RED-BLOOD-CELL INDEXES AND IRON STATUS ACCORDING TO FEEDING PRACTICESIN INFANTS AND YOUNG-CHILDREN

With the electronic counters routinely used, it has become practical t o determine the concentration of hemoglobin, red cell indices, and RDW concurrently in association with transferrin saturation and ferritin in accordance with feeding practices. The 1028 infants and children ag ed 6 to 24 months, who had been mainly admitted with acute infectious or inflammatory diseases, were divided into three groups, i.e., childr en who were exclusively breast-fed more than 6 months (group A), those who had been given iron-fortified formula milk since birth (group B), and those who had been given breast milk for 5-6 months and then swit ched to the iron-fortified formula (group C). Children with anemia com prised 34.8% (104/299) of group A, significantly more than 5.6% (34/60 8) of group B and 6.6% (8/121) of group C (p < 0.001, respectively). C hildren with MCV < 70 fl comprised 39.5% (118/299) of group A, signifi cantly more than 7.1% (43/608) of group B and 13.2% (16/121) of group C. Out of the total 146 patients with anemia, 82.2% (n = 120) had labo ratory evidence of iron deficiency, which was mostly suggested by a di etery history. The sensitivity of MCV values < 70 fl in IDA patients w as 90.0%; specificity was 53.8%. The sensitivity of RDW values greater than or equal to 15% was 83.3%; specificity was 57.7%. The positive p redictive value could be increased to 97.8% by combining MCV < 70 fl a nd RDW greater than or equal to 15%. The sensitivity of serum ferritin concentrations < 10 ng/ml was 62.4% and specificity was 100%. The sen sitivity of transferrin saturation < 12% was 72.3% and specificity was 81.3%. By combining the hemoglobin with MCV and RDW in screening for iron deficiency, the diagnostic accuracy of IDA can be increased. We s upport the use of appropriately iron-fortified weaning foods or the ro utine iron supplement starting at 6 months of age in exclusively breas t-fed infants.