The association between anemia in infants, and maternal knowledge and adherence to iron supplementation in southern Israel.

BACKGROUND: Iron deficiency is the most prevalent anemia in infants and is known to be a major public health problem.

OBJECTIVE: To examine mothers' knowledge and adherence with recommendations regarding iron supplementation and assess their association with the prevalence of anemia in infants.

METHODS: Data on 101 infants and mothers of infants born between November 2000 and February 2001 and living in a small Jewish town in southern Israel were collected using a structured questionnaire and the infants' medical charts. Anemia was defined as serum hemoglobin less than 11 g/dl. Independent variables include socioeconomic data, mothers' knowledge, and adherence to treatment as reported by them. Chi-square test was used to analyze categorical variables, t-test was used for continuous variables, and hemoglobin was tested at 9-12 months of age.

RESULTS: Of the 101 infants in the study, 47% had serum hemoglobin under 11 g/dl. Of the mothers, 62 (62%) were partially or completely non-compliant with iron supplementation; 34 (34%) had low level of knowledge regarding anemia. Multivariate logistic regression analysis revealed a significant and inverse relationship between the presence of anemia and the level of maternal knowledge (odds ratio = 5.6, 95% confidence interval 1.6-9.7; P = 0.006) and reported adherence with iron supplementation (3.2, 1.1-9.7; P = 0.04) after controlling for confounding factors: maternal education, socioeconomic status, breastfeeding, and meat consumption.

CONCLUSIONS: The presence of iron deficiency anemia in infants in southern Israel is inversely affected by the level of maternal knowledge of anemia and adherence to iron supplementation. Low level of knowledge is also directly related to low adherence.