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Introduction. Iron deficiency (ID) is the most prevalent nutritional deficiency and the main cause of anemia in infants. There is consensus on daily iron supplementation as a preventive strategy; and weekly iron supplementation has also been shown to be effective, but evidence in infants is scarce. The objective of this study was to compare the effectiveness of daily versus weekly iron administration for the prevention of ID anemia (IDA) in infants. Population and methods. Randomized, controlled clinical trial. Infants seen at a public health center, without anemia at 3 months of age, were randomized into 3 groups: daily supplementation (1 mg/kg/day), weekly supplementation (4 mg/kg/week), or no supplementation (control group with exclusive breastfeeding [EB]). Anemia and ID were assessed at 3 and 6 months old. Adherence and adverse events were recorded. Data were analyzed using the R software, version 4.0.3. Results. A total of 227 infants participated. At 6 months, the group of infants with EB without supplementation (control) had a higher prevalence of ID and IDA than the intervention groups (daily and weekly). ID: 40.5% versus 13.5% and 16.7% (p = 0.002); IDA: 33.3% versus 7.8% and 10% (p < 0.001). There were no differences between the daily and weekly supplementation groups. There were also no differences in the percentage of high adherence to supplementation (50.6% daily versus 57.1% weekly) or adverse events. Conclusions. No significant differences in effectiveness were observed between daily and weekly administration for the prevention of infant IDA., (Sociedad Argentina de Pediatría.)

Breast milk is the ideal food for infants and its benefits can be observed in the short and long term. In crisis situations, breastfeeding should be promoted the most because it is one of the most cost-effective interventions aimed at reducing infant morbidity and mortality. In addition to the multiple advantages of breast milk in the mother-child bond and biological and immune properties, the most relevant characteristic of breast milk is that it covers all nutritional needs. When breastfeeding is not possible, the World Health Organization recommends infant formula as the first option. The second option is diluted cow's milk, which entails the risk for nutritional deficiency that should be strictly monitored and timely resolved. When infants are fed with diluted cow's milk, they are mainly at risk for iron, zinc, vitamin A, D, C, and E, amino acid and essential fatty acid deficiency., Competing Interests: The manuscript was written with the help of all authors in an autonomous manner; the company did not interfere with the editorial management or the final article. The authors state that their only relationship with Mead Johnson Nutrition was their participation in conferences and symposiums organized by the company, as in others carried out by other companies., (Sociedad Argentina de Pediatría.)

Introduction: Wheat flour enrichment is a public health strategy recommended to prevent micronutrient deficiencies, including iron deficiency. The objective of this study was to determine iron content in enriched wheat flour and flour products and their contribution to nutritional recommendations for children., Population and Methods: Observational, analytical, cross-sectional study based on the total diet study method. Enriched wheat flour (as per Law no. 25630) and the most frequently consumed flour products were analyzed. Products were selected using a questionnaire on the frequency of food intake and a 24-hour recall interview with the parents of children aged 6 months to 7 years. Food iron levels were determined based on atomic absorption spectrometry and their contribution to the estimated average requirement was assessed., Results: Enriched flour and flour products showed the expected iron amount, except for French bread and breadcrumbs. The contribution of studied products to iron requirements was 7 % in children aged 6 months to 1 year, 81 % in those aged 1-3 years, and 45 % in those older than 4 years., Conclusions: Except for French bread and breadcrumbs, studied flour and flour products showed the expected enrichment level. The consumption of this type of food does not provide significant amounts of iron to infants, but it does to children older than 1 year., Competing Interests: None, (Sociedad Argentina de Pediatría.)

Introduction: Vitamin A deficiency (VAD) has been recognized as an important public health problem in developing countries. Preschoolers account for risk groups within vulnerable populations. The objective of this study was to determine the prevalence of VAD and associated factors in a sample of preschoolers., Materials and Methods: Cross-sectional study with children aged 1-6 years receiving social assistance and seen at primary health care centers in the outskirts of the city of La Plata, Buenos Aires. Vitamin A levels were determined by measuring serum retinol with a liquid chromatography; anthropometric parameters and dietary intake were recorded. A multinomial logistic regression model was used to assess the association among outcome measures., Results: Data from 624 children were analyzed. The geometric mean of retinol was 23.8 pg/dL (95 % CI: 23.3-24.3). The prevalence of VAD and the risk for VAD were 24.3 % and 57.4 %, respectively. Retinol levels were significantly lower among boys, low-weight children, and those with low intake (below the first tertile of distribution). The multivariate analysis showed a significant association between VAD and male sex (odds ratio: 1.93; 95 % CI: 1.15-3.24) and between VAD and low intake (odds ratio: 1.48; 95 % CI: 1.15-2.62)., Conclusion: The prevalence of VAD (24.3 %) is a major public health problem in this population. VAD-associated factors were male sex and low vitamin A intake., (Sociedad Argentina de Pediatría.)

