Contrary to popular belief, anemia in children these days is not such a rare disease. And it is absolutely not necessary that anemia occurs in so-called dysfunctional families or due to poor nutrition, both for the mother herself during pregnancy or breastfeeding, and for the baby herself.
Causes of anemia in children
Anemia means a pathological condition in which there is a decrease in the content of hemoglobin and red blood cells in the blood. Thus, a normal indicator, within the physiological norm for a child under 7 years of age, is considered to be a hemoglobin level in the range of 125 - 135 grams per liter. Any deviation towards a decrease in the amount of hemoglobin is pathological and requires mandatory therapeutic treatment from a specialist.
The main causes of anemia in children are age-related characteristics of the hematopoietic apparatus.
Experts distinguish 2 types of anemia:
- exogenous (in other words, external) origin;
- endogenous (internal) origin.
The causes of anemia in children of exogenous origin are usually:
- monotonous, meager food. Occurs in children during breastfeeding, especially if the nursing mother herself has a deficiency of iron in the blood. This anemia is also called nutritional anemia. With a monotonous diet, the diet lacks a number of amino acids that are involved in the synthesis of hemoglobin;
- infectious diseases, most often pyogenic infections, which lead to the development of hypochromic anemia. Hypochromic anemia is also caused by helminthic infestations;
- irregularities in work gastrointestinal tract, which lead to poor absorption of nutrients necessary for the production of hemoglobin. Such disorders include gastritis with low acidity, or achylia, ulcerative lesions of the stomach, pancreas, intestines, various enzymatic disorders, including those of a hereditary nature, enterocolitis, etc.
The causes of anemia in children of endogenous origin are primarily associated with:
- hemolysis, that is, damage to red blood cells. This phenomenon often occurs in newborns with Rh conflict (when the blood of the mother and fetus are incompatible according to the Rh factor);
- hereditary diseases of the hematopoietic organs, for example, anemia of the Minkowski-Choffard, Lederer type, etc.;
- abnormalities of hemoglobin synthesis (thalassemia and sickle cell anemia);
- insufficient development of the bone marrow responsible for hematopoiesis (aplastic and aregenerative anemia). This anemia is typical for premature babies.
Main signs of anemia in children
Any disease of the hematopoietic organs is characterized by gradually increasing symptoms and it is impossible not to notice changes both in the child’s behavior and in his appearance.
The main signs of anemia in children of any age are, first of all:
- increasing weakness and lethargy of the child;
- restless sleep, sleep dysfunction;
- pallor of the skin and mucous membranes;
- swelling and puffiness of the face, especially pronounced after sleep;
- tearfulness, moodiness, emotional instability, increased lability, restlessness, very low concentration, memory impairment, and even motor coordination;
- headaches, palpitations and shortness of breath that occur with the slightest physical exertion, fainting is possible;
- delay in physical and mental development, which is especially dangerous for children under one year old;
- dryness and hyperkeratosis (thickening and roughening of the skin on the elbows and knees) of the skin, seizures in the corners of the lips, brittle nails and hair loss, even alopecia;
- darkening and tarnishing of tooth enamel, late teething;
- from the gastrointestinal tract there is a tendency to functional failure, that is, to slow and sluggish digestion, lack of appetite, taste distortion, sudden weight loss, constipation, even intestinal atony;
- significant general decrease in immunity (frequent recurrent acute respiratory viral infections and acute respiratory infections that are difficult to treat).
Any of the above signs of anemia in children should be a reason to contact a specialist. Diagnosis of the presence of anemia is carried out using a general blood test, after which the type and type of anemia is determined and symptomatic treatment is prescribed. It should be noted that such treatment, as a rule, is very long-term and one should not neglect the recommendations of a hematologist, otherwise the disease may become chronic.
Prevention of anemia in children
Along with taking special medications and proper symptomatic treatment, the prevention of anemia is very important. This concept includes the following factors:
- normalization of diet;
- normalization of work and rest regimes;
- hardening of the body.
Prevention of anemia in children is mainly related to nutrition. The more varied the baby’s food, the more essential vitamins, minerals and microelements will be supplied to the body. The better the hematopoietic apparatus will function, producing the necessary hemoglobin and saturating the child’s blood with oxygen. And this contributes not only to its healthy development, but also to high mental and physical activity, and the full growth of tissues and cells of the body.
The diet of a healthy child, and even more so of a child suffering from anemia, must contain vitamins C, E, group B, microelements - iodine, manganese, iron, copper, potassium, magnesium, etc.
The diet of a child with anemia should be varied and include not only fruits, vegetables, cereals, but also meat products. For preventive purposes, children are prescribed fish oil. But by itself proper nutrition for an anemic child will not have the desired effect if he has concomitant diseases of the gastrointestinal tract.
Prevention of anemia in children also includes massages, mandatory feasible physical activity, sports, exposure to ultraviolet rays, hardening and water procedures. It is with this comprehensive approach that one can achieve either a complete cure for anemia, or reduce the risks to the child’s health and thereby improve his quality of life in case of hereditary diseases.
Childhood anemia - how dangerous is it? The fact is that the developing child’s body can be seriously damaged due to such a violation. That is why it is important to suspect the disease in time.
Anemia in an infant
Anemia usually appears in the second half of a child's life. This is due to the fact that even before birth, the fetus’s body accumulates such a reserve of iron, which will easily last for six months. Accordingly, if a child does not have enough iron in his mother’s milk, then he begins to develop iron deficiency. Anemia in infants most often occurs for the following reasons:
- Prematurity of the baby;
- The occurrence of infections in the digestive tract;
- The baby is growing too rapidly;
- If the mother had anemia during pregnancy and was not treated, then it is likely that the baby will have the same pathology;
- Feeding a child up to one year old with formulas that do not contain enough iron;
- If there is anemia in the mother’s body, then through breast milk she is simply not able to transfer the normal amount of iron to him.
How can you understand that a child under one year of age has anemia in his body? Firstly, he is gaining weight slowly and growing poorly. In addition, there is poor condition of nails and hair. The child may be delayed in physical development. The child gets sick quickly colds and takes a long time to recover. Moreover, the child may behave excessively restless, sleep poorly and be constantly capricious.
Severe anemia in children under one year of age is a condition that appears if anemia in a newborn has not been noticed for a long time and has been neglected. That is why it is so important to carefully monitor the child and note the slightest changes in his behavior and well-being.
Mild anemia in a child: 1 year
The causes of anemia even at one year of age are often associated with problems during pregnancy. For example, this is a constant deficiency of iron in the body of a pregnant woman, the course of a multiple pregnancy. Late or too early ligation of the umbilical cord, bleeding during delivery can also contribute to the development of anemia in the child. In addition, if the child was transferred to artificial feeding early or had rickets, this can also have an effect. In addition, sometimes there is a congenital malabsorption of nutrients by the intestines, which also leads to the development of anemia.
Anemia in a child (2 years old), anemia in a child (3 years old)
Likewise, at this age, the main cause of anemia is an improper, unbalanced diet that lacks iron. Sometimes the child’s body receives the optimal amount of iron, but not enough substances that will help it be absorbed: these are ascorbic acid and amino acids, as well as copper, manganese, zinc and cobalt.
In addition, if a child has worms or often suffers from infectious diseases, anemia may begin to develop. That is why it is necessary to carry out timely prevention of worms in a child.
Fanconi anemia in children
This anemia is a congenital pathology. As a rule, boys are affected by this disease. In many ways, the disease is associated with a low number of stem cells.
If the case is severe, then the disease can be detected already in the first year of the baby’s life. In other cases, more typical for this disease, it does not manifest itself in any way until five years.
Typically, if a child suffers from such a disease, he will be lethargic and will have little response to external stimuli. This will be especially noticeable when communicating with other children who, as a rule, want to play and are very active.
Degrees of anemia in older children
If a child is not yet six years old, the norm of hemoglobin in his blood ranges from 125 to 135 grams per liter of blood. 
If this indicator drops to 110 g/l in children under five years of age and below 120 g/l in children over five years of age, we can talk about anemia occurring in the child’s body.
Mild anemia in children is usually defined as hemoglobin levels of 90–100 g/l. A hemoglobin concentration in the blood of 70–90 g/l allows one to conclude that a child has moderate anemia. Finally, with severe anemia, the hemoglobin level drops below 70 grams per liter. This condition is very dangerous for the human body, which is why hospitalization and strict medical supervision are urgently needed.
Hypochromic in young children (anemia)
Such anemia, according to statistics, occurs in eighty percent of all children. With it, the color index is less than 0.85. TO this species It is customary to include both iron deficiency anemia (improper synthesis of hemoglobin) and thalassemia (by which we usually mean reduced synthesis of polypeptide chains that are an integral part of hemoglobin).
According to Dr. Komarovsky, if parents suspect that a child is suffering from anemia, it is urgent to carry out as detailed an examination as possible. To do this, you need to visit a pediatric hematologist and perform a detailed blood test.
Komarovsky also says that it is possible to do without the use of medications, but this can only be done when the child is diagnosed with a mild form of anemia. It is necessary to enrich your baby’s diet with foods that contain significant amounts of iron. These products include meat, fish, beans, cereals, tomatoes, beets, cranberries, strawberries, black and red caviar.
Deficiency anemias in children
Deficiency anemia in children is usually understood as anemia that is caused by a small intake of any elements into the body. Iron deficiency anemia is considered the most common. In addition, there are protein deficiency, vitamin deficiency, copper deficiency, thalassemia and orotic aciduria.
What are the causes of anemia in children? Can you tell me more about this?
Causes of anemia in children 2 years old: older and younger
Anemia is caused by a variety of reasons, but not all parents know about it. As you know, forewarned is forearmed. It is for this reason that it is advisable to be aware of all possible reasons, which can trigger the development of anemia in order to prevent it.
Newborn anemia: causes
The key causes of anemia in a newborn can be considered:
- Insufficient absorption of iron in the intestines and stomach;
- Chronic blood loss, in which there is a rapid removal of iron from the body;
- A small amount of iron in the child’s body is due to the fact that the pregnant woman was anemic, or because the nursing mother is also more anemic;
- Low birth weight or general prematurity;
- Impaired absorption of iron, which is caused by a lack of vitamins in the body. For example, iron can be fully absorbed by the human body only if it simultaneously receives ascorbic acid;
- Low intake of iron into the body. Due to the fact that a child’s body grows rapidly until it reaches one year of age, the need for iron increases greatly.
