Anaemia In Children - A Challenge Aijaz Ahmad Lone, Shakir Ahmad Wani, Zubair Ashai, Fazal Q. Parray JK-Practitioner2006:13(4);229-231 Authors’ Affiliations : Aijaz Ahmad Lone J&K Health Sciences Shabir Ahmad Wani SKIMS, Soura Zubair Ashai, Deptt. Of Pharmacology Fazal Q Parray Department of Gastroenterlogy, SKIMS Accepted for Publication : June 2006 Correspondence : Dr. Aijaz Ahmad Lone, House No. 73, R/O Rajbagh Minto Circle School Lane, Pind Code : 190 008 Ph : 2483479, Mobile : 9419517358 E-mail:aijazlone20@yahoo.co.in to iron deficiency anemia within the first six months of Anaemia in children – A challenge (6,10) Anemia is the principal nutritional dearth in the life, caused by low stocks of iron at birth . The average world, and it especially affects children and pregnant iron concentration per kilogram of body weight at birth is (6,10) women in developing countries. Nutritional Anemia 70mg/Kg for full-term infants . The average daily iron according to the WHO, is a state in which the hemoglobin needs are from 0.72mg to 0.46mg for children from five concentration in the blood is lower than levels considered months to one year old and from one to three years old, (17) normal for the age, gender, physiological state and respectively . altitude, as a consequence of shortage of essential In the diet, the quantity of bioavailable iron is (1,2) nutrients, independent of the cause of this deficiency . important, and this is determined by stimulation and (18) Nutritional anemia includes lack of nutrients such as iron, inhibitory factors that exist within a meal . Among the folic acid, vitamin B and copper, vitamin C and E and 12 iron absorption stimulation fctors in the diet are organis (3) vitamin A . acids, in particular ascorbic acid, which is found in citric (18) The occurrence of anemia due to iron deficiency fruits . Among the iron absorption inhibitory factors are (4) is labeled as iron deficiency anemia . This deficiency is phytic acids, which is found in fibres, whole grains and (19) the most common nutritional disorder in infancy, and it beans , oxalic acid, which is found in spinach and (20) affects communities not only in developing nations but beetroot , and tannin, which is found in tea, coffee and (5,6) (21) also in highly industrialized countries . Iron deficiency chocolate . Calcium, which is present in milk and dairy (7,8) (22) anemia also affects women of child bearing age . products , and other minerals that are close to iron in the Etiology periodic table, which compete with the same intestinal (23) The main factors involved in the etiology of absorption , also inhibits the absorption of iron. anemia in children are the iron reserved at birth, growth For full-term newborn babies, the iron deposits (9) rate, diet and iron loss . Organic physiological loss of at birth provide the needs for this mineral until four to six iron occurs in bile, urine and cellular desquamation of the months of age. Breastfeeding alone acts as a protective skin and intestinal lining. In children, loss also occurs due factor during the first months of life and, in spite of the to blood in the feces and by the use of whole milk in liquid low iron content of human milk (0.26 to 0.73mg/L), the (10,11 form during the first year of life . Another possible mineral in mother’s milk has high biolavailability and (24) cause of iron loss is the presence of intestinal parasites, absorption (around 50%) . Because of the greater although several studies have shown that the majority of physiological requirements within the first two years of parasitic diseases have secondary importance in the life, and specifically from 6 to 12 months because of the 12- etiology of iron deficiency anemia in under 5-year olds accelerated growth during this period, it is rare that the 16 . child will manage to ingest the recommended daily The most significant weight gain and storage of amount of iron. This is true even when good sources of iron by the fetus occurs during the last trimester of bioavailable iron are introduced into the diet. Thus, pregnancy. Premature births, intrauterine growth preventive iron supplements are usually necessary for this (17) restriction and multiple pregnancies are factors that lead age group . Prevalence According to the United Nations Childrens’ Fund (UNICEF), 90% of all types of anemia in the world (4) are due to iron deficiency . In South and Central America, iron deficiency anemia has been a severe public health problem, affecting as many as 50% of pregnant (7) women and children . Consequences of iron deficiency in children Studies show that children with iron deficiency present worse performance in psychomotor tests than do non-anemic children. The greatest prevalence of iron deficiency among breastfed infants coincides with the final period of rapid brain development (six to 24 months), when the motor and cognitive skills take shape. Long-term prospective studies have also identified persistent cognitive deficiencies in 10-year-old children who had suffered from anemia during the first month of infancy. In South Africa, six to eight-year-olds who were observed to have low iron reserves, presented with commentary JK- Practitioner Vol.13, No. 4, October-December 2006 229