(P30-009-25) Iron Deficiency in Children With Mild to Moderate Malnutrition: Prevalence and Clinical Implications

Objectives: To assess the prevalence of iron deficiency (ID) and differences in anthropometrics, sociodemographics, and dietary intake by iron status among toddlers aged 1–3 years with mild/moderate malnutrition (MMM).

Methods: Children (n=41) referred to the Nutrition Clinic at Children's Hospital Colorado for MMM due to low caloric intake and with no underlying health conditions were enrolled and categorized by iron status (normal vs. ID).ID was defined as ferritin levels < 20 μg/L, hemoglobin (Hgb), mean corpuscular volume (MCV), and erythrocyte sedimentation rate (ESR) were measured too. Anthropometrics were obtained by research staff, and standardized z-scores derived, including length/height-for-age (HAZ) and weight-for-length/height (WHZ). Dietary intake, including breastfeeding history, demographic factors, childcare attendance, and parental education, were also collected. Data were summarized by ID status using means and standard deviations (SD) or frequency counts and proportions, as appropriate. Differences were analyzed with t-tests for continuous variables, and chi-square tests for categorical variables.

Results: Iron deficiency (ID) was identified in 59.5% of children, with 45.4% of the ID group being female (n = 10). Most children with ID had normal Hgb (95%) and MCV (64%). Anthropometric measures, including HAZ and WHZ scores, did not differ by ID status (mean [SD]; HAZ: ID -1.5 [1.4] vs. normal -1.2 [0.7]; WHZ: ID -1.7 [0.4] vs. normal -2.0 [0.7]).Breastfeeding beyond one year (59% vs. 47%), childcare attendance (42.1% vs. 33.3%), and lower dietary iron intake (6.2 [3.3] mg/day vs. 7.3 [2.2] mg/day) were more common among children with ID compared to those with normal iron status. However, no observed group differences reached statistical significance (p < 0.05).

Conclusions: ID without anemia affected 60% of healthy toddlers with MMM, compared to 13.5% in 1–2-year-olds (NHANES). Reliance on Hgb and MCV alone misses most cases of ID, making the implementation of ferritin and ESR screening important in the evaluation of children with MMM. Given the adverse impact of ID on brain development, these findings underscore the importance of comprehensive screening in young children with MMM.

Funding Sources: This work was supported by a grant from Reckitt and with the support of the staff and nurses of the Colorado Child Health Research Institute.