Iron Supplementation for Infants

PEDIATRICS ◽  
1976 ◽  
Vol 58 (5) ◽  
pp. 765-768 ◽  
Author(s):  

Iron deficiency remains the most common cause of anemia in infants and children despite the increasing availability of iron-fortified foods during the past three decades. The Committee on Nutrition published a review in 1969 of the iron requirements for infants, along with recommendations for several ways of meeting these.1 In 1971, the Committee issued another statement recommending the use of iron-fortified formulas until at least 12 months of age.2 Developments since that time indicate that there are various means for fulfilling iron needs and that a broader set of recommendations is warranted. The risk of iron deficiency is greatest when neonatal iron stores have been depleted, after about two months in small, preterm infants and after four to six months in term infants.3 Previous Committee statements have made no distinction between socioeconomic groups, but recent surveys among infants and children4-6 indicate that the highest incidence of anemia, which is a late manifestation of iron deficiency, is found in lower socioeconomic populations. Possibly this reflects poor compliance with recommended feeding practices and overdependence on fresh cow's milk in the diet. Most children in middle-income families have little or no anemia.5,6 Infants of low birthweight are more likely to develop iron deficiency regardless of economic status.1 Thus, recommendations for iron supplementation in infancy must be flexible and should emphasize the needs of low-birthweight infants and of normal-birthweight infants in lower socioeconomic populations. Although there is no evidence that iron deficiency without anemia has a permanent effect on human infant growth and development, animal studies indicate that iron deficiency anemia early in postnatal development results in biochemical abnormalities of some organs (e.g., the brain) that persist long after anemia has been corrected.7

Blood ◽  
2013 ◽  
Vol 121 (14) ◽  
pp. 2607-2617 ◽  
Author(s):  
Sant-Rayn Pasricha ◽  
Hal Drakesmith ◽  
James Black ◽  
David Hipgrave ◽  
Beverley-Ann Biggs

Abstract Despite worldwide economic and scientific development, more than a quarter of the world’s population remains anemic, and about half of this burden is a result of iron deficiency anemia (IDA). IDA is most prevalent among preschool children and women. Among women, iron supplementation improves physical and cognitive performance, work productivity, and well-being, and iron during pregnancy improves maternal, neonatal, infant, and even long-term child outcomes. Among children, iron may improve cognitive, psychomotor, and physical development, but the evidence for this is more limited. Strategies to control IDA include daily and intermittent iron supplementation, home fortification with micronutrient powders, fortification of staple foods and condiments, and activities to improve food security and dietary diversity. The safety of routine iron supplementation in settings where infectious diseases, particularly malaria, are endemic remains uncertain. The World Health Organization is revising global guidelines for controlling IDA. Implementation of anemia control programs in developing countries requires careful baseline epidemiologic evaluation, selection of appropriate interventions that suit the population, and ongoing monitoring to ensure safety and effectiveness. This review provides an overview and an approach for the implementation of public health interventions for controlling IDA in low- and middle-income countries, with an emphasis on current evidence-based recommendations.


Nutrients ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 1524
Author(s):  
Carolina Thalya da Silva Paulino ◽  
Marislei Nishijima ◽  
Flavia Mori Sarti

Anemia remains a condition with high prevalence in populations worldwide, and the prevalence of anemia among children under five years old in Brazil is approximately 40%, being higher in communities marked by social inequities. Diverse government programs during recent decades targeted iron-deficiency anemia, considering its impacts throughout the lifetime. The objective of this study was to investigate the effects of two government iron supplementation programs on health outcomes related to iron-deficiency anemia among children up to 4 years old in Brazilian municipalities. A longitudinal panel encompassing data from 5570 municipalities from 1998 to 2019 was investigated using a difference-in-differences framework with multiple interventions and distinct times of adhesion, and fixed-effects models were estimated to control for invariant municipal characteristics throughout the period in order to ensure comparability. The results indicate significant effects of the federal programs in reducing hospitalizations and lengths of stay due to iron-deficiency anemia, especially in non-poor municipalities. There was complementarity in the effects of the programs; however, neither of the programs influenced mortality rates. Thus, it is important to consider possible improvements in the operationalization of the programs, in order to achieve better results in the reduction of severe iron-deficiency anemia among children up to 4 years old.


