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

• Published in: Pediatrics (Evanston) 2003-10, Vol.112 (4), p.846-854
• Main Authors: Lozoff, Betsy, De Andraca, Isidora, Castillo, Marcela, Smith, Julia B, Walter, Tomas, Pino, Paulina
• Format: Article
• Language: English
• Subjects: Anemia; Anemia, Hypochromic - drug therapy; Anemia, Hypochromic - epidemiology; Anemia, Hypochromic - prevention & control; Brain - growth & development; Child Behavior Disorders - epidemiology; Child Behavior Disorders - prevention & control; Chile - epidemiology; Developmental Disabilities - epidemiology; Developmental Disabilities - prevention & control; Dietary Supplements; Female; Hemoglobin; Humans; Incidence; Infant Food; Infant nutrition; Infant, Newborn; Iron; Iron - administration & dosage; Iron - deficiency; Iron - therapeutic use; Iron deficiency anemia; Male; Neonatal care; Pediatrics; Prevention; Psychomotor Performance - drug effects; Research Design; Treatment Outcome
• ISSN: 0031-4005; 1098-4275
• DOI: 10.1542/peds.112.4.846

To determine the behavioral and developmental effects of preventing iron-deficiency anemia in infancy. 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). 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. 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.