Diagnosis and Prevention of Iron Deficiency and Iron-Deficiency Anemia in Infants and Young Children (0–3 Years of Age)

Abstract

This clinical report covers diagnosis and prevention of iron deficiency and iron-deficiency anemia in infants (both breastfed and formula fed) and toddlers from birth through 3 years of age. Results of recent basic research support the concerns that iron-deficiency anemia and iron deficiency without anemia during infancy and childhood can have longlasting detrimental effects on neurodevelopment. Therefore, pediatricians and other health care providers should strive to eliminate iron deficiency and iron-deficiency anemia. Appropriate iron intakes for infants and toddlers as well as methods for screening for iron deficiency and iron-deficiency anemia are presented. Pediatrics 2010;126: 1040-1050 INTRODUCTIONIron deficiency (ID) and iron-deficiency anemia (IDA) continue to be of worldwide concern. Among children in the developing world, iron is the most common single-nutrient deficiency. 1 In industrialized nations, despite a demonstrable decline in prevalence, 2 IDA remains a common cause of anemia in young children. However, even more important than anemia itself is the indication that the more common ID without anemia may also adversely affect long-term neurodevelopment and behavior and that some of these effects may be irreversible. 3,4 Because of the implications for pediatric health care providers and their patients, this report reviews and summarizes this information.This clinical report is a revision and extension of a previous policy statement published in 1999, 5 which addressed iron fortification of formulas. This report covers diagnosis and prevention of ID and IDA in infants (both breastfed and formula fed) and toddlers aged 1 through 3 years.

Severe iron-deficiency anaemia and feeding practices in young children

“…For the same reason, we did not design or analyse data from these two samples as a case-control study and were unable to examine the role of potential uncontrolled confounders. Healthy full-term infants have adequate Fe stores until 4 to 6 months of age, and IDA peaks between 1 and 3 years of age (4) . Therefore, identifying optimal feeding practices beyond the first 6 months of life is critical to preventing IDA.…”

Preterm Infant Attendance at Health Supervision Visits

“…These visits may have greater importance for premature infants who are at increased risk for medical and neurodevelopmental sequelae. [2][3][4][5][6][7][8][9][10][11][12][13][14][15] There are few studies assessing adherence with health supervision visits in the general pediatric population and fewer in high-risk populations. According to Medical Expenditure Survey data, infants were found to be 83% adherent with the age-specific number of visits recommended by the AAP.…”

Health and growth status of immigrant and refugee children in Toronto, Ontario: A retrospective chart review

“…Therefore, the Canadian Paediatric Society, the American Academy of Pediatrics and The Canadian Collaboration for Immigration and Refugee Health all recommend screening for anemia in infancy and early childhood, particularly for 'high-risk' children. (10,16,24) We also found a high prevalence of elevated blood lead levels (BLL) in the clinic population. Studies from the United States (US) involving newly-arrived refugee children, similarly demonstrate higher rates of elevated BLL within this population (9,25).…”