Symptoms of iron deficiency anemia in babies

Written by Hu Qi Feng
Pediatrics
Updated on September 03, 2024
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Any age can develop the disease, but it is most commonly seen between six months and two years old, with a relatively slow onset. Generally, there is a gradual pallor of the skin and mucous membranes, most notably in the eyes, lips, oral mucosa, and nail beds. Affected children tend to be fatigued and less active, and older children may experience symptoms such as dizziness and darkening before the eyes. Physical examination may reveal enlargement of the liver, spleen, and lymph nodes; the more severe the anemia, the more pronounced the enlargement. Anemia can lead to a decreased appetite, and in some cases, pica, such as a craving to eat non-food items like soil or walls, may occur. Symptoms may also include vomiting, diarrhea, glossitis, and stomatitis. There is a general listlessness, lack of concentration, impaired memory, and intelligence that may be lower than peers of the same age. Iron deficiency anemia can also lead to decreased cellular immune function, making infections more likely.

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Written by He Li Fang
Hematology
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How long does iron deficiency anemia need to be treated?

Patients with iron deficiency anemia typically need several months of iron supplementation treatment. The specific reason is that after taking iron supplements, patients' subjective symptoms can recover quickly. The count of reticulocytes generally begins to rise within three to four days after starting the medication, reaching a peak around seven days. Hemoglobin levels notably increase within two weeks of treatment, and generally return to normal around two months. After correcting anemia, it is necessary to continue treatment for at least another three months because the body's iron stores need further supplementation. It is necessary to restore serum ferritin levels to fifty micrograms per liter to replenish these stores fully. This is required to achieve a true cure of iron deficiency anemia, as without this, patients are prone to relapse. Therefore, regular and long-term effective use of iron supplements is an essential basis for ensuring the treatment effectiveness of iron deficiency anemia.

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Written by He Li Fang
Hematology
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Causes of Iron Deficiency Anemia

There are many reasons for iron deficiency anemia, which we can categorize into several aspects. The first aspect is a decrease in iron intake, including diet, meaning insufficient dietary intake. The second aspect is decreased absorption, such as the absence of a target organ for absorption or the lack of stomach acid affecting its absorption efficacy. The second aspect refers to excessive loss, most commonly chronic gastrointestinal bleeding, such as in patients with tumors, duodenal ulcers, gastric ulcers, gastritis, ulcerative colitis, a parasitic infection with hookworms, as well as hemorrhoids, and arteriovenous malformations, all of which can cause gastrointestinal bleeding leading to increased iron loss. Excessive menstrual flow in female patients, multiple blood donations, and multiple pregnancies can all lead to iron deficiency. These are the various causes related to iron deficiency.

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Written by He Li Fang
Hematology
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What to eat for dietary supplementation in iron deficiency anemia

The dietary plan for patients with iron-deficiency anemia first involves increasing the intake of iron-rich foods, such as animal liver, blood, soybeans, black fungus, sesame paste, brown sugar, lean meat, egg yolks, pork and lamb kidneys, and dried fruits. Second, it is recommended to appropriately supplement with vitamin C, as taking iron supplements and vitamin C together can increase iron absorption, thereby achieving better iron supplementation effects. Thirdly, patients are advised to change their dietary habits to increase the intake and bioavailability of nutrients like vitamin A, vitamin B2, folic acid, and vitamin B12, which are involved in the production of red blood cells. Supplementing these nutrients can also enhance the utilization of iron from food, thereby assisting in the treatment.

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Hematology
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Characteristics of iron deficiency anemia blood picture

The clinical manifestations of iron deficiency anemia are due to the specific characteristics of anemia caused by iron deficiency and the underlying disease causing the iron deficiency. Its hematological characteristics present as typical microcytic hypochromic anemia. What does this concept mean? It refers to the values in a complete blood count where MCV is less than 80 femtoliters, MCH is less than 27 picograms, and MCHC is less than 30%. MCV refers to the average red blood cell volume, MCH refers to the mean corpuscular hemoglobin concentration, and MCHC refers to the mean corpuscular hemoglobin concentration of red blood cells. The extent of changes in red blood cell indices correlates with the duration and severity of anemia. The blood smear typically shows pale-stained red blood cells with an enlarged central pallor and varying sizes. Platelet count often tends to be high when there is concurrent bleeding and generally tends to be low in infants and children. White blood cell count is usually normal or slightly reduced, with normal differential. These are the hematological characteristics of iron deficiency anemia.

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Hematology
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The causes of iron deficiency anemia

The causes of iron deficiency anemia primarily refer to the disruption of the normal dynamic balance between iron absorption and excretion, leading to the consumption of stored iron as well as an increased need for iron and insufficient iron intake, especially in cases of chronic blood loss, resulting in a long-term negative iron balance. The causes of iron deficiency can be divided into two main aspects: insufficient iron intake and excessive iron loss. In the first aspect, decreased iron intake includes dietary insufficiency, meaning inadequate food intake, and reduced absorption, which includes decreased absorption due to lack of stomach acid and reduced absorption following gastric surgery. Excessive iron loss includes the following eight aspects: 1) gastrointestinal bleeding, which includes bleeding caused by tumors, gastrointestinal ulcers, gastritis, as well as bleeding due to parasites and hookworm infections. It also includes bleeding caused by hemorrhoids in men and arteriovenous malformations; 2) excessive menstrual bleeding; 3) frequent blood donations; 4) multiple pregnancies in women; 5) chronic intravascular hemolysis causing hemoglobinuria; 6) hereditary hemorrhagic telangiectasia; 7) primary pulmonary hemosiderosis; and 8) coagulation disorders or the use of anticoagulants leading to iron deficiency. These eight categories all result from excessive loss of iron, causing iron deficiency which leads to iron deficiency anemia.