Anemia of the lungs in newborns. How not to miss anemia in newborns? We study the symptoms and find out the causes. Anemia in infants: symptoms

Anemia in an infant is not uncommon, however, as a rule, such a diagnosis frightens his parents.

Reduced hemoglobin and a decrease in the number of red blood cells in a person’s blood is called “anemia”. This concept is quite capacious, since it includes hematopoietic disorders of different nature, cause and severity, namely the production of red blood cells.

Types of anemia in children of the first year of life

In medical science, anemia is divided into three degrees, depending on the severity of the disease, that is, the number of red blood cells and hemoglobin per unit volume of blood.

1. Light degree – more than 90 g/l.
2. Average degree – 70.0 to 90.0 g/l.
3. Severe degree – less than 70 g/l.

There is also the so-called iron deficiency anemia of newborns, which primarily occurs due to improper nutrition of the expectant mother during gestation, which leads to a weak supply of iron in the newborn.

Hemolytic anemia of newborns occurs against the background of Rh conflict incompatibility between the mother and fetus.

Also, the cause may be intrauterine infection with toxoplasmosis, rubella, or herpes virus infection.

What are the reasons

Anemia caused by iron deficiency is most often diagnosed in young children; it is also called hypochromic anemia.

The main reasons for this violation include the following:

• Violation of the principles of balanced nutrition.
• Poor nutrition of the mother during pregnancy, which led to an insufficient supply of iron in the baby after birth.
• Immaturity of systems and organs as a result of prematurity.
• Early weaning and switching to artificial nutrition.
• Acute inflammatory processes.
• Diseases of the gastrointestinal tract.
• Infectious diseases in acute form.

Symptoms

Anemia in children has its own characteristic symptoms due to the fact that there is a disruption in the access of oxygen to the tissues of the body.

1. The child's skin becomes characteristically pale and dry.
2. Children with anemia often suffer from stomatitis, and cracks appear in the corners of their lips.
3. Frequent constipation is also one of the symptoms, since with anemia, indigestion is more a pattern than a coincidence.
4. In a child suffering from anemia, you may notice inactivity and fatigue.

These symptoms should at least alert parents. They are a reason to contact your doctor for advice, he will give a referral for a general blood test of the child to confirm or exclude this diagnosis.

Is it necessary to treat

Deviation of the number of red blood cells in the blood from the norm must be treated. The thing is that red blood cells and hemoglobin perform the most important function in the human body - they transport oxygen to all cells and, accordingly, tissues of the body. Lack of oxygen has the most negative effect on the functionality of cells.

Treatment and prevention

1. Treatment of this disease should be carried out under the supervision of an experienced doctor, who, first of all, will prescribe the necessary examination of the child, on the basis of which he will write a treatment regimen and prescribe medications to correct iron levels.
2. It is recommended to take iron supplements between feedings. They should not be given to the baby with milk, as milk protein interferes with the absorption of iron.
3. When treating infants, the best option is to prescribe an iron supplement in its liquid form. Most often, the dose is calculated using the formula 3 mg per 1 kg of child weight. This will be the daily dose.
4. Such therapy, as a rule, allows you to quickly bring hemoglobin to the desired levels. But with all this, the course of treatment ranges from 2 to 6 months (at the discretion of the treating doctor). This is necessary so that the child’s body can make the necessary supply of iron.
5. If your baby is diagnosed with severe anemia, the doctor may prescribe iron injections.

What to feed

A balanced diet for a child is one of the key points of successful treatment.

Hematological syndrome, characterized by a decrease in the concentration of hemoglobin and the number of red blood cells per unit volume of blood. With various forms of anemia, children experience general weakness, fatigue, pale skin and mucous membranes, dizziness, and palpitations. Anemia in children is diagnosed according to clinical and laboratory data (general blood count, determination of bilirubin, serum iron, total iron-binding capacity of serum, bone marrow punctate examination, etc.). The general principles of treating anemia in children include organizing a balanced diet, timely introduction of complementary foods, vitamin therapy, taking iron supplements, physical therapy (gymnastics, massage, ultraviolet radiation), and, if indicated, blood transfusions.

General information

Anemia in children (anemia) is a pathological condition accompanied by a decrease in the level of hemoglobin and red blood cells in the child’s blood. Anemia in children is an extremely common disease in pediatrics. About 40% of cases of anemia are diagnosed in children under 3 years of age; 30% - during puberty; the rest - at different age periods of the child’s development.

