Risk factors for anemia in infants assisted by public health services: the importance of feeding practices and iron supplementation

Silva, Danielle G.; Priore, Sílvia Eloíza; Franceschini, Sylvia do Carmo Castro

doi:10.2223/jped.1603

Cited by 32 publications

(42 citation statements)

References 13 publications

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“…15 Associated with this are short duration of total and exclusive breastfeeding, the introduction of cow's milk to the diet, causing micro-hemorrhages in the gastrointestinal tract, allied to the introduction of a monotonous diet that is poor in iron and also a greater predisposition to infectious and parasitic diseases, are risk factors which could explain the increased vulnerability of this age group to iron deficiency and anemia. 4,16,17 The inverse correlation between Hb levels with FEP concentrations, observed in the study population, is a fact also described by Serdar et al 18 This association is, in principle, predictable, since the increase in unconjugated …”

Section: Discussionsupporting

confidence: 76%

Avaliação do estado nutricional de ferro e anemia em crianças menores de 5 anos de creches públicas

Vieira¹,

Diniz²,

Cabral³

et al. 2007

J. Pediatr. (Rio J.)

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Objective: To assess nutritional iron status and anemia prevalence in children less than 5 years old at public daycare centers in the city of Recife, PE, Brazil. Methods:A cross-sectional study, with a systematic random sampling of 162 children aged 6 to 59 months.Nutritional iron status was assessed in terms of body iron reserves (serum ferritin), transferrinemia (serum iron, total iron binding capacity, and transferrin saturation %), erythropoiesis (free erythrocyte protoporphyrin) and hemoglobin production (hemoglobin). Results:The prevalence of anemia (hemoglobin < 11.0 g/dL) was 55.6% (95%CI 47.3-63.5), evidence was found of depleted iron stocks (serum ferritin < 12.0 ng/mL) in 30.8% (95%CI 22.9-39.3), low transferrinemia levels (transferrin saturation % < 16) in 60.1% (95%CI 51.7-68.0) and deficient erythropoiesis (free erythrocyte protoporphyrin > 40 µmol/mol heme) in 69.6% (95%CI 61.0-77.1) of the children. Iron parameters were not correlated with sex (p > 0.05). However, children < 24 months exhibited lower hemoglobin concentrations (p < 0.00) and higher levels of free erythrocyte protoporphyrin (p < 0.000) and total iron binding capacity (p < 0.001) when compared with children > 24 months. The significant correlation observed between reserves, transferrinemia and erythropoiesis is a finding that is compatible with the expected lifecycle of iron in the body. Conclusions:Iron deficiency and anemia appear to be an important public health problem among children less than 5 years old at public daycare centers in Recife. Therefore, effective actions aimed at the prevention and control of this deficiency are strongly recommended in this ecological context. (Rio J). 2007;83(4):370-376 Anemia, iron deficiency, hemoglobin, serum ferritin, serum iron, total iron binding capacity, transferrin saturation, free erythrocyte protoporphyrin, preschool children. J Pediatr

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Section: Discussionsupporting

confidence: 76%

Avaliação do estado nutricional de ferro e anemia em crianças menores de 5 anos de creches públicas

Vieira¹,

Diniz²,

Cabral³

et al. 2007

J. Pediatr. (Rio J.)

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“…We also observe in the three scenarios of the multicenter study that the duration of EB in children younger than four and six months diminished as they got older, as observed in national studies in the state of São Paulo and in Ribeirão Preto (21)(22) . Similar to this study, other studies did not find significant association between anemia, EB and B (9,20) .…”

Section: Discussionsupporting

confidence: 89%

“…In places where the prevalence of anemia is high and the majority of foods consumed by infants are not fortified with iron, the recommendation is that iron supplements be a priority in the prevention of anemia (19)(20) .…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Anemia in Children Three to 12 Months Old in a Health Service in Ribeirão Preto, SP, Brazil

