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Effect of Infant Iron Deficiency on Children’s Verbal Abilities: The Roles of Child Affect and Parent Unresponsiveness

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Abstract

Background

Infants who are iron-deficient anemic seek and receive less stimulation from their caregivers, predisposing such children to be functionally isolated.

Objectives

To test the sequence whereby iron deficiency in infancy contributes to children’s disengagement from the environment, which reduces parent stimulation which, in turn, contributes to children’s poor verbal skills.

Methods

Chilean children (N = 875, 54% male) were studied, 45% of whom were iron deficient or iron-deficient anemic in infancy. We used structural equation modeling to test the sequence outlined above and to examine the effect of infant iron status on children’s verbal performance at ages 5 and 10 years including the roles of child and parent intermediate variables.

Results

Severity of iron deficiency in infancy was associated with higher levels of children’s dull affect and social reticence at 5 years (β = .10, B = .26, SE = .12, p < .05), and these behaviors were associated with parent unresponsiveness (β = .29, B = .13, SE = .03, p < .001), which related to children’s lower verbal abilities at age 5 (β = − .29, B = − 2.33, SE = .47, p < .001) and age 10 (β = − .22, B = − 3.04, SE = .75, p < .001). An alternate model where poor iron status related directly to children’s verbal ability was tested but not supported.

Conclusions

Findings support functional isolation processes resulting from a nutritional deficiency, with iron-deficient anemic infants showing affective and behavioral tendencies that limit developmentally stimulating caregiving which, in turn, hinder children’s verbal abilities.

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References

  • Armony-Sivan, R., Kaplan-Estrin, M., Jacobson, S. W., & Lozoff, B. (2010). Iron-deficiency anemia (IDA) in infancy and mother–infant interaction during feeding. Journal of Developmental and Behavioral Pediatrics, 31, 326.

    Article  PubMed Central  PubMed  Google Scholar 

  • Bates, J. E., Freeland, C. B., & Lounsbury, M. L. (1979). Measurement of infant difficultness. Child Development, 50, 794–803.

    Article  CAS  PubMed  Google Scholar 

  • Bradley, R. H., & Corwyn, R. F. (2005). Caring for children around the world: A view from HOME. International Journal of Behavioral Development, 29, 468–478.

    Article  Google Scholar 

  • Brown, J. L., & Pollitt, E. (1996). Malnutrition, poverty and intellectual development. Scientific American, 274, 38–43.

    Article  CAS  PubMed  Google Scholar 

  • Carter, R. C., Jacobson, J. L., Burden, M. J., Armony-Sivan, R., Dodge, N. C., Angelilli, M. L., et al. (2010). Iron deficiency anemia and cognitive function in infancy. Pediatrics, 126(2), e427–e434.

    Article  PubMed  Google Scholar 

  • Chang, S., Wang, L., Wang, Y., Brouwer, I. D., Kok, F. J., Lozoff, B., et al. (2011). Iron-deficiency anemia in infancy and social emotional development in preschool-aged Chinese children. Pediatrics, 127, e927–e933.

    Article  PubMed  Google Scholar 

  • Corapci, F., Radan, A. E., & Lozoff, B. (2006). Iron deficiency in infancy and mother–child interaction at 5 years. Journal of Developmental and Behavioral Pediatrics, 27, 371–378.

    Article  PubMed Central  PubMed  Google Scholar 

  • Cowan, P. A., & Cowan, C. P. (1990). Becoming a family: Research and intervention. In I. Sigel & A. Brody (Eds.), Family research (pp. 1–51). Hillsdale, NJ: Erlbaum.

    Google Scholar 

  • Dallman, P. R., Reeves, J. D., Driggers, D. A., & Lo, Y. T. E. (1981). Diagnosis of iron deficiency: The limitations of laboratory tests in predicting response to iron treatment in 1-year-old infants. Journal of Pediatrics, 99, 376–381.

    Article  CAS  PubMed  Google Scholar 

  • East, P., Lozoff, B., Blanco, E., Delker, E., Delva, J., Encina, P., et al. (2017). Infant iron deficiency, child affect, and maternal responsiveness: Testing the long-term effects of functional isolation. Developmental Psychology, 53(12), 2233–2244.

    Article  PubMed Central  PubMed  Google Scholar 

  • Enders, C. K., & Bandalos, D. L. (2001). The relative performance of full information maximum likelihood estimation for missing data in structural equation models. Structural Equation Modeling, 8(3), 430–457.

    Article  Google Scholar 

  • Gardner, J. M. M., Grantham-McGregor, S. M., Himes, J., & Chang, S. (1999). Behaviour and development of stunted and nonstunted Jamaican children. The Journal of Child Psychology and Psychiatry and Allied Disciplines, 40(5), 819–827.

    Article  CAS  PubMed  Google Scholar 

  • Georgieff, M. K. (2011). Long-term brain and behavioral consequences of early iron deficiency. Nutrition Reviews, 69(1), S43–S48.

    Article  PubMed  Google Scholar 

  • Graffar, M. (1956). A method for social classification of samples of population. Courier, 6, 455–459.

    Google Scholar 

  • Gupta, P. M., Perrine, C. G., Mei, Z., & Scanlon, K. S. (2016). Iron, anemia, and iron deficiency anemia among young children in the United States. Nutrients, 8(6), 330–333.

    Article  PubMed Central  CAS  Google Scholar 

  • Han, W. J., Leventhal, T., & Linver, M. R. (2004). The home observation for measurement of the environment in middle childhood: A study of three large-scale data sets. Parenting, 4(2–3), 189–210.

