Background:
Iron deficiency (ID) and Iron deficiency anemia (IDA) is a serious public health problem in low-and-middle income countries (LMICs). However, there is paucity of data on iron status in early infancy. So, we investigated the proportion of ID and IDA among term healthy breastfed infants in first six-months of life.
Methods:
This prospective cohort study was conducted from May 2021 to Oct 2022 in tertiary care center in Western India. Term, singleton, healthy pregnant mothers admitted in labour room were screened and well infants were enrolled. These mother-infant dyads were followed till first 6 months of age. Venous blood samples for hemogram, serum ferritin and CRP were collected from infants at birth (cord blood), 14 (±2) weeks and 6 months (±2 weeks).
Results:
A total of 546 mother-infant dyads were enrolled. Three-fourth mothers were vegetarian. Almost 99% had taken iron supplementation during pregnancy. The mean gestational age and birth weight of infants were 38.7(±1) weeks and 3066(±401) grams. Among 513 cord samples, the proportion of infants with anemia (Hb<13.5g/dl), ID (ferritin<40ug/L) and IDA was 20.4%, 8.6% and 1% respectively. Only 217 and 205 infants turned up for follow-up at 14 weeks and 6 months due to COVID 19 pandemic. Around 80% were on exclusive breastfeeding. The proportion of infants with anemia (Hb<10.5g/dl), ID (ferritin<20ug/L) and IDA was 28.6%, 8.4% and 2.4% at 14weeks respectively. Similarly, 26.5%, 13.3% and 6.1% infants had anemia (Hb<10.5g/dl), ID (ferritin<12ug/L) and IDA at 6 months respectively.
Conclusion:
Iron deficiency was observed in 8-13% of well infants possibly warranting early iron supplementation. One-fourth were anemic warranting research to determine underlying etiology apart from ID.
Dr. Neeraj Gupta, Professor and Head of Neonatology at AIIMS Jodhpur, established the Department of Neonatology and leads research in delivery room interventions, including neonatal resuscitation, cord clamping, early skin-to-skin contact, sepsis diagnostics, and neonatal equipment development. His work emphasizes public health impact through implementation research and novel early-intervention tools, aiming to improve outcomes for vulnerable newborns in resource-limited settings. Dr. Gupta has published widely in leading journals including Lancet Global Health, Pediatrics, and Cochrane. He has contributed to WHO guidelines as well as national policy frameworks, shaping neonatal care practices in India and advancing global newborn health.
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