The frequent occurrence of anemia in children is due to their intensive growth, the activity of the erythropoiesis process, and a progressive increase in the number of formed elements and bcc. At the same time, the hematopoietic apparatus in children is functionally immature and very vulnerable to various influences. Normal hematopoiesis in children requires large amounts of iron, protein, vitamins and microelements, so any feeding errors, infections, or toxic effects on the bone marrow can cause the development of anemia in a child. Children in the second half of life, whose neonatal iron reserves are depleted, are especially sensitive in this regard. Long-term anemia in children is accompanied by the development of hypoxia and profound tissue and organ changes. Children with anemia lag behind healthy peers in physical and mental development, more often suffer from intercurrent diseases, and are prone to the development of chronic pathological processes and various kinds of complications.

Causes of anemia in children

Factors contributing to the development of anemia in children are divided into antenatal, intranatal and postnatal.

Antenatal factors act during intrauterine development. For the normal course of hematopoiesis in a child during pregnancy, his body must receive from the mother and accumulate a sufficient amount of iron (about 300 mg). The most intensive transfer of iron from a pregnant woman and its deposition in the fetus occurs at 28-32 weeks of gestation. Disruption of the normal course of pregnancy during this period (gestosis, fetoplacental insufficiency, threat of spontaneous abortion, premature placental abruption, bleeding, infectious diseases of the mother, exacerbation of chronic processes) leads to disruption of iron metabolism and its insufficient accumulation in the child's body.

Anemia in children occurs if the woman also suffered from anemia during pregnancy. Premature birth leads to the fact that anemia is detected in all premature babies from birth or from approximately the 3rd month of life. Multiple pregnancy contributes to the development of anemia in newborns.

Intrapartum factors of anemia in children are associated mainly with blood loss during childbirth. Blood loss is possible in the event of premature placental abruption during childbirth, early or late ligation of the umbilical cord, bleeding from the umbilical cord when it is not properly processed, or the use of traumatic obstetric aids.

Postnatal factors of anemia in children turn on after birth and can be endogenous or exogenous. The causes of endogenous anemia in children can be damage to red blood cells due to hemolytic disease of the newborn, abnormal hemoglobin synthesis, and primary constitutional failure of the bone marrow.

Exogenous anemia in children is most often caused by nutritional reasons. In this case, anemia develops mainly in children of the first year of life who are fed monotonously with milk. Anemia in young children can occur due to insufficient iron content in breast milk; early and unjustified transfer of a child to artificial or mixed feeding; using unadapted formulas, cow's or goat's milk for feeding; late introduction of complementary foods into the child’s diet. Premature babies and children born with increased body weight need a higher intake of iron into the body. Therefore, a discrepancy between iron intake and consumption can also cause anemia in children of the first year of life.

Anemia in children can occur due to regular blood loss: with partial nosebleeds, blood diseases (hemophilia, von Willebrand disease), menorrhagia, gastrointestinal bleeding, after surgery. Children with food allergies, exudative diathesis, and neurodermatitis have an increased loss of iron through the epithelium of the skin, so such children constitute a risk group for the development of iron deficiency anemia.

In addition to iron loss, impaired absorption and metabolism can lead to the development of anemia in children. Such disorders usually occur with malabsorption syndrome (hypotrophy, rickets, lactase deficiency, celiac disease, intestinal form of cystic fibrosis, etc.). Anemia in children can be a consequence of any infectious or chronic somatic disease (tuberculosis, bacterial endocarditis, bronchiectasis, pyelonephritis, etc.) , leukemia, mycoses, helminthic infestation, collagenosis (SLE, rheumatoid arthritis, etc.).

In the development of anemia in children, a deficiency of B vitamins, microelements (magnesium, copper, cobalt), unfavorable hygienic conditions, and depletion of endogenous iron reserves, which occurs in an infant by 5-6 months, are of particular importance.

Classification of anemia in children

In accordance with etiopathogenesis, the following groups of anemia are distinguished:

On the part of the nervous system experiencing hypoxia, lethargy, tearfulness, rapid exhaustion, dizziness, shallow sleep, and enuresis are noted. A decrease in muscle tone is detected, the child does not tolerate physical activity well, and quickly gets tired. In children of the first year of life, malnutrition is observed, and psychomotor development regresses.

With anemia in children, dysfunction of the cardiovascular system is detected in the form of arterial hypotension, orthostatic collapse, fainting, tachycardia, systolic murmur.

On the part of the digestive system, children with anemia experience frequent regurgitation and vomiting after feeding, flatulence, diarrhea or constipation, decreased appetite, and possibly an enlarged spleen and liver.

