How to supplement iron in children with iron deficiency anemia? As the saying goes! It is medicine with three toxins. Therefore, for iron deficiency anemia in children, one of the keys to treatment is how to minimize adverse effects while optimizing efficacy. Iron therapy should be carried out under the guidance of a doctor, and in addition, parents should have a preliminary understanding of the dosage form and variety. This is to facilitate communication and cooperation with the physician for effective treatment of iron deficiency anemia. Types of iron supplements: 1. Oral iron supplements: For iron deficiency anemia, oral iron therapy is effective, usually 12 to 24 hours after administration. The function of iron-containing enzymes or iron-dependent enzymes also improves, and the child’s spirit and appetite then improve. Reticulocytes start to rise after 46-72 hours (peak 6%-8% in 4-11 days), and HB rises rapidly at this time, and anemia is usually corrected after 3-4 weeks of treatment; maintenance treatment is needed to replenish body iron stores to normal levels. The specific length of time depends on the concentration of serum ferritin. (1) Commonly used oral western iron supplements are: ferrous sulfate, ferrous fumarate, slow-release iron succinate, ferric succinate, ferric ammonium citrate, etc. Ferrous sulfate 20-30 mg/kg body weight per day until HB is normal and then maintain treatment for 1 to 3 months depending on the anemia of the child. Also take oral vitamin C to increase the absorption of iron. (2) Chinese patent medicine Jianshuang blood granule: It is composed of Astragalus, Radix Codonopsis, Poria, Atractylodes, Chrysanthemum, Medlar and Dazhong with ferrous sulfate and vitamin C. 2.Injectable iron: For those who cannot tolerate oral iron and have severe diarrhea and heavy anemia. Deep intramuscular injection can be considered. Iron injections are dextrose iron, iron oxide containing sugar and sorbitol iron. Dextrose iron 1 ml contains 50 mg of iron, total injected iron (mg) = [120 – hemoglobin (g/l)] x body weight/kg x 4. Oral iron non-absorption is rare, while injected iron has many side effects and should be used with caution. Dangers of iron oversupplementation in children and how to prevent it? Iron therapy in iron deficiency anemia has two purposes: to provide the iron required for the synthesis of HB and to replenish the body’s stored iron. Due to the great individual differences in the body’s absorption and metabolism of iron, the time required to achieve the above two therapeutic purposes varies greatly for each patient. An inadequate course of treatment will not achieve the therapeutic goals, while an excessively long course of treatment will result in an excessive accumulation of iron in the body. Many studies have demonstrated that iron supplementation to non-iron deficient organisms can also have a range of effects on the organism. The effects of too much iron on children: 1. Reduced immune function: Excess iron makes the body less resistant to infection, and children in many African countries routinely take iron to prevent iron deficiency anemia, which has a high prevalence there; as a result, anemia prevents infection and triggers it. The incidence of infections, particularly malaria, brucellosis, and tuberculosis, is several times higher in children taking iron than in those not taking iron. Infections caused by many conditionally pathogenic bacteria are also increased. Too much iron reduces the ability of white blood cells to swallow and kill, and provides nutrition for bacteria to multiply. 2, affect the absorption of zinc and copper: excess iron can affect the absorption of zinc, copper and other trace elements that are important for the development of children. Because these elements are absorbed in the upper duodenum, and share the same transfer protein through the same transfer channel, so a large amount of absorption of one element will inevitably affect the absorption of other elements, long-term iron overabsorption will lead to zinc and copper deficiency in children, thus affecting their growth and development. 3, other: a recent foreign study showed that in the case of sufficient iron in the body to continue to supplement iron can directly hinder the growth of infants. In addition, too much iron may also be related to the development of liver disease and malignant tumors in children. Countermeasures to prevent iron oversupplementation: It is important to master the course of iron therapy for iron deficiency anemia in children, as both too short and too long courses are detrimental to the organism. Generally speaking, serum ferritin and other indicators can reflect the state of iron storage in the body. Although theoretically a therapeutic dose within 5 months of continuous medication is not likely to cause excessive iron intake, most children currently consume fortified foods containing varying amounts of iron on a daily basis. Therefore, excessive iron intake throughout the course of iron supplementation therapy is always something to beware of, and dynamic monitoring of serum ferritin concentrations is a good way to do this.