home Auditorium 7 Anemia in infants. Anemia in infants under one year of age How does anemia manifest in infants

Anemia in infants. Anemia in infants under one year of age How does anemia manifest in infants

The term "anemia" is derived from the Greek word "eima", meaning blood, and the prefix "a", which has a negative meaning. The disease is popularly known as anemia, although in fact doctors consider anemia rather as a symptom of a certain disease (in the article we will talk about anemia both as a symptom and as a disease). We can say that anemia in an infant is a set of symptoms that are in one way or another associated with a decrease in red blood cells in the blood, as well as with a decrease in hemoglobin concentration.

About blood functions

To understand what this pathology is, you need to have some understanding of the process of hematopoiesis and the functions of red blood cells and hemoglobin.

Red blood cells are formed and mature in the bone marrow of the spine, skull and ribs, after which they enter the blood and perform their main function - transporting oxygen to the organs and tissues of the whole body. This, in turn, occurs due to the presence of a special protein in them - hemoglobin, which contains iron and is able to bind to oxygen molecules. Having given oxygen to the cell, red blood cells take the resulting carbon dioxide and deliver it to the lungs, where it is released outside.

In a newborn, hemoglobin (Hb) levels are quite high. Since, while in the womb, the child cannot receive oxygen through the air, and there is less oxygen in the mother’s blood than in the environment, the increased level of hemoglobin compensates for this problem. In the first days, the norm for hemoglobin in a baby is considered to be 180-240 g/l. By six months, a good indicator is 115-175 g/l, and later the hemoglobin level decreases slightly, and from one year to 5 years the norm is 110-140 g/l.

Red blood cells play a critical role in oxygen transport

The life cycle of red blood cells is 4 months or slightly less. After this, the cells are destroyed in the liver and spleen, but new ones take their place, so that the process of transporting oxygen and removing carbon dioxide in the blood is not interrupted.

Classification

There are several forms of anemic disease associated with disturbances in the circulatory system, bone marrow pathologies or other reasons. Let's roughly divide them into 3 categories:

Anemia due to acute blood loss. This happens when bleeding occurs due to various circumstances (pathologies of internal organs, road accidents, etc.). The body loses a large number of red blood cells and this condition is regarded as critical, life-threatening.
When there are disruptions in the production of red blood cells. Aplastic, sideroblastic, megaloblastic are types of anemia in which disturbances in the production of formed elements are detected. However, the most common form of the disease is iron deficiency anemia, which occurs either when there is insufficient intake of iron in the body or when it is not properly absorbed.
Pathological destruction of red blood cells. Hemolytic anemia in newborns often occurs when the mother has a negative Rh factor.

The severity is determined by the level of hemoglobin:

mild - Hb>90 g/l;
average - Hb=70-90 g/l;
heavy - Hb

Causes of anemia

How does anemia appear in infants? The reasons for its development can be very diverse.

Prenatal period

During intrauterine development, the baby needs to accumulate a certain amount of iron in order to form a kind of depot (approximately 300 mg). The most active period of iron transfer from mother to fetus occurs at 28-32 weeks of pregnancy. Therefore, any problems at the beginning of the third trimester (gestosis, chronic diseases of the mother, fetoplacental insufficiency, bleeding, premature placental abruption, as well as low hemoglobin in the mother herself) can interfere with the absorption and accumulation of iron, and therefore contribute to the development of anemia in infants.

Children born prematurely or from multiple pregnancies are at risk. In the first case, they do not have time to replenish their reserves of microelements, and in the second they have to share with a brother or sister

During childbirth

The situation can become more complicated if there is blood loss during the birth itself (for example, with premature placental abruption) or if traumatic obstetric aids were used. An untied or poorly treated umbilical cord also leads to bleeding.

After childbirth

Internal factors due to which postpartum anemia develops are as follows:

hemolytic disease - occurs due to incompatibility of the blood of mother and fetus according to the ABO system or Rh conflict; the destruction of fetal red blood cells often begins in the womb and can lead to the death of the baby;
bone marrow failure, when it partially fails to perform its functions of producing normal blood cells;
pathologies in hemoglobin production;
any infectious or chronic diseases (food allergies, diathesis, gastrointestinal bleeding, pyelonephritis, helminthic infestations);
hereditary diseases (cystic fibrosis, celiac disease, lactase deficiency).

About iron and its role

Fortunately, in most cases we are not talking about rare hereditary diseases or severe pathologies, but about iron deficiency anemia, which is common in children in the first year of life. It is associated with insufficient iron content in the milk of a nursing mother or with the early transfer of the baby to artificial feeding. Unadapted formulas based on goat's or cow's milk, as well as late introduction of complementary foods (lack of variety) - all this affects hemoglobin levels. Premature babies or, conversely, those who are rapidly gaining weight, especially need iron-containing elements.

Insufficient intake of B vitamins, folic acid, magnesium, cobalt and copper can also lead to iron deficiency, since these elements are simply necessary for the absorption and conversion of iron into the desired form

So, anemia in children under one year of age, especially in babies 5 months or 6 months of age, often develops gradually and is associated with poor nutrition. It needs to be treated so that it does not become chronic, especially since this type of disease responds well to treatment.

Symptoms of anemia

Regardless of the form of the disease, the signs of anemia have a similar picture associated with oxygen deficiency, which causes damage to all organs and systems, including brain cells.

First of all, the condition of the skin changes: it is often pale, dry, and prone to peeling. Hair becomes dull, nails become brittle. A distinctive sign of the disease is considered to be Filatov's symptom - during examination in transmitted light, the earlobes are visually pale.

In severe cases, cracks appear on the feet, palms, jams in the mouth, and stomatitis. The immune system is weakened, children often suffer from acute respiratory viral infections, and are prone to diseases of the intestines and bronchopulmonary system.

The nervous system is exhausted. The child gets tired quickly, is whiny, sleeps a lot (but the sleep is superficial), and is apathetic. Characterized by dizziness and muscle weakness. There is a delay in psychomotor development, nocturnal enuresis (it is difficult to track in children under one year old). Babies with anemic syndrome have a decreased appetite, they are prone to constipation, diarrhea, flatulence, and frequent regurgitation after feeding. When examined by a doctor, an enlarged liver and spleen may be detected.

Pale skin and tearfulness are some of the main symptoms of an anemic condition.

Blood pressure is usually low; in severe cases, fainting and rapid heartbeat are possible, and if nothing is done, the consequences can be extremely sad - an anemic coma occurs.

Diagnostics

A diagnostic examination for the presence of anemia in an infant begins with detailed clinical blood tests. First of all, pay attention to the content of hemoglobin and red blood cells; the overall picture is helped to see the uniform number of leukocytes, platelets, and reticulocytes. It is also desirable to define:

hematocrit;
serum ferritin;
ability and degree of saturation of transferrin:
bilirubin;
vitamins;
erythropoietin.

Sometimes, if indicated, it is necessary to take a bone marrow aspiration biopsy.

Not all of these tests are required, but it happens that they are indispensable to establish an accurate diagnosis. You may also need an ultrasound examination of some organs (for example, ultrasound of the abdominal cavity, kidneys, etc.) and additional consultation with other specialists working with children: a urologist, rheumatologist, gastroenterologist, oncologist or gynecologist.

