Iron Deficiency and Iron-deficiency Anemia in Toddlers Ages 18 to 36 Months: A Prospective Study

Carina Levin1, Shira Harpaz, Isam Muklashi

  • 1*Pediatric Department B and Pediatric Hematology Unit, Emek Medical Center, Afula ‡Clalit Health Services, Northern District †The Ruth and Baruch Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.

Insights

Iron deficiency (ID) and iron deficiency anemia (IDA) are common in toddlers, even after iron supplementation. Early detection and continued monitoring are crucial for neurodevelopment.

Area of Science:

  • Pediatrics
  • Nutritional Science
  • Hematology

Background:

  • Iron deficiency (ID) is the most common cause of anemia in young children.
  • ID can negatively impact long-term neurodevelopment and behavior.
  • Prevalence of ID and IDA in toddlers requires further investigation.

Purpose of the Study:

  • To evaluate the prevalence of ID and iron deficiency anemia (IDA) in healthy toddlers aged 18-36 months in Northern Israel.
  • To assess risk factors associated with ID and IDA.
  • To compare iron status with first-year screening results.

Main Methods:

  • Prospective evaluation of 256 healthy children aged 18-36 months.
  • Complete blood count and ferritin levels were measured.
  • Risk factors were assessed, and hemoglobin (Hgb) was compared with first-year screening.

Main Results:

  • Prevalence: 5.8% IDA, 16.3% ID without anemia, 9.6% anemia with normal ferritin.
  • In infants nonanemic at 1 year (n=156), 19.9% had ID/IDA, and 12.8% developed anemia by study evaluation.
  • ID and IDA remained prevalent and could develop during the second year of life, despite supplementation and normal first-year screening.

Conclusions:

  • Iron deficiency and iron deficiency anemia are prevalent in toddlers, even with iron supplementation and normal initial screening.
  • A significant subset of children may develop ID/IDA during their second year of life.
  • Continued monitoring and consideration of iron supplementation are essential for this vulnerable population.

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