Iron-Deficiency Anemia

It is important to remember that severe iron-deficiency anemia experienced during infancy can lead to a 10-point drop in IQ test scores. If your child tires easily, appears pale and listless, has a poor appetite, or gets sick frequently, iron-deficiency anemia should be considered.Blood tests should be performed for infants between 9 and 12 months of age, and once a year for other age groups and adolescents.

What Is Iron-Deficiency Anemia?

Iron-deficiency anemia is a common type of anemia. Anemia can occur when your red blood cells do not contain enough hemoglobin. Hemoglobin is a protein-based molecule found in red blood cells that carries oxygen throughout the body and is rich in iron.

Iron-deficiency anemia develops over time when your body does not have enough iron to produce healthy red blood cells. When there is insufficient iron, your body begins to use its stored iron.

After a short time, the stored iron is depleted. Once the stored iron is gone, the red blood cells produced by the body contain less hemoglobin than normal.Iron-deficiency anemia can cause symptoms such as paleness, weakness, and fatigue.Severe iron-deficiency anemia can lead to problems with growth and development in children, increased susceptibility to infections, and the development of heart problems.The risk of developing iron deficiency is higher in infants, young children, and adolescents, as growth and development occur more rapidly during these periods.

What Causes Iron-Deficiency Anemia?

A lack of sufficient iron in a child’s body can lead to the development of iron-deficiency anemia. In rapidly growing infants, consuming only breast milk without introducing solid foods after the first 6 months, starting cow’s milk before the age of one, and consuming more than 500 ml of cow’s milk per day can lead to iron deficiency.

There is an increased risk of iron deficiency anemia developing in infants who have not received iron supplementation after the first 6 months. Premature and low-birth-weight infants are at greater risk for iron-deficiency anemia. The iron stored in these infants’ bodies is depleted within two months. Iron supplementation should be initiated earlier in premature or low-birth-weight infants.For this reason, a blood test should be performed at least once between 9 and 12 months of age.

What Are the Signs and Symptoms of Iron-Deficiency Anemia?

The signs and symptoms of iron-deficiency anemia depend on the severity of the condition. Mild to moderate iron-deficiency anemia may not cause any signs or symptoms. Signs and symptoms can range from very mild to quite severe.The most common symptom across all types of anemia is a feeling of weakness and fatigue. In infants and young children, symptoms of anemia may include loss of appetite, slowed growth and development, behavioral issues, irritability, and frequent infections. People with iron-deficiency anemia may develop an interest in non-food items such as soil, ice, coffee grounds, paper, chalk, ash, and paint. The habit of eating non-food items is called “pica.” In individuals with pica, iron and zinc deficiencies must be investigated.

How Is Iron Deficiency Anemia Diagnosed?

To diagnose iron deficiency anemia, a complete blood count, serum iron level, iron-binding capacity, and serum ferritin level should be measured. If serum iron levels, transferrin saturation (the ratio of serum iron to serum iron-binding capacity), and serum ferritin levels are found to be low, and hemoglobin is also low, a diagnosis of iron deficiency anemia is made. Ferritin is a test that measures the body’s iron stores. Additionally, since ferritin is an acute-phase reactant, its levels rise during infection. Therefore, iron tests should be performed when the child is not experiencing an infection. Furthermore, a peripheral blood smear provides significant clues regarding the cause of the child’s anemia. If iron-deficiency anemia is present, red blood cells appear smaller and paler than normal in the peripheral blood smear.

How Is Iron Deficiency Anemia Treated?

Iron deficiency anemia is treated with iron (Fe+2) drops, syrups, or capsules. Treatment is initiated at a dose of 4 mg/kg/day for children under one year of age and 6 mg/kg/day for those over one year of age, divided into 2 or 3 doses. Once the patient’s hemoglobin level reaches normal levels for their age and gender, the iron dose is reduced by half and continued for another month. This replenishes the patient’s iron stores, after which iron therapy is discontinued. The treatment duration for iron deficiency anemia is 2–3 months. Additionally, the patient is advised to modify their diet by avoiding more than 500 ml of cow’s milk per day and consuming iron-rich red meat at least twice a week.Parents should be warned that children’s teeth may become discolored and their stool may turn black as a result of iron therapy.

They should be informed that brushing their teeth can reverse these color changes and that this discoloration is not permanent. Milk and dairy products should not be consumed simultaneously with iron therapy. Milk and dairy products negatively affect iron absorption. Children may consume milk and dairy products half an hour before and two hours after iron therapy. It should also be noted that iron absorption is improved when iron is taken with fruits and vegetables rich in vitamin C.

Kaynakça:

• World Health Organization. (2001). Iron Deficiency Anaemia: Assessment, Prevention and Control – A Guide for Programme Managers.

• World Health Organization. (2011). Haemoglobin concentrations for the diagnosis of anaemia and assessment of severity.

• American Academy of Pediatrics. (2010). Diagnosis and Prevention of Iron Deficiency and Iron-Deficiency Anemia in Infants and Young Children (0–3 Years). Pediatrics, 126(5), 1040–1050.

• Centers for Disease Control and Prevention (CDC). (Güncel). Iron and Iron Deficiency.

• Turkish Society of Hematology. (Updated). Guidelines for the Diagnosis and Treatment of Iron Deficiency Anemia.

• Turkish Pediatric Society. (Current Clinical Guidelines). Iron-Deficiency Anemia in Childhood.