Treatment

There are protocols for the treatment of anemia that doctors rely on. After the form and severity of the disease has been established, the doctor, based on this protocol, makes recommendations for treatment.

So, if it has been determined that a child has mild iron deficiency anemia, they are limited to nutritional correction. Children who are breastfed and are ready for complementary foods are introduced to the diet with meat and vegetable puree, egg yolk, liver, buckwheat, and rosehip decoction. A nursing mother is prescribed to take multivitamins containing iron or separately containing iron preparations.

Iron-containing products

For babies who, for some reason, are not breastfeeding, a careful selection of a highly adapted formula enriched with iron is carried out. In parallel, the treatment regimen includes taking multivitamins or B vitamins, as well as folic acid.

If a chronic disease that contributes to the development of an anemic condition is identified, the root cause is treated. Thus, for diseases of the gastrointestinal tract, medications are used that improve intestinal motility, relieve spasms, and normalize intestinal microflora. Herbs with an anti-inflammatory, wound-healing effect are recommended, for example, teas from decoctions of chamomile, sage, mint, and rose hips.

For severe hemolytic anemia, the use of glucocorticosteroids, immunosuppressants, and plasmapheresis is indicated. In some cases, the spleen has to be removed.

For moderate anemia, iron supplements can be prescribed, but it is worth remembering side effects such as constipation, stomach pain

It should be remembered that even mild anemia, no matter how old the child is, can only be treated by a doctor. Self-medication is unacceptable!

Prevention

Preventive measures for the occurrence of anemia are associated with adequate nutrition of the pregnant woman and timely treatment of chronic diseases. After birth, the baby needs quality food, which means the nursing mother must also continue to eat well.

The introduction of complementary foods must be done within the recommended time frame and the baby’s menu must be gradually diversified, introducing him to new products. And regular visits to the pediatrician and tests will help you notice the problem in time if it appears.

Anemia in an infant is a pathological condition that requires parents to be especially vigilant. It is characterized by a decrease in the amount of hemoglobin. It is hemoglobin that “carries” oxygen, supplying all organs and tissues with a vital element. And on the way back to the lungs, the red blood cell is “captured” by deadly carbon dioxide.

According to statistics, more than 20% of all babies born on time are susceptible to the disease. But children born before their due date suffer from the disease in almost 100% of cases.

The level of hemoglobin in the blood of children changes with age:

1 day after birth – 130-145 g/l;
2 – 14 days – 120-130 g/l;
14 – 28 days – 110-120 g/l;
1 month – 6 years – about 110 g/l.

Anemia in infants: causes

In children under 1 year of age, iron deficiency anemia is most often recorded. It occurs due to an incorrectly selected diet, congenital pathologies of the gastrointestinal tract, and prematurity. If a child is bottle-fed from the moment of birth, then the risk of getting Anemia increases sharply.

Children who are overweight and infants who quickly gain weight will more actively use up the iron reserves accumulated during the prenatal period. And if the expectant mother did not eat well enough during her pregnancy or she has chronic diseases of the digestive system, then the fetus’s body is not able to “put aside” the substance it needs so much. A similar situation occurs in cases where a nursing mother has low hemoglobin or eats poorly for a long time during breastfeeding.

Signs of anemia in a baby

The main signs of the disease include:

pallor of not only the skin, but also visible mucous membranes;
frequent stomatitis;
cracks in the corners of the mouth;
dry skin;
physical inactivity;
dysbacteriosis;
irritability, tendency to cry;
frequent constipation.

You should carefully analyze the condition of the children, and if you notice at least one of the listed symptoms, then you need to give the child a blood test. Anemia of the first degree is said to occur when the hemoglobin level remains within 90 g/l.

What is dangerous about Anemia in infants: complications

The consequences of previously suffered Anemia may appear several years later. The rapidly growing children's brain does not tolerate a lack of oxygen quite well, because the rate of formation of new nerve cells decreases, which leads to many disorders of neuropsychic health.

Low hemoglobin - School of Dr. Komarovsky

Anemia in infants: symptoms, causes and treatment

Low hemoglobin in an infant

Causes of anemia - Dr. Komarovsky

Anemia in children. Advice for parents - Union of Pediatricians of Russia

Many pediatricians consider the appearance of Anemia to be the first “bell” of Rickets, a disease that develops due to a lack of vitamin D. In the advanced stage of the disease, not only the brain, but also the heart muscle suffers, and this immediately affects the well-being of a small child.

Treatment of Anemia

Treatment of Anemia in an infant begins only after in-depth diagnosis. An individual course of treatment is prescribed based on the identified root cause of the disease.

For almost all types of illness, the medication treatment regimen includes:

folic acid;
vitamins of group B, C, PP;
iron supplements.

It is important to remember that it is better to give iron supplements to children in the form of liquid syrups. But, the child’s diet mainly consists of milk and lactic acid products, and they interfere with the absorption of iron in the gastrointestinal tract. Therefore, syrups are given only during the break between feedings, when the milk in the stomach is partially digested.

Treatment of the disease in children is quite long. In iron deficiency Anemia, despite the rapid stabilization of hemoglobin levels, it continues for at least 2 months. The child's body must receive a sufficient supply of iron, and this is a long process.

If the child’s condition does not improve, then the pediatrician will prescribe injections of not only iron supplements, but also folic acid. If the treatment regimen is drawn up correctly, then the first positive results can be noticed after 10-14 days from the start of the medication course.

Nutrition as a way to treat anemia

Nutrition plays a special role in the treatment of Anemia. The meager diet for infants is expanded with foods rich in iron, such as buckwheat, turkey meat, beef tongue, chicken egg yolk, greens, and rosehip decoction (in the absence of allergies). Dr. Komarovsky advises children with the initial stage of Anemia to spend more time in the fresh air and take long walks.

If the baby continues to receive breast milk, then the feeding mother's nutrition is monitored with special care. It is important during this period to strictly limit smoking, consumption of strong coffee, tea, whole cow's milk, semolina and rice porridge. These foods interfere with the normal absorption of iron.

Anemia in premature babies

The disease is especially severe in premature babies. It can develop already in the first weeks after “premature” birth and is difficult to treat. Control blood tests are done at intervals of 4-6 days. As a rule, injectable forms of iron-containing drugs are prescribed from the first days of treatment. It is worth using vitamin complexes more actively in order to achieve normalization of blood counts in the shortest possible time.

D50 Iron deficiency anemia

P55 Hemolytic disease of the fetus and newborn

Epidemiology

Statistics on the spread of anemia indicate that about 5% of newborn babies encounter this problem in the first month of life, and more than 40% of cases of anemia are etiologically related to problems of pregnancy and childbirth. The prevalence of iron deficiency anemia ranges from 0.9 to 4.4%, which varies by race, ethnicity, and socioeconomic status, but accounts for only about 40% of total anemia in young children. The remaining 60% are hemolytic and aplastic anemias.

Causes of anemia in a newborn

Most of the anemias encountered today are anemias associated with iron deficiency. Other anemias are congenital aplastic, hemolytic anemia also occurs, but much less frequently and with a more vivid clinical picture.

