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Published on: January 19, 2024
Iron status of one-year-old infants in a well baby clinic
Ampaiwan Chuansumrit1, Pasra Arnutti, Siriluk Apivanich
1Department of Pediatrics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand.
Insights
Iron deficiency affects 8.3% of one-year-old infants, with feeding practices being a key risk factor. Ensuring adequate iron supplementation through solid foods is crucial for preventing iron deficiency in infants.
Area of Science:
- Pediatrics
- Hematology
- Nutrition
Background:
- Iron deficiency is a prevalent nutritional deficiency in infants worldwide.
- Early detection and intervention are critical to prevent long-term health consequences.
- Thalassemia and hemoglobinopathies are common genetic blood disorders that can affect iron status.
Purpose of the Study:
- To evaluate the iron status in healthy one-year-old infants.
- To determine the prevalence of iron deficiency and its association with thalassemia and hemoglobinopathy carrier status.
- To identify risk factors for iron deficiency in this age group.
Main Methods:
- Blood samples were collected from 72 healthy infants on their first birthday.
- Complete blood count, hemoglobin typing, DNA analysis, and serum ferritin levels were assessed.
- Infants were categorized into four groups based on iron status: iron deficiency anemia, iron deficiency without anemia, borderline iron depletion, and iron sufficiency.
Main Results:
- 8.3% of infants exhibited iron deficiency, with 1.4% having iron deficiency anemia.
- 34.7% of infants were carriers of thalassemia and hemoglobinopathies, showing lower hemoglobin and MCV levels.
- Risk factors for iron deficiency included breastfeeding without adequate iron supplements, exclusive formula feeding, and inadequate solid food intake.
Conclusions:
- Adequate heme iron supplementation in three solid meals daily is essential for preventing iron deficiency in one-year-old infants.
- Carrier status for thalassemia and hemoglobinopathies can contribute to anemia in infants.
- Dietary interventions focusing on iron-rich foods are recommended for infant nutrition.
Abstract:
Seventy-two healthy infants (37 males, 35 females) attending a private well baby clinic were enrolled in the study. Their mean birthweights and body weights at one year of age were 3,079 grams and 10 kilograms, respectively. Blood samples were drawn approximately on their first birthday for evaluating the iron status. Complete blood count, hemoglobin (Hb) typing and DNA analysis for common carrier status of thalassemia and hemoglobinopathis were also determined. According to the infants of serum ferritin, the patients were classified into 4 groups: group 1, iron deficiency anemia (Hb <11 g/dl and ferritin <12 ng/L) in 1 infants (1.4%); group 2, iron deficiency without anemia (Hb >11 g/dl and ferritin <12 ng/L) in 5 infants (6.9%); group 3, borderline iron depletion (ferritin 12-30 ng/L) in 39 infants (54.2%); group 4, iron sufficiency (ferritin >30 ng/L) in 27 infants (37.5%). The iron deficiency state emerged as 8.3 per cent (6/72). There was no significant difference of levels of Hb and mean corpuscular volume (MCV) among the infants with iron deficiency without anemia, borderline iron depletion and iron sufficiency. The results also revealed that 25 out of 72 (34.7%) infants were carriers of thalassemia and hemoglobinopathies. The carrier infants had significant lower Hb and MCV than those of the non-carrier infants with the p-values of 0.004 and 0.000, respectively; while their serum ferritin levels were not significantly different. Additionally, the association of carrier and iron deficiency state was further evaluated. The Hb and MCV among carrier infants with and without iron deficiency were not significantly different. Six infants with carrier state were found to have slightly decreased levels of Hb ranging from 10.3 to 10.9 g/dl with the ferritin ranging from 18.7 to 382.9 ng/L while the remainders had Hb of >11 g/dl. Therefore, 7 out of 72 (9.2%) infants had anemia (Hb <11 g/dl) which was caused by the carrier state of thalassemia and hemoglobinopathies (n=6) and iron deficiency anemia (n=1). The risk factors of iron deficiency status were associated with feeding regimen including continuation of breast feeding until one year of age without adequate haem iron supplement, exclusive formula feeding, inadequacy of solid food supplement with only one meal per day and excluding haem iron from animal liver without substitution. The infants with risk factors had significantly lower levels of serum ferritin (mean 14.1 +/- 1.7 ng/L) than those without risk factors (mean 31.9 +/- 1.9 ng/L) with a p-value of 0.000. In conclusion, adequate haem iron supplement in 3 meals of solid food is essential for the prevention of iron deficiency status in one-year-old infants.
