Blood Res 2016; 51(4): 268-273  https://doi.org/10.5045/br.2016.51.4.268
Iron deficiency anemia in infants and toddlers
Eun Young Joo, Keun Young Kim, Dong Hyun Kim, Ji-Eun Lee, Soon Ki Kim
Department of Pediatrics, Inha University College of Medicine, Incheon, Korea
Correspondence to: Soon Ki Kim, M.D., Ph.D.
Department of Pediatrics, Inha University School of Medicine, 27, Inhang-ro, Jung-gu, Incheon 22332, Korea
E-mail: pedkim@inha.ac.kr
Received: July 29, 2016; Revised: October 20, 2016; Accepted: November 18, 2016; Published online: December 31, 2016.
© The Korean Journal of Hematology. All rights reserved.

cc This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background
In Korea, the prevalence of anemia and iron deficiency anemia (IDA) among older infants and young children remains high. To detect IDA early and to reduce its adverse impact, we assessed the characteristics of infants and young children who had IDA or were at risk of developing IDA, or who exhibited characteristics associated with severe anemia.
Methods
Among the 1,782 IDA-affected children aged 6 months to 18 years who visited the hospital, we retrospectively analyzed the medical records and laboratory data of 1,330 IDA-affected children aged 6‒23 months who were diagnosed between 1996 and 2013. We excluded patients with a C-reactive protein level ≥5 mg/dL.
Results
IDA was predominant in boys (2.14:1) during infancy and early childhood. The peak IDA incidence was noted among infants aged 9‒12 months. Only 7% patients exhibited symptoms of IDA, while 23.6% patients with severe IDA demonstrated classic symptoms/signs of IDA. Low birth weight (LBW) infants with IDA demonstrated low adherence to iron supplementation. In a multivariate analysis, prolonged breastfeeding without iron fortification (odds ratio [OR] 5.70), and a LBW (OR 6.49) were identified as risk factors of severe anemia.
Conclusion
LBW infants need more attention in order to increase their adherence to iron supplementation. For the early detection of IDA, nutritional status of all infants, and iron batteries of high-risk infants (LBW infants, infants with prolonged breastfeeding, picky eaters, and/or infants with the presence of IDA symptoms) should be evaluated at their health screening visits.
Keywords: Iron deficiency anemia, Infant, Child, Risk factors, Breastfeeding, Low birth weight


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