title: Iron deficiency anemia in predominantly breastfed young children.
abstract: BACKGROUND
  Due to the increase of breastfeeding in infants, iron deficiency anemia (IDA) related to prolonged, predominant breastfeeding should be of concern. Mostly, the manifestation of IDA is indistinguishable and the enthusiastic advocacy of breastfeeding without concomitant education of complementary food may lead to ignorance of breast milk-related IDA, which may result in impaired psychomotor development of the baby. This retrospective study was conducted to re-emphasize this easily ignored but still prevalent illness.
  
  
  METHODS
  This retrospective study involved 15 breastfeeding babies who were diagnosed with IDA between January 2007 and December 2010 at age 6-18 months. The clinical presentation, age at diagnosis, initial hemoglobin level and mean corpuscular volume, growth percentile, and duration of treatment were recorded and analyzed.
  
  
  RESULTS
  None of the babies was suspected to have anemia by caregivers. Pallor was noticed by physicians in nine patients; one patient had seizure, one patient had pica, and, for the remaining four patients, IDA was diagnosed incidentally due to other medical events. Oral iron supplementation for an average of 3.6 months improved both hemoglobin level (from 8.0 g/dL to 11.5 g/dL) and mean corpuscular volume (from 57.5 fL to 73.9 fL). Most babies had appropriate growth and normal neurological development; two babies had both IDA and thalassemia.
  
  
  CONCLUSIONS
  Although the association of IDA with prolonged, predominant breastfeeding is well known, its presentation is so subtle that its detection relies mainly on alert medical personnel.
authors: Department of Pediatrics, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
authors: Shu-Fan
authors: SF
authors: Tsai
authors: Department of Pediatrics, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Department of Pediatrics, National Yang-Ming University School of Medicine, Taipei, Taiwan, ROC. Electronic address: chensj@vghtpe.gov.tw.
authors: Shu-Jen
authors: SJ
authors: Chen
authors: Department of Pediatrics, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
authors: Hsiu-Ju
authors: HJ
authors: Yen
authors: Department of Pediatrics, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
authors: Giun-Yi
authors: GY
authors: Hung
authors: Department of Pediatrics, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Institute of Emergency and Critical Care Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan, ROC.
authors: Pei-Chen
authors: PC
authors: Tsao
authors: Department of Pediatrics, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Institute of Emergency and Critical Care Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan, ROC.
authors: Mei-Jy
authors: MJ
authors: Jeng
authors: Department of Pediatrics, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Institute of Emergency and Critical Care Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan, ROC.
authors: Yu-Sheng
authors: YS
authors: Lee
authors: Department of Pediatrics, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Institute of Emergency and Critical Care Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan, ROC.
authors: Wen-Jue
authors: WJ
authors: Soong
authors: Department of Pediatrics, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
authors: Ren-Bin
authors: RB
authors: Tang
mesh_terms: D018798:Anemia, Iron-Deficiency / Q000209:etiology*; D001942:Breast Feeding / Q000009:adverse effects*; D004909:Erythrocyte Indices; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D012189:Retrospective Studies
keywords: breastfeeding; iron deficiency anemia; young children