To understand the causes of anemia in newborns, you need to consider the role of iron in the blood. If we simplify the diagram, we can imagine that iron is in the center of the heme molecule, which is externally surrounded by the protein globin. This is how hemoglobin itself is built, which is the basis for the red blood cell. It is hemoglobin that is responsible for binding oxygen molecules in the lungs and transporting such a complex throughout the body, to every cell that requires oxygen. When iron levels decrease, heme levels also decrease, so red blood cells cannot bind oxygen, which underlies the development of anemia and its manifestations. This is why it is so important for a newborn baby that the mother, and then the baby, have a sufficient amount of iron.

Iron sufficiency is a condition in which the iron content is sufficient to maintain normal physiological functions; in this case, the pregnant woman must take into account the double need for it.

Iron deficiency is a condition in which the iron content is insufficient to maintain normal physiological functions. Iron deficiency is the result of insufficient absorption of iron to meet the increased needs of the mother during pregnancy, or is the result of a long-term negative iron balance. Any of these situations leads to a decrease in iron stores, which is determined by measuring serum ferritin concentrations or bone marrow iron levels. Therefore, iron deficiency in the mother during pregnancy is the first and main cause of iron deficiency anemia in the newborn, even regardless of gestational age.

The deficiency of total iron in the body in premature infants is greater, the lower the gestational age. It is exacerbated by rapid postnatal growth, which occurs in many children, and by frequent phlebotomies without adequate blood replacement.

Of the iron available in the body of a newborn, 80% accumulates during the third trimester of pregnancy. Babies born prematurely lose this period of rapid growth and are deficient in total body iron. A number of maternal conditions, such as anemia, hypertension with intrauterine growth restriction, or diabetes during pregnancy, can also lead to decreased fetal iron stores in both full-term and preterm infants.

The concept of breastfeeding is very related to this, since breast milk contains as much iron as a baby needs in his first five months of life. And if a child does not breastfeed immediately after birth, this may be one of the main reasons for the development of anemia.

Other causes of anemia in a newborn that may be associated with pregnancy and childbirth include pathology of the intrapartum period. Fetoplacental transfusion and intrapartum bleeding due to birth trauma and anomalies in the development of blood vessels of the placenta and umbilical cord can lead to significant blood loss in the mother. This continuously affects the formation of red blood cells in the child.

Anemia can also develop for other reasons, which are more serious and associated with the pathology of iron intake into the newborn’s body due to organic pathology. Impaired absorption of iron can be observed in malabsorption syndrome, congenital intestinal obstruction, and short bowel syndrome. All this secondary leads to the development of anemia. Iron loss in significant quantities can be observed during bleeding of various etiologies. In newborns, this is most often bleeding from the navel or intestinal bleeding due to hemorrhagic disease.

Although iron deficiency is the main cause of anemia, we should not forget about other anemias that a newborn may have. These include congenital aplastic anemia and hemolytic anemia.

Aplastic anemia is a condition characterized by a decrease in hemoglobin levels due to disruption of the formation of red blood cells in the bone marrow. In newborns, aplastic anemia is often congenital in nature. The main cause of congenital aplastic anemia can never be accurately determined. Children are born with a pathology, but the exact cause cannot be determined. Risk factors include ionizing radiation, genetic mutations, medications, viral and bacterial agents, and others.

The pathogenesis of aplastic anemia is based on a violation of the development of the stem cell, which gives rise to all blood cells. And depending on which germ is involved, there may be a decrease in the levels of other blood cells.

Hemolytic anemia occurs in children more often due to hereditary causes. This occurs due to a mutation in the gene that is responsible for the structure of the red blood cell cell. Therefore, its membrane cannot function normally and periodically it is destroyed, which is called hemolysis. The most common type of anemia is Minkowski-Choffard anemia in newborns. This anemia occurs due to a genetic mutation of the red blood cell membrane proteins spectrin and ankyrin. Therefore, the main cause of anemia in this disease is disruption of the cell membrane due to a lack of these proteins.

Anemia in newborns has similar clinical manifestations, but it is imperative to know the cause and understand the pathogenesis of development for the correct treatment tactics.

Symptoms of anemia in a newborn

Speaking about the clinical manifestations of anemia, you need to understand the stages of its development. If we are talking about iron deficiency anemia, then it has its own stages of development. At first, the baby is born absolutely healthy, because immediately after birth he has a physiological increase in the level of red blood cells. But at this time, the number of red blood cells that should be formed in the bone marrow decreases due to a lack of iron. This corresponds to the hidden or latent stage of anemia. There are no clinical manifestations yet, but iron deficiency leads to a critical decrease in hemoglobin and red blood cells.

The next stage is long-term iron deficiency leads to the appearance of clinical symptoms, so this is a clear stage of anemia.

The symptoms of anemia in a newborn baby are very difficult to identify, especially for the mother. Since the child is still very small and sleeps most of the time, the mother cannot notice any signs. It is also common for a baby to develop physiological jaundice, which can make it difficult to see symptoms. This proves the importance of preventive examinations of the child during this period.

The first signs of anemia differ depending on the etiology. Iron deficiency anemia in newborns is the most common, and its first symptom is pale skin and mucous membranes of the child. All newborn babies are usually first red and then pink, and with anemia they are a little pale. This symptom is very subjective, but it may be the first sign of anemia.

Other clinical manifestations may already be associated with severe hypoxia caused by a lack of oxygen. This may be the appearance of cyanosis of the skin and shortness of breath during feeding, which may cause anxiety in the baby.

All symptoms of anemia can be generalized and divided into several groups. The main syndromes for anemia in newborns are anemic-hypoxic and sideropenic, and when talking about hemolytic anemia, hyperbilirubinemia syndrome is also added.

The first syndrome occurs due to lack of oxygen and is manifested by pallor, especially mucous membranes, poor health, decreased appetite, and lack of strength. All this manifests itself in a child by the fact that he eats poorly and does not gain weight. Sideropenic syndrome occurs due to disruption of enzymes that depend on oxygen. This disrupts the functioning of all cells and is manifested by dry skin against a background of pallor, in newborns the fontanelle does not heal well, there is no inherent muscle hypertonicity, but on the contrary, hypotension occurs.

Hemolysis syndrome occurs due to increased breakdown of red blood cells in the vascular bed, which causes the release of bilirubin and an increase in its concentration. Then, against the background of anemia and all the above symptoms, a yellow coloration of the child’s skin and sclera occurs. Hemolytic anemia in a newborn is most often genetic in nature. One type of such pathology is Minkowski-Choffard anemia. One of your family members has this disease, which makes diagnosis a little easier. All syndromes are the same, and it is important not to confuse jaundice with such hemolytic anemia with physiological one.

Congenital anemia in newborns is often aplastic in nature and is the most severe type of anemia. There are several types. One of them is Blackfan-Diamond anemia. With this pathology, it is the number of red blood cells that decreases due to damage to this germ in the red bone marrow. In the first month of life, it rarely appears; clinical signs are more visible closer to the sixth month of life.

Congenital Estren-Dameshek anemia is a decrease in the level of all bone marrow cells. Therefore, in addition to anemia and hypoxia, there will be bleeding and early infectious lesions. Another type of aplastic congenital anemia is Fanconi anemia. Symptoms of this disease, in addition to anemic, are congenital malformations in the form of microcephaly, other malformations of the skull, underdevelopment of the fingers, underdevelopment of internal organs.

