Normal hemoglobin at the age of 1 year does not protect infants from developing iron deficiency anemia in the second year of life

Background: Iron deficiency anemia (IDA) is the most common hematologic disorder worldwide. Measures to prevent IDA in infants have been successful with questionable sustainability. AIM: To evaluate the incidence of developing IDA in the second year of life, in infants who were nonanemic at the age of 1 year on routine blood test. Methods: Blood samples were obtained from 193, 24-month-old toddlers, from 2 large clinics of both main sectors in Southern Israel, comparable for lower economic status. IDA was defined as hemoglobin<11 gr% and microcytosis as mean corpuscular volume<70 fL. Results: IDA was detected in 8 of 118 Bedouins (5 males) and in 10 of 75 Jewish (6 males) infants (P<0.01). The probability of a nonanemic child to develop IDA in the second year of life for the whole study population was 9.3% (18 of 193 infants) and significantly higher in the Jewish population (13.3.0% vs. 6.8%, P<0.01). Conclusions: Given the difficulty of toddlers to maintain a non-IDA status, and the very low probability of iron overload, our Results clearly support the need to continue iron supplementation into the second year.