    Article  Google Scholar 

  • Holmes, T. H., & Rahe, R. H. (1967). The Social Readjustment Rating Scale. Journal of Psychosomatic Research, 11, 213–218.

    Article  CAS  PubMed  Google Scholar 

  • Kline, R. B. (2011). Principles and practice of structural equation modeling (3rd ed.). New York: Guilford Press.

    Google Scholar 

  • Landry, S. H., Smith, K. E., Swank, P. R., & Guttentag, C. (2008). A responsive parenting intervention: The optimal timing across early childhood for impacting maternal behaviors and child outcomes. Developmental Psychology, 44(5), 1335.

    Article  PubMed Central  PubMed  Google Scholar 

  • Levitsky, D. A., & Strupp, B. J. (1995). Malnutrition and the brain: Changing concepts, changing concerns. Journal of Nutrition, 125, 2212S–2220S.

    Article  CAS  PubMed  Google Scholar 

  • Lozoff, B., Corapci, F., Burden, M. J., Kaciroti, N., Angulo-Barroso, R., Sazawa, S., et al. (2007). Preschool-aged children with iron deficiency anemia show altered affect and behavior. Journal of Nutrition, 137, 683–689.

    Article  CAS  PubMed  Google Scholar 

  • Lozoff, B., De Andraca, I., Castillo, M., Smith, J. B., Walter, T., & Pino, P. (2003). Behavioral and developmental effects of preventing iron-deficiency anemia in healthy full-term infants. Pediatrics, 112, 846–854.

    PubMed  Google Scholar 

  • Lozoff, B., Smith, J. B., Clark, K. M., Perales, C. G., Rivera, F., & Castillo, M. (2010). Home intervention improves cognitive and social–emotional scores in iron-deficient anemic infants. Pediatrics, 126, e884–e894.

    Article  PubMed  Google Scholar 

  • McCann, J. C., & Ames, B. N. (2007). An overview of evidence for a causal relation between iron deficiency during development and deficits in cognitive or behavioral function. American Journal of Clinical Nutrition, 85, 931–945.

    Article  CAS  PubMed  Google Scholar 

  • Muthén, L. K., & Muthén, B. O. (2010). Mplus user’s guide (6th ed.). Los Angeles: Authors.

    Google Scholar 

  • Quintana, S. M., Aboud, F. E., Chao, R. K., Contreras-Grau, J., Cross, W. E., Hudley, C., et al. (2006). Race, ethnicity, and culture in child development: Contemporary research and future directions. Child Development, 77, 1129–1141.

    Article  PubMed  Google Scholar 

  • Radloff, L. S. (1977). The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1(3), 385–401.

    Article  Google Scholar 

  • Stevens, G. A., Finucane, M. M., De-Regil, L. M., Paciorek, C. J., Flaxman, S. R., Branca, F., et al. (2013). Global, regional, and national trends in haemoglobin concentration and prevalence of total and severe anaemia in children and pregnant and non-pregnant women for 1995–2011: A systematic analysis of population-representative data. Lancet Global Health, 1, e16–e25.

    Article  PubMed  Google Scholar 

  • Tamis-LeMonda, C. S., Bornstein, M. H., & Baumwell, L. (2001). Maternal responsiveness and children’s achievement of language milestones. Child Development, 72(3), 748–767.

    Article  CAS  PubMed  Google Scholar 

  • Totsika, V., & Sylva, K. (2004). The home observation for measurement of the environment revisited. Child and Adolescent Mental Health, 9(1), 25–35.

    Article  PubMed  Google Scholar 

  • Wachs, T. D. (2009). Models linking nutritional deficiencies to maternal and child mental health. American Journal of Clinical Nutrition, 89, 935S–939S.

    Article  CAS  PubMed  Google Scholar 

  • Wechsler, D. (1955). The Manual for the Wechsler Adult Intelligence Scale. Oxford: Psychological Corp.

    Google Scholar 

  • Wechsler, D. (1989). Wechsler preschool and primary scale of intelligence-revised. San Antonio, TX: The Psychological Corporation.

    Google Scholar 

  • Wechsler, D. (1991). Manual for the Wechsler intelligence scale for children-(WISC-III). San Antonio, TX: The Psychological Corporation.

    Google Scholar 

  • Woodcock, R. W., & Muñoz-Sandoval, A. F. (1993). Woodcock–Muñoz language survey, Spanish form. Itasca, IL: Riverside Publishing.

    Google Scholar 

  • World Medical Association. (2013). Declaration of Helsinki: Ethical principles for medical research involving human subjects. Journal of the American Medical Association, 310, 2191–2194.

    Article  CAS  Google Scholar 

  • Zimmerman, I. L., Steiner, V. G., & Pond, R. E. (1992). Preschool language scale (3rd ed.). San Antonio, TX: Psychological Corporation.

    Google Scholar 

Download references

Acknowledgements

This study was supported by National Institute of Child Health and Human Development under Grant No. RO1-HD-033487 and National Heart, Lung, and Blood Institute under Grant Nos. R01-HL-088530 and T32-HL-079891.

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Correspondence to Patricia East.

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East, P., Delker, E., Blanco, E. et al. Effect of Infant Iron Deficiency on Children’s Verbal Abilities: The Roles of Child Affect and Parent Unresponsiveness. Matern Child Health J 23, 1240–1250 (2019). https://doi.org/10.1007/s10995-019-02764-x

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