It is also worth highlighting conditions in which a decrease in the amount of hemoglobin can also be observed - this is anemia in premature newborns. This is caused by immaturity of the bone marrow and unpreparedness for the processes of breathing through the lungs. This is considered normal and such anemia can resolve on its own without treatment. Physiological anemia of the newborn can also occur in a full-term baby, and the exact cause is not known. This may be due to the destruction of fetal hemoglobin and the low dynamics of growth of type A hemoglobin, as in an adult. This condition should also not cause concern and is transient.

The consequences of anemia in a newborn can be very serious if the pathology is not noticed in time. After all, constant hypoxia leads not only to lack of body weight, but also the lack of oxygen affects the brain. It is known that iron is necessary for the normal development of the nervous system. Iron deficiency anemia affects neuronal energy metabolism, neurotransmitter metabolism, myelination, and memory function. Therefore, anemia in the neonatal period can cause irreversible impairment of memory function, delayed psycho-motor development, behavioral abnormalities and speech delays in the future. As for other complications, anemia increases the risk of other infectious diseases. The consequence of lately diagnosed hemolytic anemia can be brain damage and the development of bilirubin encephalopathy.

Stages

Tests can also classify anemia by severity:

first degree – hemoglobin level within 120 (110) – 91 T/L;
second degree of anemia – 90 - 71 T/L;
third degree – hemoglobin level 70-51 T/L;
fourth degree – hemoglobin level less than 50 T/L.

Grade 1 anemia in a newborn is considered mild and may be a sign of physiological processes, but requires monitoring and observation. Mild anemia in a newborn premature infant can also be considered transient and requires monitoring.

Diagnosis of anemia in a newborn

The main criterion for anemia is certainly laboratory confirmation of a decrease in the level of hemoglobin and red blood cells. But the main task of the mother and the doctor is the timely diagnosis of anemia, so it should begin with general clinical signs. Paleness of the skin and mucous membranes should already give rise to the idea of possible anemia. If a child is not gaining weight well, then you also need to look for the cause and think about anemia. It is important to ask the mother about pregnancy and childbirth, whether she took vitamins and whether there was massive blood loss. All these thoughts can lead to a diagnosis. Even if a child is premature, in most cases he has a hidden iron deficiency and this is potentially dangerous for the development of anemia in the future.

On examination, in addition to pallor, there may be a systolic murmur at the apex of the heart upon auscultation, which also requires attention. This occurs due to turbulence in the blood flow with a low concentration of red blood cells relative to the liquid part of the blood. There are practically no other objective symptoms.

Laboratory diagnosis of anemia is the most accurate and necessary for an accurate diagnosis. A general blood test can detect a decrease in the level of red blood cells and hemoglobin. And such a diagnostic number is:

decrease in hemoglobin level below 145 T/L in children in the first two weeks of life;
hemoglobin level is less than 120 T/L in newborns after the second week of life;
in children under five years of age less than 110 T/L;
in children after five years - less than 120 T/L.

In a general blood test, if anemia is suspected, it is also necessary to determine the level of reticulocytes. These cells are responsible for the formation of red blood cells in the red bone marrow and are their precursors. The reticulocyte level is subsequently necessary to assess response to treatment.

To establish a diagnosis of iron deficiency anemia, one or more tests should be added to the determination of hemoglobin concentration. Three parameters that provide summary information about iron status are the concentrations of ferritin, chromium and transferrin. Ferritin concentration is a sensitive indicator for assessing iron stores in healthy individuals. Measuring ferritin concentrations is widely used in clinical practice and is available abroad. But in Ukraine, of these indicators, only the level of transferrin is used.

Today, most blood tests are carried out on special analyzers, which, in addition to the formula, allow us to evaluate the size of red blood cells and their structure. In anemia, the average hemoglobin content in the erythrocyte is reduced, the average size of the erythrocytes is reduced, and the average hemoglobin concentration in the erythrocyte is also below normal.

Among other tests, a microscopic examination of the smear is also performed, which in anemia has characteristic changes in the form of anisocytosis, inclusions and granules in red blood cells.

If a child has jaundice combined with anemia, then a study of total bilirubin and its value by fractions is required. This is also necessary to exclude hemolytic anemia or differentiate from hemolytic disease of the newborn. The level of total bilirubin should be between 8.5 and 20.5 micromoles.

These are the main laboratory indicators that can confirm the diagnosis of anemia and establish the etiology.

Instrumental diagnostics for iron deficiency anemia are not used, but if hereditary hemolytic anemia is suspected, an ultrasound examination may be performed. It shows the condition of the spleen, which affects the child’s condition with this pathology and indicates treatment options.

Differential diagnosis

Differential diagnosis of anemia should be carried out primarily according to the etiological principle. It is necessary to distinguish between the symptoms of anemia in a child with physiological jaundice and the manifestations of hemolytic anemia. In the first case, a decrease in hemoglobin levels will be accompanied by an increase in bilirubin below critical values - this is below 100 micromoles. If we are talking about congenital hemolytic anemia, then bilirubin will be above 100, even up to 250 and above. There will also be blood hyperchromia (increased color index above 1.05).

Treatment of anemia in a newborn

Of course, the approach to the treatment of anemia of different etiologies is different. That is why it is so important to know the cause of this or that type of pathology. If we are talking about iron deficiency anemia, which occurred after prolonged bleeding in a child or due to a congenital pathology of impaired iron absorption, then the first step to treatment is to exclude the cause of the anemia.

Speaking about iron deficiency anemia as the most common problem, it should be noted that the main element of the treatment of such anemia is replenishing iron reserves. Therefore, the medications used in treatment are iron supplements. Iron is absorbed most easily from the trivalent form, so iron supplements, especially for newborns, should be in this form. Preparations based on ferric iron are better absorbed, better absorbed and have fewer negative and side effects.

Treatment of anemia begins not with the calculation of the drug, but with the calculation of the dose of iron that the child needs. After all, each drug contains a certain amount of iron, which must also be taken into account when choosing this drug. The therapeutic dose of iron is 3-5 milligrams per kilogram of the child’s body weight, which should be taken per day. The minimum treatment period for anemia is one month. Further, if blood counts are within normal limits, then a prophylactic dose is given for another six months. The prophylactic dose is half the therapeutic dose, and it is given for ten days of each month for six months. Medicines that are used to treat iron deficiency anemia are the following:

This treatment of anemia with iron supplements is carried out for a month, then preventive therapy is given. It is very important during this period that if the mother is breastfeeding, her diet should contain the maximum amount of iron and all useful microelements. If the child is bottle-fed, then it is necessary that the formula is also fortified with iron. It should be said that in the presence of anemia, the cause of which is impaired absorption of iron, it is necessary to use injectable forms. The same applies to cases where the child has had surgery on the stomach or intestines and oral forms of iron cannot be used.

The effectiveness of treatment should be assessed 7-10 days after the start, when it is necessary to repeat the blood test. In this case, an increase in the number of reticulocytes will be evidence of the positive dynamics of treatment. An increase in hemoglobin will be observed towards the end of the course of treatment in the third or fourth week.