Diagnosis of anemia in children

The basis for diagnosing anemia in children is laboratory tests. A general blood test for anemia in children reveals a decrease in hemoglobin (Hb less than 120-110 g/l), a decrease in Er (12/l), a decrease in CP, puncture and bone marrow studies.

During the diagnostic process, the form and severity of anemia in children is determined. The latter is assessed by the content of red blood cells and hemoglobin:

• mild anemia – Hb 110-90 g/l, Er - up to 3.5x1012/l;
• moderate anemia - Hb 90-70 g/l, Er - up to 2.5x1012/l;
• severe anemia - Hb less than 70 g/l, Er - less than 2.5x1012/l.

According to indications, children with anemia may need consultations with specialized specialists (pediatric gastroenterologist, pediatric rheumatologist, pediatric nephrologist, pediatric gynecologist, etc.), examination of the gastrointestinal tract (EGD, abdominal ultrasound) and kidneys (renal ultrasound).

Treatment of anemia in children

For anemia in children, it is necessary to organize a correct daily routine and a balanced diet for the child, carry out drug therapy and general strengthening measures. Children are recommended to have sufficient exposure to fresh air and extra sleep; Gymnastics and massage, Ural Federal District are prescribed.

Children with anemia who are breastfed should be given complementary foods (juices, egg yolk, vegetables, pureed meat) in a timely manner. At the same time, it is necessary to adjust the diet of a nursing woman, add multivitamins and iron supplements. Children receiving artificial feeding are prescribed adapted milk formulas fortified with iron. The diet of older children should contain liver, beef, legumes, greens, seafood, fruit and vegetable juices.

Drug therapy for anemia in children includes the prescription of iron supplements and multivitamin preparations until clinical and laboratory parameters are completely normalized (on average 6-10 weeks). In severe cases, blood transfusion may be required.

Prognosis and prevention

The prognosis for iron deficiency anemia in children is usually favorable. With timely diagnosis, proper nutrition, treatment of anemia and concomitant diseases, complete recovery occurs. Severe anemia in children may be grounds for postponing vaccination.

The antenatal stage of preventing anemia in children includes good nutrition for the pregnant woman, sufficient exposure to fresh air, and taking mineral and vitamin complexes containing iron. Postnatal prevention of anemia in children comes down to natural feeding, introduction of complementary foods at the recommended time, prevention of early childhood diseases, organization of good care and optimal regimen for the child, and conducting preventive treatment and prophylactic courses in risk groups.

Anemia (or anemia) is a condition characterized by a decrease in the level of hemoglobin and red blood cells in the blood of children.

Why does anemia develop in children - all the reasons in the table

Table No. 1. Causes of anemia in children.

How to identify anemia in children: symptoms, diagnostic methods

Table No. 2. Symptoms of anemia in babies under one year old and in older children

Anemia in infants is most often first detected at the 4th month of life. Why? Read below.

Daily routine and child development in the 4th month of life

The average weight of a 3-month-old child is 6 kg, height is 60 cm.

Mode

By this time, the daily routine has already formed. Lactation is improving. And mom feels better. The child now eats 6-7 times a day (5 during the day). He sleeps during the day 2-3 times for 1.5 - 2 hours, and stays awake for the same amount of time. During the day, the child sleeps approximately 16-17 hours and is awake for 7-8 hours.

Daily walks at this age should last at least 2 hours a day in summer and 1 hour in winter. The child should receive only breast milk or formula from food. Approximately this regime lasts up to 5 months.

New

By this age, the child begins to actively move his arms and legs. Knows how to roll over on its side (read more about what a baby can do at 3 months at 4 months). And he may accidentally roll over onto his stomach. Therefore, under no circumstances should it be left unattended in a place where it could fall.

From three months you can transfer your child to bathe in a large bath. And start swimming with a circle around your neck. You can see a complex of massage and gymnastics for children

Toys should be hung at arm's length from the child. So that the child can practice grasping the toy.

The most common problems identified at this age are anemia and rickets.

Anemia in infants

Anemia in infants is a decrease in hemoglobin level below 110 g/l (the norm for a child is 120-140 g/l). In children, anemia is usually iron deficiency, associated with a lack of iron in the body. In addition to a decrease in hemoglobin levels, with such anemia the color index decreases to less than 0.85.

Anemia in infants Causes

The causes of iron deficiency anemia in an infant can be: prematurity, anemia in the mother during pregnancy, multiple pregnancy, hemolytic disease of the newborn, artificial feeding, large weight gain in the first months of life, viral and infectious diseases of the child, etc. Anemia is detected more often in children just by chance during a screening (mandatory for everyone) blood test at 3 months.

