk until 12 months of age and restriction of intake to less than 500 ml per day for toddlers. The article analyzes iron deficiency impact on the development of central nervous system, the characteristics of iron homeostasis in children, iron deficiency anemia causes and pathophysiological mechanisms. Based on the latest scientific literature iron deficiency prevention strategies and practical recommendations are provided.