Objective: To determine vitamin A content in breast milk and evaluate whether it satisfies the recommendations for infants., Material and Methods: Observational, prospective, cross sectional study. Milk samples were obtained between 30 and 90 days postpartum from mothers seen in public hospitals, and analyzed. Vitamin A concentration was determined by chromatography and its adequacy to the recommended dietary intake. The correlation between outcome measures was analyzed using Spearman's correlation coefficient., Results: A total of 79 mothers participated. Vitamin A concentration in milk samples was 1.80 umol/L (1.36-2.30) and the mean breastfeeding time was 57 days. No significant correlation between breastfeeding days and vitamin A content was observed. In 50% of the samples, vitamin A content did not satisfy the recommendations for infants., Conclusion: Vitamin A content was not enough to satisfy the recommendations in half of the cases., (Sociedad Argentina de Pediatría.)

Introduction: Lead is a toxic metal which, even at low blood levels, can alter normal neurodevelopment in children, so no blood lead level is acceptable. Lead absorption from diet accounts for the highest contribution to blood lead levels in the population who is not exposed to contaminated environments or because of their occupation. The objective of this study was to determine the contribution of diet to lead exposure among children aged 1 to 7 years who attended Hospital de Niños de La Plata for health check-ups., Population and Methods: The study was conducted between June 2015 and May 2016. A questionnaire on the frequency of food intake was administered to 91 children whose average age ± standard deviation was 3.0 ± 1.7 years, and foods included in the analysis were selected based on this questionnaire. Selected foods were purchased from different regional stores. Composite samples were made up of different food groups. Lead levels corresponding to each food group were determined and, finally, the daily intake of lead was estimated for the studied population., Results: The daily intake of lead was 138 µg/day. The food groups with the higher intake rates were processed meat products (15.4%), bakery products (14.8%), milk (12.5%), and meat (11.7%)., Conclusions: Children aged 1 to 7 years attending a public hospital in La Plata have a lead burden from dietary intake of 138 µg/day., (Sociedad Argentina de Pediatría)

Programming and implementation of health policies for the prevention of overweight and obesity have traditionally focused on the dissemination of specific messages identifying healthy foods and pointing out the importance of physical activity. Despite recurrent efforts, the prevalence of obesity in both adult and children populations continues to rise. The configuration of preventive proposals seems to neglect the more complex reality of the eating phenomenon, whose nature goes beyond its biological basis. Behind the presence of overweight or obesity, there are factors that exceed individual behaviors, which are constituted as elements of social order. This premise is based on the contributions made from several fields such as anthropology, sociology, and social epidemiology, especially over the past thirty years. This study aims to analyze the traditional models of institutional intervention while making visible the importance of a socially-oriented perspective that takes into account context and network analysis to address the problem of childhood overweight and obesity, centered on the food component., (Sociedad Argentina de Pediatría.)

Introduction: Lead has neurotoxic effects in children, even at a very low level in blood. The risk factors (RFs) for lead exposure have not been adequately identified in La Plata. The objectives of this study were to determine mean blood lead levels and identify RFs in children aged 1 to 6 years old living in La Plata and the outskirts., Population and Methods: A cross-sectional study was conducted in children who attended primary health care centers for a health check-up. Blood lead levels were determined by atomic absorption spectroscopy, and a socioenvironmental survey was administered to outline RFs. The Mann-Whitney test was used to compare measurements. A multivariate statistical analysis was done to establish the most relevant RFs., Results: A total of 319 children participated (51% were boys); the median (interquartile range) blood lead level was 2.2 pg/dL (1.1-3.6 pg/dL). Significant mean differences in blood lead levels were observed for age≤ 3years old, anemia, pica behavior, overcrowding, dirt floors, and maternal education < 7 years. Age≤ 3years old and pica behavior were both RFs with significant odds ratios (ORs). The OR as adjusted by logistic regression was significant only for age≤ 3years old., Conclusions: The median blood lead level in the studied population was 2.2 pg/dL. The main RFs identified for lead exposure were age≤ 3years old and pica behavior. Other less relevant RFs included anemia, maternal education < 7 years, overcrowding, and dirt floors., (Sociedad Argentina de Pediatría)

