Eight-month-old Dudu is chubby and lively, but was recently found to be mildly anemic during a physical examination at the health station. The family was puzzled by the fact that all the growth indicators were normal, the weight was in the upper level of children of the same age, the height was also in the upper level, and Dudu could drink a lot of milk every day, so why was he still anemic?
The health care doctor patiently explained to Dudu’s family that Dudu was suffering from nutritional iron deficiency anemia, which is the most common type of pediatric anemia and occurs in babies between the ages of 6 months and 2 years. Why are babies at this age prone to iron deficiency? The following causes can exist individually or together.
I. Insufficient iron storage in the body
The most iron is obtained from the mother in the last trimester of fetal life. Severe iron deficiency anemia in the mother, prematurity or twin births resulting in low birth weight of the baby, and blood loss from the fetal circulation are the causes of reduced iron stores in the newborn.
Insufficient intake of iron
Insufficient supply of iron in the diet is an important cause of iron deficiency anemia. The iron content of human milk and cow’s milk is low and not enough for infants, so if milk is fed alone without adding supplementary food containing more iron in time, iron deficiency anemia will easily occur.
Third, iron absorption disorder
The absorption of iron can be affected by unreasonable food combination, and iron absorption disorders caused by long-term diarrhea, digestive tract malformation, intestinal malabsorption, etc. can also lead to iron deficiency anemia.
IV. Rapid growth and development
With weight growth, blood volume increases accordingly, and the faster the growth rate, the greater the relative need for iron, the more likely iron deficiency occurs. The weight of infants increases to 3 times that of their first birth by the age of one year, and can increase to 5-6 times in preterm infants, so infancy, especially preterm infants, is most likely to have iron deficiency anemia.
V. Excessive loss or consumption of iron
Normal infants excrete more iron by feces than by diet within two months after birth, and lose relatively more iron by skin. In addition, intestinal blood loss can also be caused by intestinal polyps, Meckel’s diverticulum, hookworm disease, etc. Since 1 ml of blood loss is equivalent to 0.5 mg of iron loss, long-term small amount of blood loss caused by whatever reason is an important cause of iron deficiency anemia. Long-term repeated infectious diseases can cause anemia due to increased consumption.
After birth, Dudu has been artificially fed, and only recently began to add rice flour and egg yolk, adding very little, and Dudu has been growing rapidly since birth, and now weighs three times more than at birth; in addition, Dudu has just recovered from diarrhea that lasted for more than twenty days. After some explanations from the health care doctor, Dudu’s family finally understood that the above factors can lead to nutritional iron deficiency anemia.
The main concern of Dodo’s family now is to have this disease, what will be the effect on the baby? How should it be treated? How can this disease be prevented?
There is a lot of research evidence that iron deficiency can affect various functions of children such as growth and development, exercise and immunity, so active treatment and prevention are very important.
First, mothers should take better care of their babies to avoid infections. If there is a clear cause, prompt treatment is needed, such as exclusion of hookworms, surgical treatment of intestinal malformations, and control of chronic blood loss. Both breastfed or artificially fed babies should promptly add supplementary foods rich in iron with high iron absorption rate, and pay attention to a reasonable mix of meals. If the hemoglobin is above 90g/L (9g/dL), adjust the diet first, and then take iron supplements after 1 month when the hemoglobin does not improve. If the hemoglobin is below 90g/L (9g/dL), iron should be applied under the guidance of the doctor. Iron is an effective drug for the treatment of iron deficiency anemia, and oral iron is generally used. It is best to take the drug between meals, not only to reduce the stimulation of the gastric mucosa, but also to facilitate absorption; at the same time, oral vitamin C can promote the absorption of iron. Iron should continue to be used until the hemoglobin reaches a normal level about 2 months before stopping, in order to replenish the iron stores. It is best to measure serum ferritin during treatment to avoid iron overdose. If it is still ineffective after 3 weeks of oral administration, consideration should be given to whether there is a diagnostic error or other reasons affecting the efficacy.
VI. Preventive measures include.
1, pay attention to maternal health: pregnant women should pay attention to iron supplementation in order to supply blood to the fetus.
2, promote breastfeeding: breast milk contains little iron, but the absorption rate of up to 50%, the general absorption rate of food iron is only 1% – 22%, lactating mothers should also have sufficient iron intake.
3, good feeding guidance: whether breastfeeding or artificial feeding of infants, should be timely added iron-rich, iron absorption rate of auxiliary food, such as lean meat, animal blood, offal, fish, soybean products, and pay attention to a reasonable mix of meals, the daily need for a certain amount of fruit and vegetable intake. Infants such as fresh milk feeding, must be heated to reduce intestinal blood loss due to milk allergy, but by special breast milk powder, no need to boil.
4, infant food (cereal products, milk products, etc.) should be fortified with appropriate amounts of iron.
5. For preterm infants, especially very low weight preterm infants, exclusive breastfeeders should start iron supplementation from 2-4 weeks of age at a dose of 1-2mg/kg/d elemental iron until 1 week of age. For full-term infants, due to the high bioavailability of iron in breast milk, they should be breastfed for 4-6 months as much as possible, and thereafter, if they continue to be exclusively breastfed, iron-rich foods should be added in time.