Anemia in infants: the causes of this disease can also be associated with the influence of negative factors on the child’s body, but this happens less frequently.
Anemia in newborns: causes and consequences
What is the risk for a child if his anemia is not treated? Firstly, mild stage anemia can easily progress to the medium stage, and from there to severe stage, in which the baby will urgently need to be hospitalized. In the absence of proper treatment, the child may even remain disabled.
If the doctor diagnoses congenital aplastic anemia, we can talk about a negative prognosis. The problem is that such children usually live only five to six years.
Causes of anemia in children under one year of age
The causes of anemia in infants (we will now talk about babies who have reached the age of six months) are varied, but they are also often associated with problems that were observed in the woman during the period of bearing the baby.
Very often, anemia will develop in infants up to a year old if the woman did not eat well during pregnancy. This is especially true in the third trimester. If a pregnant woman has a deficiency of folic acid and cyanocobalamin in her body, this condition can also develop. Moreover, if during pregnancy a woman was exposed to E. coli disease, respiratory diseases, genitourinary infections or STDs, this can provoke chronic fetal hypoxia and anemia.
Another point that needs to be taken into account is the occurrence of Rh conflict in mother and child. In this case, hemolytic anemia often appears.
Causes of anemia in children 2 years old
In this case, the main reason is a diet that is not rich in iron. Most children by this age have already switched to artificial feeding and are introduced to complementary foods. For this reason, it is important to monitor your child’s diet and ensure that the menu includes a sufficient amount of iron-containing foods.
Causes of anemia in teenagers
Statistics show that approximately a third of teenagers suffer from a condition called iron deficiency anemia. The fact is that during this period the need for iron is seriously increasing, 
which is due to the rapid growth of the girl or young man, increased blood volume and muscle mass.
Iron deficiency most often affects teenage girls. This is due to the fact that their menstrual function is developing and every month they begin to experience blood loss, which was previously unusual for the body.
It is also interesting to note that anemia tends to develop in adolescents who adhere to strict vegetarianism. However, this also applies to adults. Moreover, the chance of developing anemia increases in people with low socioeconomic status. Another reason why anemia occurs is obesity.
How to recognize anemia in a child? What should parents pay special attention to?
The key sign by which anemia can be recognized in children and adults is pallor of the skin and mucous membranes. In addition, the child does not feel well. But these are not all the manifestations that show themselves during this disease.
Iron deficiency anemia in infants: symptoms and treatment
You can suspect a decrease in the number of red blood cells in the blood of a baby based on the following signs:
- Decreased appetite;
- Poor weight gain;
- Constant regurgitation;
- Inflammation of the eyelids and oral cavity in a newborn;
- Tearfulness and moodiness;
- Increased sweating.
Based on these signs, we can conclude that the child is anemic. However, such signs do not always indicate this particular disease.
Anemia in an infant: symptoms and treatment - what else can be noted about them? All symptoms should be carefully checked by a doctor and only after appropriate diagnosis is therapy indicated.
Signs of anemia in children under one year of age are usually expressed by the child’s excessive whims. As mentioned above, this is also represented by sleep disturbances. That is, most often it is too long, but it can also be very limited.
Signs of anemia in infants (additional)
Anemia: symptoms in children under one year of age - what else can be noted? In addition to all the symptoms listed above, some other reactions from the body may occur. Often the child begins to constantly get sick. First of all, diseases mean acute respiratory infections. If an infant develops anemia at the age of more than six years, then we can talk about taste disorders. Such a baby often begins to want to eat earth or chalk, some foods that he has never liked. This is exactly what should alert the baby’s parents. The child may also begin to lag behind in physical and mental development. Cracks may appear in the corners of the mouth, plus hair may fall out and the skin may peel off.
Anemia: symptoms in children 2 years old
At the age of two years, the main manifestation of anemia in a child is a lethargic state. He doesn't want to play and do what he does in healthy condition. The child may also not sleep well, either too much or too little. You can often notice how a child's hair falls out and nails become brittle. Parents should take all such manifestations into account.
Signs of anemia in teenagers
Anemia: symptoms in adolescents - what are they? In some cases, anemia in adolescence does not manifest itself in any way, however, this does not mean that it cannot occur in a latent form in the growing body. Why? The fact is that the iron reserves in the body cannot disappear instantly; they are depleted rather slowly. However, it is customary to identify symptoms by the presence of which one can judge the course of anemia in a teenager. All assumptions must be verified by passing the appropriate tests, and sometimes the doctor will prescribe additional diagnostic procedures. So, the manifestations of anemia in adolescents include:
- Poor appetite;
- The appearance of weakness and fatigue even after minimal physical activity;
- Heart murmurs and increased heart rate compared to normal;
- Pallor of the skin;
- Irritability of a teenager over all sorts of little things;
- Problems with thinking abilities and dizziness.
In some cases, a teenager wants to eat something that is inedible, that is, the taste is distorted. This desire to eat earth, paints, chalk. Perversion of taste suggests that anemia is no longer even at a mild stage of its development, but has begun to progress further.
If a teenager’s body constantly lacks iron, complications may arise. Cardiomyopathy may occur in the heart, resulting in later heart failure. The general defenses of the body decrease, and fainting may occur.
Iron deficiency anemia: symptoms and treatment in children
Symptoms of iron deficiency anemia in children - is there anything else you can tell about them? In this case, we will talk about symptoms that can be observed in children of different age groups.
In the vast majority of cases, anemia in a child becomes a real discovery for parents, as it is detected only during a routine laboratory test. But there are symptoms that are divided into four groups. Such clinical manifestations indicate that the child needs to consult a hematologist, no matter what age he is.
The first group is devoted to general symptoms. Among such manifestations are headache, tinnitus, sleep disturbance (inability to fall asleep), decreased ability to concentrate, moodiness. But you need to be very careful with these symptoms, as they can also indicate chronic fatigue. This is especially typical for school-age children due to intense mental work and psycho-emotional overload.
The second group of clinical manifestations is represented by impaired functioning of the cardiovascular system. The child may be diagnosed with heart failure, hypotension, systolic murmur and fainting, as well as an increased heart rate compared to normal.
From the digestive system, the child may experience bloating, decreased appetite, and dry oral mucosa. Ulcers may form on the oral mucosa. A baby may begin to spit up constantly, even to the point of gag reflex. In addition, the child often begins to suffer from either diarrhea or constipation.
As for appearance, the child may lose weight and develop swelling. Seizures tend to appear in the corners of the mouth, nails become more brittle, and hair falls out. The skin becomes unnaturally pale.
How can anemia be detected, besides observing the external condition of the child? This requires laboratory diagnostics and some additional examinations.
Diagnosis of anemia in children
Appropriate diagnosis is necessary when anemia is suspected. But sometimes the diagnosis becomes clear during a routine laboratory test, that is, the parents previously did not suspect that the child had anemia.
Test for hemoglobin in a child
Blood test for hemoglobin: the norm in children - what should it be? The number of iron-containing cells varies depending on the age of the child, the rate of growth and development of his body. The first examination of a child’s hemoglobin level is carried out in the maternity hospital. 
At the age of one month, the hemoglobin norm should be 110 grams per liter of blood.
At the age of two months, hemoglobin levels range from 90 to 140 grams per liter of blood. As for children aged three to six months, the following hemoglobin level limits will be considered optimal: 95 – 135 grams per liter. For children under five years of age, the limit starts from 105 and ends at 140 grams per liter of blood. From five to twelve years, the normal hemoglobin concentration level can start at 115 and end at 145. Treatment cannot be prescribed based on hemoglobin levels alone. In addition, it is necessary to conduct a general assessment of the baby’s condition and behavior.
How is hemoglobin indicated in a child’s test? As a rule, this is Hb.
Blood test: increased hemoglobin in a child
Increased hemoglobin is a rarer phenomenon compared to decreased hemoglobin. An increase in its concentration is due to the fact that in a certain location in the body there is oxygen starvation. As a result, additional red blood cells are produced to bring the situation back to normal. An increase in hemoglobin concentration is also caused by a lack of water in the child’s body, blood diseases, the presence of oncology in the body, improper functioning of the heart and blood vessels, as well as frequent constipation.
Differential diagnosis of anemia in children
This diagnosis of anemia involves the implementation of examination procedures in several stages. The first stage is manifested in establishing the reliable fact of anemia. Next comes the definition of the pathogenetic variant of the disease. The last stage is represented by the selection of additional diagnostic methods, if necessary.
Anemia, based on pathogenetic signs, can be:
- Iron deficient. In this case, hemoglobin production is observed due to an acute lack of iron in the body;
- Aplastic, which is observed due to bone failure;
- Megaloblastic, in which pathology of DNA synthesis is observed;
- Posthemorrhagic, when anemia appears due to intense blood loss;
- Hemolytic, in which the lifespan of red blood cells is greatly reduced;
- Anemia of chronic diseases. This situation occurs when chronic processes occur in the body. In this case, erythropoiesis is significantly impaired.
Diagnosis of anemia in children
The width of the distribution of red blood cells is often also determined. It allows you to find out and differentiate the causes of anemia in children. This indicator will be high in iron deficiency anemia, and in thalassemia the value will be within the normal range. When assessing this indicator, it is also possible to identify normocytic anemia of various etiologies.
After carrying out the appropriate diagnosis, the doctor decides on the appropriate treatment. What can it be and what type of therapy is the most productive? First, patients often try to use traditional treatment. Is it possible to do this safely for the body?
Childhood anemia: treatment
Anemia in children: classification, treatment and prevention - what can be said about these aspects of the disease? There are quite a few classifications of anemia, so this has already been discussed separately. As for prevention, this is usually a balanced diet rich in vitamins and minerals, and most importantly, iron. Moreover, moderate physical activity and walks in the fresh air are needed. But what are the treatments for anemia in children? The first thing to say is that they are slightly different for different age periods.
Anemia in infants: treatment
An infant should be treated exclusively under medical supervision, since the baby’s body is still quite weak and any wrong action can cause harm. As a rule, infants are prescribed medications in liquid form. The average dosage of the medicine taken is most often up to 3 m, the calculation is made per kilogram of the baby’s body weight. This dosage allows you to quickly normalize the level of hemoglobin in the child’s blood. But after normalization of the level, you should under no circumstances stop taking the medications, since the body needs to accumulate a certain amount of iron.
