A critical characteristic of iron nutrition in infancy, as compared to adults, is
the greater dependency of the infant on external sources of iron for daily red cell
production. Dallman et al. (1) have calculated that in a 1-year-old, 10-kg infant,
dietary iron must provide 30% of the needs for hemoglobin iron turnover as
compared to only 5% in the adult male (Table 1).
Until about 20 years ago, the diagnosis of iron deficiency was justifiably considered
a simple matter. The focus of attention was then on hospitalized patients
with a severe or moderate degree of anemia.
Iron undernutrition is the most common single nutrient deficiency worldwide.
Iron deficiency has often been presumed to have few deleterious effects unless
severe enough to compromise cardiovascular function.
Even a rapid review of the literature reveals that millions of people around the
world, especially in developing countries, suffer from nutritional anemia despite
advances in detection as well as in methods of prevention and treatment.
Since the early 1920s pediatric textbooks have recognized that infants often
become anemic a few months after a preterm birth. However, except for its greater
severity, the anemia does not differ in any way from that of full-term infants.
The iron content of breast milk is often characterized as low. In fact, the amount
of iron provided by breast milk appears to be adequate to prevent iron deficiency
anemia for at least the first 6 months of life.
The full-term infant receives a generous and relatively fixed iron supply from
the mother. As a result, iron absorption in the early postnatal period is lower than
at any later time in childhood;
Bioavailability of a single iron source is difficult to predict. It can vary considerably
due to the enhancing or inhibitory effects of other food components on iron
absorption and, especially for the less-available sources, it is strongly influenced
by the physical characteristics of the iron compound itself.
Infants and children need to absorb about 1 mg of iron per day. This is a
disproportionate requirement, compared to adults, that derives from growth. Children
consume less food than adults and their diet often consists of foods with little
iron content and poor iron availability.
Adenine nucleotides, in breast milk, 131
iron requirements in, 3
risk for iron deficiency in, 13
Africa, prevalence of iron deficiency in,
Age-specific reference standards, 15, 63
American Academy of Pediatrics,
recommended iron intakes of, 6