Anemia in infants, grade 3

Decrease in hemoglobin level to

• 90 - 110 g/l - mild anemia.
• 70 - 90 g/l - medium severity.
• less than 70 g/l - severe anemia.

A decrease in hemoglobin level within 110 - 119 g/l is not anemia. It is considered a temporary functional deviation. No treatment is required for the child. Usually, in such cases, correction of the mother is carried out (mandatory introduction of beef meat into the diet of at least 100 g/day). And she is prescribed multivitamins or iron supplements. But, in this case, the child will definitely need to repeat the blood test after 1 month to make sure that hemoglobin has returned to normal. Or, if it drops below 110 g/l, promptly prescribe treatment.

Most often, mild anemia is detected in infants. She may have no symptoms. Or they may be minimal (pallor of the skin, decreased appetite, systolic heart murmur). If a child's hemoglobin is higher than 100 g/l, preventive vaccinations are usually allowed. But, if less, they are postponed until the hemoglobin level increases. Mild anemia will be treated by your local pediatrician. Usually, in this case, iron supplements are prescribed. For infants, it is most convenient to use drugs dosed in drops (Maltofer, actiferrin, hemofer, etc.); they are produced in special bottles equipped with a dropper. The doctor will select the dose strictly individually. Under no circumstances should you give your child iron supplements without a doctor’s prescription. They have a strict dosage, depending on the weight and age of the child, and side effects.

Treatment with iron supplements

Side effect

If, after a doctor's prescription, you start giving your child an iron supplement, his stool turns black and becomes more frequent and liquid. This is normal and you shouldn't be afraid of it. The black color of stool is associated with the presence of a large amount of iron in the intestinal contents. This coloration of the stool will persist until you stop taking the drug. Loose stools, as well as loss of appetite and even vomiting, can be associated with the irritating effect of iron on the mucous membrane of the gastrointestinal tract.

To reduce these symptoms, it is recommended to start taking the drug gradually. For example, if a child is prescribed medicine 5 drops - 2 times a day. On the first day you need to give 1 drop 2 times a day, on the second 2 times a day and so gradually reach the desired dose.

In order not to provoke vomiting, you can give the medicine to your child during meals.

A month after the start of treatment, the child is given a repeat blood test.

Immediately after normalization of hemoglobin, iron supplements are not canceled! Treatment with iron supplements is stopped no earlier than a month after hemoglobin levels have normalized. Since “iron reserves” must still be formed in the body.

If hemoglobin does not normalize during treatment, or the child has moderate or severe anemia, the child will need to consult a hematologist.

Severe anemia is manifested in infants by pale and bluish skin, decreased appetite, fatigue and shortness of breath during sucking and physical activity, and systolic heart murmur. A child who has a decrease in hemoglobin of less than 110 g/l remains under the supervision of a doctor until 3 normal blood tests are obtained. They are repeated 3 and then 6 months after hemoglobin normalization.

The first signs of rickets

At the same age, if the child was not given vitamin D or the dose of vitamin D was insufficient for your child, the baby may show initial signs of rickets. Mom should definitely pay attention to them and point them out to the doctor. These are increased excitability, fearfulness, irritability (whims), shuddering, sweating and baldness of the back of the head. The doctor will prescribe treatment. If all this is left unattended, the child will develop distinct skeletal changes.

Rickets is a disease associated with impaired absorption of calcium in the child's body. Calcium in our body is absorbed only with the participation of vitamin D; with a lack of this vitamin, rickets develops. Vitamin D can be synthesized in our body under the influence of ultraviolet rays. But in the middle zone where we live, children do not get enough sun exposure to require additional vitamin D in a prophylactic dose. Therefore, vitamin D (1 drop of vitamin D3 or 500 IU) in a prophylactic dose is prescribed to everyone.

Rickets more often occurs in bottle-fed children, premature babies, children with insufficient physical activity (prolonged tight swaddling, lack of gymnastics, massage, walks, bathing), in children who undergo long-term anticonvulsant therapy, calcium absorption in the intestines is impaired (hereditary disorders, long-term intestinal infections, dysbacteriosis).

If signs of rickets are detected, the dose of vitamin D is increased. Only a doctor prescribes vitamin D and selects the dose, because an excess of this vitamin is worse than its deficiency. This vitamin can cause poisoning in the body. During the period of initial manifestations, vitamin D3 is usually prescribed in a daily dose of 1500-2000 IU or 3-4 drops of solution for 1.5 - 2 months, followed by a transition to a prophylactic dose. If treatment is not started early, rickets will require larger doses of vitamin D3, longer treatment, and may not be able to avoid skeletal deformities. But timely treatment will lead to good results. In the treatment of rickets and anemia, proper nutrition of the mother, daily routine, walks, gymnastics and massage are of great importance.

