Occurrence and detection of iron-deficiency anemia in infants and toddlers.

Infants and toddlers are particularly vulnerable to developing iron deficiency, which can cause irreversible deficits in neurodevelopment. Children at highest risk include premature and low birth weight infants, those who are fed cow's milk rather than breast milk or formula prior to age one, and those who drink large amounts of cow's milk as toddlers. It is important to detect iron deficiency before it becomes frank anemia through the use of appropriate laboratory tests. Hemoglobin or hematocrit testing, at around age one, has been the usual screening test. These tests, however, do not become abnormally low until frank anemia has developed. Over the past decade, research has shown the assay for reticulocyte hemoglobin content to be a much earlier indicator of iron deficiency. This article provides an overview of the epidemiology, occurrence, and detection of iron deficiency and iron deficiency anemia in young children as well as a comparison of the utility of various laboratory tests.