Iron deficiency anemia presenting with behavioral problem in prolonged exclusive breast- fed infant

Iron deficiency  is a common nutritional problem 
in  infants  and  children  and  in  adolescents  with 
obesity.  Exclusive  breast  feeding  for  prolonged 
period can result in iron deficiency anemia in late 
infancy and  early childhood (1).
Iron   deficient   children   during   development 
are  particularly  prone  to  impaired  cognitive 
and  behavioral  functions.  Verbal  learning  and 
memory can be affected in these children (2,3). 
Infants and children with iron deficiency state are 
also found to score low on mental development 
index    (MDI)    in    Bailey    scales    of    infant 
development (BSID), and scores of such infants 
usually increase after proper iron therapy (1,4).
We present here a baby boy of 2 yrs who attended 
the outpatient clinic due to fidgety and overactive 
behavior  for  previous  5  to  6  months.  He  had  a 
normal  growth  and  development  after  a  normal 
birth  and  postnatal    period.  He  had  been  given 
exclusive  breast  feeding  by  his  mother  since 
his  birth  without  any  attempt  to  wean  him.  On 
evaluation  he  was  found  to  have  moderate  iron 
deficiency anemia. He was treated with oral iron 
in a therapeutic dose and gradual weaning from 
breast  milk  of  his  mother  and  introduction  of 
other nutritional supplements. He showed clinical 
and  hematological  improvement  in  following  2 
months. His behavioral problem and fidgetiness 
also improved.