Iron deficiency anemia
Infants grow and develop rapidly and need iron in their diet to develop normally. For the first 4 to 6 months, an infant can rely on the body's own storage supply of iron. After that, if an infant does not consume enough iron, there is a risk of developing iron deficiency.
When this happens, the body's red blood cells suffer and their ability to support the rapidly growing body is affected. Iron deficiency can cause anemia, a condition that can delay an infant's mental, motor, and behavioral development and create problems that last long after the iron level is raised to a healthy level. Poor motor skills, behavior problems at home and school, and poor performance in school can be the long-term consequences of not receiving enough iron as an infant and young child (0 to 3 years of age).
Early use and overuse of cow's milk exacerbates existing causes of iron deficiency in infants. Less often, the problem is due to a severe blood loss or something interfering with the body's ability to absorb iron, such as a medication the infant is taking or a chronic illness involving the stomach or intestines. Premature and low-birth-weight babies are at greater risk. Breast-fed babies usually obtain enough iron, unless the nursing mother's own supply is low.
The American Academy of Pediatrics (AAP) advises screening all infants for anemia with a hemoglobin test around 12 months of age, along with assessment of risk factors for iron deficiency and iron deficiency anemia.
However, the U.S. Preventive Services Task Force has concluded that the current evidence is insufficient to assess the balance of benefits and harms of screening for iron deficiency anemia in children ages 6 to 24 months.
Like several other organizations, including the U.S. Centers for Disease Control and Prevention (CDC), the AAP recommends that infants and toddlers be screened at any point if they have risk factors, including:
- Premature birth or low birth weight
- Households with a low income or living in poverty
- Exposure to lead
- Exclusive breastfeeding beyond 4 months of age without supplemental iron
- Weaning to whole milk or complementary foods that do not include iron-fortified cereals or foods naturally rich in iron
- Feeding problems, inadequate nutrition
- Poor growth
Sources Used in Current Review
U.S. Preventive Services Task Force. Iron Deficiency Anemia in Young Children: Screening. Release Date: September 2015. Available online at https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/iron-deficiency-anemia-in-young-children-screening. Accessed October 2016.
Baker RD and Greer FR, The Committee on Nutrition. Diagnosis and Prevention of Iron Deficiency and Iron-Deficiency Anemia in Infants and Young Children (0-3 Years of Age). Pediatrics November 2010, Volume 126 / Issue 5. Available online at http://pediatrics.aappublications.org/content/126/5/1040.full. Accessed October 2016.