2021 ◽  
Vol 4 (Supplement_1) ◽  
pp. 289-291
Author(s):  
L Russell ◽  
R Mangat ◽  
J Plant ◽  
S Hansen ◽  
D Armstrong ◽  
...  

Abstract Background Iron deficiency (ID) is common in patients receiving parenteral nutrition (PN), likely due to a lack of iron in the PN formula. There is no clear consensus on how often serum iron should be tested or iron supplementation should be given, at which dose or route, in patients on long-term PN. Within the Hamilton Health Sciences (HHS) home PN (HPN) program, the prevalence of ID or iron deficiency anemia (IDA) is unknown. This knowledge will contribute to better iron prescribing practices with ultimate benefit on patient’s health. Aims To assess the prevalence of ID and IDA in patients enrolled in the HHS HPN Program. The secondary aim was to assess supplementation practices for patients enrolled in the HPN program according to gastrointestinal(GI) diagnosis and duration on PN. Methods We conducted a retrospective study including consecutive adult patients enrolled in the HHS-HPN program from January 2015 to November 2020. We collected data on demographics (age, sex, and GI diagnosis), iron supplementation (dose, duration, and route), and information related to iron-deficiency (hemoglobin, serum iron, ferritin, TIBC, and folate) at pre-set intervals (enrollment, 3, 6, 12, 18, 24, 30, 36, 48, 60 months) and last measured. ID was defined as ferritin ≤45μg/L or serum iron ≤9μmol/L. IDA was defined as hemoglobin <130g/L in men or <120g/L in women in the context of ID. Data were expressed as median (IQR) for continuous variables and n/N(%) for categorical variables. Chi2 was performed to assess differences between groups and logistic regression to assess predictors of ID and IDA. The analysis was conducted using SPSS software(v26). Results The analysis included 125 HPN patients (50 males, median age of 55 (40–65) years). Patients received PN for a median of 195 (83–521) days. The most common diagnoses were malignancy (36.8%) and inflammatory bowel disease (23.2%); the most common indications for HPN was short bowel (29.6%) and bowel obstruction (27.2%). Iron profiles were measured in 77% of patients. At enrollment, 42.2% of patients had ID and 38.9% had IDA. Only 13% of patients with ID and 22.8% with IDA had iron supplementation (Figure 1). A total of 38 patients received iron either oral or IV (oral=44.7% vs IV=55.3%; p=0.66). There was no correlation between low levels of serum iron or ferritin with iron supplementation (p=0.23, 0.45 respectively). Age, sex, diagnosis, or reason for PN did not correlate with ID or IDA at any time point. Conclusions Iron-deficiency and IDA are common in patients enrolled in the HHS HPN program independently of age, sex, diagnosis and reason for PN. Prospective studies are needed to implement the most effective way to ensure proper monitoring and treatment of iron deficiency in this population. Funding Agencies None


Author(s):  
OJS Admin

Depression is a public health disorder, ranking third after respiratory and cardiac diseases. There were many evidences that iron deficiency anemia (IDA) is one of the foremost causes regarding nutritional pointof view for depression. We reviewed these evidences that IDAlinking to depression. We identified seventeen studies in four databases including randomized-controlled trials (RCTs) and observational studies assessing the impact of IDAand iron supplementation on the risk of depression. We extracted data on the basis of sample size, geographical region, measures of depression, hemoglobin, iron levels and intake of iron supplementation and critically appraised the results from the studies. Eleven out of sixty one studies were experimental, which indicated that dietary supplementation particularly iron supplementation had an association (r − 0.19 to −0.43 and ORs 1.70–4.64) with severity of depression. Evidences showed that women of reproductive age were more vulnerable to iron deficiency anemia than other population. Low ferritin and low hemoglobin level were associated with severity of depression. Iron is an essential nutrient for all living creatures, as a cofactor of various enzymes and plays significant role in environmental stimulant for the articulation of numerous virulence factors. Many clinical problems are caused by iron deficiency. Therefore, this review intended to highlight the important role of iron supplementation in reducing the severity of depression.