The average course of treatment ranges from two to seven months, and it all depends on at what stage of anemia the baby’s treatment was started.
In a situation where the baby is admitted to hospital (that is, his anemia has already reached a severe stage), it is necessary to administer injections of drugs.
The problem in treating breastfed babies is that the milk protein found in breast milk tends to bind to iron. Because of this, it is difficult to assimilate the element. This is why it is so important that the doctor prescribes the correct treatment.
Thus, anemia in an infant (treatment of this disease) is a condition that should be strictly monitored by a doctor.
Treatment of anemia in children under one year of age should also be carried out only after receiving the results of the tests.
If anemia poses a direct threat to the baby's life, a blood transfusion should be given.
There are some other tips that will be effective in treating neonatal anemia. A baby with anemia needs to have a massage and take more walks in the fresh air, since the limited supply of oxygen to the body has an even more negative effect on anemia and its course. Another way that can help is gymnastics. Of course, all these tips are relevant only for the initial stage of anemia.
Prevention and treatment of anemia in young children
The first tip to help prevent the development of anemia in young children is breastfeeding. It is advisable to breastfeed the child for as long as possible. At a minimum it should be four to six months. If the mother is anemic, the baby can be given liquid forms of iron.
When introducing complementary foods to your child, you should also think about enriching it with foods that contain a lot of iron. These are instant porridges, fruit and vegetable purees, fruit juices and wellings. All these products increase the concentration of iron in the baby’s body.
In addition, the prevention of anemia at an early age should also be carried out in the maternity hospital. How does this happen? Late clamping of the umbilical cord is necessary, which means clamping no earlier than thirty seconds after the baby is born and no later than two to three minutes.
Protocol for the treatment of anemia in children
This protocol includes the main causes of anemia in children, clinical manifestations of the disease, diagnostic methods and therapy, and preventive recommendations.
Childhood anemia: treatment according to the protocol involves the timely introduction of complementary foods, which must include meat (veal is very important), offal, hard cheeses and oatmeal, buckwheat. Since the absorption of iron significantly worsens with the simultaneous intake of phosphates, calcium and tannin, it is necessary to limit the intake of these substances into the child’s body. But of course, you can’t do without calcium completely. Therefore, it is at least worth giving your child foods containing calcium separately from foods rich in iron.
Iron supplements are indicated to be administered parenterally only if the child is diagnosed with ulcerative colitis, extensive resection of the small intestine and severe dysbiosis.
Treatment of anemia in a teenager
Anemia in teenage girls: treatment - why does this request appear more often than for boys? Anemia affects girls more often, precisely because many of them have heavy and prolonged menstruation. That is why, regarding the treatment of anemia in adolescents, attention is focused more on girls.
In order to treat this condition, it is necessary to enrich the diet with foods high in iron, namely turkey, seafood, beans, beef, fish, and green vegetables. It is difficult to say anything specific about the drugs, since only the doctor decides what to prescribe and in what dosage. Moreover, such a decision is made after the girl undergoes tests. Many teenage girls refuse medications that the doctor prescribes for them. The reason for this is serious side effects such as persistent nausea, vomiting, diarrhea or constipation. In this case, you can replace traditional drugs with liposomal iron, for example Sideral Forte.
In this case, the iron is located in the phospholipid shell, which protects the walls of the small intestine from direct interaction with iron. This minimizes side effects.
What is iron deficiency anemia in children? What can be said about her other than what has been mentioned?
Iron deficiency anemia in children: relevance
“Prevention of iron deficiency anemia in children: abstract and list of references”, “iron deficiency anemia in children: coursework” - what is meant by such queries? “Iron deficiency anemia in children: relevance” is another query that often appears on the Internet, and it comes from medical students. Why is this topic so common? The fact is that today a huge number of children suffer from anemia and there is still a need to find new methods of treatment and prevention of this disease that will reduce its prevalence. But before you search for something new, you need to know everything to the smallest detail among what has already been studied and known.
Iron deficiency anemia of newborns
A decrease in hemoglobin concentration in the blood of newborns occurs very often. That's why you shouldn't worry too much about it. As a rule, if this condition is diagnosed in time, you will not even need to take medications. It will be enough to spend more time with your baby in the fresh air and make the diet more balanced. A newborn's sleep should also be as healthy as possible, for which it is necessary to at least ventilate the room in which he falls asleep before going to bed.
Among the main reasons why the condition occurs in newborns, it is customary to highlight late introduction of complementary foods and monotonous nutrition. All the useful substances, minerals, elements and vitamins that were in the baby’s body at birth constitute a kind of strategic reserve, which is only enough for six months. During this time, they can be significantly consumed and if the body does not receive the required amount of these elements, then a deficiency occurs. This is exactly the situation that is often observed with regard to iron.
If anemia has just begun to develop in a child’s body, it will be difficult to notice. But as it progresses, nails begin to break, hair falls out, and the skin becomes drier. The baby's appetite drops significantly, he constantly regurgitates, that is, there is no longer normal absorption of food. A routine examination by a doctor can reveal a lag in physical development from other children.
Iron deficiency anemia in infants is successfully treated by taking the drugs Actiferrin and Maltofer between feedings. This rule must be observed quite strictly, since iron and milk protein cannot be absorbed at the same time. To be more precise, in this situation only protein is well absorbed, which cannot be said about iron.
After a few days of taking the drugs, the hemoglobin level returns to normal, however, this does not mean that the use should be stopped. It is important to take iron supplements for another six months so that the necessary supply of iron is formed in the child’s body.
Prevention of anemia in infants should begin even before their birth and consist of eliminating iron deficiency in a pregnant woman, if any. She needs to provide a balanced, healthy eating, spend more time in the fresh air, don’t be nervous and take multivitamin complexes to provide the body with useful substances in the proper amount.
Most children who are on artificial feeding, as food they should receive mixtures enriched with iron. That is why it is very important that parents are interested in what they are giving their child as food. Such mixtures should be given to the baby until the parents begin to introduce so-called hard foods, which becomes possible when the child turns one year old.
In order for parents to be able to prevent iron deficiency in their child, it is necessary to provide them with consultations and training.
It is important to check full-term infants for the presence of IDA at the age of six months; for premature infants, this should be no later than three months of age.
If a child has moderate or severe anemia, regular consultations with a hematologist are necessary.
Treatment of iron deficiency anemia in children: drugs
Iron deficiency anemia in young children: treatment - what should it be? More precisely, how to treat it? The exact choice of drug and dosage is made by the doctor, but it is still better for parents to have a general understanding of the drugs of this spectrum.
For younger children, it is usually necessary to take medications in the form of drops. From birth to two years, you can also take medications represented by the following names: Maltofer, Aktiferrin, Hemofer. They are also prescribed to children who were born prematurely. In addition, to make it easier to take, you can mix them with juice or tea.
It is convenient for children from two to five years old to give drugs in a form such as syrup. These are Actiferrin, Ferrum Lek and Ferronal. Each bottle comes with a measuring cap, which is also very convenient for a child to take.
Older children can already take drugs in tablet form. Such agents are represented by Aktiferrin, Ferrum Lek, Tardiferron, Hemofer.
Diagnosis of iron deficiency anemia in children
In order to diagnose this condition in a child, not only a hematologist is usually involved, but also a pediatric gynecologist, a pediatrician, a neonatologist, and a pediatric gastroenterologist.
During an external examination, the pediatrician usually notes the pallor of the skin and visible mucous membranes, for example, the oral cavity and conjunctiva. You may also notice dark circles under the eyes.
Laboratory indicators by which one can judge the presence or absence of anemia in a child are represented by hemoglobin and serum ferritin.
In order to establish the exact cause of anemia in a child, a number of additional studies are sometimes required. These usually include bone marrow puncture, colonoscopy, FGDS, ultrasound examination of the pelvic organs and peritoneum, as well as procedures such as irrigoscopy and radiography of the stomach. It is important to examine stool for dysbacteriosis, helminth eggs and protozoa.
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The site provides background information for informational purposes only. Diagnosis and treatment of diseases must be carried out under the supervision of a specialist. All drugs have contraindications. Consultation with a specialist is required!
What is anemia in children?
Anemia (anemia) is a pathological condition characterized by a decrease in hemoglobin content per unit volume of blood, usually with a simultaneous decrease in red blood cells in relation to the physiological level necessary to meet the oxygen needs of tissues. Such a condition as anemia deciphers itself - there is not enough blood. Blood, in turn, consists of the following parts:
- liquid part - plasma;
- shaped elements.
- water (occupies 80%);
- proteins;
- fats;
- carbohydrates;
- biologically active substances.
- red blood cells;
There are fewer leukocytes in the blood, they have a nucleus and do not have a permanent shape. Platelets are presented in the form of thin plates. They are responsible for blood clotting, stopping bleeding.
Most of the blood contains red blood cells. They are red blood cells of a biconvex shape, lacking a nucleus. The cavity of the red blood cell is filled with hemoglobin, a special protein that contains iron. Due to hemoglobin, red blood cells transport various gases, in particular, the delivery of oxygen to organs and tissues. Due to a lack of hemoglobin in the blood, anemia develops and the body experiences oxygen starvation.
Blood cells are formed in red bone marrow.
Hematopoietic system
The hematopoietic system consists of a group of central and peripheral organs responsible for the constancy of blood composition in the human body.The main components of the hematopoietic system are:
- red bone marrow;
- spleen;
- The lymph nodes.
A type of bone marrow consisting of fibrous and hematopoietic tissue. Most red bone marrow is located inside the bones of the pelvis, sternum and ribs. It is in these places that the formation of blood cells, such as red blood cells, platelets, and leukocytes, occurs.
Spleen
Parenchymal organ located in the abdominal cavity. The internal contents of the spleen are divided into two zones - the red pulp and the white pulp. Mature blood cells accumulate in the red pulp, most of which are red blood cells. White pulp consists of lymphoid tissue, in which the production of lymphocytes, the main cells of the human immune system, occurs.
The lymph nodes
They are peripheral organs of the lymphatic system. Lymph nodes produce lymphocytes and plasma cells. The latter are the main cells producing antibodies in the human body. Antibodies, in turn, are necessary to identify and neutralize various foreign objects (for example, viruses, bacteria).
The following types of anemia are distinguished:
- posthemorrhagic anemia;
- Iron-deficiency anemia;
- folate deficiency anemia;
- B12 deficiency anemia;
- dyserythropoietic anemia;
- hypoplastic (aplastic) anemia;
- hemolytic anemia.
