Topics : Iron Deficiency Anemia

Group : Paediatric

IRON DEFICENCY ANEMIA

What is iron deficiency anaemia?
Anemia is a condition where the body has lack of healthy red blood cells. Red blood cells are
very important to provide oxygen to our body tissues. There are many types of anaemia. Most
common type of anaemia in children is iron deficiency anaemia.
Iron deficiency anaemia happen when the body has lack of iron to produce red blood cells.
Iron is key part of red blood cells. Without enough iron, our body cannot produce enough
haemoglobin -Hb (a protein in red blood cells) to carry oxygen. As a result it lead us to
tiredness and pale.

Normal amount of red

blood cells

Anemic amount of red

blood cells

What cause it?

Low body iron store may be cause by many reasons
Blood loss
Lack of iron in diet
Inability to absorb iron
Children have higher risk of getting iron deficiency anaemia
Infants and children at highest risk of iron deficiency include:

Babies who are born prematurely more than three weeks before due date or
have a low birth weight

Babies who drink cow's milk before age 1

Breast-fed babies who aren't given complementary foods containing iron after age 6
months

Babies who drink formula that isn't fortified with iron

Children ages 1 to 5 that drink more than 24 ounces (710 milliliters) of cow's milk,
goat's milk or soy milk a day

Children who have certain health conditions, such as chronic infections or restricted
diets

Children ages 1 to 5 who have been exposed to lead

Adolescent girls also are at higher risk of iron deficiency because their bodies lose iron during
menstruation.

Symptoms
Initially iron deficiency anaemia can be mild and unnoticeable. As the body iron store become
more deficient and anaemia worsen our body will slowly starts to produce symptoms. The
symptoms may include:

Feeling grumpy
Feeling weak or tired more often than usual, or with exercise
Headaches
Problems concentrating or thinking

As the anaemia gets worse, more symptoms will appear such as:

Blue color to the whites of the eyes

Brittle nails
Desire to eat ice or other non-food things (pica)
Light-headedness when you stand up
Pale skin color
Shortness of breath
Sore tongue

Test
Iron deficiency and iron deficiency anemia are typically diagnosed through blood tests. The
American Academy of Pediatrics recommends that all infants be tested for iron deficiency
anemia starting between ages 9 months and 12 months and, for those who have risk factors
for iron deficiency, again at later ages.
The test includes:
1. Complete blood count
2. Iron study (Ferritin level, serum iron level, iron binding capacity)

Normal hemoglobin level in different age group

Age

Hemoglobin (g/dl)

Birth

14.9 23.7

2 months

9.4-13.0

12 months

11.3 -14.1

2 - 6 years

11.5 - 13.5

6 - 12 years

11.5 - 15.5

12 - 18 years girl

12.0 - 16.0

12 - 18 years boy

13.0 - 16.0

Treatment
Treatment may include taking iron supplements and eating iron-rich foods.
Iron-rich foods

Chicken

Dried lentils, peas, and beans

Fish

Meats (liver is the highest source)

Peanut butter

Soybeans

Whole-grain bread

Oatmeal

Raisins, prunes, and apricots

Spinach and other greens

Iron supplements such as syrup ferrous ammonium citrate is most commonly prescribed by
doctor to treat iron deficiency anaemia. If failure to correct the anaemia after started the
medication it can be because of
non-compliance to medications
Inadequate iron dosage
Impaired absorption
Incorrect diagnosis
Outcome
Outcome is good with treatment but it depends on cause as well

When to see doctors

When you have symptoms of anemia

Prevention
Risk of iron deficiency anemia can be reduce by taking iron-rich food & food that contain
vitamin C to enhance iron absorption.

Vitamin C - rich food

Broccoli
Grapefruit
Kiwi
Leafy greens
Melons
Oranges
Peppers
Strawberries
Tangerines
Tomatoes

Preventing iron deficiency anemia in infants

To prevent iron deficiency anemia in infants, ensure that you add iron fortified cereals or
pureed meats between 5-6 months. Iron-rich food should be taken at least twice a day to
boost iron intake. After one year, be sure children do not drink more than 24 ounces of milk a
day. Too much milk often takes the place of other foods, including ones that are rich in iron.

Reference
Iron and iron deficiency. U.S. Centers for Disease Control and Prevention.
http://www.cdc.gov/nutrition/everyone/basics/vitamins/iron.html. Accessed Sept. 11, 2013.
Brittenham GM. Disorders of iron homeostasis: iron deficiency and overload. In: Hoffman R,

Benz EJ Jr, Silberstein LE, et al., eds.Hematology: Basic Principles and Practice
Paediatric Protocols for Malaysian Hospitals 3rd Edition. Hussain Imam Hj Muhammad
Ismail, Ng Hoong Phak, Terrence Thomas.