Nursing care for neonatal anemia is very important if the anemia is congenital. If we are talking about hemolytic anemia or congenital aplastic anemia, then it is very important to properly organize the child’s daily routine and nutrition. Considering that complications can arise from the influence of bilirubin on the central nervous system, it is important that medical personnel monitor the child. After all, there may be symptoms that threaten the child’s life, and the mother may simply not notice them due to inexperience. Therefore, the issue of treating congenital anemia in a hospital is so important.

Speaking about the surgical treatment of anemia, it should be noted that severe anemia, in which the hemoglobin level is less than 70, requires blood transfusions. This is considered an intervention at the same level as surgery. The child's blood type and Rh factor must be determined.

Surgical treatment of congenital hemolytic anemia is performed for children at an older age, closer to five years. It is performed for severe anemia with frequent hemolytic crises. The essence of the operation is to remove the spleen. The spleen is an immunocompetent organ in which the destruction of red blood cells occurs and in hemolytic anemia it is constant. Therefore, splenectomy results in fewer flare-ups because fewer red blood cells are destroyed. But before such an operation, it is necessary to vaccinate the child outside of the plan, since such an operation disrupts the normal immune status.

Vitamins for a child with anemia are considered mandatory, as it increases the absorption of iron and has a good effect on appetite. For newborns, vitamins from the carnitine group can be used, which promote weight gain, which is important for anemia. One such drug is Steatel.

Steatel is a vitamin that contains the metabolically active substance levocarnitine. It promotes the absorption of biologically useful substances and accelerates metabolism in cells, which especially affects the synthesis of new red blood cells. The drug is available in the form of syrup. One milliliter of syrup contains 100 milligrams of the substance, and the dosage is 50 milligrams per kilogram. The drug can be used even in premature babies. Side effects can be in the form of stool disorders, colic, and convulsions.

Physiotherapeutic treatment of anemia in the acute period in newborns is not used.

Traditional treatment of anemia

Of course, a newborn cannot take anything other than mother’s milk and medications, because he may be allergic to any herbs or traditional medicine. Therefore, all folk remedies are aimed at ensuring that a young mother who is feeding a child follows the advice of traditional medicine, taking certain remedies.

The main thing for treating anemia is to eat right for the mother in order to improve hematopoiesis for both herself and the child. Therefore, if a newborn has iron deficiency anemia, then the mother should include in her diet the maximum amount of foods that contain iron. These products include: red meat, fish, buckwheat porridge, parsley and spinach, legumes, pomegranate. These products must be in your diet.
Pomegranate is known for its beneficial effect not only on blood vessels, but also on the heart and the formation of formed elements. Therefore, to stimulate erythropoiesis, you need to take 150 grams of fresh pomegranate juice, add 50 grams of beet juice and the same amount of carrot juice. You need to take this vitamin mix four times a day. These products are very allergenic, so you need to start with a small amount - ten to twenty grams. You can drink it for a month.
Another folk remedy is the use of blueberry extract. To do this, you need to take two hundred grams of fresh berries and add 50 grams of water. You need to leave for two hours and then beat with a blender. Mom needs to take a tablespoon five times a day in the intervals between feedings.

Herbal treatment for anemia is also widely used:

Hellebore and yarrow herbs should be taken in equal proportions and poured with hot water. This tincture should be allowed to stand for two days, and then you can take a teaspoon in the morning and evening, adding a little lemon juice.
Rose hips must be poured with hot water and left for ten to twenty minutes. Mom should take a glass throughout the day instead of tea. This tea not only accelerates the synthesis of red blood cells, but also speeds up the work of the liver, which synthesizes proteins, including transferrin. This complex action brings recovery closer.
Birch leaves must be dried in the oven and made into a decoction. To do this, you need to take thirty grams of dry leaves and add a liter of hot water. After infusion, after two hours, you can take a tablespoon of the decoction twice a day.

Homeopathic remedies can also be used by the mother:

Natrium chloratum is a homeopathic medicine based on organic elements. It is available as a single drug in granules or in combination with succinic acid, which has a better effect on iron absorption. The dosage of the drug for the mother depends on the severity of the anemia - for the first degree, two granules three times, and for more severe ones, the dose is doubled. There may be side effects such as pale skin and mucous membranes of the child, which is caused by the action of the drug and will disappear after a few days.
Poetam is a multicomponent drug, which consists mainly of different types of antibodies to erythropoietin in homeopathic concentrations. The effect of the drug is to stimulate the work of cells that are the precursors of red blood cells. The dosage of the drug is 1 tablet per day or six drops once a day. Side effects are an increase in body temperature to subfebrile levels.
Cuprum metalicum is a homeopathic remedy that contains copper molecules that accelerate the maturation of red blood cells in the red bone marrow. The drug is used for the mother in a dose of one grain six times a day. Side effects can only occur if the mother is intolerant, and the newborn may have problems with bowel movements.
Galium-Hel is a combination remedy in homeopathy that is used to treat anemia, which is accompanied by a child’s weight loss, poor appetite, and stool disorders in the form of diarrhea. The drug is dosed five drops three times a day for the mother, since it is not recommended for the child in the acute period. For the first three days, you can take five drops every three hours. No side effects were found.

Forecast

The prognosis for anemia is favorable with proper and timely treatment, if we are talking about iron deficiency. Congenital aplastic anemia has an unfavorable prognosis; children, as a rule, live five to six years. Congenital hemolytic anemia has a good prognosis for life if all crises are correctly corrected and concomitant pathologies are treated.

Anemia in newborns is very common, especially if the mother had certain problems during pregnancy or childbirth. Most often we have to deal with iron deficiency anemia, which with the right treatment tactics is well corrected. But if there is congenital anemia in the family, then you need to consult a doctor while planning your pregnancy.

And on the way back to the lungs, the red blood cell is “captured” by deadly carbon dioxide.

Anemia in an infant

According to statistics, more than 20% of all babies born on time are susceptible to the disease. But children born before their due date suffer from the disease in almost 100% of cases.

The level of hemoglobin in the blood of children changes with age:

1 day after birth – g/l;
2 – 14 days –g/l;
14 – 28 days –g/l;
1 month – 6 years – about 110 g/l.

Anemia in infants: causes

Signs of anemia in a baby

The main signs of the disease include:

pallor of not only the skin, but also visible mucous membranes;
frequent stomatitis;
cracks in the corners of the mouth;
dry skin;
physical inactivity;
dysbacteriosis;
irritability, tendency to cry;
frequent constipation.

What is dangerous about Anemia in infants: complications

Low hemoglobin is the topic of our today's program.

Dr. Komarovsky will explain what causes an

Union of Pediatricians of Russia. http://www.pediatr-russia.ru National �

Treatment of Anemia

Treatment of Anemia in an infant begins only after in-depth diagnosis. An individual course of treatment is prescribed based on the identified root cause of the disease.

For almost all types of illness, the medication treatment regimen includes:

Treatment of the disease in children is quite long. In iron deficiency Anemia, despite the rapid stabilization of hemoglobin levels, it continues for at least 2 months. The child's body must receive a sufficient supply of iron, and this is a long process.

Nutrition as a way to treat anemia

Anemia in premature babies

All information on the site is presented for informational purposes. Before using any recommendations, be sure to consult your doctor.

Anemia

Anemia is a blood disorder that occurs when the number of red blood cells in the body decreases. These cells carry oxygen using a special protein - hemoglobin. If the number of these cells or this protein decreases, anemia occurs.