Severity of anemia in children
The severity of anemia depends on the severity of the decrease in hemoglobin levels. With mild severity, the hemoglobin level is more than 90 g/l. With moderate severity, the hemoglobin level is within 90 – 70 g/l. In severe anemia, the hemoglobin level is less than 70 g/l.
Causes of anemia in children
Exist Various types anemia, which, in turn, have three main development mechanisms:
- acute or chronic blood loss;
- violation of hematopoiesis (blood formation);
- hemolysis (increased breakdown of red blood cells).
| Anemia associated with blood loss | ||
| Types of anemia | Description | The most common causes |
| Posthemorrhagic anemia | Decrease in circulating blood volume due to acute or chronic blood loss. |
|
| Anemia associated with impaired blood formation | ||
| Iron-deficiency anemia | Impaired hemoglobin formation due to iron deficiency in the blood serum. |
|
| Iron-rich anemia | Insufficient iron content in red blood cells due to impaired heme synthesis. Heme, in turn, is a complex compound that forms the hemoglobin molecule. |
|
| Folate deficiency anemia | Hematopoietic disorders due to deficiency of folic acid in the body ( vitamin B9). |
|
| B12 deficiency anemia | Hematopoietic disorders due to a lack of vitamin B12 in the body. |
|
| Dyserythropoietic anemia
(hereditary and acquired) | Violation of red blood cell formation. |
|
| Hypoplastic
(aplastic)anemia | Insufficient formation of red blood cells due to inhibition of the hematopoietic function of the bone marrow. |
|
| Anemia associated with increased blood destruction | ||
| Hemolytic anemia | Increased intravascular or intracellular destruction of red blood cells. |
|
Factors contributing to the development of anemia in children can be divided into three groups:
- Antenatal arising during the period of intrauterine development of the fetus.
- Intrapartum, acting during the life of the fetus, from the onset of labor to the birth of the child.
- Postnatal observed in the postpartum period.
Antenatal factors
Normally, at the intrauterine stage, the pregnant woman actively transfers iron to the fetus. This is necessary so that the newborn child has a supply of this microelement for the first time. Due to pathological processes that develop in a woman during pregnancy, the process of iron deposition in the fetus is disrupted. Ultimately, such a child will develop anemia.Antenatal factors of anemia in children most often include the following diseases and pathological processes that develop in a pregnant woman:
- chronic hepatitis;
- fetoplacental insufficiency;
- premature placental abruption;
- bleeding;
- anemia;
- premature birth;
- multiple pregnancy;
- severe toxicosis.
Intrapartum factors
As a rule, this is significant blood loss during childbirth due to the following reasons:- premature placental abruption;
- bleeding from the umbilical cord due to improper handling;
- early or late ligation of the umbilical cord;
- use of traumatic obstetric instruments.
Postnatal factors
Postnatal factors | Causes |
Damage to red blood cells |
|
Blood loss |
|
Malabsorption and iron metabolism |
|
Increased iron loss through the epithelium of the skin |
|
Also, postnatal factors include diseases such as:
- bacterial endocarditis;
- tuberculosis;
- systemic lupus erythematosus;
- leukemia
Symptoms of anemia in children
Common symptoms of anemia in children include the following:
- pallor of the skin and mucous membranes;
- severe fatigue;
- psychological lability;
- timidity;
- increased nervousness;
- unmotivated low-grade fever (temperature increase from 37 to 38 degrees Celsius);
- selective appetite;
- chilliness of hands and feet;
- skin itching;
- decreased muscle tone;
- bedwetting.
- changes in teeth (caries);
- hair changes (thinning, hair loss, split ends);
- skin changes (dryness, cracks, angular stomatitis);
- changes in the eyes (bluish tint of the sclera);
- changes in nails (curvature, brittleness, transverse striations).
System name | Pathological changes |
The immune system |
|
The cardiovascular system |
|
Digestive system |
|
Nervous system |
|
Iron deficiency anemia in children
Most often (in more than eighty percent of cases), anemia in children occurs due to a lack of iron in the body. This type of anemia is called iron deficiency. According to the World Health Organization, the prevalence of iron deficiency anemia in Russia and developed European countries is fifty percent.
Iron is an essential trace element. Normally, the human body contains about four grams of iron. Approximately 75% of the total is contained in red blood cell hemoglobin. About 20% of iron is found in the bone marrow, liver and macrophages, representing a reserve reserve. Myoglobin (oxygen-binding protein) contains 4% iron. In enzymatic structures - about 1%.
Iron in the human body performs the following functions:
- transports oxygen and carbon dioxide;
- participates in hematopoietic processes;
- takes part in the formation of myoglobin and hemoglobin;
- is an integral part of many enzymes;
- takes a major part in the growth process of the body;
- regulates immunity.
The degree of absorption (absorption) of iron depends on the following factors:
- the amount of iron in food consumed;
- bioavailability (digestibility);
- conditions of the gastrointestinal tract.
Causes of iron deficiency anemia in children
Frequent iron deficiency in childhood is due to rapid growth of the child. During this period of time, the volume of blood in the baby’s body increases and intense metabolism occurs. At the same time, the need for iron increases, and its influx is limited.The most common causes of iron deficiency anemia include:
- the presence of iron deficiency in the mother during pregnancy;
- insufficient intake of iron into the body from food;
- increased body need for iron;
- iron losses exceeding physiological ones;
- consumption of foods that inhibit iron absorption;
- diseases of the gastrointestinal tract (for example, gastritis, Crohn's disease, celiac disease);
- disruption of iron transport;
- congenital anomalies.
Causes of iron deficiency anemia | Description |
The presence of iron deficiency in the mother during pregnancy | Iron deficiency in the mother during pregnancy leads to insufficient accumulation of iron reserves in the depot during the period of intrauterine development of the fetus. A deficiency of this element in a pregnant woman may occur due to poor nutrition ( for example, a vegetarian diet), multiple pregnancy, and also due to complicated pregnancy. Complications during pregnancy include:
|
Insufficient intake of iron from food | Nutritional iron deficiency is a common cause of iron deficiency anemia in children. In most cases, it develops in newborns who are bottle-fed with unadapted milk formulas, goat's or cow's milk. By the first year of a child’s life, a lack of iron may be due to improper introduction of complementary foods, due to poor nutrition with a predominance of dairy and flour products, or due to insufficient consumption of meat products, due to vegetarianism. |
Increased body need for iron | There are the following periods of life during which the need to consume iron reserves increases:
Also, the child’s body may experience an increased need for iron due to inflammatory diseases or due to long-term use of cyanocobalamin. The latter is used in the treatment of B12 deficiency anemia. |
Iron losses exceeding physiological ones | Increased consumption of iron can be observed in various chronic diseases accompanied by blood loss or heavy menstruation in girls. |
Eating foods that inhibit iron absorption | There are certain food products that contain special active substances and microelements that block absorption of iron into the body. These products include milk, cheese ( contain calcium and phosphate), green leafy vegetables, tea ( contain polyphenols), chicken eggs (which contains albumin and phosphoprotein), spinach ( containing oxolinic acid and polyphenols), as well as corn and whole grain products ( containing phytate). |
Gastrointestinal diseases | Due to pathological processes in the gastrointestinal tract, the function of iron absorption and its digestibility is disrupted.
There are the following diseases and pathological processes of the gastrointestinal tract, against the background of which iron deficiency anemia may develop in children:
|
Impaired iron transport | Occurs as a result of the following pathological processes:
Transferrin is a protein that performs the function of transporting iron from places of its accumulation. |
Congenital anomalies | This includes such anatomical congenital pathologies as intestinal polyposis and Meckel's diverticulum. |
Symptoms of iron deficiency anemia in children
At an early stage of the disease, as a rule, minor clinical changes are observed. Most often, one of the first signs of iron deficiency anemia is pallor of the skin and mucous membranes, as well as blue sclera of the eyes. Lack of iron in cellular enzymes causes trophic disorders of the skin and its derivatives. The child's hair becomes thin and dry, and hair loss is observed. There is a noticeable decrease in the baby’s emotional tone. The child experiences frequent weakness and fatigue. Such children have difficulty coping with physical activity. In response to oxygen starvation, the cardiovascular system also reacts. The child develops tachycardia and a systolic murmur is heard.In addition, the child may experience symptoms such as:
- tearfulness;
- moodiness;
- easy excitability;
- decreased or lack of appetite;
- vomiting after feeding;
- decreased visual acuity;
- superficial sleep;
- craving for non-food components (for example, paper, soil);
- dullness and brittleness of nails;
- painful cracks in the corners of the mouth;
- caries (tooth decay);
- retardation in physical and psychomotor development.
Diagnosis of iron deficiency anemia in children
When examining blood microscopically, typical signs of iron deficiency anemia are:- decreased levels of hemoglobin and red blood cells;
- weak coloration of red blood cells (hypochromia);
- anisocytosis (the presence of red blood cells of different sizes in the blood);
- poikilocytosis (the presence of red blood cells of different shapes in the blood).
Treatment of iron deficiency anemia in children
Usually, when treating mild anemia, the attending physician is limited to adjusting the child’s diet. In case of severe and moderate anemia, in addition to diet therapy, drug treatment is prescribed, aimed at restoring iron reserves in the baby’s body.Nutrition adjustments
After birth, the only source of iron for the baby is food. That is why natural feeding is so important, as well as the timely introduction of juices and complementary foods. It is recommended that a child up to six months be fed exclusively with mother's breast milk. It contains all the necessary nutrients, hormones and enzymes, and most importantly, a highly bioavailable form of iron, in which the absorption of the beneficial microelement reaches seventy percent. It should be noted that with artificial feeding, the percentage of iron absorption is less than ten.
Children suffering from iron deficiency anemia should be introduced to complementary foods at five to five and a half months. For starters, these could be special baby cereals fortified with iron, fruit purees, juices and vegetables. After six months, meat should be introduced into the diet.
Also, food products should contain elements that promote the absorption of iron, for example, folic acid, vitamins C and E, B vitamins, zinc, magnesium, copper.
Drug treatment
Iron-containing medications are prescribed for a period of at least three months. The dose of the drug and the duration of treatment depend on the age of the child, the severity of the disease, as well as the level of iron deficiency in the body.
