"...all doctors should be able to diagnose and treat nutritional deficiencies."

Royal College of Physicians. Nutrition and Patients: A Doctor's Responsibility. London 2002

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This page has been printed from the www.stewartnutrition.co.uk web site.


The Extremes of Life - Infants

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Both infants and the elderly are at increased risk of deficiency due to:

  • limitations in food intake
  • reduced tissue stores compared with adults
  • the high demands of growth

The main consequences of nutritional deficiency in infants are:

  • Poor growth – stunting or poor muscle bulk
  • Anaemia – mainly iron deficiency
  • Recurrent or severe infection – diarrhoea, measles, respiratory, TB and HIV
  • Developmental problems – cognitive development, behavioural problems, decreased attention

Any infant or child with the above problems should have an assessment of their nutritional state. Uncorrected nutritional deficiencies in infancy and before birth have major adverse effects upon physical health and the economic potential for the individual and community because of reduced intellectual capacity. http://go.worldbank.org/DL9AKYWQ70

Common Deficiencies

According to the National Diet and Nutrition Survey of British Infants aged one and a half years to four and a half years the commonest deficiencies are:

  • Anaemia was found in 7% of all infants and was more common in the younger age groups and in girls
  • Iron intakes were below the Lower Reference Intake in 20% of infants and a similar number had evidence of iron deficiency as assessed by plasma ferritin levels
  • Vitamin A intakes were below the Lower Reference Intake in 7.5% of infants and a similar percentage had plasma levels below the lower end of the normal range but none were found to have a severe deficiency
  • Zinc intakes were below the Lower Reference Intake in over 20% of infants with girls being more at risk than boys
  • Calcium intakes were below the Lower Reference Intakes in approximately 10% of infants
  • Vitamin D deficiency was only seen in 1% of those surveyed but borderline levels were found in a further 18%.  However only 20% of parents followed the recommendation to give a vitamin D supplement to all infants between 6 months and 2 years
  • Vitamin C levels were low (plasma <11.0 umol/l) in 3% of infants

For more detail see National Diet and Nutrition Survey: Infants

Now and Then – Dietary Intake of British 4-year old Children

The dietary intake by infants of certain nutrients in 1950 has been compared with those obtained in the National Diet and Nutrition Survey of infants and older children. 

The table below summarises the main findings:

Nutrient Intake 1950
4 yr olds
Intake 1990
3.5 to 4.5 yr olds
Intake 1997
4 to 6 yr olds
       
Protein 46 g 38.5 g 46.75 g
Fat 64 g 48.6 g 58.0 g
Iron 7.7 mg 6.15 mg 7.75 mg
Vitamin A 738 ug 405 ug 317 ug
Carotene 1049 ug 906 ug 1212 ug
Total vitamin A 903 ug 563 ug 518 ug
Retinol equivalents
Vitamin C 40 mg 52.3 mg 71.6 mg
* Deficiency based upon blood test results

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Copyright Dr. Alan Stewart M.B.B.S.M.R.C.P. (UK)M.F. Hom.
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