Journal of Nutrition and Health

  • 제31권1호
  • /
  • Pages.96-101
  • /
  • 1998
  • /
  • 2288-3886(pISSN)
  • /
  • 2288-3959(eISSN)
한국영양학회 (The Korean Nutrition Society)
권호 표지

Anemia and Iron Deficiency according to Feeding Practices in Infants Aged 6 to 24 Months

  • 발행 : 1998.01.01
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

The prevalence of iron deficiency in later infancy and the toddler years(25% to 40% at 1 year of age) has not decreased remarkably , except in Western countries. The purpose of this study was to 1) determine the relationship between current feeding practices and iron status, and 2) assess compliance to infant feeding instructions. Two groupsof infants were examined. The first group of 302 infants aged 6 to 24months was seen at a well baby clinic while the second group of 135 infants of the same age group was assessed by venipuncture. Cutoff values for laboratory tests were as follows ; hemoglobin<11g/dL, mean corpuscular volume (MCV) <72fl ; red cell distribution width(RDW)>15% ; serum ferritin level<10ng/ml ; and transferrin saturation (serum iron(TIBC)<10%. The diagnosis of iron deficiency anemia (IDA) was made when a low hemoglobin level was associated with either low ferritin orlow transferrin saturation . Of the 302 children brought to the well baby clinic , 12.3%(n=37) were found to have anemia (hemoglobin<11.0/dL). In terms of children grouped according to feeding practices, it was found that children with anemial comprised 32.0% (24/75) of the prolonged breast-fed group (Group A), significantly more than the 4.0%(7/176) of the artificial milk feeding group(Group B). and 3.9%(2/51) of the switched from breast milk to iron -fortified weaning foods group(Group C).Among the 107 children with IDA , iron deficiency in 105 children(98.1%) was suggested by their dietary histories ; exclusive or prolonged breast-feeding for more than 6 months without iron fortification in 98 infants ; cow's milk consumption> 500ml/day without iron fortification during infancy(n=12), or >800ml without iron-fortified foods after infancy(n=15) ; and the use of unfortified forumula or unbalanced diets, mainly limited to rice gruel. Despite the relatively high (79.6%) motivation on the part of the infants mothers and supervison by professional personnel, the poor results in the infants receiving iron fortified foods were due to poor compliance(85.75). Among the mothers of 98 IDA patients who were contacted by telephone , it was revealed that 29% did not give the oral iron preparation for more than 2 months. Furthermore, negligence or disregard by the parents occurred in 14% of the case , discontinuance of the oral iron preparation by the parents due to side effects occurred in 6%, and the children's refusal or poor oral intake and no further trial occurred in 6%. The dietary history of a large group of infants was highly predictive of their risk for anemia . Continued consumption of breast milk until the age of 1 year is not warranted unless iron-fortified foods are given concomitantly. Because there is a problem with compliance, more successful and safe strategies for preventing iron deficiency woold included dual coverage in the from of therapeutic iron supplementation as well use of iron-fortified foods for teddlers who are at risk of iron deficiency.

