Iron Deficiency Anemia: A Review
Even moderate anemia may lead to irreversible depressed mental and motor development in young children. This review covers the causes, effects and prevention of iron deficiency.
Risk Factors: In a healthy infant's first months outside the womb, breastfeeding does not provide adequate iron, so iron stored in the liver and bone marrow is utilized.
However, around six months of age, these stores are depleted and blood volume is doubling at this time. Premature birth; early cord clamping; prolonged and excessive breastfeeding; wrong types of complementary foods; and frequent infections can all lead to anemia in infants. In children and adolescents, it is usually the result of menstruation combined with restricted food intake in females.
In infants, iron deficiency is characterized by altered behavior, such as excessive wariness, irritability and depression; and altered motor development, including a fear of leaving the caregiver's side. Adolescents and children who were anemic as infants may have lower grades and cognitive test scores; lower math scores; and lowered verbal learning and memory abilities.
Red meat, poultry and fish are the best natural sources of dietary iron. Fortified cereals and infant formulas are also excellent sources. Infants 7-12 months old, children ages 4-8, and adolescents ages 14-18 require the most dietary iron. When detected, anemia should be treated with fumarate or ferrous sulfate supplementation, the best bioavailable sources of iron.
Zlotkin S. Clinical nutrition:8. The role of nutrition in the prevention of iron deficiency anemia in infants, children and adolescents. Canadian Medical Association Journal
2003:168(1), pp. 59-63. www.cmaj.ca