Nutritional Education and the Prevention of Iron Depletion in Children 9 Months to 2 Years
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Purpose
Iron depletion in young children is common and may progress to iron deficiency anemia which is associated with irreversible neurodevelopmental effects. Efforts to prevent iron depletion are key to preventing these effects. In a recent study of 150 young children (12 to 38 months), we found that bottle fed children were almost three times as likely to be iron depleted compared with cup fed children (37% vs 18%). Thus, we hypothesize that an educational intervention designed to encourage timely bottle weaning will lead to a reduction in iron depletion.
| Condition | Intervention |
|---|---|
|
Iron Deficiency |
Other: Healthy milk intake Other: Standard nutrition counselling |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor) Primary Purpose: Prevention |
| Official Title: | Nutritional Education and the Prevention of Iron Depletion in Children 9 Months to 2 Years: a Randomized Controlled Trial |
- The primary outcome is iron depletion, and will be defined as serum ferritin <10 mcg/L. [ Time Frame: Age 24 months ] [ Designated as safety issue: Yes ]
- Iron deficiency (defined as serum ferritin <10 mcg/L and MCV < 70 mcm3 iron deficiency. [ Time Frame: Age 24 months ] [ Designated as safety issue: Yes ]
- IDA (hemoglobin < 110 g/L with iron deficiency) [ Time Frame: Age 24 months ] [ Designated as safety issue: Yes ]
| Enrollment: | 253 |
| Study Start Date: | January 2006 |
| Study Completion Date: | May 2009 |
| Primary Completion Date: | May 2009 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
| Active Comparator: 1 |
Other: Standard nutrition counselling
Parents of children will receive nutrition counselling via trained study personnel, including recommendations for iron containing food choices and timing of cow's milk introduction. This group will also receive a colourful nutrition book.
|
| Experimental: 2 |
Other: Healthy milk intake
In addition to the standard nutrition counselling, the intervention group will receive specific information regarding healthy milk intake (2 cups per day, maximum 16 ounces) and the potential negative health effects of prolonged bottle use and excessive milk intake including anemia, iron depletion, and dental carries.
|
Detailed Description:
We plan to undertake a randomized controlled trial to evaluate the effectiveness of an office-based educational intervention for the prevention of iron depletion in young children. Healthy children will be recruited from a community pediatric office which serves a diverse, urban population. Children will be randomized to the intervention education group or the control education group at 9 months of age. Blood work (~4mL) for complete blood count and ferritin along with additional measures such as transferrin, iron, and reticulocyte count will be obtained at 24 months of age. Rates of iron depletion and anemia will be compared in the two groups. The two groups will also have 25-hydroxy vitamin D, calcium and alkaline phosphatase levels analyzed at the 24 month visit to ensure that the intervention for prevention of iron depletion does not adversely affect these measures.
Eligibility| Ages Eligible for Study: | 9 Months to 9 Months |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | Yes |
Inclusion Criteria:
- Children aged 9 months who are attending a routine primary care well-child visit.
- Children who are in good general health.
- Children whose parents provide informed consent to participate.
Exclusion Criteria:
- Children with chronic illness.
- Children with birth weight less than 2.5 kg.
- Children with previously diagnosed anemia (including known iron deficiency anemia). This includes children with marrow failure (aplastic anemia, Fanconi anemia), hemoglobinopathies (sickle cell disease, thalassemia), lead intoxication, sideroblastic anemia, megaloblastic anemia, enzymopathies (G6PD deficiency, pyruvate kinase deficiency), or membranopathies (hereditary spherocytosis).
- Children currently receiving medications associated with anemia. This includes children taking antimetabolites or phenytoin.
- Children currently receiving iron supplementation other than iron fortified formula.
Contacts and Locations| Canada, Ontario | |
| The Hospital for Sick Children | |
| Toronto, Ontario, Canada | |
| Principal Investigator: | Patricia Parkin, MD | The Hospital for Sick Children |
More Information
No publications provided by The Hospital for Sick Children
Additional publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
| Responsible Party: | Patricia Parkin, MD, FRCPC/ principal investigator, Hospital for Sick Children |
| ClinicalTrials.gov Identifier: | NCT00907088 History of Changes |
| Other Study ID Numbers: | 1000007781 |
| Study First Received: | May 21, 2009 |
| Last Updated: | May 25, 2009 |
| Health Authority: | Canada: Ethics Review Committee |
Keywords provided by The Hospital for Sick Children:
|
Iron depletion Children Educational intervention Office-based Iron Depletion |
Additional relevant MeSH terms:
|
Anemia, Iron-Deficiency Anemia, Hypochromic Anemia Hematologic Diseases Iron Metabolism Disorders Metabolic Diseases |
Iron Trace Elements Micronutrients Growth Substances Physiological Effects of Drugs Pharmacologic Actions |
ClinicalTrials.gov processed this record on June 17, 2013