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Published on: February 14, 2019
Effect of iron supplementation in children with breath holding spells
Rahul Jain1, Divin Omanakuttan1, Amitabh Singh1
1Department of Pediatrics, Chacha Nehru Bal Chikitsalaya, New Delhi, India.
Insights
Iron supplementation effectively treats breath holding spells in children, regardless of iron levels. Even children without iron deficiency showed significant improvement, indicating iron
Area of Science:
- Pediatrics
- Hematology
- Nutritional Science
Background:
- Breath holding spells (BHS) are common in young children.
- The role of iron in BHS management is debated, particularly in non-anemic children.
- Understanding factors influencing treatment response is crucial for effective intervention.
Purpose of the Study:
- To evaluate the efficacy of iron supplementation for children experiencing breath holding spells.
- To determine if iron status impacts the response to iron therapy in BHS.
- To identify predictors of treatment success or failure in BHS management.
Main Methods:
- A prospective interventional study involving 100 children aged 6-36 months with recurrent BHS.
- Participants received elemental iron (3 mg/kg/day) for 12 weeks.
- Outcomes assessed included remission or reduction in spell frequency; factors associated with response were analyzed.
Main Results:
- 73% of children experienced complete remission of BHS, and 23% had >50% reduction in frequency.
- High spell frequency at diagnosis and oral iron intolerance were linked to poor response.
- Response rates were similar in iron-deficient and non-iron-deficient (serum ferritin ≥ 30 µg/L) groups.
Conclusions:
- Iron supplementation is a highly effective treatment for breath holding spells in children.
- Efficacy extends to children who are not iron-deficient or anemic.
- Iron therapy offers a viable management strategy for BHS across different iron status levels.
Aim:
The aim of this study was to analyse the effect of iron supplementation in children with breath holding spells, irrespective of their iron status and study the factors associated with the response.
Methods:
This was a prospective interventional study. Study population comprised of patients aged 6-36 months, attending a paediatric outpatient department with recurrent episodes (more than three in last 4 weeks) of breath holding spells. Children with loss of consciousness or convulsive movements associated with breath holding spells were considered as severe. After baseline investigations, all enrolled patients were given elemental iron at the dose of 3 mg/kg/day as a single daily dose. Four weekly follow-ups were done until 3 months after initiation of the intervention. At 12 weeks, investigations were repeated and outcome assessed for remission or decrease in severity of breath holding episodes.
Results:
A total of 100 children with breath holding spells received iron supplementation. Almost 73% of children showed complete response, with another 23% showing greater than 50% reduction in frequency. Frequency of spells at diagnosis and intolerance to oral iron were significantly associated with poor response to iron supplementation. Other factors such as age at onset, age at presentation, severity of spells, anaemia and serum iron parameters had no significant association with the response. Of the 27 children without iron deficiency (serum ferritin ≥ 30 µg/L), 77.7% responded completely to iron supplementation, similar to the iron-deficient group.
Conclusions:
Iron supplementation is effective in the management of breath holding spells. Non-anaemic and iron-replete children with breath holding spells also respond well to iron supplementation.
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