키워드

참고문헌

  1. Nutrition in Infancy and Childhood Prevalence of nutritional anemia in infancy and childhood with emphasis on developing countries Florentino,R.F.;Guirriec,R.M.;Stekel,A.(eds.)
  2. World Health Stat. Q v.38 The prevalence of anemia in the world De Maeyer,E.;Adiels-Tegman,M.
  3. JAMA v.277 Prevalence of iron deficiency in the United States Looker,A.C.;Dallman,P.R.;Carroll,M.D.;Gunter,E.W.;Johnson,C.L.
  4. J Pediatr v.92 The effects of therapy on the developmental scores of iron deficient infants Oski,F.A.;Honig,A.S.
  5. Adv Pediatr v.35 Behavioral alterations in iron deficiency Lozoff,B.
  6. Pediatrics v.84 Iron deficiency anemia : Adverse effects on infant psychomotor development Walter,T.;de Andraca,I.;Chadud,P.;Perales,C.G.
  7. Neurology of the Newborn(2nd ed.) Neuronal proliferation, migration, organization and myelination Volpe,J.J.
  8. Am J Clin Nutr v.50 Brain iron : A lesson from animal models Yehuda,S.;Youdim,M.
  9. J Pediatr v.104 Exclusive breast-feeding for 9 months : risk of iron deficiency Siimes,M.A.;Salmenpera,L.;Perheentupa,J.
  10. J Pediatr v.118 Iron status with different infant feeding regimens : Relevance to screening for anemia Pizarro,F;Yip,R.;Dallman,P.R.;Olivares,M.;Hertrampf,E.;Walter,T.
  11. Pediatrics v.90 Iron status in exclusively breast feeding infants Calvo,E.B.;Galindo,A.C.;Aspres,N.B.
  12. AJDC v.134 Inhibition of iron absorption from human milk by baby foods Oski,F.A.;Landaw,S.A.
  13. J Pediatr v.94 Percentile curves for hemoglobin and red cell volume in infancy and childhood Dallman,P.R.;Siimes,M.A.
  14. J Pediatr v.92 Developmental change in red blood counts and indices of infants after exclusion of iron deficiency by laboratory criteria and continuous iron supplementation Saarinen,U.M.;Siimes,M.A.
  15. Pediatrics v.80 Declining prevalence of anemia in childhood in a middle-class setting : A pediatric success story? Yip,R.;Walsh,K.M.;Goldfarb,M.G.;Binkin,N.J.
  16. Pediatr Rev v.15 The changing face of anemia in infancy Graham,E.A.
  17. Can Med Assoc J v.146 Iron deficiency anemia in 1 yr-old children of disadvantaged families in Montreal Lehmann,F.;Gray-Donald,K.;Mongeon,M.;DiTommaso,S.
  18. Am J Clin Nutr v.52 Prevalence of iron deficiency in children aged 9-24 mo from a large urban area of Argentina Calvo,E.B.;Gnazzo,N.
  19. Kao Hsiung I Hsueh Ko Hsueh Tsa Chih v.6 Iron status of inancy and early childhood in south Taiwan Chiou,S.S.;Chang,T.T.;Perng,J.J.;Chen,T.S.
  20. Ann Trop Paediatr v.15 The prevalence and correlates of anemia among young children and women of childbearing age Al Ain, United Arab Emirates Hossain,M.M.;Bakir,M;Pugh,R.N.;Sheekh-Hussen,M;BinIshaq,S.A.;Berg,D.B.(et al.)
  21. Pediatrics v.58 Iron sufficiency in breast-fed infants and availability of iron from human milk McMillan,J.A.;Landaw,S.A.;Oski,F.A.
  22. J Pediatr v.90 Iron sufficiency in breast-fed infant Woodruff,C.W.;Latham,C.;McDavid,S.
  23. Pediatr Clin North Am v.32 Human milk feeding Anderson,G.H.
  24. Arch Dis Child v.61 Combined deficiency of iron and vitamin D in Asian toddlers Grindulis,H.;Scott,P.H.;Belton,N.R.;Wharton,B.A.
  25. Am J Clin Nutr v.43 Absorption of fortification iron from milk formulas in infants Stekel,A.;Olivares,M.;Pizarro,F.;Chadud,P.;Lopez,I.;Amar,M.
  26. DHSS, Report on Health and Socal Subjects 20 Present day practice in infant feeding Oppe,T.E.;Arneil,G.C.;Davies,D.P.
  27. Nutrition in Infancy and Childhood Availability of iron from infant food Cook,J.D.;Bothwell,T.H.;Stekel,A.(ed.)
  28. Trans R Soc Trop Med Hyg v.88 The effects of iron supplementation during pregnancy, given by traditional birth attendants, on the prevalence of anemia and malaria Menendez,C.;Todd,J.;Alonso,P.L.;Francia,N.;Lulat,S.;Ceesay,S.(et al.)
  29. Monatsschr Kinderheilkd v.123 Orale Eisentherapie im Sauglings- und Kindersalter Erfahrungen mit einer modifizierten Eisengluconat-Zubereitung Gburek,F.K.;Kornhuber,B.
  30. Ann Trop Paediatr v.9 Iron deficiency anaemia and its response to oral iron : Report of a study in rural Gambian children treated at home by their mothers Smith,A.W.;Hendrickse,R.G.;Harrison,C.;Hayes,R.J.;Greenwood,B.M.