Regarding Iron Deficiency in Childhood

Which of the following statements is true regarding iron deficiency in childhood?

A) Iron deficiency commonly occurs in term infants during the first 3 months.
B) Ingestion of cow’s milk can result in iron overload.
C) Iron deficiency rarely leads to complications.
D) Pica is associated with iron deficiency.
E) Mild iron deficiency typically leads to symptoms of pallor, fatigue, and delayed motor development.

Answer and Discussion

The answer is D. (Pica is associated with iron deficiency.)

The incidence of iron deficiency in children has decreased substantially due to improved nutrition and the increased availability of iron-fortified infant formulas and cereals. Normal-term
infants are born with sufficient iron stores to prevent iron deficiency for the first 4 to 5 months of life. Thereafter, sufficient iron needs to be absorbed to maintain the needs of rapid growth. For this reason, nutritional iron deficiency is most common between 6 and 24 months of life. A deficiency
earlier than age 6 months may occur if iron stores at birth are reduced by prematurity, small birth weight, neonatal anemia, or perinatal blood loss or if there is subsequent iron loss due to hemorrhage. Iron-deficient children older than 24 months should be evaluated for blood loss. Iron deficiency, in
addition to causing anemia, has adverse effects on multiple organ systems.
Symptoms and signs vary with the severity of the deficiency. Mild iron deficiency is usually asymptomatic. In infants with more severe iron deficiency, pallor, fatigue, irritability, and delayed motor development are common. Children whose iron deficiency is due in part to ingestion of
unfortified cow’s milk may be fat and flabby, with poor muscle tone. A history of pica is common