In some cases, anemia is temporary - if it is caused by nutritional deficiencies or blood loss. In others, it is the result of chronic or hereditary diseases, including autoimmune, genetic, cancer and others. Severe anemia can be life-threatening.

The main causes of anemia are listed below.

The most common iron deficiency anemia is caused, as you might guess, by a lack of iron. Without enough iron, the body cannot produce hemoglobin for red blood cells. In this case, doctors usually recommend changing your diet or taking iron supplements.
In addition to iron, your body needs folic acid and vitamin B12 to produce enough red blood cells.
Hemolytic anemias occur when red blood cells are destroyed faster than bone marrow can replace them. This happens with some blood diseases and poisonings.
Other rare causes include certain chronic, autoimmune, hereditary, blood and bone marrow diseases.

About the main causes of anemia and how to treat anemia

A 4-month-old child has a hemoglobin level of 106. A diagnosis of MILD ANEMIA was made. I was prescribed iron for two months. Question: is it really necessary to give the child medicine at this level of hemoglobin?

The baby was prescribed an iron supplement due to low hemoglobin. After this, the child’s tummy actively swells and gas is constantly released. The child is restless and screams. What to do? Can an iron-containing drug have such side effects?

Hemoglobin norms in children

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Doctor Komarovsky about hemoglobin in children

If a child’s hemoglobin level is reduced, most often in the clinic his parents immediately begin to be frightened with diagnoses and possible dire consequences. Most children, regardless of their age, are prescribed iron supplements. And moms and dads, who are far from medical terminology, have a lot of worries and questions. How to raise a baby’s hemoglobin level and whether it is possible to do this without pharmaceutical medications is often explained by the famous pediatrician Evgeniy Olegovich Komarovsky.

Definition and norm

Hemoglobin is an iron-containing protein that “can” bind to oxygen and transport it to various parts of the human body. If the level of this protein is insufficient, the child will not receive the required amount of oxygen, which is so important for his life and development. This condition is called anemia.

Dr. Komarovsky’s opinion on children’s hemoglobin and ways to solve problems with low hemoglobin can be seen in the following video.

Normally, hemoglobin values depend on gender and age. In children, these values are more than unstable, and they change. However, there are certain control figures that the doctor will rely on after receiving the results of the baby’s general blood test:

At birth, an infant's hemoglobin value can range from 160 g/l to 240 g/l.
Starting from 3 months and up to almost a year, the level of iron-containing protein decreases gradually and reaches values of 100 - 135 g/l.
From 1 year until adulthood, the hemoglobin level will gradually rise, reaching values characteristic of a man or a woman (these hematological results are different for representatives of different sexes).

Reasons for the decline

Evgeny Komarovsky, speaking about the problem of anemia in children, emphasizes that until about 5-6 months the child has a sufficient supply of such an important protein in the body. The baby makes it during the period of intrauterine development, however, during the first months of life, iron is consumed and practically not replenished. That is why, according to Komarovsky, in all children without exception, by 5-6 months there is a decrease in hemoglobin levels.

However, in addition to relatively harmless physiological reasons, a child’s hemoglobin may be reduced due to other, more dangerous factors:

Nutritional deficiency;
Blood loss of various etiologies;
Bone marrow diseases;
Kidney failure;
Neoplasms;
Vitamin B12 deficiency;
Rickets;
Congenital anemia. If during almost all 9 months of pregnancy the expectant mother suffered from low hemoglobin levels

Hemoglobin may be excessively high in children with congenital heart defects.

In any case, Evgeniy Komarovsky urges parents to examine the child as thoroughly as possible, do an extensive blood test, and, if necessary, visit a pediatric hematologist. The diagnosis of anemia should be taken seriously.

When asked whether it is possible to do without pharmaceutical drugs in the difficult task of increasing the level of low hemoglobin in a child, Komarovsky replies that this is possible. But only for the mildest forms of anemia. If the pediatrician diagnoses a mild stage, parents can try to improve the child’s blood test results by saturating his diet with foods that contain a lot of iron. Naturally, if the baby’s age allows them to be eaten.

First of all, these are meat, liver, fish, white poultry, grain porridges, especially buckwheat and beans. From vegetables it is recommended to add more tomatoes and beets, from fruits and berries - pomegranate seeds, strawberries and cranberries and others. Caviar - red and black - raises hemoglobin very well.

Evgeniy Olegovich advises giving your child seafood, dried mushrooms and nuts with caution. Although they increase hemoglobin, they are strong allergens.

Parents often wonder if it is possible to increase iron levels by giving their child goat's milk. The doctor replies that there is no direct connection between this product and the composition of the blood, and separately notes that goat milk will not be particularly beneficial for a small child if he is under three years old.

If a 3-month-old child has a decrease in hemoglobin levels, and he does not yet eat such foods due to his age, then even at a mild stage of anemia the baby will need drug treatment. It involves feeding with adapted milk formulas, which contain iron and vitamin B 12, as well as ascorbic acid, which helps iron and folic acid to be better absorbed.

Komarovsky strongly does not recommend choosing iron supplements on your own, or relying on reviews on the Internet. Only a doctor, based on a blood test, will be able to select the right medication and prescribe the required dosage. At the same time, he will take into account not only hemoglobin indicators, but also the quality and quantity of red blood cells, platelets, etc. Evgeniy Olegovich advises taking the prescribed drug without fail, strictly observing the frequency and conditions of administration.

The course of treatment, according to Komarovsky, should not be less than 2 months. Sometimes longer therapy is required.

In order to prevent the development of anemia or to increase the child’s hemoglobin level if everything has already happened, Evgeniy Komarovsky recommends taking the child outside more often, providing him with active games in the fresh air, and long walks. The baby's sleep should be longer; it would be nice if the parents can provide the child with gymnastics and massage.

Before reaching the age of one, a well-known pediatrician advises to introduce complementary foods on time and correctly, and not to neglect the expansion of the menu allowed by age.

Very often, in clinics, according to established practice, children with anemia are given an exemption from the next mandatory vaccination. Evgeniy Komarovsky emphasizes that mild stage anemia should not be a reason for postponing vaccination. Only if the hemoglobin deficiency is severe and the child is diagnosed with a severe form, then the timing of the vaccine can be shifted by 2-3 months until the blood counts return to normal or approach normal.

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Iron is one of the basic and very important microelements that our body needs. If it is deficient, anemia may occur. How to treat it if it occurs in an adult, and how if a child gets sick? The first step is to change your diet, says Dr. Evgeniy Komarovsky in his book “Handbook of Sensible Parents.”

The daily human requirement for iron is:

up to 6 months - 6 mg;

6 months - 10 years - 10 mg;

over 10 years old - 12-15 mg;

pregnant women - 19 mg (sometimes - up to 50 mg);

nursing - 16 mg (sometimes - up to 25 mg).

The bulk of the iron found in the human body is found in hemoglobin, each molecule of which contains 4 iron atoms. It is not surprising in this regard that the main indication for prescribing iron supplements is the prevention and treatment of iron deficiency anemia.

Iron is found in many foods of both plant and animal origin (meat, fish, legumes, cereals, bread, vegetables, fruits, berries). It is fundamentally important that iron in food sources can be in two forms:

iron as part of the hemoglobin molecule - heme iron;

iron in the form of inorganic salts.

