Anemia in James Bay Cree infants of northern Quebec

• Main Author: Willows, Noreen D.
• Other Authors: Gray-Donald, Katherine (advisor)
• Format: Thesis
• Language: English
• Published: McGill University 2000
• Subjects: Iron deficiency anemia > James Bay Region; Iron deficiency diseases in infants > James Bay Region; Infants > Nutrition > James Bay Region; Cree Indians > James Bay Region > Food; Cree indians; James Bay
• Online Access: http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=36731

The objectives of this research were to determine the prevalence of anemia, and identify risk factors for anemia, in 9-month-old Cree infants living in northern Quebec. The prevalence of anemia (hemoglobin <110 g/L) was 25--32%, depending on the study sample. Iron deficiency was present in 28.2% of infants who could be classified and 14.4% had iron deficiency anemia. Fewer than 2% of infants had low birth weight (<2500 g) so most infants should have been born with adequate iron stores. One cause of anemia that was identified was a diet that was low in iron. Only 15.1% of infants were reported by guardians to eat meat daily and 28.5% were reported to never eat meat. Infants who were breastfed or cow's milk fed did not obtain sufficient iron for effective erythropoiesis. Compared with formula that was predominantly iron fortified, the odds ratio (OR) for anemia was 7.9 (95% CI 3.4--18.2) for breast milk and 5.0 (95% CI 2.0--12.7) for cow's milk. When milk type was controlled for, weight gain since birth was significantly associated with microcytic erythrocytes (OR comparing the highest tertile of weight gain to the lowest tertile 2.9, 95% CI 1.2--6.6). This indicates that fast-growing infants were not meeting their iron needs for growth. Another risk factor for anemia that was identified was common childhood infections. The prevalence of anemia among infants reported as recently unwell with an infection was higher than among infants reported as recently well (31.1% vs. 19.0%, chi2 = 4.27, p = 0.039). The prevalence of elevated blood lead was 2.7% and is not a major public health problem. No evidence for vitamin A deficiency was found. Serum retinol was positively associated with all iron status indicators. Cree infants who were given supplements containing vitamin A had a lower prevalence of anemia (hemoglobin <105 g/L) (10.8% vs 23.2%, chi2 = 5.97, p = 0.015). These results suggest a role for vitamin A in iron metabolism. To prevent anemia in aboriginal i