What is the prevalence of anemia in toddlers?

Prevalence of Anemia in Toddlers

Anemia is common in toddlers, affecting approximately 16.42% of children under 5 years globally, with higher rates in low-income populations and certain ethnic groups. 1

Prevalence and Risk Factors

The prevalence of anemia in toddlers varies significantly based on geographic location and socioeconomic factors:

• Global prevalence: 16.42% for iron deficiency anemia and 17.95% for iron deficiency without anemia 1
• Regional variations:
  • 15-25% in Latin America and Indonesia
  • 70-80% in sub-Saharan Africa and India 2
  • Higher rates in low-income families, children living at or below poverty level, and Black or Mexican-American children in the United States 3

Key Risk Factors

Several factors increase the risk of anemia in toddlers:

• Age less than 2 years (26% higher odds) 1
• Living in large family size (38% higher odds) 1
• Born to anemic mothers (20% higher odds) 1
• Low birth weight (15% higher odds) 1
• Not consuming iron-fortified milk (28% higher odds) 1
• Excessive cow's milk intake (>24 oz daily) 4
• Premature birth or low birthweight 4

Screening Recommendations

The Centers for Disease Control and Prevention (CDC) and American Academy of Pediatrics recommend:

• Universal screening for anemia in high-risk populations between 9-12 months of age 3, 4
• Follow-up screening 6 months later and annually from ages 2-5 years 4
• Selective screening based on risk factors for low-risk populations 3, 4

Some experts suggest that the timing of screening should be reconsidered:

• Screening at 9-12 months may be too early for children receiving iron-fortified formulas 5
• Additional or postponed screening at 15-18 months may be more effective 5

Clinical Significance

Anemia in toddlers is concerning because:

• Untreated iron deficiency anemia can lead to developmental delays and behavioral alterations that may persist long-term 4, 6
• Iron deficiency, even without anemia, can negatively impact cognitive, social, and emotional functioning 6
• These effects can decrease school performance, productivity in adult life, quality of life, and future income 6

Prevention Strategies

The CDC recommends several preventive measures:

• Encourage breastfeeding with appropriate iron supplementation after 4-6 months 3
• For non-breastfed infants, use only iron-fortified formula 3
• For breastfed infants with insufficient iron from supplementary foods by age 6 months, provide 1 mg/kg/day of iron drops 3
• For preterm or low birthweight breastfed infants, provide 2-4 mg/kg/day of iron drops from 1 month until 12 months 3, 4
• Limit cow's milk intake to no more than 24 oz daily 4
• Encourage consumption of iron-rich foods and vitamin C-rich foods to enhance iron absorption 4

Anemia in toddlers remains a significant public health concern, particularly in developing countries and among at-risk populations. Early detection through appropriate screening and preventive measures can help mitigate the long-term negative impacts on child development.