Iron Deficiency and Iron Deficiency Anemia in 3-5 months-old, Breastfed Healthy Infants.
OBJECTIVE
To assess the prevalence of iron deficiency (ID) and iron deficiency anemia (IDA) in predominantly breastfed, 3-5-mo-old infants, born at term, with a birth weight ≥ 2.5 kg.


METHODS
The cross-sectional study was conducted in the outpatient department of a tertiary care center from January 2013 through December 2014.


METHODS
Age: 90-180 d, exclusively/predominantly breastfed, birth weight ≥ 2.5 kg and term gestation.


METHODS
systemic illness, leucocytosis, leucopenia, thrombocytopenia, peripheral smear abnormality or iron supplementation. Blood sample was collected for complete blood count and ferritin assay. ID was defined as serum ferritin <12 μg/L. IDA was defined as ID plus Hb ≤ 10.5 g/dl.


RESULTS
Two hundred ninety six infants were initially recruited; 29 declined consent; 22 had leukocytosis, leucopenia or eosinophilia; 15 had thrombocytopenia; 15 samples were hemolyzed or insufficient. Finally, 215 infants were evaluated. The male-female ratio was 1.8:1. The mean birth weight was 2.9 (0.4) kg. The mean Hb was 10.8 (1.2) g/dl. The median serum ferritin was 44 μg/L (18, 120). The prevalence of ID at 3, 4 and 5 mo of age was 5.4%, 21.4% and 36.4%, while that of IDA was 4.6%, 16.7% and 11.4%, respectively.


CONCLUSIONS
The prevalence of ID at 4 and 5 mo of age in predominantly breastfed, term infants was 21.4% and 36.4%, respectively. The study generates evidence for considering iron supplementation for well-babies from 4 mo of age, instead of the currently recommended 6 mo by National Iron plus Initiative in India.
Hematology-Oncology Unit, Department of Pediatrics, Advanced Pediatrics Center, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India.
Sudarsan
S
Krishnaswamy
Hematology-Oncology Unit, Department of Pediatrics, Advanced Pediatrics Center, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India.
Dharmagat
D
Bhattarai
Social Pediatrics Unit, Department of Pediatrics, Advanced Pediatrics Center, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Bhavneet
B
Bharti
Hematology-Oncology Unit, Department of Pediatrics, Advanced Pediatrics Center, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India.
Prateek
P
Bhatia
Department of Hematology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Reena
R
Das
Hematology-Oncology Unit, Department of Pediatrics, Advanced Pediatrics Center, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India. deepakbansaldr@gmail.com.
Deepak
http://orcid.org/0000-0002-1009-7649
D
Bansal
D018798:Anemia, Iron-Deficiency / Q000453:epidemiology*; D001942:Breast Feeding; D003430:Cross-Sectional Studies; D019587:Dietary Supplements; D005260:Female; D005293:Ferritins / Q000097:blood; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007194:India / Q000453:epidemiology; D007223:Infant; D007501:Iron / Q000627:therapeutic use; D000090463:Iron Deficiencies; D008297:Male; D015995:Prevalence
D006454:Hemoglobins; D005293:Ferritins; D007501:Iron
Anemia; Breastfeeding; Infants; Iron deficiency; Supplementation