The high prevalence of low hemoglobin concentration among Indonesian infants aged 3-5 months is related to maternal anemia

Iron deficiency anemia among young children is a large health problem. However, there is little information about the prevalence of anemia among young infants because it has been assumed that normal, breast-fed infants have adequate iron stores until 4-6 mo of age. We analyzed cross-sectional data from the HKI/GOI Nutrition and Health Surveillance System in rural Java, Indonesia from Sept. 1999 to Feb. 2001 for hemoglobin (Hb) of 3- to 5-mo-old breast-fed infants (n = 990) and related factors. The prevalence of Hb < 90 g/L was 13.4%, < 100 g/L, 37%, and < 110 g/L, 71 %. Multiple logistic regression analysis revealed that normal birth weight infants (>2500 g) of anemic mothers (Hb < 120 g/L) had an odds ratio (OR) [95% confidence interval (Cl)] of 1.81 [1.34-2.43] to have a low Hb (< 100 g/L) compared with infants of nonanemic mothers with a normal birth weight. Infants of nonanemic mothers but with low birth weight had an OR of 1.15 [0.61-2.16], and those with low birth weight and anemic mothers of 3.68 [1.69-8.02]. Other risk factors included stunting (OR 1.70 [0.97-2.95]), a young mother (<20 y, OR 1.54 [0.95-2.49]), lower maternal education and living in West Java or East Java. Considering that maternal postpartum Hb reflects Hb during pregnancy, that anemia among mothers in this population is due mainly to iron deficiency, and that children born to anemic mothers are at higher risk of a low Hb, we hypothesize that low infant Hb in this population is due to iron deficiency. Intervention studies in iron deficient populations should test this hypothesis.