Iron deficiency, prolonged bottle-feeding, and racial/ethnic disparities in young children

Jane M. Brotanek, Jill S. Halterman, Peggy Auinger, Glenn Flores, Michael Weitzman

Research output: Contribution to journalArticle

Abstract

Background: Childhood iron deficiency is associated with behavioral and cognitive delays. Few studies have explored the relationship between prolonged bottle-feeding and iron-deficiency anemia among toddlers. Objective: To examine the association between prolonged bottle-feeding and iron deficiency in a nationally representative sample of children ages 1 to 3 years. Design and Methods: The National Health and Nutrition Examination Survey III provides data on the feeding practices of children 1 to 3 years old and contains measures of iron status including transferrin saturation, free erythrocyte protoporphyrin, and serum ferritin. The prevalence of iron deficiency and duration of bottle-feeding were determined for black, white, and Mexican American toddlers. Bivariate and multivariate analyses were performed to examine the association between bottle-feeding duration and iron deficiency. Results: Among 2121 children ages 1 to 3 years, the prevalence of iron deficiency was 6% among whites, 8% among blacks, and 17% among Mexican Americans (P<.001). With increasing duration of bottle-feeding, the prevalence of iron deficiency among all children increased (3.8%, bottle-fed ≤12 months; 11.5%, bottle-fed 13-23 months; and 12.4%, bottle-fed 24-48 months [P<.001]). At 24 to 48 months of age, 36.8% of Mexican American children were still bottle-fed, compared with 16.9% of white and 13.8% of black children. In multivariate analyses, bottle-feeding for 24 to 48 months and Mexican ethnicity were associated with iron deficiency (odds ratio, 2.8; 95% confidence interval, 1.3-6.0; and odds ratio, 2.9; 95% confidence interval, 1.5-5.6, respectively). Conclusions: Children with prolonged bottle-feeding and Mexican American children are at higher risk for iron deficiency. Screening practices and nutritional counseling should be targeted at these high-risk groups.

Original languageEnglish (US)
Pages (from-to)1038-1042
Number of pages5
JournalArchives of Pediatrics and Adolescent Medicine
Volume159
Issue number11
DOIs
StatePublished - Nov 1 2005

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Bottle Feeding
Iron
Multivariate Analysis
Odds Ratio
Confidence Intervals
Iron-Deficiency Anemias
Nutrition Surveys
Transferrin
Ferritins
Counseling
Erythrocytes

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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Iron deficiency, prolonged bottle-feeding, and racial/ethnic disparities in young children. / Brotanek, Jane M.; Halterman, Jill S.; Auinger, Peggy; Flores, Glenn; Weitzman, Michael.

In: Archives of Pediatrics and Adolescent Medicine, Vol. 159, No. 11, 01.11.2005, p. 1038-1042.

Research output: Contribution to journalArticle

Brotanek, Jane M. ; Halterman, Jill S. ; Auinger, Peggy ; Flores, Glenn ; Weitzman, Michael. / Iron deficiency, prolonged bottle-feeding, and racial/ethnic disparities in young children. In: Archives of Pediatrics and Adolescent Medicine. 2005 ; Vol. 159, No. 11. pp. 1038-1042.
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abstract = "Background: Childhood iron deficiency is associated with behavioral and cognitive delays. Few studies have explored the relationship between prolonged bottle-feeding and iron-deficiency anemia among toddlers. Objective: To examine the association between prolonged bottle-feeding and iron deficiency in a nationally representative sample of children ages 1 to 3 years. Design and Methods: The National Health and Nutrition Examination Survey III provides data on the feeding practices of children 1 to 3 years old and contains measures of iron status including transferrin saturation, free erythrocyte protoporphyrin, and serum ferritin. The prevalence of iron deficiency and duration of bottle-feeding were determined for black, white, and Mexican American toddlers. Bivariate and multivariate analyses were performed to examine the association between bottle-feeding duration and iron deficiency. Results: Among 2121 children ages 1 to 3 years, the prevalence of iron deficiency was 6{\%} among whites, 8{\%} among blacks, and 17{\%} among Mexican Americans (P<.001). With increasing duration of bottle-feeding, the prevalence of iron deficiency among all children increased (3.8{\%}, bottle-fed ≤12 months; 11.5{\%}, bottle-fed 13-23 months; and 12.4{\%}, bottle-fed 24-48 months [P<.001]). At 24 to 48 months of age, 36.8{\%} of Mexican American children were still bottle-fed, compared with 16.9{\%} of white and 13.8{\%} of black children. In multivariate analyses, bottle-feeding for 24 to 48 months and Mexican ethnicity were associated with iron deficiency (odds ratio, 2.8; 95{\%} confidence interval, 1.3-6.0; and odds ratio, 2.9; 95{\%} confidence interval, 1.5-5.6, respectively). Conclusions: Children with prolonged bottle-feeding and Mexican American children are at higher risk for iron deficiency. Screening practices and nutritional counseling should be targeted at these high-risk groups.",
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