Name of the drug | Directions for use and dosage |
Ferrum Lek | The drug is prescribed orally in half or one measuring spoon ( 2.5 – 5 ml) syrup once a day, during or after meals. One or two measuring spoons are prescribed ( 5 – 10 ml) of the drug once a day. Children over twelve years old the drug in the form of chewable tablets should be taken one to three pieces, in the form of syrup two to six measuring spoons ( 10 – 30 ml) once a day. Pregnant women the drug is prescribed in the form of chewable tablets, two to four pieces per day. In the form of syrup, you need to take four to six measuring spoons ( 20 – 30 ml) once a day until the hemoglobin level normalizes, after which you should take two scoops ( 10 ml) until the end of pregnancy. |
Maltofer | Premature babies the drug is administered orally in the form of drops, one to two drops per kilogram of body weight once a day for three to five months. Children under one year of age the drug is prescribed orally, in the form of syrup, 2.5 - 5 ml ( 25 – 50 mg iron) or in the form of drops of 10–20 drops once a day. Children from one to twelve years old the drug is prescribed orally, in the form of syrup, 5–10 ml ( 50 – 100 mg iron) or in the form of drops of 20–40 drops, once a day. Children over twelve years old the drug is prescribed orally, in the form of tablets, one to three tablets ( 100 – 300 mg) once a day. Women during pregnancy the drug is prescribed orally, in the form of tablets, two to three tablets ( 200 – 300 mg) once a day. If a child has impaired iron absorption, drugs are administered parenterally ( intravenously). |
After normalization of hemoglobin levels, taking iron supplements continues for several weeks in order to replenish iron reserves in the body.
Treatment of iron deficiency anemia is usually carried out on an outpatient basis, but in severe forms of anemia the child is hospitalized in the hematology department.
Hemolytic anemia in children
Hemolytic anemia is a group of diseases that cause increased breakdown of red blood cells in the human body. On average, red blood cells live in the body for one hundred to one hundred and twenty days, after which they are destroyed in the liver and spleen. Every day, approximately one percent of red blood cells are destroyed and replaced by new red blood cells that enter the peripheral blood from the red bone marrow. This balance constantly ensures a constant number of red blood cells in the blood. The pathological reduction of red blood cells in the blood leads to the fact that the red bone marrow increases its activity six to eight times. As a result, reticulocytosis is observed in the blood of such a patient, indicating the presence of hemolysis (increased destruction of red blood cells).
Unlike iron deficiency anemia, hemolytic anemia is much more complex. Only a correct diagnosis and timely medical care can save a child’s life.
Symptoms of hemolytic anemia in children
All forms of hemolytic anemia are characterized by acute crises, manifested by a sudden increase in body temperature, jaundice of the skin and mucous membranes, as well as a sharp drop in hemoglobin levels.In addition, the child may experience the following symptoms:
- dizziness;
- general weakness;
- decreased performance;
- unmotivated sudden increase or decrease in body temperature;
- change in urine color (urine becomes brownish or reddish);
- subcutaneous hemorrhages;
- ulcerations on the lower extremities;
- tower shape of the skull, wide bridge of the nose, high Gothic sky, dense enlarged spleen (characteristic of hereditary spherocytosis);
- olive skin tone, brown or black urine (due to glucose-6-phosphate dehydrogenase deficiency);
- pronounced pallor of the skin, moderate enlargement of the liver and spleen (with immune hemolytic anemia).
Diagnosis of hemolytic anemia in children
Hemolytic anemias have many common symptoms, but each has its own specific features. They help make an accurate diagnosis and choose the right treatment tactics.A hemolytic crisis can be triggered by taking medication. This is usually observed in patients with glucose-6-phosphate dehydrogenase deficiency. When performing a benzidine test, free hemoglobin and its breakdown products are detected in the child’s blood and urine. In a clinical blood test, degenerative forms of red blood cells and their fragments - schizocytes - are observed. As a sign of regeneration, nuclear red blood cells – normoblasts – are found. Neutrophilia (increased number of neutrophils) is typical.
A classic example of hemolytic anemia is also hereditary spherocytosis, in which a defect in the erythrocyte membrane is formed. In a general blood test, such patients have a large number of spherical red blood cells with a reduced diameter. The number of reticulocytes (young red blood cells) with specific inclusions in the cytoplasm increases sharply. The minimum somatic resistance of erythrocytes is also reduced (cells are destroyed with a small dilution of saline solution).
If hemolytic anemia is of an immune nature, then to confirm the diagnosis it is necessary to carry out the Coombs test and the AGA test. If antibodies deposited on red blood cells are detected in the blood, the test is considered positive.
Treatment of hemolytic anemia in children
In order to prevent renal failure due to glucose-6-phosphate dehydrogenase deficiency, a concentrated solution of glucose and diuretics is administered intravenously to a sick child. If there is a sharp drop in hemoglobin, a transfusion of red blood cells is performed.The only radical treatment for hereditary spherocytosis is splenectomy (removal of the spleen). As a rule, after the operation the child recovers, and the hemolytic crisis never recurs.
The main treatment for immune hemolytic anemia is glucocorticoid therapy (for example, Prednisolone, Dexamethasone). If there is a threat of anemic coma, an emergency transfusion of washed red blood cells is performed.
B12 deficiency anemia in children
A disease of the blood system caused by impaired hematopoiesis due to a lack of vitamin B12 in the body. Normally, vitamin B12 enters the body with food. Having reached the stomach, the vitamin enters into contact with the so-called intrinsic Castle factor (gastromucoprotein). Castle factor promotes the absorption of vitamin B12 and also acts as its protection against the negative effects of intestinal microflora. Thanks to gastromucoprotein, vitamin B12 reaches the lower part of the small intestine and is easily absorbed into its mucous layer, after which it enters the blood.
Vitamin B12 enters the bloodstream into:
- red bone marrow, where it participates in the formation of red blood cells;
- the liver, where it is deposited;
- the central nervous system, where it takes part in the synthesis of the myelin sheath, which surrounds nerve fibers.
Causes of B12 deficiency anemia in children
The main causes of B12 deficiency anemia in children include:- dysbiosis (changes in the normal microflora) of the intestine due to the development of pathogenic flora;
- insufficient intake of vitamin B12 from food;
- presence of helminths;
- Castle factor deficiency due to pathologies such as congenital disorders of intrinsic factor synthesis, atrophic gastritis;
- increased need for vitamin B12, for example, during periods of rapid body growth in children actively involved in sports.
Symptoms of B12 deficiency anemia in children
With B12 deficiency anemia in children, the following symptoms are observed:- weakness;
- pallor of the skin, often with an icteric tinge (due to liver damage);
- change in the consistency and color of the tongue (the tongue acquires a varnished surface and a bright red color);
- burning sensation of the tongue;
- tingling feeling in the arms and legs;
- loss of smell;
- weight loss;
- difficulty walking and, as a result, uneven gait;
- stiffness of movements;
- intellectual disorder;
- there may be an increase in the size of the liver and spleen (hepatosplenomegaly).
Diagnosis of B12 deficiency anemia in children
In a clinical blood test, the following indicators will be characteristic:- decrease in hemoglobin and red blood cell count;
- increase in color index – above 1.5;
- increase in red blood cell size (macrocytosis);
- inclusions in erythrocytes - Jolly bodies and Cabot rings;
- presence in the blood various forms red blood cells (poikilocytosis);
- increase in the level of lymphocytes and reticulocytes.
Vitamin therapy
To saturate the body with vitamin B12, the drug Cyanocobalamin is prescribed. The initial dose of the drug is usually 30 - 50 mcg daily or every other day. The vitamin is administered subcutaneously, intramuscularly or intravenously. The course of vitamin therapy is fifteen days. The maintenance dose of the drug is 100–250 mcg, subcutaneously, once every two to four weeks.
Diet therapy
In order to replenish vitamin B12 reserves in the body, a diet is prescribed in which the consumption of foods rich in vitamin B12 is increased.
The daily intake of vitamin B12 depends on the age of the child.
In addition, enzyme preparations (for example, Festal, Pancreatin) can be prescribed to normalize the intestinal flora. If a child has helminthic infestations, deworming drugs are prescribed (for example, Fenasal).
Diagnosis of anemia in children
Diagnosis of anemia in children is based on the following studies:
- taking anamnesis;
- medical examination;
- laboratory research;
- instrumental diagnostics.
History taking
First of all, anamnesis is collected, that is, the doctor, through a survey, obtains certain information about the patient. Particular attention is paid to child nutrition issues. The doctor is usually interested in whether the child is bottle-fed or breastfed, what food he receives and how often. In addition, the doctor asks about the presence of physiological or pathological conditions accompanied by blood loss (for example, menstruation in girls, bleeding gums). Certain information is also collected about the patient’s relatives, for example, whether anyone in the family had an operation to remove the spleen, whether there were diseases that were accompanied by increased blood loss or diseases of the gastrointestinal tract.Medical checkup
When examining a child, the doctor first of all pays attention to the color and condition of the patient’s skin and mucous membranes. Anemia often reveals pale or yellow skin and a bluish tint to the sclera. Also, during the examination, the doctor palpates (feels) the child’s abdomen to identify pathological increases in the size of internal organs such as the liver and spleen. In addition, the lymph nodes are palpated to see if they are enlarged, blood pressure, pulse, number of respiratory movements per minute are determined, and it is also determined whether the child has shortness of breath.Laboratory research
One of the main methods for diagnosing anemia in children is a laboratory test called a clinical (general) blood test. After the birth of the child, a general blood test is carried out in mandatory all children aged one, three, six and nine months.The analysis is carried out on an empty stomach, usually in the early morning, so that the child can eat after the procedure. Most often, blood is taken from the cubital vein in the elbow area. If the child’s age is too young and the medical professional is not able to palpate (grope) the necessary vein, then another site for blood sampling is selected (for example, the back of the hand, head, forearm).
A general blood test determines the following indicators:
- hemoglobin and red blood cell levels;
- concentration and amount of hemoglobin in the erythrocyte;
- properties and qualitative characteristics of hemoglobin;
- reticulocytes;
- hematocrit (the ratio of blood cells to plasma);
- the number of other blood cells (for example, leukocytes, platelets).
There are the following indicators of normal red blood cell content (per liter of blood) in children:
- in newborns 4.3 – 7.6x10 to the twelfth power/l;
- in one month 3.8 – 5.6x10 to the twelfth power/l;
- at six months 3.5 – 4.8x10 to the twelfth power/l;
- from one year to twelve years, the normal range of red blood cells is 3.5 – 4.76x10 to the twelfth power/l.
