Iron deficiency

Iron deficiency remains one of the world’s greatest public health problems. Globally it is the greatest contributor to anaemia, affecting 47% of pre-school age children and 25% of school age children worldwide, and is a major contributor to both physical and neuro-developmental morbidity.Iron deficiency results from inadequate intake, excess turnover or excessive loss. Whilst inadequate intake is the commonest cause of deficiency in children in the industrialized world, impaired absorption through malabsorption syndromes like inflammatory bowel disease and coeliac disease should also be considered. Blood loss additionally causes iron deficiency, the three most common causes of which are cows’ milk enteropathy, menstruation and hook worm infection.Prevention of iron deficiency, though theoretically simple, is complex at a population level. Treatment requires appropriate management of the underlying cause as well as additional iron replacement. In the western world, the focus has been on preventing iron deficiency through public education and modification of iron availability in children’s diets. It is recommended that children should not receive whole cows’ milk during the first year of life, but should instead be given breast milk or iron fortified formula. Worldwide management strategies again focus on dietary improvements, as well as the control of hook worm and malaria infections to reduce levels of iron deficiency.