The source of heme iron is meat and fish, but in berries, vegetables and fruits it is represented by inorganic salts. Why is this so important? First of all, because heme iron is absorbed (digested) 2–3 times more actively, compared to inorganic iron. That is why it is quite difficult to ensure adequate iron intake exclusively from plant foods.

Currently used iron preparations are usually divided into two main groups:

ferrous iron preparations - iron sulfate, gluconate, chloride, succinate, fumarate, lactate, etc.;

ferric iron preparations - iron hydroxide in the form of a polymaltose or sucrose complex.

The vast majority of iron preparations are used for oral administration (drops, solutions, syrups, capsules, simple and chewable tablets are available), but there are also dosage forms intended for parenteral administration - both intramuscularly and intravenously.

Parenteral administration of iron preparations is quite often accompanied by serious adverse reactions (in 0.2–3% of patients, parenteral administration of iron preparations is fraught with severe allergic reactions - even anaphylactic), therefore it is generally accepted that intravenous or intramuscular administration of iron is carried out only when there is absolutely nowhere to go, when oral administration is completely impossible or completely ineffective - intestinal absorption is impaired, an operation has been performed to remove a significant part of the small intestine, etc.

Adverse reactions are not uncommon when taking iron supplements orally, but they are predictable and less dangerous. As a rule, there is nausea, pain in the upper abdomen, constipation, and diarrhea. At the same time, the severity of reactions in ferrous iron preparations is much higher. Hence, the generally accepted recommendations are to start taking ferrous iron supplements at a dose that is 2-4 times less than the average therapeutic dose, and gradually (over 1-2 weeks) increase it, taking into account individual tolerance.

Another important nuance is the very significant and very negative effect of food on the absorption of iron, which again occurs precisely when we are talking about ferrous iron preparations. It is not surprising that all drugs in this group are recommended to be taken on an empty stomach - optimally an hour before meals.

There is no particular difference in the clinical effects of various iron salts. The main thing is to select the correct dose of the drug, since each specific salt contains a strictly defined amount of iron. So, for example, in ferrous sulfate iron accounts for about 20% of the mass, respectively, in gluconate it is 12% iron, and in fumarate it is 33%. But, let us emphasize this again, the given figures do not at all indicate that ferrous fumarate is three times better or three times more active than gluconate. It’s just that if you take solutions of the same concentration, you will need 5 drops of fumarate, and 15 drops of gluconate.

Ferrous iron preparations

Aktiferrin (iron sulfate), capsules, syrup, drops for oral administration

Apo-Ferrogluconate (iron gluconate), tablets

Hemofer (iron chloride), solution-drops for oral administration

Hemofer prolongatum (iron sulfate), dragee

Iron gluconate 300 (iron gluconate), tablets

Iron fumarate 200, tablets

Kolet iron (iron carbonate), tablets

Megaferin (iron gluconate), effervescent tablets

Orferon (iron sulfate), tablets, oral drops

PMS-Iron sulfate (iron sulfate), tablets

Tardiferon (iron sulfate), tablets

Feospan (iron sulfate), capsules

Ferrlecite (iron gluconate), solution for injection

Ferrogradumet (iron sulfate), tablets

Ferronal (iron gluconate), tablets

Ferronal 35 (iron gluconate), syrup

Ferronate (iron fumarate), oral suspension

Heferol (iron fumarate), capsules

Ektofer (iron sorbate), solution for injection

The absorption of ferric iron preparations is practically unrelated to food intake, so they can be taken with meals. The tolerability of these drugs does not have such a pronounced relationship with the dose, so full doses are used from the very beginning of treatment.

Ferric iron preparations

Argeferr (iron hydroxide sucrose complex), solution for intravenous administration

Venofer (iron hydroxide sucrose complex), solution for intravenous administration, solution for injection

Dextrafer (iron dextran), solution for injection

Iron saccharate - Iron wine, oral solution

CosmoFer (iron hydroxide dextran), solution for intramuscular and intravenous administration

Likferr (iron hydroxide sucrose complex), solution for intravenous administration

Maltofer (iron hydroxide polymaltosate), chewable tablets, syrup, oral solution, injection solution

Monofer (iron hydroxide polyisomaltose), solution for intravenous administration

Profer (iron protein acetyl aspartylate), oral solution

Fenyuls Baby (iron hydroxide polymaltosate), drops

Fenyuls Complex (iron hydroxide polymaltosate), drops for oral administration, syrup

Ferbitol (iron chloride hexahydrate), solution for intravenous administration

Ferinject (iron carboxymaltose), solution for intravenous administration

Ferry (iron hydroxide polymaltosate), syrup

Ferrlecite (iron sorbitol glucone complex), injection solution

Ferrolek-Zdorovye (iron dextran), solution for injection

Ferrostat (iron hydroxide sorbitol complex), solution for intramuscular administration

Ferrum Lek (iron hydroxide polyisomaltose), solution for intramuscular administration

Ferrum Lek (iron hydroxide polymaltosate), chewable tablets, syrup

Ferumbo (iron hydroxide polymaltosate), syrup

Treatment of anemia, as a rule, is complex and in addition to iron supplements, patients receive other substances that affect the hematopoietic system and metabolism. It is not surprising in this regard that the pharmaceutical market has a significant number of combination drugs that, in addition to iron, contain cyanocobalamin, folic acid, and some other vitamins and microelements.

In conclusion, we formulate 10 basic rules for the treatment of iron deficiency anemia:

It is impossible to help a child only by correcting nutrition! The use of iron supplements is always necessary;
whenever possible, iron supplements should be taken orally, but the dose of ferrous iron should be increased gradually, starting with a fourth of the prescribed amount;
the average daily therapeutic dose of iron is 2-3 mg/kg (the average prophylactic dose is equal to half the therapeutic dose - 1–1.5 mg per day);
the daily dose is divided into 3 doses, and more or less precise adherence to the intervals is very important: the bone marrow responds most optimally to the constant supply of iron, so regular use of the medicine dramatically increases the effectiveness of treatment;
hemoglobin levels begin to increase, as a rule, after 3-4 weeks of treatment, although improvement in well-being may occur much earlier;
hemoglobin increases at an average rate of about 10-14 g/l per week. It is obvious in this regard that the duration of treatment is largely determined by the severity of anemia at the time of starting to use iron supplements, but in most cases it takes 1-2 months to restore normal hemoglobin levels;
normalization of hemoglobin levels in the blood is not a reason to stop treatment: it is necessary to continue using iron supplements in a prophylactic dose for another 1.5-3 months to create iron reserves in the child’s body;
parenteral administration of iron supplements, as a rule, is carried out not daily, but once every 2-3 days;
Divalent iron preparations should be taken on an empty stomach, that is, 1–2 hours before meals;
absorption of iron supplements is enhanced in the presence of ascorbic acid, but the risk of side effects also increases.

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Anemia in children

This is the name of the disease, the essence of which is the low content of hemoglobin in the child’s blood. What should parents know about the normal levels of this substance? Why does anemia occur and what are its symptoms? What is the prevention and treatment of this disease? Let's find out in detail.