- in the first three days of a child’s life it is 180 – 240 g/l;
- by the first month, the norm of hemoglobin in the blood is 115 – 175 g/l;
- from six months to six years, the hemoglobin level is on average 105 - 140 g/l;
- from seven to twelve years of age, the hemoglobin normal range is 110 – 160 g/l.
Laboratory criteria for anemia for children of different age groups are:
- a decrease in hemoglobin level of less than one hundred g/l for children aged from one month to five years;
- a decrease in hemoglobin levels of less than 115 g/l for children aged six to eleven years;
- a decrease in hemoglobin levels of less than 120 g/l for children aged twelve to fourteen years.
It is important to determine the size and shape of the red blood cell, since some types of anemia can cause characteristic changes in the parameters of red blood cells. Normal red blood cells have a diameter of 7.2 – 8.0 microns (micrometers). Cells with a diameter of more than 8.0 microns are called macrocytes, more than 11 microns are called megalocytes, and less than 7.0 are called microcytes.
Also in a clinical blood test, it is important to know the number of reticulocytes to determine the reticulocyte index. The latter indicates the degree of increase in the formation of red blood cells, which makes it possible to determine the severity of anemia. In this regard, aregenerative, hyporegenerative, normoregenerative and hyperregenerative anemias are distinguished.
Depending on the value of the color index, the size of red blood cells and the number of reticulocytes, one or another type of anemia can be approximately characterized.
Test results | Characteristic type of anemia |
| Hypoplastic (aplastic)anemia |
| Congenital hemolytic anemias |
| Acute posthemorrhagic anemia, autoimmune hemolytic anemia |
| B12 deficiency anemia, folate deficiency anemia |
| Iron-deficiency anemia |
If the hemoglobin concentration is not reduced in a general blood test, and the child has clinical manifestations of anemia, a biochemical blood test is performed, which additionally examines indicators such as transferrin, ferritin, and serum iron.
For severe types of anemia, as well as to clarify the diagnosis, a bone marrow puncture is performed, followed by examination of the contents under a microscope and displaying the results in table form (myelogram).
Instrumental diagnostics
For anemia, the following instrumental research methods may be prescribed:- ultrasound examination of the abdominal organs, kidneys, pelvic organs;
- endoscopic examination - examination of the stomach and intestines using fibrogastroduodenoscopy and colonoscopy;
- electrocardiography (ECG) – a study of the heart, characterized by recording the electric fields generated during the work of the heart;
- computed tomography – layer-by-layer examination of organs and tissues using x-rays.
Prevention of anemia in children
Prevention of anemia in children should be carried out even before the child is born. Research shows that if the mother had anemia during pregnancy, then the risk of developing anemia in children by the first year of life increases significantly. That is why a woman during pregnancy needs to regularly monitor the level of hemoglobin and red blood cells in blood tests. An important role in the prevention of anemia is played by the diet and quality of nutrition of expectant mothers.
During pregnancy, a woman is recommended to eat the following foods:
- meat;
- liver;
- fresh vegetables and fruits;
- eggs;
- spinach;
- dried fruits;
- nuts;
- porridge (for example, buckwheat).
From birth to six months, the baby must be breastfed as many times as he wants, at any time of the day or night. It is contraindicated to give your child goat's or cow's milk, as well as any other food or liquid.
After six months, the child must receive additional foods rich in iron (for example, fruit puree, juices, vegetables, meat, fish). However, it should be remembered that there are certain rules for introducing complementary foods.
The following rules for introducing complementary foods can be distinguished:
- It is necessary to observe consistency and gradual management of complementary feeding products.
- Each type of complementary feeding should be started with one least allergenic product.
- On the first day of introducing complementary foods, the child is given a quarter or half a teaspoon of the product. Then, over the course of a week, the volume of complementary foods gradually increases to the age norm.
- Complementary foods are offered to the baby before breastfeeding.
- It is better to offer a new complementary food to the child in the first half of the day. This is done in order to later (during the rest of the day) monitor the baby’s reaction to the administered product.
- If you experience abdominal pain, abnormal bowel movements, or rashes on the body, the new product should be discontinued.
- The interval between the introduction of different dishes should be seven to ten days.
- It is not recommended to introduce more than one new product in one day.
- Complementary feeding dishes should be tender and uniform in consistency.
- Complementary foods are given warm, from a spoon, with the child in a sitting position.
- Complementary foods are administered only to a healthy child.
Particular attention should be paid to premature babies. They, in turn, need special baby food with a high content of iron and vitamins.
Before use, you should consult a specialist.Anemia in children is a syndrome characterized by a decrease in hemoglobin levels and the concentration of red blood cells in the blood. Most often, pathology is diagnosed in children before three years. There are a large number of predisposing factors that can influence the development of such a disease. This can be influenced by both external and internal factors. In addition, the possibility of the influence of inadequate pregnancy cannot be excluded.
The clinical picture is quite nonspecific, since it includes the child’s rapid fatigue, pale skin, increased heart rate and dizziness.
Since anemia belongs to the category of blood diseases, laboratory tests will form the basis of diagnostic measures. In addition, physical examination data play an important role in diagnosis.
Treatment of anemia in children, regardless of the severity of the disease, is based on conservative methods.
IN International classification diseases of the tenth revision, such pathology has several meanings, which differ in the form of its course. Iron deficiency and hypochromic anemia has a code according to ICD-10 - D 50, sideropenic - D 50.1, post-hemorrhagic - D 62. This also includes unspecified anemia - D 50.9, as well as other types of the disease - D 50.8.
Etiology
Pediatric experts note that anemia in children is an extremely common pathology. In addition, the age category of the patient plays an important role. Prevalence by age:
- in infants and children up to three years old - 40%;
- puberty - 30%;
- other children's age categories - 30%.
The frequent prevalence of the disease is due to the following reasons:
- intensive growth of the child's body;
- the activity of a process such as erythropoiesis (a type of hematopoiesis);
- progressive increase in the number of enzyme elements;
- immaturity of the hematopoietic apparatus.
Anemia in infant is formed against the background of the influence of antenatal factors that affect the fetus during its intrauterine development. In order for children to have normal hematopoiesis, during pregnancy their body must receive and accumulate a certain amount of iron received from the mother, namely approximately 300 milligrams.
The most intense process of iron transfer from mother to fetus is observed in the interval from 28 to 32 weeks of gestation, but there are several reasons that cause disruption of such iron exchange. These include:
- threat of spontaneous miscarriage;
- premature;
- intense internal hemorrhages;
- infectious diseases suffered by the expectant mother during pregnancy or exacerbation of chronic diseases;
- occurs in a woman during the period of intrauterine development of the fetus.
After the baby is born, both external and internal unfavorable factors can cause iron deficiency anemia in children.
Endogenous causes of anemia are presented:
- newborns;
- disorders of hemoglobin synthesis;
- bone marrow failure.
- lack of iron, proteins and vitamins in the diet;
- unjustified transfer of the baby to artificial feeding;
- earlier introduction of complementary foods;
- presence of excess body weight.
In addition, among the causes of anemia in children, it is worth highlighting regular blood loss, which can occur against the background of:
- nasal hemorrhages;
- leaks and other blood pathologies;
- bleeding in the gastrointestinal tract;
- previous surgical interventions.
The main risk group, which has a high predisposition to developing deficiency anemia in children, includes children who have:
- any type of allergy;
- exudative form;
- improper absorption and metabolism of iron;
Immune hemolytic anemia can result from:
Not least important in the formation of pathology are:
- lack of substances such as copper, cobalt and magnesium.
Classification
According to the mechanism of formation, the disease is divided into:
- primary- this includes physiological anemia in children, which arose as a result of genetic predisposition;
- secondary- in such situations, anemia develops against the background of other pathological processes and unfavorable factors.
In accordance with the pathogenesis, there is the following classification of anemia:
- post-hemorrhagic nature - caused by blood loss, which can be acute or chronic;
- caused by disruption of hematopoiesis;
- caused by the destruction of red blood cells, as well as the predominance of the process of blood destruction over the process of hematopoiesis.
Types of anemia in children caused by inadequate hematopoiesis are:
- hypochromic or iron deficiency;
- sideroachrestic or iron-saturated;
- megaloblastic - this includes B12-deficiency anemia and folate deficiency anemia;
- dyserythropoietic;
- aplastic or hypoplastic anemia.
Types of anemia associated with increased destruction of red substances in the blood:
- membranopathy;
- fermentopathy;
- hemoglobinopathy;
- autoimmune anemia;
- hemolytic disease of the newborn.
In addition, there are degrees of anemia, depending on the severity of the pathology:
- light- in such situations, children have practically no symptoms. In some cases, there are complaints of slight fatigue and decreased physical activity;
- medium-heavy- has pronounced symptoms, which leads to a significant deterioration of the patient’s condition. In this case, the patient cannot tolerate even the lightest physical activity;
- heavy- changes appear in the skin, hair, nails and internal organs.
There are also several types of physiological anemia and anemia caused by other disorders, depending on the size of the red blood cells:
- microcentral - volumes are reduced;
- normocentric - without any changes;
- macrocentral - the sizes are increased.
Variants of the course of the disease depending on how saturated the red blood cells are with hemoglobin:
- normochromic anemia;
- hypochromic anemia in children;
- hyperchromic anemia.
Symptoms
The normal hemoglobin content in children under six years of age is considered to be 125-135 grams per liter. Physiological or acquired anemia is indicated by values below 110 g/l in a child under five years of age, below 120 g/l in children over five years of age.
Folate deficiency, hemolytic, iron deficiency, aplastic anemia in children and other types of pathology have the same symptom complex, which includes:
- dry and pale skin;
- hair fragility;
- separation and deformation of the nail plates;
- peeling of the skin;
- formation of cracks on the palms, soles and corners of the mouth;
- lethargy and tearfulness;
- lack of interest in previously loved things;
- fast fatiguability;
- exercise intolerance;
- a decrease in the immune system, which is why the child is very often exposed to acute respiratory viral infections, pneumonia, bronchitis and intestinal infections;
- sleep disturbance;
- headache;
- severe dizziness;
- decreased blood pressure;
- attacks of loss of consciousness;
- defecation disorder;
- regression of motor skills development;
- increased gas production;
- decreased appetite;
- stopping the psychomotor development and growth of the child;
- noise and ringing in the ears;
- the appearance of “goosebumps” before the eyes;
- severe shortness of breath;
- pain in the chest area that is stabbing in nature.
