Posted in Child Wellness
July 28, 2009

Diagnosing Anemia

Anemia is defined as a decrease in the number of red blood cells or blood concentration of hemoglobin. There are several reasons for anemia, depending on the age of the child.

Lack of iron is the most important risk factor for anemia in Israeli children aged six months to two years, but medical studies have not yet found an explanation why the prevalence of iron deficiency is so high amongst children in Israel. Anemia is a significant problem because the lack of iron may impair the development of the child, and according to medical research, there is the possibility of irreversible damage even after the child receives treatment with iron.

Iron absorption is particularly low in infants, and it varies depending on the nutritional source of iron and on the amount iron in the infant’s diet. For example, the amount of iron in breast milk is lower than that in formula, however, breast milk iron is much better absorbed than the iron in formula.

If a child is not getting enough iron, iron stores will decrease. Once the stores are depleted, then anemia will ensue.
How to identify anemia?

There are a few ways of identifying anemia: general weakness, lack of appetite, increased sleepiness, decreased activity and pallor. Over time, chronic lack of iron may also impair the development of the brain, ability to concentrate resulting in the delay of physical development. Anemia may also damage the digestive system resulting in diarrhea or constipation. It is important to note that anemia can be present without any symptoms at all and can be a very slow process of developmental deterioration. Therefore it is the accepted practice to check the level of hemoglobin of every child at the age of one year.

Diagnosis

First and foremost the diagnosis is made by doing a simple blood count, which enables measurement of the level of hemoglobin. There are additional tests that are available that can help to identify other causes of anemia if iron deficiency is not the cause.

The Ministry of Health recommends preventive treatment of iron from the age of four months until the age of one year. At the age of 4-6 months there is a recommended daily dose of 7 mg (3 drops),and at the age of six months until the age of years 15 mg (6 drops) is recommended. It is recommended to give the iron drops alone and not with milk or tea which can decrease the absorption. From the age of six months, it is recommended to give foods rich in iron, such as meat, chicken or turkey with vegetables in addition to the iron supplement. Other foods such as cereal. They also add iron nutrition of the baby.

* Please note these data refer to babies born on time, ie after forty weeks of pregnancy. Children born before 37 weeks have different guidelines for iron supplementation depending on the reason for prematurity and birth weight.