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A longitudinal study of iron status in children at 12, 24 and 36 months

Published online by Cambridge University Press:  01 June 1998

VE Freeman ,
J Mulder ,
MA van't Hof ,
HMV Hoey  and
MJ Gibney
VE Freeman*
Affiliation:
Division of Nutritional Sciences, Department of Clinical Medicine, Trinity Centre for Health Sciences, St James's Hospital, Dublin 8, Ireland
J Mulder
Affiliation:
Department of Medical Statistics, Catholic University of Nijmegen, Nijmegen, The Netherlands
MA van't Hof
Affiliation:
Department of Medical Statistics, Catholic University of Nijmegen, Nijmegen, The Netherlands
HMV Hoey
Affiliation:
Department of Paediatrics, the University of Dublin, Trinity College, Dublin 2, Ireland
MJ Gibney
Affiliation:
Division of Nutritional Sciences, Department of Clinical Medicine, Trinity Centre for Health Sciences, St James's Hospital, Dublin 8, Ireland
*
*Corresponding author:[email protected]
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Abstract

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Objectives:

To assess iron status in a sample of clinically well, Caucasian children and explore the complex factors which contribute to iron deficiency during infancy.

Design:

Infants recruited at birth and followed longitudinally at 1, 2, 3, 4, 5, 6, 9, 12, 24 and 36 months; feeding practices and socioeconomic data recorded. Iron status assessed using venous blood at 12, 24 and 36 months.

Setting:

Baseline data recorded in the maternity unit. Follow-up visits took place in the infants' homes and blood sampling in a paediatric hospital.

Subjects:

Subjects comprised a mixed socioeconomic group of healthy children (n=121). Blood samples taken from 85, 72 and 67% at 12, 24 and 36 months, respectively.

Results:

Prevalence of anaemia (Hb < 110 gl−1) in the longitudinal sample (n=76) increased from 2.6% at age 12 months to 9.2% at 24 months, and at age 36 months (n=70) was 8%. The most significant finding was that at age 12 months, cows' milk consumption was negatively associated with iron status. Other variables also had an influence. At both 24 and 36 months the most significant predictor of iron status was earlier iron status.

Conclusions:

Infants born to anaemic mothers or mothers who smoke and infants who consume cows' milk during infancy are at increased risk of developing anaemia. Breast milk is the ideal, but for the infant who is not breast fed an iron fortified formula should be used. Advice to mothers should focus on the importance of introducing nutrient dense complementary foods, such as meat, which contains readily absorbable iron.

Keywords

AnaemiaInfant feedingcows' milk
Type
Research Article
Information
Public Health Nutrition , Volume 1 , Issue 2 , June 1998 , pp. 93 - 100
Copyright
Copyright © CABI Publishing 1998

