Tan LZ, Adams SE, Kennedy A, Kepreotes H, Ooi CY. Are children on jejunal feeds at risk of iron deficiency? World J Gastroenterol 2015; 21(18): 5751-5754 [PMID: 25987804 DOI: 10.3748/wjg.v21.i18.5751]
Corresponding Author of This Article
Dr. Chee Y Ooi, Discipline of Paediatrics, School of Women’s and Children’s Health, Medicine, University of New South Wales, New South Wales, Sydney NSW 2052, Australia. keith.ooi@unsw.edu.au
Research Domain of This Article
Pediatrics
Article-Type of This Article
Letters To The Editor
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. May 14, 2015; 21(18): 5751-5754 Published online May 14, 2015. doi: 10.3748/wjg.v21.i18.5751
Are children on jejunal feeds at risk of iron deficiency?
Li-Zsa Tan, Susan E Adams, Alison Kennedy, Helen Kepreotes, Chee Y Ooi
Li-Zsa Tan, Chee Y Ooi, Department of Gastroenterology, Sydney Children’s Hospital, Randwick NSW 2031, Australia
Susan E Adams, Alison Kennedy, Department of Surgery, Sydney Children’s Hospital, Randwick NSW 2031, Australia
Susan E Adams, Chee Y Ooi, Discipline of Paediatrics, School of Women’s and Children’s Health, Medicine, University of New South Wales, Sydney NSW 2052, Australia
Helen Kepreotes, Department of Dietetics, Sydney Children’s Hospital, Randwick, NSW 2031, Australia
Author contributions: Adams SE, Kennedy A and Ooi CY formulated the study; Tan LZ drafted and edited the manuscript; Kennedy A and Kepreotes H contributed to the data acquisition and critically reviewed the manuscript; Adams SE and Ooi CY critically reviewed the manuscript and approved the final manuscript.
Conflict-of-interest: No potential conflicts of interest relevant to this article were reported.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Chee Y Ooi, Discipline of Paediatrics, School of Women’s and Children’s Health, Medicine, University of New South Wales, New South Wales, Sydney NSW 2052, Australia. keith.ooi@unsw.edu.au
Telephone: +61-29-3821752 Fax: +61-2-93821787
Received: November 24, 2014 Peer-review started: November 25, 2014 First decision: January 8, 2015 Revised: February 3, 2015 Accepted: March 12, 2015 Article in press: March 12, 2015 Published online: May 14, 2015
Abstract
Children on exclusive jejunal feeding may be at risk of iron deficiency due to the feeds bypassing the duodenum, which is the primary site for iron absorption. We describe the biochemical and hematological features of six children on exclusive jejunal feeding who did not receive iron supplementation. At a mean (standard deviation) period of 11 (6.5) mo after commencing jejunal feeds, there was a significant reduction in both serum iron (18.5 g/L vs 9.8 g/L, P = 0.01) and transferrin saturation levels (23.1% vs 13.7%, P = 0.02), suggesting iron deficiency. However, there was no significant change in ferritin, hemoglobin and mean corpuscular volume levels post-commencement of jejunal feeds. This may be the result of small bowel adaptation in response to early iron deficiency. Larger and longer term prospective studies are required to investigate if children on jejunal feeds are at risk of developing iron deficiency.
Core tip: Children who are exclusively jejunally fed are prime candidates to develop iron deficiency. We found that serum iron and transferrin saturation levels were significantly reduced at a mean of 6.5 mo post commencement of exclusive jejunal feeds, suggesting that an early iron deficient state was induced. Ferritin levels, haemoglobin and mean corpuscular volumes however were stable during the same period, lending further evidence that the proximal jejunum may have the capacity to adapt to iron deficiency.
