Investigation of the frequency of iron insufficiency among infants in a population in which routine iron supplementation is implemented

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Çullas-İlarslan NE, Günay F, İleri DT, Elhan AH, Ertem M, ArsanS. Investigation of the frequency of iron insufficiency among infants in apopulation in which routine iron supplementation is implemented. Turk JPediatr 2018; 60: 22-31.Iron deficiency anemia (IDA) represents the most common cause of anemiaworldwide. Because of potential irreversible neurodevelopmental impairment,its prevention during infancy is essential. We aimed to investigate thefrequency of iron insufficiency among infants in a population which routineiron supplementation is implemented; and to examine related risks. A totalof 501 infants, aged 9-15 months, were screened with complete blood countand serum ferritin. Infants were divided into two groups. [Group 1 (ironinsufficient), [Group 1a: Iron deficiency (ID), Group 1b: IDA (IDA)], Group2 (Iron sufficient (IS)]. Anemia was recognized in 122 (24.3%) infants.Microcytosis was observed in 110 (90.2%) of anemic infants. Group 2accounted for 49.5% (n=248) whereas 152 (30.3%) and 101 (20.2%) infantsbelonged to Groups 1a and 1b, respectively. Multiple logistic regressionanalysis showed that male gender (OR=1.53; 95%CI 1.07 and 2.17), receiving>500 ml/day cow’s milk (OR=2.77; 95%CI 0.87 and 8.83) and incomplianceto iron supplementation (OR=2.51; 95%CI 1.75 and 3.60) were distinctivecharacteristics of Group 1 while prevalence of iron insufficiency was higher ininfants consuming less formula (OR=3.10; 95%CI 2.00 and 4.80). The mostfrequent reasons for incompliance were consideration of supplementationas unnecessary (n=69, 31.1%) and neglection (n= 59, 26.6%). Our studydemonstrated a high frequency of iron insufficiency among infants in asetting utilizing national iron supplementation and “incompliance” to ironas the most evident risk factor for iron insufficiency. Effective counseling offamilies by health care providers concerning importance of compliance to ironprophylaxis is essential for prevention of iron insufficiency. We also suggestscreening of infants for ID as well as IDA in settings with high frequencyof iron insufficiency.