title: Iron deficiency anemia in infants and toddlers.
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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Pediatrics, Inha University College of Medicine, Incheon, Korea.
authors.forename: Eun Young
authors.initials: EY
authors.lastname: Joo
authors.affiliation: Department of Pediatrics, Inha University College of Medicine, Incheon, Korea.
authors.forename: Keun Young
authors.initials: KY
authors.lastname: Kim
authors.affiliation: Department of Pediatrics, Inha University College of Medicine, Incheon, Korea.
authors.forename: Dong Hyun
authors.initials: DH
authors.lastname: Kim
authors.affiliation: Department of Pediatrics, Inha University College of Medicine, Incheon, Korea.
authors.forename: Ji-Eun
authors.initials: JE
authors.lastname: Lee
authors.affiliation: Department of Pediatrics, Inha University College of Medicine, Incheon, Korea.
authors.forename: Soon Ki
authors.initials: SK
authors.lastname: Kim
keywords: Breastfeeding; Child; Infant; Iron deficiency anemia; Low birth weight; Risk factors