Severe Iron Deficiency Anemia - Consequences of Excessive Intake of Dairy Products in Children

Background: Iron deficiency can have several clinical consequences such as anemia or short and long-term developmental delay in children.

Iron deficiency anemia is multifactorial. It can occur due to problems of intestinal absorption, including excessive intake of dairy products, which interfere with the absorption of iron from other food.

Objective: Remind severe possible drawbacks of excess dairy food in pediatric age.

Methods: Report of a clinical case from a suburban hospital in Portugal.

Clinical Report: Male, two years and eight months old, ex premature with delayed psychomotor development. Gypsy ethnicity, consanguineous parents, family history of Favism. Artificial milk-based feeding since birth due to poor adaptation to breastfeeding and food diversification since eight months of age.

Sent to an appointment due to failure to thrive, with all parameters inferior to percentile three according to WHO curves. Prostration and extremely pale mucosa were observed, being decided hospital admission for investigation.

Analytical evaluation: Hemoglobin 4.8g/dl (normal 11,5-13,5g/dl), Hematocrit 20.3% (normal 34–40%), Iron 19ug/dl (normal 60-170 μg/dl), Ferritin<1ng/mL (normal 15-300ng/ml); transferrin saturation 4% (normal 20-50%); Total capacity fixing iron 503ug/dl (normal 250-400 μg/dl). Peripheral blood with marked microcytosis and hypochromia, elliptocytes and dacryocytes. Abdominal ultrasound was unremarkable.

Blood transfusion was performed and iron therapy was initiated with an improvement of all analytical parameters.

During hospitalization, health professionals verified continuous intake of milk, instigated by parents, with detriment and refusal of other food by the child. Parents later admitted that infant feeding is milk-based at all meals.

Conclusion: Excessive milk ingestion is a common cause of iron deficiency in preschool age children

After six months of age, it is necessary to supply iron with complementary food and limit milk intake. Reinforcing this information and stimulating its practice to parents is extremely important for the prevention of anemia and its consequences in childhood.