Skip to main content Accessibility help
×
Home

Iron deficiency in healthy 18-month-old Danish children is associated with no oral iron supplementation in infancy and prolonged exclusive breast-feeding

  • Anh Thao N. Andersen (a1), Steffen Husby (a1) (a2), Henriette B. Kyhl (a2) (a3), Maria B. Sandberg (a4), Stine D. Sander (a1) and Christian Mølgaard (a1) (a2) (a5)...

Abstract

Fe deficiency (ID) defined as plasma ferritin <12 µg/l is associated with delayed cognitive development in early childhood and increased incidence of infections; however, the longitudinal association between early-life factors and ID in 18-month-old children in Denmark is unknown. The present study aimed to determine the prevalence of ID and to describe risk factors associated with ID in healthy 18-month-old Danish children. Blood samples, anthropometric measurements and self-reported questionnaire data had been obtained in the birth cohort, Odense Child Cohort. The questionnaires were modified from those used in the Danish National Birth Cohort. Plasma ferritin and C-reactive protein in venous, non-fasting samples were analysed in the final sample size of 370 children after exclusion of seventy-nine children due to chronic disease, acute infection, C-reactive protein >10 mg/l, twin birth or prematurity. Associations with ID were analysed by logistic regression, adjusting for sex, maternal education, duration of partial breast-feeding and current intake of milk, fish and meat. Overall, fifty-six children had ID (15·1 %). Factors associated with increased risk were exclusive breast-feeding beyond 4 months (OR 5·97; 95 % CI 1·63, 21·86) and no intake of oral Fe supplements from 6 to 12 months (OR 3·99, 95 % CI 1·33, 11·97. Duration of partial breast-feeding and current diet was not associated with ID. In conclusion, the ID prevalence was 15·1 %, and both exclusive breast-feeding beyond 4 months and no intake of oral Fe supplements from 6 to 12 months were associated with increased risk of ID in 18-month-old children.

