Iron in Infancy and Childhood

Editor(s): O.Hernell Annales Nestlé Vol.68 / 3,  2010


Iron requirements in late infancy are higher than during any other period in life. Iron deficiency is the most common nutritional deficiency in children worldwide. It is estimated that close to 50% of preschool children are anemic globally, and most of these children are anemic due to iron deficiency. Much new information has been published in the last decade on requirements, metabolism, physiological and neurodevelopmental effects of iron as well as of iron deficiency. The challenges to define strategies for prevention, treatment by managing the risk of adverse effects of too much iron given to iron-replete individuals remain. This issue of the Annales is therefore dedicated to the topic "Iron Deficiency in Infancy and Childhood".

  • Homeostatic Regulation of Iron and Its Role in Normal and Abnormal Iron Status in Infancy and Childhood

    Author(s): B.Lönnerdal, O.Hernell

    Iron is important in neurodevelopment and cognitive function, and globally preventing iron deficiency and iron deficiency anemia remains a high priority. Term breast-fed infants and infants fed an iron-fortified formula usually have a satisfactory iron status during the first 6 months of life, but there are still ambiguities in assessing iron status in infants and how to properly meet their iron requirements. This is particularly evident for preterm infants, who are born with low iron stores, and for whom recommendations for iron provision vary considerably. In part, this may be due to immaturity in the regulation of iron homeostasis in young infants. Whereas 9-month-old infants appear to be able to downregulate iron absorption when being iron replete, 6-month-old infants cannot do this. Iron may be provided as drops or in iron-fortified products, but the forms provided may be metabolized differently, and excess iron in drops may cause adverse effects, possibly due to a limited ability to regulate iron absorption in young infants. Adverse effects are manifested by decreased growth: in well-nourished infants by reduced gain in length, in poorly nourished populations by lower gain in weight. The mechanism behind the decreased growth is not known, but it may involve free radical-mediated effects of iron or an interaction with zinc absorption/homeostasis. It therefore seems that iron drops should not be given to iron-replete infants.

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