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ANEMIA IN CHILDREN

Dr. Elias Jimenez

Anemia is present when the hemoglobin levels are below the normal ones for a certain age and sex.

A child is born with a high level of hemoglobin, in general it is more than 15 g/dl, and it starts to decrease slowly during the child's first months of age, reaching 9 g/dl by the time the child is 3 months old. This levels then start to increase back gradually, to the point that when the child is 1 year old it is normal that it has reached 12 g/dl or more. After adolescence, a normal value for a boy is 13 g/dl and for a girl it is approximately 1 g/dl lower.

Hemoglobin levels change with age, they change with sex after adolescence, and also with the location of the residence. For example, people that live near the coast will have lower levels and the higher the altitude the higher the levels of hemoglobin. All of these points have to be taken into consideration before the result of a hemoglobin test can be interpreted.

The different factors that cause anemia vary with the age of the child, but in general the most common cause in all ages (especially in children 1 to 2 years old) is iron deficiency, or ferropenic anemia.

An adequate quantity of iron is essential in the child's diet, especially during his first years of age and his adolescence.

To prevent ferropenic anemia, the American Academy of Pediatrics clearly suggests that: every child who is being fed with canned milk should receive extra iron as soon as he reaches four months of age, after his six months if he is being breast fed, or as soon as he reaches his first month if he is premature.

Most children drinking iron enriched canned milk receive the necessary amount of if and this can be bought in any grocery store and have a very good quality. On certain occasions it is necessary to provide the child with extra iron through drops, and this will be left to the pediatrician's criteria.

If the child is being breast fed the iron he receives is absorbed better and the need for extra iron decreases, which adds to all the other advantages of maternal milk. Even if this is the case, when the child reaches his six months he must be given extra iron, which can be done through an iron enriched cereal or iron drops.

An iron-enriched cereal is a very good alternative, but one has to be sure that the appropriate quantity is given; this is usually reached by feeding the child 6 to 8 small spoons of cereal a day.

A child who is a year old or younger should not drink regular milk since it has been proven that it may cause intestinal bleeding in young ones and therefore increase the iron deficiency in some children.

Several studies have shown that ferropenic anemia can alter the child's growth in a permanent way, from here the importance of preventing it.

To prevent ferropenic anemia in adolescence is easier as their diet is very varied, they eat everything they find, and if the doctor find it necessary, iron tablets may be given to them.