If one or more of the above symptoms occur, it is necessary to show the child to a specialist as soon as possible.
Diagnostics
A pediatrician or hematologist can help treat anemia, make a correct diagnosis and determine the type of disease in children.
The basis of diagnosis is laboratory tests, but often the diagnosis of anemia in children involves A complex approach. The first stage involves the clinician performing the following manipulations:
- studying the medical history of not only the patient, but also his close relatives - this will help to find out the causes of iron deficiency anemia and any other type of pathology;
- collection and analysis of the patient’s life history;
- a thorough physical examination of the child - at the same time assessing his appearance, blood pressure is measured and heart rhythm is listened to;
- a detailed interview with the patient or his parents - this will enable the clinician to understand how the disease progresses.
For anemia, the following laboratory tests are performed:
- general clinical blood test - to determine the severity of the disease;
- general urine analysis;
- blood biochemistry - will show changes in the composition of such human biological fluid;
- PCR tests and serological tests.
Instrumental activities include the implementation of:
- bone marrow puncture examination;
- trepanobiopsy;
- Ultrasound of the peritoneum;
Based on individual indications, a small patient may be sent for additional examinations to pediatric specialists from more specialized areas of medicine.
Treatment
Hemolytic anemia in children and any other type of disease can be eliminated using conservative medicine. Therefore, treatment may include:
- taking iron or vitamin B12 supplements if they are deficient;
- completing a therapeutic massage course;
- physiotherapeutic procedures, in particular ultraviolet irradiation;
- performing gymnastic exercises, the program of which is drawn up by the attending physician individually for each patient;
- enriching the diet with offal and legumes, herbs and seafood, fresh fruits and vegetables. Formula-fed babies should be given adapted milk formulas. This also includes adjusting the diet of a woman who is breastfeeding;
- the use of medications for etiotropic and symptomatic therapy aimed at eliminating the cause and relieving clinical signs.
In severe cases of the disease, it is necessary to quickly replenish the number of red blood cells, which is carried out through a procedure such as transfusion of red blood cells.
Possible complications
Anemic syndrome, provided that it is not treated in any way, can lead to the following consequences:
- anemic coma;
- dysfunction of internal organs;
- lag in physical and mental development compared to peers;
- a decrease in the immune system, making the child more susceptible to various infectious or inflammatory diseases.
Prevention and prognosis
To avoid the development of folate deficiency, iron deficiency and any other form of pathology, the following rules for the prevention of anemia in children should be followed:
- control over the adequate course of pregnancy;
- providing the child with adequate nutrition appropriate to his age category;
- strengthening the immune system;
- preventing the development or timely treatment of diseases that can lead to the development of such an illness;
- Regular examination of the baby by a pediatrician.
As for the prognosis of anemia in children, it is often favorable - early diagnosis and timely therapy guarantee complete recovery.
Anemia in children is a pathological condition characterized by a reduced hemoglobin content in the blood.
The most common causes of anemia in children are nutritional deficiencies and iron deficiency. Normal levels of hemoglobin in the blood of a child under the age of approximately six years are 125–135 grams per liter, the last acceptable limit is 110 g/l.
An increased risk of anemia exists primarily for children born during premature or multiple pregnancies, as well as those suffering from any concomitant intestinal diseases. The highest incidence rate is observed in children under three years of age, which is associated with insufficient maturity of the organs of the hematopoietic system and their increased susceptibility to negative impacts environment. Iron deficiency anemia occurs most often at an early age.
According to World Organization healthcare, this form of anemia occurs in approximately 20-25% of all newborns. Among children under the age of four years– for forty-three percent, from five to twelve years – for thirty-seven percent. Experts also believe that latent iron deficiency anemia, which is not accompanied by clinical manifestations, occurs much more often. In order to prevent anemia, it is recommended to eat a full and balanced diet, spend more time in the fresh air, move actively, get required amount vitamins and microelements.
ICD-10 code
D50-D53 Anemia associated with nutrition
Causes of anemia in children
- Lack of substances in the body responsible for the production of hemoglobin.
- Various pathological processes associated with disorders of the intestinal tract, in particular, with impaired absorption of nutrients that are needed for the production of hemoglobin.
- Deviations in the functioning of the hematopoietic system in the bone marrow.
- Anatomical and physiological immaturity of the organs of the hematopoietic system.
- Negative impact of unfavorable ecology.
- Presence of worms.
- Increased incidence of morbidity.
- Disturbed and unbalanced diet and nutrition.
- Lack of microelements in the body, in particular iron, copper, manganese, cobalt, nickel, as well as vitamins B and C, folic acid.
- If the baby was born much earlier than expected (premature pregnancy).
Symptoms of anemia in children
Symptoms of anemia in children are classified depending on the type and severity of the disease. A number of symptoms are common to all types of anemia. At the same time, its individual types can cause various associated symptoms. Only a qualified specialist can differentiate the signs and diagnose the disease. The most common symptoms of anemia in children are:
- Paleness of the skin.
- Tachycardia.
- Dyspnea.
- Feeling of tinnitus, dizziness, headache.
- Fast fatiguability.
- General state of weakness, lethargy.
- Poor appetite.
- Taste disorders (for example, a child may eat chalk).
- Brittle hair and nails.
- Muscle weakness.
- Deterioration in the appearance of the skin (for example, rough surface of the skin).
- Yellow skin tone.
- Hardening and enlargement of the liver and spleen.
- Frequent infectious diseases.
- Nose bleed.
Deficiency anemias in children
Deficiency anemia in children is the result of a lack of substances in the body that promote the formation of hemoglobin. They are more common among children under one year of age. One of the most common deficiency anemias is nutritional anemia. As a rule, it occurs as a result of malnutrition associated with insufficient consumption of substances that are necessary for the full growth and development of the child, for example, a lack of protein or iron. Deficiency anemia can occur in diseases associated with impaired absorption of substances in the intestine; weakened immunity (increased incidence of morbidity) and prematurity of the child during pregnancy can also contribute to their development.
Iron deficiency anemia in children
Iron deficiency anemia in children is divided into the following forms:
Asthenovegetative
This form of anemia occurs as a result of impaired functioning of the brain and manifests itself in the form of insufficient development of psychomotor functions. A child with an asthenovegetative form of anemia is usually irritable, has absent-minded attention and memory, and may experience bedwetting, muscle pain, and hypotension.
Epithelial
Symptoms of the disease include degeneration and atrophy of the mucous membranes, skin, as well as nails and hair. The child, as a rule, has poor appetite, heartburn, belching, nausea, flatulence, disorders of the swallowing process, the absorption process in the intestines is disrupted, and with a very low level of hemoglobin, paleness of the skin and conjunctiva may be observed.
Immunodeficiency
This disease causes frequent acute respiratory viral infections, as well as intestinal pathologies of an infectious nature. In most cases, children with this disease have low iron levels in the blood plasma and weakened protective functions of the body.
Cardiovascular
This form occurs with severe iron deficiency anemia. The child gets tired quickly, has low blood pressure, a rapid heartbeat, a systolic murmur is heard, and dizziness may occur.
Hepatolienal
The rarest form of anemia, usually occurring against the background of rickets and severe iron deficiency.
B12 anemia in children
B12 anemia in children is characterized by the formation of very abnormally shaped cells in the bone marrow large sizes, destruction of red blood cells inside the bone marrow, low platelet count, which leads to increased bleeding and difficulty in stopping bleeding. Also, with B12 deficiency anemia, a sharp decrease in neutrophils in the blood can occur, which is extremely life-threatening. With acute deficiency of vitamin B12, disturbances occur in the gastrointestinal mucosa and nervous disorders occur. Vitamin B12 deficiency often occurs due to impaired production of the glycoprotein that is responsible for its normal absorption.
The disease can make itself felt after suffering enteritis or hepatitis, which is associated with impaired absorption of vitamin B12 in the small intestine or with its complete elimination from the liver. Clinical manifestations of anemia include dysfunction of the hematopoietic system, as well as the nervous and digestive systems. During physical activity, tachycardia occurs, the child quickly gets tired and becomes lethargic. On the part of the digestive tract, there is depression of gastric secretion, absence of gastric juice of hydrochloric acid. A burning sensation may be felt on the tongue, the skin becomes yellowish, the spleen (sometimes the liver) is slightly enlarged, and the level of bilirubin in the blood is increased. For treatment, cyanocobalamin is administered once a day for one to one and a half months. After improvements occur, the drug is administered once every seven days for two to three months, then twice a month for six months. After stabilization of the condition, vitamin B12 is prescribed for preventive purposes once or twice a year (five to six injections).
Hypochromic anemia in children
Hypochromic anemia in children occurs as a result of a reduced level of hemoglobin in red blood cells. Diagnosis of the disease is carried out on the basis general research blood with determination of the number of red blood cells and hemoglobin level, as well as the value of color characteristics. For hypochromic anemia low level hemoglobin in all cases is combined with a decrease in color indicators. The size and appearance of red blood cells also influence the diagnosis. In hypochromic anemia, red blood cells have a round shape, dark edges and a light spot in the middle. Hypochromic anemia is divided into iron deficiency, iron-saturated, iron redistribution and mixed type anemia. Symptoms of the disease depend on its form and may include such signs as a general state of weakness, dizziness, slowing of mental and physical functions, tachycardia, pallor of the skin, etc. As an auxiliary treatment in folk medicine use the following remedy: mix a glass of freshly squeezed pomegranate juice with lemon, apple and carrot juice (in proportions of one hundred milliliters), add fifty to seventy grams of natural bee honey, mix thoroughly and take two tablespoons three times a day warm. The finished mixture must be kept in the refrigerator; before taking, you must ensure that there are no allergic reactions and consult a doctor.
Aplastic anemia in children
Aplastic anemia in children is a type of hypoplastic anemia and is its most common form. When the bone marrow is damaged, the functions of the hematopoietic system are disrupted, the level of leukocytes, platelets and erythrocytes decreases. The etiology of the disease is usually associated with infectious or toxic factors affecting the bone marrow. Aplastic anemia often develops spontaneously and is acute. The skin becomes pale, blood is released from the nose, bruises form under the skin when touched, and a temperature reaction may occur. These symptoms require immediate medical attention, as this disease is characterized by fairly rapid progression. In most cases, treatment requires chemical therapy and transfusion of a suspension of red blood cells obtained from whole blood by removing plasma in order to normalize the functioning of the bone marrow. If there is no positive effect, a bone marrow transplant may be needed.
