Policy statement on iron deficiency in pre-school-aged children.
OBJECTIVE
We aimed to develop policy in relation to three areas: (i) the diagnosis of iron deficiency; (ii) maternal-infant issues and the prevention of iron deficiency; and (iii) the treatment of iron deficiency.


METHODS
Within each of these topic areas we completed a literature review and developed recommendations to help direct activities of the Royal Australasian College of Physicians, update paediatricians and guide clinical practice.


RESULTS
Iron deficiency can be defined using cut-off values for laboratory measures of iron status or, if an intercurrent infection is not present, by demonstrating a response to a therapeutic trial of iron. The appropriate measures of iron status vary depending upon the presence of intercurrent infection. Full-term babies are born with iron stores sufficient to meet their needs to age 4-6 months but premature infants are not. After age 6 months infants are dependent upon dietary iron from complementary foods even with continued breastfeeding. Infants <33 weeks gestation or <1800 g birthweight should receive iron from 4 weeks of age. In most settings recommended treatment of iron deficiency is with oral ferrous sulphate as a single or twice daily dose of between 3 and 6 mg/kg/day.


CONCLUSIONS
Iron deficiency is prevalent and an important determinant of child health. Precise and accurate diagnosis remains challenging. Iron supplementation is required for premature and low-birthweight infants. Oral iron salts remain the recommended treatment of choice in most instances.
Grant
Cameron C
CC
Department of Paediatrics, University of Auckland, Auckland, New Zealand. cc.grant@auckland.ac.nz
Wall
Clare R
CR
Brewster
David
D
Nicholson
Ross
R
Whitehall
John
J
Super
Leanne
L
Pitcher
Lydia
L
D018798:Anemia, Iron-Deficiency / Q000097:blood / Q000178:diet therapy / Q000517:prevention & control; D001315:Australia; D002675:Child, Preschool; D005260:Female; D005296:Ferrous Compounds / Q000627:therapeutic use; D006291:Health Policy; D006801:Humans; D007223:Infant; D007227:Infant Nutritional Physiological Phenomena; D007231:Infant, Newborn; D019266:Iron, Dietary / Q000008:administration & dosage; D008297:Male; D009520:New Zealand; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D011295:Prenatal Care
D005296:Ferrous Compounds; D019266:Iron, Dietary; C020748:ferrous sulfate