ANEMIA IN INFANTS WITH MILD INFECTIONS

A group of 467 healthy infants had Hgb, MCV, erythrocyte protoporphyrin (EP), serum ferritin (SF), serum iron (Fe) and TIBC measured as part of a nutritional evaluation in conjunction with the well child examination at 12 months of age. In addition to the nutritional history, the frequency of clinic visits within 3 months of examination related to infection (URI, otitis, gastroenteritis) was determined. Frequent recent infection visits were associated with a pattern of reduced Hgb, MCV, and Fe with elevated EP and SF that is also characteristic of the anemia of chronic inflammation. (In iron deficiency, SF is typically decreased.) Of the infants with ≥ 3 recent infections, 22% had Hgb<11.5 g/dl, in contrast to 9% of those with no infection (p=0.005,X2). A subgroup of 323 infants was treated with either placebo or iron (30 mg iron/day as ferrous sulfate) for 3 mo. The percentage of subjects with a≥1g/dl rise in Hgb was 35% in infants with ≥3 infection visits compared to 13% in those with no infection visits (p<0.001). Each of the response rates was slightly but not significantly higher in the iron treated compared to the placebo group. Mild, acute, antecedent infections contribute substantially to the frequency of low Hgb values in infants who are screened for iron deficiency.