Iron deficiency in healthy, term infants aged five months, in a pediatric outpatient clinic: A prospective study

Adnan, Nur Aida and Breen, Emer and Tan, Chin Aun and Wang, Crystal C. and Jalaludin, Muhammad Yazid and Lum, Lucy Chai See (2024) Iron deficiency in healthy, term infants aged five months, in a pediatric outpatient clinic: A prospective study. BMC Pediatrics, 24 (1). ISSN 1471-2431, DOI https://doi.org/10.1186/s12887-023-04277-7.

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Official URL: https://doi.org/10.1186/s12887-023-04277-7

Abstract

Background Iron deficiency (ID) is prevalent in Malaysian children. The incidence of ID in infants under 6 months of age is unknown. Our aim was to determine the prevalence of iron deficiency (ID) and iron deficiency anemia (IDA) in healthy, term infants aged below 6 months in our hospital population.Methods A prospective longitudinal pilot study of mother-infant pairs was conducted on infants receiving routine immunizations in a mother and child clinic at a university hospital, in Kuala Lumpur, Malaysia. Mothers completed standardized questionnaires at 3- and 5-month postnatal visits. Maternal and infant full blood count, ferritin, and C-reactive protein (CRP) levels were measured at 3 months and for the infants repeated at 5 months. Infant anthropometric measurements were obtained at both visits. We conducted a univariate analysis to identify factors associated with ID and IDA.Results Altogether, 91 mother-infant pairs were enrolled, with 88 completing the study. No infant had ID or IDA at 3 months; the lowest ferritin level was 16.6 mu g/L. At 5 months, 5.9% (5/85) of infants had ID, and 2.4% (2/85) had IDA. Median (interquartile range) infant ferritin levels significantly declined from 113.4 (65.0-183.6) mu g/L at 3 months to 50.9 (29.2-70.4) mu g/L at 5 months, p < 0.001. Exclusive breastfeeding until 3 or 5 months was significantly associated with ID at 5 months (p = 0.020, and p = 0.008, respectively) on univariate analysis. The drop in ferritin between 3-5 months was significantly associated with weight and length gains between 0-3 months (p = 0.018, p = 0.009, respectively). Altogether, 14.3% of infants exclusively breastfed until 5 months developed ID. At 5 months, 3.4% of infants were underweight, 1.1% stunted, and 10.2% wasted.Conclusions In exclusively breastfed term infants, ID occurred by 5 months. Early introduction of iron-rich foods should be considered in exclusively breastfed babies. A high prevalence of wasting suggests a calorie deficit in this population and will lead to stunting if not addressed.

Item Type: Article
Funders: UNSPECIFIED
Uncontrolled Keywords: Anemia iron deficiency; Breastfeeding; Ferritin; Prospective study
Subjects: R Medicine > RG Gynecology and obstetrics
R Medicine > RJ Pediatrics
Divisions: Faculty of Medicine > Paediatrics Department
Universiti Malaya Medical Centre (UMMC)
Depositing User: Ms. Juhaida Abd Rahim
Date Deposited: 11 Jun 2024 08:09
Last Modified: 11 Jun 2024 08:09
URI: http://eprints.um.edu.my/id/eprint/44163

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