Reis

Nakano

Silva

et al. 2010

Rev. Latino-Am. Enfermagem

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Iron deficiency anemia is the most common nutritional deficiency among children. This crosssectional, descriptive and quantitative study is part of a multicenter project, which verified the prevalence of anemia in children aged three to 12 months, treated by a health service unit in Ribeirão Preto, SP, Brazil. Interviews with mothers and determining hemoglobin dosage were carried out with 121 children who participated in the study. Two international criteria were adopted as parameters of anemia according to the children's age. Descriptive statistics, measures of central tendency and associations were used for data analysis. The prevalence of anemia among 69 children aged three to 5 months was 20.2% and 48.0% among 52 children aged six to 12 months. The total prevalence of anemia was 32.2%.There was significant association between anemia and children's age, and anemia and the consumption of liquid cow's milk. Para a análise dos dados foram utilizadas estatística descritiva, medidas de tendência central e associações. A prevalência de anemia nas 69 crianças de 3 a 5 meses foi de 20,2% e naquelas 52, de 6 a 12 meses, foi de 48%. A prevalência total de anemia foi de 32,2%. Encontrou-se associação significativa entre anemia e idade da criança e anemia e uso de leite de vaca fluido.Descritores: Anemia; Prevalência; Saúde da Criança. La prevalencia de anemia en niños de 3 a 12 meses de vida en un servicio de salud de Ribeirão Preto, SP, BrasilEntre las carencias nutricionales de niños, la anemia ferropénica es la más frecuente.Estudio transversal, descriptivo, cuantitativo es un extracto de un proyecto multicéntrico que verificó la prevalencia de anemia en niños de 3 a 12 meses de edad, en un servicio de salud de Ribeirão Preto, SP, Brasil. Fueron realizadas entrevistas y dosificación de hemoglobina en los 121 niños. Dos criterios internacionales fueron adoptados como parámetro de anemia, de acuerdo con la edad del niño. Estadística descriptiva, medidas de tendencia central y testes de asociación fueron usados para el análisis de datos. La prevalencia de anemia en los 69 niños de 3 a 5 meses fue del 20,2%, y en los 52 niños de 6 a 12 meses fue del 48,0%. En total, la prevalencia de anemia fue del 32,2%. Encontró asociación significativa entre anemia y edad del niño y anemia y el consumo de leche de vaca liquido.

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“…19 Data in the literature on the association between breastfeeding and anemia are conflicting. Some authors have not detected any association, 20 as observed in this study, while others identify breastfeeding, especially exclusive, as an important factor of protection in infants less than 6 months old. 21,22 Another study of infants under 6 months found a risk of anemia around two and three times greater among children Another study, conducted with children on exclusive breastfeeding in the same age group, found that they had higher hemoglobin levels when compared with children on different feeding regimes.…”

Section: Hemoglobin (G/dl) N (%) Concentration Pcontrasting

confidence: 77%

Influência do tipo de aleitamento materno e da presença de anemia na mãe na concentração de hemoglobina aos 6 meses de idade

Teixeira¹,

Lira

Coutinho³

et al. 2010

J. Pediatr. (Rio J.)

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Objective: To verify the influence of breastfeeding type and of maternal anemia on hemoglobin concentration in 6-month-old infants.Methods: This was a cross-sectional study nested in a community-based, randomized and controlled intervention study that aimed to prolong the duration of exclusive breastfeeding during the first 6 months of life. This study was conducted in four towns in the Brazilian state of Pernambuco and newborn infants were recruited from March to August of 2001. The hemoglobin concentrations of 330 mothers and infants were assayed and type of breastfeeding was assessed 6 months after delivery. Multivariate linear regression analysis was used to identify factors that independently contributed to the infants' hemoglobin concentration. Results:The type of feeding had no influence on the hemoglobin concentration in the sample as a whole, however, there was a significant difference when the "exclusive + predominant breastfeeding" subset of infants was analyzed, with the children of anemic mothers exhibiting a reduction of 0.7g/dL in median hemoglobin. Mothers' hemoglobin level, type of flooring at home, type of delivery, and birthweight all significantly contributed to the variation in the infants' hemoglobin concentration. Conclusions:In contrast with type of breastfeeding, maternal anemia did have an influence on the hemoglobin levels of 6-month-old infants, even when only children on "exclusive + predominant breastfeeding" were analyzed. These findings highlight the need to prevent maternal anemia before conception, during pregnancy and throughout lactation. No conflicts of interest declared concerning the publication of this article.Suggested citation: Teixeira ML, Lira PI, Coutinho SB, Eickmann SH, Lima MC. Influence of breastfeeding type and maternal anemia on hemoglobin concentration in 6-month-old infants. J Pediatr (Rio J). 2010;86(1):65-72.

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Risk factors for anemia in infants assisted by public health services: the importance of feeding practices and iron supplementation

Cited by 32 publications

References 13 publications

Avaliação do estado nutricional de ferro e anemia em crianças menores de 5 anos de creches públicas

Avaliação do estado nutricional de ferro e anemia em crianças menores de 5 anos de creches públicas

Prevalence of Anemia in Children Three to 12 Months Old in a Health Service in Ribeirão Preto, SP, Brazil

Influência do tipo de aleitamento materno e da presença de anemia na mãe na concentração de hemoglobina aos 6 meses de idade

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