Severe iron-deficiency anaemia and feeding practices in young children

Area of Science:

• Pediatrics
• Hematology
• Nutritional Science

Background:

• Iron-deficiency anaemia (IDA) affects 1-2% of infants in developed countries, peaking between 1-3 years of age.
• IDA in early childhood is associated with long-term cognitive deficits.
• Severe IDA presents with significant morbidity, including developmental delay, heart failure, and cerebral thrombosis.

Purpose of the Study:

• To characterize young children with severe IDA in a developed country.
• To identify modifiable risk factors associated with severe IDA in this population.

Main Methods:

• Prospective study utilizing two samples: a national surveillance program and a regional longitudinal study.
• Recruitment of young children from community-based health-care practices in Canada (2009-2011).
• Comparison between children with severe IDA (Hb<80 g/l) and children with non-anaemic iron sufficiency.

Main Results:

• Children with severe IDA (n=201) exhibited a mean Hb of 55.1 g/l and high healthcare utilization (42% hospitalization).
• Compared to iron-sufficient children (n=597, mean Hb 122.4 g/l), those with severe IDA consumed more cow's milk (median 1065 ml vs. 500 ml) and were more likely to use bottles during the day and in bed.
• Significant associations were found between severe IDA and daytime bottle use (OR=6.0) and bottle use in bed (OR=6.5).

Conclusions:

• Severe IDA in young children is associated with considerable morbidity and is potentially preventable.
• Key modifiable feeding practices linked to IDA include consuming >500 ml cow's milk daily, daytime bottle use beyond 12 months, and bottle use in bed.
• These findings underscore the need to highlight specific feeding practices in public health and primary care recommendations to prevent IDA.