Introduction: The prevalence of iron deficiency anemia (IDA) is high among infants younger than two years old, especially in disadvantaged populations., Objective: To study certain social and biological determinants associated with IDA in children aged 12 to 23.9 months old in Northeast Argentina in the 2004-2005 period., Methodology: Cross-sectional design. Explanatory outcome measures were organized in three levels: distal (food assistance, unmet basic needs, and head of household with medical coverage), intermediate (breastfeeding, iron supplementation, and iron intake), and proximal (nutritional status, gestational age, birth weight, age, and sex). The association between selected outcome measures and IDA (Hb< 11 g/dL, ferritin < 12 ng/dL, WBCs < 15 000/mL) was assessed using logistic regression models with hierarchical selection of outcome measures., Results: Lack of food assistance (OR: 1.85 [1.14, 3.02]) and inadequate iron intake (OR: 2.60 [1.18, 5.71]) were associated with IDA. The prevalence of anemia was higher with a younger gestational age (OR: 0.89 [0.81, 0.97]) and a younger age in months old (OR: 0.90 [0.84, 0.96])., Conclusions: This study evidences the strong and complex relationship between social determinants and anemia, a disease that is highly prevalent among young children. Food assistance programs may have a protective effect against IDA; consumption of fortified foods may improve iron intake in infants younger than two years old. In addition, emphasis is placed on the need to assess the impact of policies on population health., (Sociedad Argentina de Pediatría.)

Introduction. Anemia is a public healthcare problem that particularly affects children under the age of 2 years, with consequences that greatly affect psychomotor and intellectual growth during childhood and productive capacities in adulthood. Objective. To study the prevalence of anemia, its variations and possibly associated factors in children under 6 months of age. Material and methods. Cross-sectional descriptive study analyzing health records of 363 children aged 4-5 months assisted in the period 2007-2010. We determined the association of anemia (hemoglobin <10,3 g/dl) with feeding (exclusive breastfeeding and mixed feeding), type of birth and sex. Birth weight means and z-scores for weight-for-age, height-for-age, and weight-for-height were compared in anemic versus non-anemic children. Results. Anemia was present in 28.9% (105/363) of children, being its prevalence significantly higher in boys (38.3% versus 20.9%; p= 0.000). There were no significant differences in type of birth or feeding. Mean birth weight and mean z-score for weight-for-age, height-for-age and weight-for-height was significantly lower in anemic vs. non-anemic children. We found a significant reduction in anemia (37.8% in 2007 to 20.3% in 2010 during the study period, p= 0.012) Conclusion. The prevalence of anemia was 28.9%; decreased significantly between 2007 and 2010, and represents a serious public healthcare problem. The prevalence was higher in boys, in children with lower birth weight and in those with lower antropometric indices. Our results, even though local, reflect the high nutritional risk of the population under 6 months of age.

Introduction: Environmental exposure to lead and the subsequent poisoning are a main public health concern worldwide. Children have a higher vulnerability to lead toxic effects, and many reports have shown the association between iron deficiency and lead poisoning. In Argentina, reports about lead levels in children are scarce. Our aims were to assess blood lead levels in children and determining their relationship with iron deficiency and known lead exposure risk factors., Material and Methods: We performed a cross-sectional study in a sample of 93 children (age range, 6 months to 5 years) receiving care at La Plata Children s Hospital. A social and environmental survey was done, and blood lead, hemoglobin and ferritin levels were assessed., Results: Geometric mean blood lead level was 4.26 microg/dl (95% CI, 3.60-5.03); prevalence of blood lead levels >or=10 microg/dl was 10.8%. Higher blood lead levels were found in children living in households with lead-handling contaminating activities (6.74 vs. 3.78 microg/dl; p= 0.005) and in very low-income households (5.68 vs. 3.71 microg/ dl; p= 0.020). The presence of blood lead levels >or=10 microg/dl was strongly associated with iron deficiency (OR 5.7; 95% CI: 1.34-23.41) and with lead-handling activities at home (OR 4.8; 95% CI: 1.12-20.16)., Conclusion: The prevalence of blood lead levels >or=10 microg/dl is a matter of concern in the population studied. Iron deficiency and development of lead-handling activities at home were the risk factors associated with high blood lead levels.