Iron deficiency in infancy and mother-child interaction at 5 years

Five-year-old Costa Rican children, who had either chronic, severe iron deficiency or good iron status in infancy, were observed with their mothers during a structured interaction task in a laboratory setting and everyday interactions in their home. Child affect and behavior as well as the quality of mother-child interaction of the formerly chronic iron-deficient children (n = 40) were compared to those with good iron status in infancy (n = 102). Children who had chronic iron deficiency in infancy were more likely to display lower levels of physical activity, positive affect, and verbalization during the structured task at 5 years, despite iron therapy that corrected their iron deficiency anemia in infancy. Mother-child reciprocity during the structured task (e.g., eye contact, shared positive affect, turn taking) was more likely to be lower in the chronic iron deficiency group compared to the good iron group. Mothers of children in the chronic iron deficiency group showed less responsivity in both settings. These results show that children with chronic, severe iron deficiency in infancy continue at behavioral disadvantage relative to their peers at school entry. Sustained differences in mother-child interaction might contribute to the long-lasting behavioral and developmental alterations reported in children with chronic, severe iron deficiency in infancy.