This term refers to a condition in which the level of hemoglobin and hematocrit in the blood decreases, which causes a decrease in the number of red blood cells and iron levels.

Causes of anemia

In newborns with iron deficiency anemia, not only the quantitative content of red blood cells decreases, but their appearance also changes, which can be seen during microscopic examination.

They lose their brightness - the color is now not bright red, but pink, their shape changes - they become oval, and not round, as required by the norm. These signs of iron deficiency anemia in infants are recorded during laboratory examinations.

The cause of anemia in infants can be considered to be insufficient amounts of iron, copper or folic acid in the body. The reserve that was received from the mother’s body ends after 6 months of independent life. Next, he must replenish nutrients from food.

IDA can lead to:

Hypochromic anemia in infants is caused by internal hemorrhages and impaired iron absorption. Symptoms and treatment of anemia in infants depend on the severity of this condition.

At an early stage, a decrease in the level of hemoglobin in the blood does not cause any symptoms and is detected only by laboratory tests.

• On the 1st day after birth it should not fall below 130 g/l;
• by week 3 the level drops to 120 g/l.

Signs of the disease

Signs of a decrease in the number of red blood cells in the blood are as follows:

But based on these symptoms, it cannot be said that the baby has anemia. This condition may be a sign of other diseases.

The degrees of anemia differ in the severity of the condition:

• Dangerous degree 3 – hemoglobin in the blood is less than 70 g/l;
• causes a change in behavior indicator from 70 to 90 g/l -2 degree of anemia;
• with grade 1 anemia in an infant, the hemoglobin level does not fall below 90 g/l.

Anemia requires elimination, as it provokes a slowdown in overall development and inhibits the final formation of the brain.

Treatment of anemia

We have already found out why anemia is dangerous for infants, which means that the condition requires mandatory treatment. At the first degree of severity of the disease in an infant, treatment begins with the selection of a diet for his mother. It is necessary to include foods with a high iron content in your diet.

When changing diet, it is necessary to monitor how the baby’s intestines react to the introduction of new foods. Some nursing mothers believe that fruits and vegetables contain the greatest amount of beneficial substances, and they happily begin to feast on pomegranates, apples, strawberries... Such a diet can cause colic in the baby. Buckwheat, red meat, and chicken breast contain no less iron - so you always have the opportunity to choose a diet suitable for your child.

A diet for a nursing mother with anemia should include the following foods:

• Brussels sprouts;
• greens - parsley, spinach, lettuce;
• chicken egg yolks;
• sea ​​fish;
• red meat;
• rosehip decoction;
• buckwheat porridge.

Hypochromic anemia and the condition of 2nd degree of severity cannot be cured only by changing the diet - there is a need to take glandular supplements and folic acid. A baby with anemia needs it, otherwise red blood cells will not reproduce. Folic acid, like iron supplements, is introduced into the mother's body.

All vitamin preparations, necessary medical procedures and intravenous injections are prescribed by a doctor. It is he who must choose the treatment regimen. There are certain formulas intended for artificially-bred children with a high content of iron and folic acid. This type of nutrition includes "Nutrilon with iron", "Enfamil with iron", "Similac with iron" and the like.

Doctors advise switching to such a diet after the baby reaches 3 months, not earlier, since before this age the baby’s intestines are simply not prepared to absorb iron.

From 6 months, rosehip decoction can be introduced directly into the diet of infants. Stage 3 anemia can only be treated with medications. In this case, iron-containing drugs are administered to the infant, mostly by injection - when administered orally, the child often regurgitates the medicine. Therapeutic measures are recommended to be carried out in a hospital setting.

The body takes iron supplements very hard, and side effects include vomiting, intestinal upset, and hyperemia of the skin.

Doctors usually calculate the dose individually, depending on the clinical picture of the disease and the severity of the condition.

Iron supplements are administered between feedings - milk blocks their absorption. Therefore, the mother must follow a daily feeding schedule so that he receives food at a strictly defined time.

If side effects develop, you need to inform your doctor - the range of glandular preparations allows you to choose the appropriate remedy that the baby will tolerate more easily.

During treatment, due to the increased intake of iron in the diet, the child's stool becomes black. Mommy should know about this and not be scared when she sees something like this. Therapy is carried out until hemoglobin levels in the blood normalize and a small reserve is created - at least until it exceeds 10 units - that is, when the blood level reaches 120 g / mol, iron supplements can be abandoned.