Comparing Iron Prophylaxis Strategies in Infants: Is Sucrosomial Iron a Better Alternative?

Area of Science:

• Pediatric Hematology
• Nutritional Anemia
• Public Health Interventions

Background:

• Iron deficiency and iron deficiency anemia (IDA) are significant health concerns in infancy, potentially leading to irreversible complications.
• The 'Iron Like Turkey' program, initiated in 2004, mandates iron prophylaxis from the fourth month of life for at least five months to prevent IDA.
• Evaluating the real-world implementation and comparative effectiveness of different iron preparations is essential for optimizing prophylaxis strategies.

Purpose of the Study:

• To assess the implementation status of iron prophylaxis in infants within Turkey.
• To compare the effectiveness of different iron preparations, specifically Fe+3 and Sucrosomial Iron (SI), used in infant iron prophylaxis.
• To identify factors influencing the success of iron prophylaxis programs in preventing IDA.

Main Methods:

• A cross-sectional study involving 248 healthy, full-term, breastfed infants aged 9 to 15 months referred to Manisa City Hospital's Pediatric Hematology clinic.
• Data collected between January 2021 and January 2024 on iron prophylaxis administration, usage patterns, and type of iron preparation used (Fe+3 or SI).
• Assessment of iron deficiency anemia (IDA) and relevant hematological parameters including hemoglobin (Hb), mean corpuscular volume (MCV), ferritin, and transferrin saturation.

Main Results:

• Iron prophylaxis was administered to 82.3% of infants, but 44.1% exhibited irregular usage.
• Fe+3 was used by 53.9% and Sucrosomial Iron (SI) by 46.1%; no infants received Fe+2.
• IDA was diagnosed in 57.3% of infants. While adherence and duration did not differ significantly between Fe+3 and SI groups, infants receiving Fe+3 had significantly higher Hb, MCV, ferritin, and transferrin saturation levels compared to those on SI.

Conclusions:

• Iron prophylaxis is a vital and effective strategy for preventing IDA in infants.
• Fe+3 appears to be more effective than Sucrosomial Iron (SI) in improving key hematological markers of iron status, despite similar adherence.
• Ensuring timely and adequate duration of iron prophylaxis for both pregnant mothers and infants is critical; further research on various iron formulations is warranted.