2021 ◽  
Vol 5 (1-1) ◽  
pp. 25-32
Author(s):  
Rini Sekartini

The fetal brain anatomy development starts during the last trimester of pregnancy and continue in early months of life. This critical process makes it vulnerable to insufficient nutrition, while brain growth continues into adulthood, micronutrient status can affect functioning beyond childhood. Iron is an important nutrient for the production and growth of cells in the immune and neural systems. Iron deficiency (ID) is the most common nutrient deficiency in the world, affecting about half of all pregnant women and their offspring. Iron deficiency anemia has long been believed to have an effect on the central nervous system. Iron deficiency in late trimester and in newborn leads to abnormal cognitive function and emotional control that may continue in adulthood. In summary, despite some evidence that iron supplementation enhances cognitive performance. Evidence of the role of iron in brain development and the effect of iron deficiency or iron supplementation on early development is uncertain.


2014 ◽  
Vol 162 (1-3) ◽  
pp. 242-251 ◽  
Author(s):  
Juan Ma ◽  
Xiaosha Wen ◽  
Fengfeng Mo ◽  
Xiaoli Wang ◽  
Zhilei Shen ◽  
...  

2000 ◽  
pp. 217-223 ◽  
Author(s):  
M Zimmermann ◽  
P Adou ◽  
T Torresani ◽  
C Zeder ◽  
R Hurrell

OBJECTIVE: In developing countries, many children are at high risk for both goiter and iron-deficiency anemia. Because iron deficiency may impair thyroid metabolism, the aim of this study was to determine if iron supplementation improves the response to oral iodine in goitrous, iron-deficient anemic children. DESIGN: A trial of oral iodized oil followed by oral iron supplementation in an area of endemic goiter in the western Ivory Coast. METHODS: Goitrous, iodine-deficient children (aged 6-12 years; n=109) were divided into two groups: Group 1 consisted of goitrous children who were not anemic; Group 2 consisted of goitrous children who were iron-deficient anemic. Both groups were given 200mg oral iodine as iodized oil. Thyroid gland volume using ultrasound, urinary iodine concentration (UI), serum thyroxine (T(4)) and whole blood TSH were measured at baseline, and at 1, 5, 10, 15 and 30 weeks post intervention. Beginning at 30 weeks, the anemic group was given 60mg oral iron as ferrous sulfate four times/week for 12 weeks. At 50 and 65 weeks after oral iodine (8 and 23 weeks after completing iron supplementation), UI, TSH, T(4) and thyroid volume were remeasured. RESULTS: The prevalence of goiter at 30 weeks after oral iodine in Groups 1 and 2 was 12% and 64% respectively. Mean percent change in thyroid volume compared with baseline at 30 weeks in Groups 1 and 2 was -45.1% and -21.8% respectively (P<0.001 between groups). After iron supplementation in Group 2, there was a further decrease in mean thyroid volume from baseline in the anemic children (-34.8% and -38.4% at 50 and 65 weeks) and goiter prevalence fell to 31% and 20% at 50 and 65 weeks. CONCLUSION: Iron supplementation may improve the efficacy of oral iodized oil in goitrous children with iron-deficiency anemia.


2014 ◽  
Vol 60 (1) ◽  
pp. 18-22 ◽  
Author(s):  
Rosa F.S.V. Marques ◽  
José A.A.C. Taddei ◽  
Fábio A. Lopez ◽  
Josefina A.P. Braga

Objective The objective was to determine the prevalence of iron deficiency and iron deficiency anemia among exclusively breastfed infants from one to six months of life and to identify associated risk factors. Methods This is a cohort study of the hemoglobin and serum ferritin levels of 102 healthy full-term infants, weighing more than 2500 grams (5.5 pounds) at birth, evaluated for growth development and supported to promote exclusive breastfeeding. Hemoglobin and ferritin levels were measured in the first, fourth, and sixth months of life. The hemoglobin and ferritin levels of the mothers were also measured in the first month postpartum. Results At four months, 5.7% presented iron deficiency and 3.4% had iron deficiency anemia. At six months, the percentage of children with iron deficiency increased more than four times, reaching 26.1%, while iron deficiency anemia was present in 23.9% of the infants studied. Iron deficiency at six months of age was significantly correlated to growth velocity. Conclusion According to the results of this study, exclusive breastfeeding protects infants from iron deficiency and iron deficiency anemia for the first four months of life. After this age, in accordance with the literature, the findings of this study demonstrated an increase in anemia and iron deficiency rates, adding to evidence that supports the monitoring of iron levels in exclusively breastfed children presenting higher weight gains beginning at four months of age.


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