Carenza di ferro nei bambini dai 6 ai 36 mesi: sondaggio nazionale sulla pratica clinica dei pediatri di famiglia

Iron deficiency (ID) is the most common micronutrient deficiency worldwide, particularly in infancy because of rapid growth that leads to high iron requirements. We conducted a national survey with the aim to assess the clinical practice of general pediatricians (GPs) concerning ID in infants aged 6-36 months. A 15 item questionnaire was distributed to GPs in 16 different regions in Italy between November 2016 and March 2017. The questions evaluated the opinion of GPs on the most frequent causes of ID in children 6-36 months and how GPs prevented or treated ID (eg timing what type of blood tests, dosage of iron supplementation for prophylaxis and treatment). A total of 2979 questionnaires were filled in. In the opinion of the majority of GPs, the most common cause of ID in children 6-36 months was the early introduction (< 12 months) of cow’s milk (37.13% of responses). In Italy overall, the majority of GPs do not recommend iron supplementation as prophylaxis (64.78% of responses); this clinical practice is common in breastfed infants only in 3 regions of the South of Italy (Sicily, Puglia, Calabria). For treatment of iron deficiency anemia (IDA), the majority of GPs recommend iron in ferrous form at the dosage of 3 mg/kg/day for at least 3 months. The present study highlights the different clinical practice between North and South regions of Italy concerning ID and the need to clarify whether iron prophylaxis is a useful practice in infants and toddlers aged 6-36 months.