Symptoms of anemia in children

For each age period of a baby’s life, there are generally accepted pediatric norms for the amount of hemoglobin in the blood. It is measured in grams per liter. So, in a newborn, the hemoglobin level remains normal, at the age of one month it is already, from six months to a year -, at 3-6 years -, at 18 years -.

Why does anemia occur in children? The causes may be diseases of the digestive system, kidneys and liver, impaired absorption of iron, on which hemoglobin directly depends. During periods of increased baby growth and puberty, the child may also develop anemia.

In preschool age, the hematopoietic organs are not fully formed; they are susceptible to the influence of negative factors from the outside. But in children, such conditions should not be left without parental attention, because they can lead to metabolic disorders.

This disease begins gradually, with depletion of iron reserves in the child’s body, but the hemoglobin level remains normal. Then the absorption of iron from food and its amount in the blood serum deteriorate. After this, the number of red blood cells in a unit of blood decreases - this indicates the development of iron deficiency anemia.

Its symptoms are as follows:

Astheno-neurotic syndrome. It is manifested by increased excitability, irritability, and emotional instability. The child may lag behind in his physical development, gets tired quickly, and develops apathy.
Epithelial syndrome. The baby has pale skin and mucous membranes. Peeling of the skin, pale ears, and the appearance of pigmentation are possible. Low-symptomatic caries and loss of appetite, disruption of the gastrointestinal tract may occur. In severe forms of anemia, even intestinal bleeding occurs.
Muscle syndrome. This is weakness of the bladder sphincter, enuresis, developmental delay in physical parameters.
Cardiovascular syndrome, which is manifested by shortness of breath and palpitations. The baby develops a tendency to lower blood pressure, and systological murmurs are detected in the heart.
Syndrome of decreased immune defense. It is manifested by frequent illnesses. At the same time, the child’s spleen and liver increase in size.

With a mild form of anemia, the level of hemoglobin in the baby’s blood is g/l. The moderate form is characterized by g/l, severe - less than 70 g/l, super-heavy 50 g/l.

Anemia in children: treatment

If the pediatrician has diagnosed anemia in a child, he will prescribe internal supplementation containing iron. A balanced diet is also of great importance for increasing hemoglobin levels. This includes eating foods rich in iron. Among cereals, buckwheat takes the lead in the content of this substance. There is a lot of iron in liver, beef, and pomegranates. Parents should also take into account the fact that after normalization of hemoglobin levels in the blood, they should not stop taking iron-containing drugs. After all, the increase in the level of this substance in the blood is only temporary.

Typically, other means are used in the complex treatment of anemia:

Herbal medicines. When a child has a disturbed digestive system, herbs help relieve inflammation and normalize the functions of the intestinal mucous membranes.
Products with antioxidant effects. They are necessary to protect cell membranes from damage.

The local pediatrician decides which iron-containing drugs to prescribe to the child.

Prevention of anemia plays an important role for a child's health. These include regular examinations with a pediatrician and clinical tests to detect anemia. If it is detected on time, then treatment will be more effective.

Doctors should pay increased attention to children at risk. This refers to those who were born with low body weight, premature, and bottle-fed. To prevent anemia, premature babies are prescribed iron at half the therapeutic dose - from two months to two years.

Adequate nutrition for such a child is the daily presence in the diet of the required amount of proteins, vitamins, and minerals necessary for the baby’s body for a healthy hematopoiesis process.

It is important that the child spends a lot of time outdoors, even in the cold season. A routine for such children should become a prerequisite for development and upbringing.

But parents should not independently treat anemia in their baby. In therapy, it is important to select drugs that correspond to the severity of the disease.

Anemia in infants under one year of age

Pediatric statistics indicate that this disease is more common in children after six months. It is during this period that babies’ neonatal reserves of iron decrease, and the amount that enters their body with food is not enough.

If the mother had severe blood loss during childbirth, this may become a factor in the development of anemia in the newborn. Such a baby experiences dry and flaky skin, pale skin, dystrophy of hair and nails, cold extremities, regurgitation, vomiting, angular stomatitis or atrophic glossitis, and stool instability.

A child who has lost a lot of blood during childbirth is given a transfusion.

Children with anemia are apathetic and lethargic, drowsy and irritable. They often lag behind in physical and psychomotor development. They experience muffled heart sounds, tachycardia, and shortness of breath. Compared to their peers, they get sick more often and are more prone to infections and colds, which take a long time to cure.

If we are talking about an illness in a premature baby, then this is early anemia of prematurity, the cause of which is the breakdown of red blood cells with fetal hemoglobin with insufficient bone marrow maturity.

When a baby is diagnosed with hemolytic disease of the newborn, many red blood cells are destroyed by the antibodies of the mother’s body while still in the womb. Hereditary spherocytosis is a disease in which red blood cells are spherical in shape. And this is also a risk factor for the development of anemia.

Intrauterine infections (for example, rubella, toxoplasmosis, syphilis, cytomegalovirus infection) can lead to the destruction of red blood cells. Late anemia of prematurity is diagnosed in babies three to four months of age. Its cause is depletion of iron reserves in utero.

Parents of children under one year old should know that a mild degree of iron deficiency anemia may not manifest itself outwardly. Therefore, it is important to take blood tests on time and identify the disease.

Treatment for iron deficiency anemia in babies under one year of age is as follows:

Prescribing iron supplements.
Blood transfusion (hemotransfusion), if necessary.
Ensuring adequate feeding. The mother must do everything in her power to breastfeed her baby. This is the best protection for the baby.
Timely treatment of dystrophies and rickets, infectious and gastrointestinal.
Regular clinical blood tests.

All this can be avoided if during pregnancy the mother monitors her health, paying due attention to the prevention of anemia, following all doctor's recommendations and eating right.

Anemia in children: Komarovsky

The pediatrician, based on many years of practice, states that hemoglobin increases not so much with medications and nutrition, but with lifestyle. Evgeniy Olegovich emphasizes: the more energy the baby spends, the higher his hemoglobin level will be. Therefore, with a reading of 104, it is necessary to jump, run and spend a lot of time outdoors, even in winter. Parents should monitor that the baby does not have constipation.

As for nutrition as a factor in auxiliary therapy for low hemoglobin, the doctor recommends that such babies eat more meat, which is the main source of iron in animal food. Liver for anemia should also become part of the child’s diet. The menu should also contain a lot of fruits rich in vitamin C and vegetables rich in fiber. Legumes are a good source of iron.

If, with increased nutrition and sufficient exposure to fresh air, the blood test does not improve after a month or two, then most likely the doctor will prescribe iron supplements. Mr. Komarovsky emphasizes that they can cause constipation in the child. This is not uncommon. Moreover, such reactions are more often observed when the child takes ferrous iron supplements. It is important that their intake is gradual and strictly dosed. You should not stop taking these medications if you experience constipation. You just need to consult your pediatrician.

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.

Light degree – more than 90 g/l.
Average degree – 70.0 to 90.0 g/l.
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 iron supply 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 oxygen access to the body tissues is impaired.

The child's skin becomes characteristically pale and dry.
Children with anemia often suffer from stomatitis, and cracks appear in the corners of their lips.
Frequent constipation is also one of the symptoms, since with anemia, indigestion is more a pattern than a coincidence.
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

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.
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.
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.
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.
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.