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Iron Deficiency and Iron Deficiency Anemia in 3–5 months-old, Breastfed Healthy Infants

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Abstract

Objective

To assess the prevalence of iron deficiency (ID) and iron deficiency anemia (IDA) in predominantly breastfed, 3–5-mo-old infants, born at term, with a birth weight ≥ 2.5 kg.

Methods

The cross-sectional study was conducted in the outpatient department of a tertiary care center from January 2013 through December 2014. Inclusion criteria: Age: 90–180 d, exclusively/predominantly breastfed, birth weight ≥ 2.5 kg and term gestation. Exclusion criteria: systemic illness, leucocytosis, leucopenia, thrombocytopenia, peripheral smear abnormality or iron supplementation. Blood sample was collected for complete blood count and ferritin assay. ID was defined as serum ferritin <12 μg/L. IDA was defined as ID plus Hb ≤ 10.5 g/dl.

Results

Two hundred ninety six infants were initially recruited; 29 declined consent; 22 had leukocytosis, leucopenia or eosinophilia; 15 had thrombocytopenia; 15 samples were hemolyzed or insufficient. Finally, 215 infants were evaluated. The male-female ratio was 1.8:1. The mean birth weight was 2.9 (0.4) kg. The mean Hb was 10.8 (1.2) g/dl. The median serum ferritin was 44 μg/L (18, 120). The prevalence of ID at 3, 4 and 5 mo of age was 5.4%, 21.4% and 36.4%, while that of IDA was 4.6%, 16.7% and 11.4%, respectively.

Conclusions

The prevalence of ID at 4 and 5 mo of age in predominantly breastfed, term infants was 21.4% and 36.4%, respectively. The study generates evidence for considering iron supplementation for well-babies from 4 mo of age, instead of the currently recommended 6 mo by National Iron plus Initiative in India.

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Authors and Affiliations

  1. Hematology-Oncology Unit, Department of Pediatrics, Advanced Pediatrics Center, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India

    Sudarsan Krishnaswamy, Dharmagat Bhattarai, Prateek Bhatia & Deepak Bansal

  2. Social Pediatrics Unit, Department of Pediatrics, Advanced Pediatrics Center, Postgraduate Institute of Medical Education and Research, Chandigarh, India

    Bhavneet Bharti

  3. Department of Hematology, Postgraduate Institute of Medical Education and Research, Chandigarh, India

    Reena Das

Authors
  1. Sudarsan Krishnaswamy
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  2. Dharmagat Bhattarai
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  3. Bhavneet Bharti
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  4. Prateek Bhatia
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  5. Reena Das
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  6. Deepak Bansal
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Contributions

SK and DBh: enrolled the children, collected and analyzed the data; SK: drafted the manuscript; BB: contributed to study design and enrollment of children; PB and RD: performed the study investigations; DB: conceived, designed and supervised the study and revised the manuscript. All authors approved the final manuscript. DB will act as guarantor for the paper.

Corresponding author

Correspondence to Deepak Bansal.

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Krishnaswamy, S., Bhattarai, D., Bharti, B. et al. Iron Deficiency and Iron Deficiency Anemia in 3–5 months-old, Breastfed Healthy Infants. Indian J Pediatr 84, 505–508 (2017). https://doi.org/10.1007/s12098-017-2330-4

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  • DOI: https://doi.org/10.1007/s12098-017-2330-4

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