Hemolytic anemia in children
Hemolytic anemia in children is characterized by excessive destruction of red blood cells and can be hereditary or acquired. With hereditary anemia, increased destruction of red blood cells occurs with the release of hemoglobin from them. Defective red blood cells can remain viable for eight to ten days and are destroyed mainly in the spleen. The first signs of the disease can appear immediately after birth or be detected at any other age. With hemolytic anemia, the skin acquires a yellow color, becomes pale, and physical and, in some cases, mental development is delayed. The spleen and liver may be enlarged and hardened. Crises that occur with this disease can last seven to fourteen days and are accompanied by a temperature reaction, headaches, a sharp loss of strength, muscle weakness, decreased motor activity, etc. To relieve or alleviate the symptoms of the disease, surgical intervention to remove the spleen can be performed.
Anemia in children under one year of age
Anemia in children under one year of age is divided into anemia of newborns, anemia of prematurity, nutritional anemia resulting from malnutrition, post-infectious anemia and severe anemia of the Yaksh-Gayema type.
Nutritional anemia occurs before the age of six months and is a consequence of a lack of iron, salt, vitamins and proteins. In most cases it occurs in the absence breastfeeding. The development of anemia manifests itself in the form of loss of appetite, pale skin, and muscle weakness. The stool is dry or clayey, and the liver may be slightly enlarged. The child is lethargic, gets tired quickly, and jaundice may occur. In severe forms of the disease, the mental and physical state is disrupted, the skin becomes excessively pale, there is an increase in lymph nodes and liver, body temperature rises, a murmur is heard in the heart, and shortness of breath appears. Hemoglobin levels drop sharply, but red blood cell levels may remain normal. In case of iron deficiency, it must be included in the diet. Treatment of the disease is aimed at correcting nutrition and eliminating the causes that cause it.
Anemia in premature babies
Anemia in premature babies occurs in approximately twenty percent of cases, while it is much more common during infancy. The severity of anemia is directly related to the gestational age of the child, which corresponds to the gestational age - the lower it is, the more severe the disease. In the first few months after birth, premature babies weighing less than one and a half kilograms and gestational age less than thirty weeks require a transfusion of red blood cell suspension in approximately ninety percent of cases. Anemia in premature infants is characterized by a progressive decrease in hemoglobin (ninety to seventy g/l or less), a decreased level of reticulocytes (preceding red blood cells in the process of hematopoiesis) and inhibition of bone marrow hematopoietic functions. There are early and late anemias in premature babies. The first, as a rule, develop in the fourth to tenth week after birth. The reticulocyte level is less than one percent, the maximum hemoglobin level is seventy to eighty g/l, the hematocrit value decreases to twenty to thirty percent. Symptoms of anemia in premature infants coincide with the symptoms of general anemia and can manifest themselves in the form of pale skin, rapid heartbeat, etc. In the development of anemia in premature infants, a lack of folic acid, vitamin B6, and microelements such as zinc, copper, selenium, molybdenum, and Negative influence infectious agents. Late anemia in premature babies appears around the age of three to four months. The main symptoms of this disease are loss of appetite, paleness and dryness of the skin and mucous surfaces, an increase in the size of the liver and spleen, and acute iron deficiency.
Degrees of anemia in children
Degrees of anemia in children are divided into mild, moderate and severe. With a mild degree, the child becomes inactive, lethargic, his appetite decreases, his skin turns pale, and the level of hemoglobin and red blood cells decreases slightly. With moderate anemia, activity is noticeably reduced, the child eats poorly, the skin becomes dry and pale, the heart rate increases, the liver and spleen are compacted and enlarged, the hair thins and becomes brittle and brittle, a systolic murmur is heard, the level of hemoglobin and red blood cells decreases. In severe forms of the disease, there is a lag in physical development, muscle weakness, painful thinness, problems with bowel movements, excessive dryness and pale appearance of the skin, brittle nails and hair, swelling of the face and legs, disturbances in the functioning of the cardiovascular system, and decreased saturation of red blood cells. hemoglobin with color indices less than 0.8.
Mild anemia in children
Mild anemia in children may not have pronounced clinical symptoms, while existing iron deficiency provokes further development and complication of the disease. In such cases, timely diagnosis can prevent the progression of the disease. However, it should be noted that in some cases, clinical symptoms with mild anemia can be even more pronounced than with severe anemia. To make a diagnosis, it is necessary to take into account such factors as the level and average volume of red blood cells, color characteristics, the content and concentration of hemoglobin in red blood cells, the presence of iron in the blood serum, etc. There is a simple method for determining iron deficiency at home. If your urine turns pink after eating beets, you most likely have an iron deficiency in your body. In this case, you should consult a doctor.
Anemia 1st degree in children
Anemia of the 1st degree in children is characterized by a decrease in hemoglobin levels to one hundred to eighty grams per liter of blood. At this stage of the disease, external signs of anemia may be absent or paleness of the skin and lips may be observed. To correct the condition after the studies, the attending physician prescribes nutritional therapy and iron supplements.
How to treat anemia in children?
To correctly determine how to treat anemia in children, it is necessary to know exactly the causes and mechanisms of its development. If there is a lack of iron, for example, it is necessary to take iron supplements in combination with a complete and balanced diet. Accept such medicines It is recommended between meals or an hour before meals; the medicine should be taken with natural fruit juices, preferably citrus fruits, if there is no allergic reaction. After normalization of the hemoglobin amount, treatment should be continued after full course. Complex treatment includes complete and proper nutrition, foods containing iron (beef, cod liver, milk, buckwheat, eggs, chicken and rabbit meat, semolina, beef kidneys, walnuts, etc.). Herbal medicine is prescribed for disorders of the digestive system and malabsorption of nutrients. To normalize the intestinal microflora and relieve inflammatory processes, mint and chamomile decoctions, as well as decoctions of rose hips, sage, oak bark, and St. John's wort are recommended for use. The complex treatment also includes preparations containing vitamins and minerals. For iron deficiency, the drug hemoferon is used. Hemoferon is taken orally half an hour before meals. The dosage is calculated based on body weight: three to six milligrams of hemic iron per kilogram of body weight. The approximate dosage for children under three months of age is 2.5 ml, from four to nine months - 5 ml, from ten months to one year - 7.5 ml, from one to three years - about 10 ml, from four to six years - 12.5 ml, from seven to ten years - 15 ml.
Treatment of iron deficiency anemia in children
Treatment for iron deficiency anemia is primarily aimed at eliminating the cause of the disease and replenishing iron reserves in the body with the help of iron-containing drugs. The basic principles in the treatment of iron deficiency conditions in children are the following:
- Compensation for iron deficiency with the help of medications and a therapeutic diet.
- Continue treatment after normalization of hemoglobin levels.
- Carry out blood transfusion in emergency cases only if there is a threat to life.
The drugs used in ferrotherapy are divided into ionic (salt and polysaccharide iron compounds) and non-ionic (part of the hydroxide-polymaltose complex of ferrous iron). The daily daily dose of an iron-containing drug is calculated taking into account the age of the child. The recommended daily dose of salt preparations containing iron for the treatment of iron deficiency for children under three years of age is 3 mg/kg body weight; for children aged three years and over – 45–60 mg of elemental iron per day; for persons adolescence– up to 120 mg/day. When using preparations of trivalent iron hydroxide-polymaltose complex, the daily dosage for young children is 3–5 mg/kg body weight. The positive effect of taking iron supplements appears gradually. After normalization of hemoglobin levels, an improvement in muscle condition is noted; two weeks after the start of treatment, an increase in the level of reticulocytes is noted. The disappearance of clinical symptoms of anemia is observed, as a rule, one to three months after the start of therapy, and complete replenishment of iron deficiency is observed after three to six months from the start of treatment. The daily dose of an iron-containing drug after increasing hemoglobin levels is half the therapeutic dose. If treatment is not completed, there is a high probability of relapse of the disease. For intramuscular administration of iron, the drug Ferrum Lek is used. The maximum daily dose for intramuscular injections for children weighing up to five kilograms is 0.5 ml, for children weighing from five to ten kilograms - 1 ml. The approximate duration of treatment for mild anemia is two months, for moderate anemia - two and a half months, for severe anemia - three months.
Nutrition for anemia in children
Proper and nutritious nutrition for anemia in children is very important. In the first months after birth, the baby should receive the required amount of iron through mother's milk. With the further introduction of complementary foods (at about six to seven months of age), breast milk improves the absorption of iron from other foods. Children who are low in weight, who are often ill, or who were born much earlier than expected are especially in need of monitoring their iron intake. Starting from eight months, the child’s diet should include meat, which is a complete source of iron, buckwheat and barley porridge. Starting from the age of one year, in addition to meat, the diet should include fish. Eating meat and fish products together with vegetables and fruits improves the absorption of iron from them. Taking vitamin C also improves the absorption of iron. Nutrition for anemia in children may include dishes and products from dietary table No. 11. Diet No. 11 includes foods high in calories, the required amount of proteins, fats and carbohydrates, vitamins, and minerals. The recommended diet is five times a day. Dietary table No. 11, recommended for feeding children with anemia, includes the following dishes and products: bread, flour products, soups, meat, fish, liver, cottage cheese, cheese, butter, eggs, buckwheat, oatmeal, pasta, pea or bean puree, berries, vegetables, fruits, natural bee honey, rose hip decoction.
Prevention of anemia in children
Prevention of anemia in children is carried out using laboratory blood tests in order to timely detect and prevent further development of mild forms of anemia. The local pediatrician, based on a general examination and laboratory data, prescribes the necessary preventive measures. The risk group includes children with a hereditary predisposition to this disease if the mother had iron deficiency in the body during pregnancy, late toxicosis, swelling or other factors that inhibit the process of hematopoiesis in the fetus. Also at risk are children with low birth weight; children who are bottle-fed and do not receive enough nutrients; children born during premature pregnancy. Children born during premature pregnancy are prescribed iron supplements for preventive purposes from the third month after birth until two years of age. Prevention of anemia in children also consists of a complete and balanced diet containing the required amount of proteins, vitamins and minerals. The child should eat meat, liver, eggs, fish, cheeses, cottage cheese, vegetables and fruits, and natural juices. To strengthen the body overall, it is necessary to healthy image life, walk in the fresh air, exercise and toughen up.