References

1Oski, FA. Iron deficiency in infancy and childhood. N. Engl. J. Med. 1993; 329: 190–3.Google ScholarPubMed
2Gregory, JR, Collins, DL, Davies, PSW, Hughes, JM, Clarke, PC. National Diet and Nutrition Survey: children aged 1½–4½ years. London: HMSO, 1995.Google Scholar
3Emond, AM, Hawkins, N, Pennock, C, Golding, J and the ALSPAC Children in Focus Team. Haemoglobin and ferritin concentrations in infants at 8 months of age. Arch. Dis. Child. 1996; 74: 36–9.CrossRefGoogle ScholarPubMed
4Walter, T, De Andraca, I, Chadud, P, Perales, CG. Iron deficiency anaemia: adverse effects on infant psychomotor development. Pediatrics 1989; 84: 7–17.CrossRefGoogle ScholarPubMed
5Lozoff, B, Jimenez, E, Wolf, AW. Long-term developmental outcome of infants with iron deficiency. N. Engl. J. Med. 1991; 352: 687–94.CrossRefGoogle Scholar
6Walter, T. Impact of iron deficiency on cognition in infancy and childhood. Eur. J. Clin. Nutr. 1993; 47 307–16.Google ScholarPubMed
7Erhardt, P. Iron deficiency in young Bradford children from different ethnic groups. Br. Med. J. 1986; 292: 90–3.CrossRefGoogle Scholar
8Kim, SK, Cheong, WS, Jun, YH, Choi, JW, Son, BK. Red blood cell indices and iron status according to feeding practices in infants and young children. Acta Paediatr. 1996; 85: 139–44.CrossRefGoogle ScholarPubMed
9James, J, Lawson, P, Male, P, Oakhill, A. Preventing iron deficiency in pre-school children by implementing an educational and screening programme in an inner city practice. Br. Med. J. 1989; 299: 838–40.CrossRefGoogle Scholar
10Daly, A, MacDonald, A, Aukett, A, Williams, J, Wolf, A, Davidson, J, Booth, IW. Prevention of anaemia in inner city toddlers by an iron supplemented cows' milk formula. Arch. Dis. Child. 1996; 75: 9–16.CrossRefGoogle ScholarPubMed
11Duggan, MB, Steel, G, Elwys, G, Harbottle, L, Noble, C. Iron status, energy intake, and nutritional status of healthy young Asian children. Arch. Dis. Child. 1991; 66: 1386–9.CrossRefGoogle ScholarPubMed
12Mills, AF. Surveillance for anaemia: risk factors in patterns of milk intake. Arch. Dis. Child. 1990; 65: 428–31.CrossRefGoogle ScholarPubMed
13Jacobs, A, Worwood, M. Ferritin in serum. N. Engl. J. Med. 1975; 05: 951–6.CrossRefGoogle ScholarPubMed
14Burman, D. Haemoglobin levels in normal infants aged 3 to 24 months, and the effect of iron. Arch. Dis. Child. 1972; 47: 261–71.CrossRefGoogle ScholarPubMed
15Dallman, P, Yip, R, Johnson, C. Prevalence and causes of anemia in the United States, 1976 to 1980. Am. J. Clin. Nutr. 1984; 39: 437–45.Google ScholarPubMed
16Burman, D. Iron metabolism in infancy and childhood. In: Jacobs, A, Worwood, M, eds. Iron in Biochemistry and Medicine. London and New York: Academic Press, 1974; 543–62.Google Scholar
17Anttila, R, Siimes, MA. Serum transferrin and ferritin in pubertal boys: relations to body growth, pubertal stage, erythropoiesis and iron deficiency. Am. J. Clin. Nutr. 1996; 63 179–83.CrossRefGoogle ScholarPubMed
18Penrod, JC, Anderson, K, Acosta, PB. Impact on iron status of introducing cows' milk in the second six months of life. J. Paediatr. Gastro. & Nutr. 1990; 10: 462–7.Google ScholarPubMed
19Harbottle, L, Duggan, MB. Comparative study of the dietary characteristics of Asian toddlers with iron deficiency in Sheffield. J. Hum. Nutr. Diet. 1992; 5: 351–61.CrossRefGoogle Scholar
20Michaelsen, KF, Milman, N, Samuelson, G. A longitudinal study of iron status in healthy Danish infants: effects of early iron status, growth velocity and dietary factors. Acta Paediatr. 1995; 84: 1035–44.CrossRefGoogle ScholarPubMed
21Puolakka, J, Jänne, O, Vihko, R. Evaluation by serum ferritin assay of the influence of maternal iron stores on the iron status of newborns and infants. Acta Obstet. Cynecol. Scand. Suppl. 1980; 95: 53–6.CrossRefGoogle ScholarPubMed
22Kelly, AM, Macdonald, DJ, McDougall, AN. Observations on maternal and fetal ferritin concentrations at term. Br. J. Obst. & Gynae. 1978; 85: 338–43.CrossRefGoogle ScholarPubMed
23Mills, A, Tyler, H. Food and Nutrient Intakes of British Infants Aged 6–12 Months. London: HMSO, 1992.Google Scholar
24Schulz-Lell, G, Buss, R, Oldigs, H-D, Dörner, K, Schaub, J. Iron balances in infant nutrition. Acta Paediatr. Scand. 1987; 76: 585–91.CrossRefGoogle ScholarPubMed
25Health Promotion Unit. A National Breastfeding Policy for Ireland. Dublin: Health Promotion Unit, Department of Health, 1994.Google Scholar
26Ferguson, AE, Tappin, DM, Girwood, RWA, Kennedy, R, Cockburn, F. Breast feeding in Scotland. Br. Med. J. 1994; 308: 824–5.CrossRefGoogle ScholarPubMed
27Bradley, CK, Hillman, L, Sherman, AR, Leedy, D, Cordano, A. Evaluation of two iron-fortified, milk-based formulas during infancy. Pediatrics 1993; 91: 908–14.CrossRefGoogle ScholarPubMed
28Fomon, SJ, Ziegler, EE, Serfass, RE, Nelson, SE, Frantz, JAErythrocyte incorporation of iron is similar in infants fed formulas fortified with 12 mg/l or 8 mg/l of iron. J. Nutr. 1997; 127(1): 83–8.CrossRefGoogle ScholarPubMed
29Almaas, R, Rootwelt, T, Oyasaeter, S, Saugstad, OD. Ascorbic acid enhances hydroxyl radical formation in iron-fortified infant cereals and infant formulas. Eur. J. Pediatr. 1997; 156 488–92.CrossRefGoogle ScholarPubMed
30Mira, M, Alperstein, G, Karr, M, Ranmuthugala, G, Causer, J, Niec, A, Lilburne, A-M. Haem iron intake in 12–36 month children depleted in iron: case-control study. Br. Med.j. 1996; 312: 881–3.CrossRefGoogle ScholarPubMed
31Department of Health. Report on Health and Social Subjects no. 45. Weaning and the Weaning Diet. London: HMSO, 1994.Google Scholar