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children and infants rely on their parents or clinical physicians to be alert to the signs and symptoms of their swallowing
problems...

In 573 normal infants and children, we found the concentration of serum ferritin to parallel known changes in iron stores during development. The median serum ferritin concentration was 101 ng/ml at birth, rose to 356 ng/ml at 1 mo of age, and then fell rapidly to a median value near 30 ng/ml (95% confidence limits: 7-142 ng/ml) between 6 mo and 15 yr of age. In the adult, median concentrations diverged according to sex, 39 ng/ml in the female and 140 ng/ml in the male. In 13 children with iron-deficiency anemia, the serum ferritin concentration was 9 ng/ml or less.

The prevalence rates of [iron deficiency anemia] IDA, H pylori infection, and H pylori-associated IDA in female [adolescent] athletes were higher than in the control group. The relative risk of IDA was 2.9 (95% CI, 1.5 to 5.6) for those with H pylori infection. Athletes who exhibited H pylori-associated IDA showed significant increases in hemoglobin, iron, and ferritin levels after H pylori eradication. The subjects in the control group who were treated orally with iron alone showed no significant changes.

The differential diagnosis of dysphagia in children is widespread. Dysphagia is defined here as any process that produces difficulty with active transport of food and liquid from mouth to stomach. This article divides diagnostic pediatric dysphagia into categories including congenital, infectious/inflammatory, systemic, neoplastic, traumatic, and miscellaneous causes (Table 1).

Feeding and swallowing disorders during childhood are on the increase and typically occur in conjunction with multiple and complex medical, health, and developmental conditions. A multidisciplinary approach is essential for the evaluation of these disorders and the prompt initiation of appropriate treatment. Following a brief description of the terms feeding and swallowing, this article provides an overview of the available epidemiologic data on dysphagia and its common diagnostic conditions, impact, evaluation, and management in the pediatric population.

Difficulty swallowing or dysphagia can be present in children and adults alike. Pediatric dysphagias have long been recognized in the literature. Certain groups of infants with specific developmental and/or medical conditions have been identified as being at high risk for developing dysphagia. Still others may present with a swallowing or feeding problem as their primary symptom. Left untreated, these problems in infants and children can lead to failure to thrive, aspiration pneumonias, gastroesophageal reflux, and/or the inability to establish and maintain proper nutrition and hydration. Awareness of the prevalence of pediatric dysphagia in today's population and the signs and symptoms of this condition aids in its treatment. Early detection of dysphagia in infants and children is important to prevent or minimize complications. This article provides a review of symptoms, etiologies, and resources available regarding management of this condition to help the primary care physician and the families of young children and infants in its management... children and infants rely on their parents or clinical physicians to be alert to the signs and symptoms of their swallowing
problems... Objective swallowing assessments used may include
a videofluoroscopic swallow study (often called a cookie swallow), which is performed with radiology and determines how well the infant or child can tolerate amounts and types of liquids and soft foods... barium esophogram can be used to assess esophageal motility and rule
out gastroesophageal reflux