Copyright

Corresponding author

*Corresponding author: Christian Mølgaard, email cm@nexs.ku.dk

References

Hide All
1. World Health Organization (2001) Iron deficiency anaemia: assessment, prevention and control. http://www.who.int/nutrition/publications/micronutrients/anaemia_iron_deficiency/WHO_NHD_01.3/en2001 (accessed May 2016).
2. McLean, E, Cogswell, M, Egli, I, et al. (2009) Worldwide prevalence of anaemia, WHO Vitamin and Mineral Nutrition Information System, 1993–2005. Public Health Nutr 12, 444454.
3. Akkermans, MD, van der Horst-Graat, JM, Eussen, SR, et al. (2016) Iron and vitamin D deficiency in healthy young children in Western Europe despite current nutritional recommendations. J Pediatr Gastroenterol Nutr 62, 635642.
4. Bakoyiannis, I, Gkioka, E, Daskalopoulou, A, et al. (2015) An explanation of the pathophysiology of adverse neurodevelopmental outcomes in iron deficiency. Rev Neurosci 26, 479488.
5. Lukowski, AF, Koss, M, Burden, MJ, et al. (2010) Iron deficiency in infancy and neurocognitive functioning at 19 years: evidence of long-term deficits in executive function and recognition memory. Nutr Neurosci 13, 5470.
6. Lozoff, B, Beard, J, Connor, J, et al. (2006) Long-lasting neural and behavioral effects of iron deficiency in infancy. Nutr Rev 64, S34S43; discussion S72–S91.
7. Jauregui-Lobera, I (2014) Iron deficiency and cognitive functions. Neuropsychiatr Dis Treat 10, 20872095.
8. Bruner, AB, Joffe, A, Duggan, AK, et al. (1996) Randomised study of cognitive effects of iron supplementation in non-anaemic iron-deficient adolescent girls. Lancet 348, 4.
9. Abdullah, K, Kendzerska, T, Shah, P, et al. (2013) Efficacy of oral iron therapy in improving the developmental outcome of pre-school children with non-anaemic iron deficiency: a systematic review. Public Health Nutr 16, 14971506.
10. Jonker, FA & Hensbroek, BM (2014) Anaemia, iron deficiency and susceptibility to infections. J Infect 69, Suppl. 1, S23S27.
11. Beard, JL (2001) Iron biology in immune function, muscle metabolism and neuronal functioning. J Nutr 131, 120.
12. Michaelsen, KF, Milman, N & Samuelson, G (1995) A longitudinal study of iron status in healthy Danish infants: effects of early iron status, growth velocity and dietary factors. Acta Paediatr 84, 10351044.
13. Domellof, M, Braegger, C, Campoy, C, et al. (2014) Iron requirements of infants and toddlers. J Pediatr Gastroenterol Nutr 58, 119129.
14. Gondolf, UH, Tetens, I, Michaelsen, KF, et al. (2013) Iron supplementation is positively associated with increased serum ferritin levels in 9-month-old Danish infants. Br J Nutr 109, 103110.
15. Oliveira Fde, C, Assis, KF, Martins, MC, et al. (2014) Timing of clamping and factors associated with iron stores in full-term newborns. Rev Saude Publica 48, 1018.
16. Mastroeni, SS, Okada, IA, Rondo, PH, et al. (2006) Concentrations of Fe, K, Na, Ca, P, Zn and Mg in maternal colostrum and mature milk. J Trop Pediatr 52, 272275.
17. Emmett, PM & Rogers, IS (1997) Properties of human milk and their relationship with maternal nutrition. Early Hum Dev 49, Suppl., S7S28.
18. Shashiraj, , Faridi, MM, Singh, O, et al. (2006) Mother’s iron status, breastmilk iron and lactoferrin – are they related? Eur J Clin Nutr 60, 903908.
19. Teucher, B, Olivares, M & Cori, H (2004) Enhancers of iron absorption: ascorbic acid and other organic acids. Int J Vitam Nutr Res 74, 403419.
20. Hallberg, L, Rossander-Hultén, L, Brune, M, et al. (1992) Bioavailability in man of iron in human milk and cow’s milk in relation to their calcium contents. Pediatr Res 31, 524527.
21. The Danish Health Authority (2015) 03/17/15–04:31: New advice on infant food. http://danish228.rssing.com/chan-26035462/latest.php?q=new+advice+on+infant+food&site=rssing.com&stype=rssing (accessed August 2019).
22. Hörnell, A, Lagström, H, Lande, B, et al. (2013) Breastfeeding, introduction of other foods and effects on health: a systematic literature review for the 5th Nordic Nutrition Recommendations. Food Nutr Res 57, 10.3402/fnr.v57i0.20823.
23. Bruun, S, Buhl, S, Husby, S, et al. (2017) Breastfeeding, infant formula, and introduction to complementary foods-comparing data obtained by questionnaires and health visitors’ reports to weekly short message service text messages. Breastfeed Med 12, 554560. (Epublication ahead of print version 23 August 2017).
24. Kyhl, HB, Jensen, TK, Barington, T, et al. (2015) The Odense Child Cohort: aims, design, and cohort profile. Paediatr Perinat Epidemiol 29, 250258.
25. Olsen, J, Melbye, M, Olsen, SF, et al. (2001) The Danish National Birth Cohort – its background, structure and aim. Scand J Public Health 29, 300307.
26. WHO Multicentre Growth Reference Study Group (2006) WHO Child Growth Standards based on length/length, weight and age. Acta Paediatr Suppl. 450, 7685.
27. Levin, C, Harpaz, S, Muklashi, I, et al. (2016) Iron deficiency and iron-deficiency anemia in toddlers ages 18 to 36 months: a prospective study. J Pediatr Hematol Oncol 38, 205209.
28. Edena, AN & Sandoval, C (2012) Iron deficiency in infants and toddlers in the United States. Pediatr Hematol Oncol 29, 5.
29. Dewey, KG, Domellof, M, Cohen, RJ, et al. (2002) Iron supplementation affects growth and morbidity of breast-fed infants: results of a randomized trial in Sweden and Honduras. J Nutr 132, 32493255.
30. Bharati, S, Pal, M, Chakrabarty, S, et al. (2015) Socioeconomic determinants of iron-deficiency anemia among children aged 6 to 59 months in India. Asia Pac J Public Health 27, 11.
31. Henriksen, LO, Faber, NR, Moller, MF, et al. (2014) Stability of 35 biochemical and immunological routine tests after 10 hours storage and transport of human whole blood at 21 degrees C. Scand J Clin Lab Invest 74, 603610.

Keywords

Iron deficiency in healthy 18-month-old Danish children is associated with no oral iron supplementation in infancy and prolonged exclusive breast-feeding

  • Anh Thao N. Andersen (a1), Steffen Husby (a1) (a2), Henriette B. Kyhl (a2) (a3), Maria B. Sandberg (a4), Stine D. Sander (a1) and Christian Mølgaard (a1) (a2) (a5)...

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed