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Objective. To examine whether there is a continuation of the decline in prevalence of anemia among low-income infants and children 6.0 to 59.9 months old from the early 1980s to the mid-1990s. Study Design. Cross-sectional trend analysis of data from the Centers for Disease Control and Prevention's Pediatric Nutrition Surveillance System from the 5 states (Colorado, New Mexico, Oklahoma, Utah, and Vermont) that have been using the same laboratory method for anemia screening since 1984 or earlier. Results. The overall prevalence of anemia decreased substantially in each state from the early 1980s to the mid-1990s as follows: Colorado by 52%; New Mexico by 75%; Oklahoma by 67%; Utah by 57%; and Vermont by 48%. In each state, the prevalence of anemia declined for children of different age groups, birth weights, genders, type of pediatric care visit (screening or follow-up), and most race/ethnic groups. Conclusions. The decline in the prevalence of anemia initially observed in the 1980s continued well into the 1990s. This decline is likely attributable to better iron nutrition related to greater usage of iron-fortified products and possibly better iron bioavailability in some of the food products. Pediatrics 2001;107:677-682; anemia, low-income children, breast feeding, iron-fortified formula, iron-fortified cereal., ABBREVIATIONS. WIC, Special Supplemental Nutrition Program for Women, Infants, and Children; NHANES, National Health and Nutrition Examination Survey; PedNSS, Pediatric Nutrition Surveillance System; CDC, Centers for Disease Control and Prevention. [...]

Children who follow a vegetarian diet may be at risk for poor growth. The diet can be inadequate in essential nutrients such as protein. It is difficult to provide for the nutritional needs of growing children with vegetarian diets, but it is possible with careful planning. The growth of 404 vegetarian children living in a collective community in rural Tennessee was studied. The community, called The Farm, was established in 1971 and most of the children had lived there all their lives. Until 1983, the community adhered to a vegan diet. This is the most strict form of vegetarianism which does not allow meat, fish, eggs, or dairy products. The community members were knowledgeable about combining complementary protein sources and also added vitamins A, D and B-12 to the soy milk manufactured on The Farm. Other vitamin and mineral supplements were used as well. In 1983, some residents liberalized their diets by adding eggs and dairy products. The children's height and weight measurements were taken between 1980 and 1984, when they ranged in ages of four months to 10 years. Most of the children had heights and weights between the 25th and 75th percentiles of the United States growth standards which is considered acceptable. However, the average height-for-age and weight-for-age were slightly below the reference standard. Because no marked abnormalities were found, the authors concluded that the childrens' growth was adequate, although it was slightly below standard. Children can achieve satisfactory growth on a vegan diet if a balanced nutrient intake is provided. (Consumer Summary produced by Reliance Medical Information, Inc.)

Abstract. Most previous studies of the relationship between birth weight and childhood growth have concentrated on the growth of low birth weight infants. To examine this relationship throughout the full range of birth weights, growth data for children <5 years of age from the Tennessee Special Supplemental Food Program for Women, Infants, and Children linked to birth certificate records for 1975 to 1985 were used. Growth status was compared for 500-g birth weight categories from 1,000 g to 4,999 g using mean Z scores and the percentage of children more than 2 SD above or less than 2 SD below the median for height for age, weight for age, and weight for height. Infants with lower birth weights were likely to remain shorter and lighter throughout childhood, especially those who were intrauterine growth retarded rather than premature. Conversely, those infants with higher birth weights were likely to remain taller and heavier and to have a higher risk of obesity. Birth weight is a strong predictor of weight and height in early childhood, not only for low birth weight children but also for those of normal and high birth weight. [ABSTRACT FROM AUTHOR]

Abstract. To study trends of anemia among middle-class children, we collected 6,162 hematocrit measurements from the medical records of 2,432 children, ages 9 months through 6 years, as seen at a private pediatric clinic during the past 18 years. A decline in prevalence of anemia was observed during that period. The overall age-adjusted rate of anemia decreased from 6.2% in 1969 to 1973, 5.8% in 1974 to 1977, 3.8% in 1978 to 1981, and 2.7% in 1982 to 1986. The decline was also observed when trends were determined for three age groups using a single hematocrit measurement per child. The 1982 to 1986 prevalences of anemia for various age groups among this middle-class pediatric population were relatively low: 2.8% among 9- to 23-month-old children, 2.4% among 24- to 47-month-old children, and 2.7% among 48- to 83month-old children. Most of these recent cases of anemia were mild--most were only slightly less than the hematocrit values used to define anemia--and most did not show strong evidence of iron deficiency based on elevated levels of erythrocyte protoporphyrin. We conclude that iron deficiency is now mild and uncommon in these middle-class children. This improved nutritional status with regard to iron is probably related to increased intake of iron among infants and young children during the past two decades. These findings suggest that the recommended screening schedule for iron deficiency with hemoglobin or hematocrit measurements may need to be reassessed for well-defined populations of low-risk children. Pediatrics 1987;80:330-334; iron deficiency anemia, erythrocyte protoporphyrin. [ABSTRACT FROM AUTHOR]

Abstract. An evaluation was made of 278 healthy-appearing 1-year-old infants who were tested for iron deficiency to determine the relative frequency of adverse side effects attributable to oral iron treatment. After obtaining parental informed consent, laboratory tests of iron status were performed on venous blood and infants with hemoglobin level greater than 10.5 g/dL were randomly chosen to receive 1.2 mL of ferrous sulfate (FeSO[sub 4]) drops (about 3 mg of iron per kilogram per day) or equal volume of placebo for 3 months. After 3 months of treatment, infants were to return to the clinic for repeat blood testing, compliance estimation, and evaluation for possible adverse side effects. There was no significant difference (P > .50) in the frequency of vomiting, diarrhea, or fussiness in iron-treated infants (6%) compared with placebo-treated infants (9%). Constipation was slightly more frequently reported (P = .03) in placebo-treated infants (9%) than in iron-treated infants (1%). Compliance with therapy was confirmed in 179 completely evaluated infants by the lack of remaining medication at 3 months, the higher incidence (P < .0001) of dark stools reported among iron-treated infants, and the changes in laboratory tests of iron status. No parents reported dark stools as an adverse effect of therapy. It is concluded that once daily, moderate-dose FeSO[sub 4] therapy given to fasting 1-year-old infants results in no more gastrointestinal side effects than placebo therapy. [ABSTRACT FROM AUTHOR]

Abstract. Elevation of erythrocyte protoporphyrin (EP) level is one of the consequences of iron deficiency. As the EP test has been established to be a screening test for lead poisoning, the screening capability of the EP test for iron deficiency was investigated. A total of 4,160 children between ages 6 months to 12 years had EP determined together with serum ferritin and hematocrit. Comparing the relationship of EP to serum ferritin and using a serum ferritin value is less than or equal to 15 micro g/L as the criterion of iron deficiency, the optimal cutoff limit for the EP test appears to be 35 micro g/dL of whole blood. At this level, 88% of the subjects with low levels of serum ferritin can be detected (sensitivity), in contrast to the 53% detected at a higher cutoff value (is less than or equal to 50 micro g/dL) used to screen for lead toxicity, or to the 59% detected by age-related hematocrit value. At an EP screening level of 35 micro g/dL of whole blood, 90% of the subjects with normal serum ferritin level are correctly determined to be screen negative (specificity). The predictive value of tow levels of serum ferritin for all subjects above screening level is 38%. In general, an elevated EP level, by itself, represents inadequate iron supply for hematopoiesis and signals iron deficiency regardless of whether the serum ferritin value is below the diagnostic level or not. A trial course of orally administered iron is suggested for children who are found to have an elevated EP value, with an increase in hemoglobin or hematocrit value serving, retrospectively, as confirmation of prior iron deficiency. [ABSTRACT FROM AUTHOR]