Researchers from the Inha University College of Medicine in Korea said while the breastfeeding rate increased from 10.2% in 2000, to 45.6% in 2012, iron supplementation did not.
Other factors include not having enough iron in homemade weaning foods, the increased number of low-birth weight infants, and low adherence to iron supplementation in LBW infants.
“The highest prevalence of iron deficiency anaemia (IDA) was noted in the infants aged 9–12 months. This is due to an inadequate iron supply despite a high iron requirement at this age. The estimated requirement for absorbed iron during the first year of infancy ranges between 0.55 mg/day and 0.75 mg/day,” they wrote in the Blood Research Journal.
“After six months of age, obtaining enough iron through breastfeeding alone becomes difficult.
“The mean iron level in breast milk is approximately 0.4 mg/L, and although half of the iron contained in breast milk is absorbed due to its high bioavailability, only 0.2 mg/day of total iron can be absorbed by exclusive breastfeeding.”
The low iron-containing rice soup usually fed to the Korean infants during the early stages of weaning, was also a factor.
To get more details as to why IDA remained prevalent at an early age, and to reduce the adverse impact of deficiency, the study assessed the clinical characteristics of infants and young children with IDA who visited the Inha University Hospital in the last 17 years.
“Of the 1,782 IDA patients who visited the pediatric department of the Inha University Hospital Pediatric Department between January 1997 and December 2013, 1,330 IDA patients aged 6–23 months were included in the study.”
The results revealed that IDA was observed predominantly in boys than in girls [906 boys, and 424 girls; M:F=2.14:1].
“The peak IDA incidence was observed among infants aged 9–12 months; the incidence then decreased until the age of 18 months and exhibited a plateau thereafter,” the study noted.
“The proportions of mild, moderate, and severe anemia were 36.9% (N=491), 59.3% (N=789), and 3.8% (N=50), respectively.”
Lastly, the study noted that a large proportion of children with IDA were not followed-up because many clinicians did not consider it to be a real health issue.
“Clinicians should recommend appropriate iron supplementation to children, especially to infants at a higher risk of developing iron deficiency,” said researchers.
“Notably, the marginally low birth weight infants need special attention to ensure adherence to iron supplementation.”
“In addition, a prospective and well-organised risk assessment study in infants and young children is necessary to improve iron nutritional status and to control IDA,” they concluded.
Source: Blood Research Journal
“Iron deficiency anemia in infants and toddlers”
Authors: Eun Young Joo, Keun Young Kim et al.