In childhood, IDA accounts for 90% of all anemias. It is found in all countries of the world, but its prevalence depends on socio-economic conditions, population income, diet and other factors. Infants, young children and adolescents are at the highest risk of developing IDA.
The main reasons for IDA development in children and adolescents:
iron deficiency at birth; insufficient intake of iron from food: exclusive breastfeeding over the age of 4 months, late introduction of complementary foods, artificial feeding with unadapted milk formulas, goat or cow milk, in adolescents - unbalanced nutrition, vegetarianism, diets; increased needs of the body for iron (rapid growth of a child at the age of 1-3 and puberty at the age of 14-16, playing professional sports);
Prevalence of anemia: Children aged 0-4 years 20.1-39%; Children aged 5 to 14 years 5.9-48.1% iron loss in a body, exceeding physiological (bleeding of various etiologies, including profuse menstrual blood loss); iron deficiency anemia in adolescents is often observed in conditions such as anorexia nervosa, stomach and duodenum disorders, including those associated with H. pylori, repeated intestinal infections, giardiasis, helminthic infestations, inflammatory bowel diseases, lactase deficiency, celiac disease, infectious diseases.
Hemoglobin concentration, in case of less level anemia is diagnosed in children of different ages (WHO): from 1 month to 5 years ≤110 g / l; from 5 to 11 years old ≤115 g / l; 12-14 years ≤120 g / l
Consequences of iron deficiency
Iron deficiency could lead to long-term and irreversible consequences. The most serious of these at early age are delayed psychomotor development and impaired cognitive functions. Such children perform poorly in school and have more behavior problems in middle age. Iron deficiency could also lead to delayed sexual development, cause chronic fatigue syndrome, affect the immune status, increase the risk of infectious diseases, disrupt the functioning of endocrine glands, nervous system, and increase the absorption of heavy metals.
In older children and adults, as a result of iron deficiency, memory deteriorates clearly and significantly, shifts in psyche appear, especially in its late formed elements (lack of the ability to communicate collectively, to establish friendly relations, ability to forgive petty insults). As a result, the individual becomes withdrawn, unjustified uncompromising, nervousness and irritability increase.
Adequate treatment and elimination of the causes of iron deficiency anemia in children leads to normalization of blood counts and complete recovery of the child.
WHO recommendations (2016): Daily iron supplementation (30-60 mg elemental iron daily for 3 months) is recommended for school-aged children (5 years and older) living in conditions in which prevalence of anemia in infants and young children is 40% or more, in order to prevent iron deficiency and anemia. Recommendations for IDA prevention in infants and young children (1-3 years) of the American Academy of Pediatrics full-term babies who are breastfed or have mixed feeding (breast milk makes up more than half of the diet) should additionally receive 1 mg of iron per 1 kg of body weight per day, starting from 4 months of age and before introduction of complementary foods; babies aged 6-12 months should receive 11 mg of iron per day. Red meat and vegetables with high iron content should be used as complementary foods. In case of insufficient intake of iron with milk mixtures or complementary foods, iron should be additionally prescribed in the form of drops or syrup; babies aged 12-36 months should receive 7 mg of iron per day. Better - in the form of food containing sufficient amount of red meat, vegetables and fruits with high iron content and vitamin C, which increases the iron absorption. It is also possible the additional appointment of liquid forms of iron preparations or multivitamins; all babies born prematurely, while breastfeeding, should receive 2 mg of iron per 1 kg of body weight per day, starting from the 1st month of life and until the transition to artificial feeding with milk formulas fortified with iron, or before the introduction of complementary foods.
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