Iron Deficiency Anemia and Vitamin D Deficiency in Breastfed Infants

Eun Hye Choi; Soo Ho Jung; Yong Hoon Jun; Yoo Jin Lee; Ji Yeon Park; Jeong Soon You; Kyung Ja Chang; Soon Ki Kim

doi:10.5223/kjpgn.2010.13.2.164

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Choi, Jung, Jun, Lee, Park, You, Chang, and Kim: Iron Deficiency Anemia and Vitamin D Deficiency in Breastfed Infants

Original Article

Nutrition

Korean Journal of Pediatric Gastroenterology and Nutrition

Korean Journal of Pediatric Gastroenterology and Nutrition 2010; 13(2): 164-171.

Published online: 30 September 2010

DOI: https://doi.org/10.5223/kjpgn.2010.13.2.164

Iron Deficiency Anemia and Vitamin D Deficiency in Breastfed Infants

Eun Hye Choi, M.D., Soo Ho Jung, M.D., Yong Hoon Jun, M.D., Yoo Jin Lee^*, Ji Yeon Park^†, Jeong Soon You^†, Kyung Ja Chang^†, Soon Ki Kim, M.D.

Department of Pediatrics, College of Medicine, Inha University, Incheon, Korea.

^*Dietary Department, Health Promotion Center, Inha University Hospital, Incheon, Korea.

^†Department of Food and Nutrition, Inha University, Incheon, Korea.

Corresponding author (pedkim@inha.ac.kr)

Received 13 August 2010 Revised 17 August 2010 Accepted 10 September 2010

Abstract

Purpose

Iron deficiency anemia (IDA) is one of the most common nutritional problems, despite a recent improvement of nutritional status of infants and children. We assessed the risk factors for IDA in infants and vitamin D deficiency and IDA by nutrition analysis.

Methods

We analyzed blood tests and evaluated 103 children with IDA and 123 children without IDA, 6-36 months of age, who were cared for in our hospital between March 2006 and July 2010. Nutritional analysis using Canpro was performed among breastfed infants 6~12 months of age who had been diagnosed with IDA and had detailed diet histories.

Results

Breastfed infants accounted for 87.4% and 40.7% of the IDA and comparison groups, respectively. The IDA and comparison groups began weaning food at 6.4±1.8 and 5.9±1.3 months, respectively. In the IDA and comparison groups, 46.4% and 53.5% began to adapt to weaning food within 4 weeks, respectively. The most common reason for hospital care of the IDA group was respiratory symptoms constituting 36.2%. Only 18.6% visited the hospital for palloror anemia. The Canpro analysis, performed on 11 infants with IDA, showed that iron and vitamin D were <40% and 30% of recommended intakes, respectively.

Conclusion

Weaning food should be started 4~6 months of age in breastfed infants. In infants at high risk for IDA and vitamin D deficiency, screening tests should be recommended. The high-risk infants may require iron, vitamin D fortified formula, or oral supplements.

Keywords: Iron deficiency anemia, Vitamin D deficiency, Weaning food, Breastfed

Figures and Tables

Table 1

Comparison of Feeding Patterns between IDA and Comparison Groups

^*Others mean mixed feeding or formula feeding only.

Table 2

Interval from the Beginning of Weaning to the Proper Solid Food Intake

Table 3

Chief Complaints or Diseases on Initial Visit in the IDA Group

Table 4

Hematologic Values of the IDA and Comparison Groups

Hb: hemoglobin, Hct: hematocrit, MCV: mean corpuscular volume, MCH: mean corpuscular hemoglobin, RDW: red cell distribution width, TS: transferrin saturation, TIBC: total iron binding capacity.

Table 5

Weaning Food Plus Breast-fed Nutrition Composition in Children with IDA

^*Absorbable iron was calculated with 50% from breast milk and 10% from complementary food, ^†Vit D 1µg=40 IU. AAP: American Academy of Pediatrics, DFE: dietary folate equivalent, KDRIs: dietary reference intakes for Koreans, RDA: recommended daily allowance, RE: recommended intake.

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