Behavioral and Developmental Effects of Preventing Iron-Deficiency Anemia in Healthy Full-Term Infants

Author:

Lozoff Betsy1,De Andraca Isidora2,Castillo Marcela2,Smith Julia B.3,Walter Tomas4,Pino Paulina5

Affiliation:

1. Center for Human Growth and Development and Department of Pediatrics and Communicable Diseases, University of Michigan, Ann Arbor, Michigan

2. Psychology Unit, Institute of Nutrition and Food Technology, University of Chile, Santiago, Chile

3. Department of Curriculum, Instruction, and Leadership, Oakland University, Rochester, Michigan

4. Hematology Unit, Institute of Nutrition and Food Technology, University of Chile, Santiago, Chile

5. Department of Environmental and Occupational Health, School of Public Health, Faculty of Medicine, University of Chile, Santiago, Chile

Abstract

Objective. To determine the behavioral and developmental effects of preventing iron-deficiency anemia in infancy. Methods. Healthy full-term Chilean infants who were free of iron-deficiency anemia at 6 months were assigned to high- or low-iron groups or to high- or no-added-iron groups. Behavioral/developmental outcomes at 12 months of age included overall mental and motor test scores and specific measures of motor functioning, cognitive processing, and behavior. There were no differences between high- and low-iron groups in the prevalence of iron-deficiency anemia or behavioral/developmental outcome, and they were combined to form an iron-supplemented group (n = 1123) for comparison with the no-added-iron group (n = 534). Results. At 12 months, iron-deficiency anemia was present in 3.1% and 22.6% of the supplemented and unsupplemented groups, respectively. The groups differed in specific behavioral/developmental outcomes but not on global test scores. Infants who did not receive supplemental iron processed information slower. They were less likely to show positive affect, interact socially, or check their caregivers’ reactions. A smaller proportion of them resisted giving up toys and test materials, and more could not be soothed by words or objects when upset. They crawled somewhat later and were more likely to be tremulous. Conclusions. The results suggest that unsupplemented infants responded less positively to the physical and social environment. The observed differences seem to be congruent with current understanding of the effects of iron deficiency on the developing brain. The study shows that healthy full-term infants may receive developmental and behavioral benefits from iron supplementation in the first year of life.

Publisher

American Academy of Pediatrics (AAP)

Subject

Pediatrics, Perinatology and Child Health

Reference46 articles.

1. Florentino RF, Guirriec RM. Prevalence of nutritional anemia in infancy and childhood with emphasis on developing countries. In: Steckel A, ed. Iron Nutrition in Infancy and Childhood. New York, NY: Raven Press; 1984:61–74

2. deMaeyer E, Adiels-Tegman M. The prevalence of anaemia in the world. World Health Stat Q.1985;38:302–316

3. Stoltzfus RJ. Defining iron-deficiency anemia in public health terms: a time for reflection. J Nutr.2001;131:565S–567S

4. Dallman P. Upper limits of iron in infant formulas. J Nutr.1989;119:1852–1855

5. Yip R, Reeves JD, Lonnerdal B, Keen CL, Dallman PR. Does iron supplementation compromise zinc nutrition in healthy infants?Am J Clin Nutr.1985;42:683–687

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