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ANEMIA, IRON-DEFICIENCY
ANEMIA, IRON-DEFICIENCY
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GENERAL INFORMATION
DESCRIPTIONIron-deficiency anemia means a decreased number of circulating blood cells, or insufficient hemoglobin in the cells due to an inadequate supply of iron for optimal formation of red blood cells. Anemia is not a disease but is a symptom (as is fever) of other disorders. For proper treatment, the cause must be found. The blood, which affects all body cells, and the bone marrow are involved.
Appropriate health care includes:
Physician's monitoring of general condition and medications.
Self-care after diagnosis.
SIGNS & SYMPTOMS
Signs of pronounced anemia include tiredness and weakness; paleness, especially in the hands and lining of the lower eyelids.
Less common signs include tongue inflammation; fainting; breathlessness; rapid heartbeat; unusual quietness or withdrawal; loss of appetite; abdominal discomfort; cravings for ice, paint, or dirt; susceptibility to infection.
CAUSES
Decreased absorption of iron or increased need for iron. Causes in infants and children include poor nutrition (between 6 months and 2 years of age, children may consume large quantities of milk, to the exclusion of iron-containing foods); premature birth (premature babies often have low stores of iron at birth).
Causes in adolescents include rapid growth spurts; heavy menstrual bleeding; pregnancy; malabsorption of iron; gastrointestinal disease with bleeding, including cancer.
RISK FACTORS
Poverty; recent illness, such as an ulcer, diverticulitis, colitis, hemorrhoids, or gastrointestinal tumors.
PREVENTING COMPLICATIONS OR RECURRENCEMaintain an adequate iron intake for your child through a well-balanced diet or iron supplements. Provide iron-fortified formula for bottle-fed infants. Most children under 2 should receive supplemental iron to prevent this anemia. Foods with high iron content include meat, fish, poultry, whole or enriched grain, and foods high in ascorbic acid (such as citrus).
BASIC INFORMATION
MEDICAL TESTS
Your own observation of symptoms.
Medical history and physical exam by a doctor.
Laboratory blood studies, especially of hematocrit (See Glossary), hemoglobin, and red-blood-cell counts.
X-rays of the gastrointestinal tract.
POSSIBLE COMPLICATIONSFailure to diagnose a bleeding malignancy.
PROBABLE OUTCOME
Usually curable with iron supplements if the underlying cause can be identified.
TREATMENT
HOME CAREThe most important part of treatment for iron-deficiency anemia is to correct the underlying cause. Iron deficiency can be treated well with iron supplements. Blood transfusions are sometimes prescribed, but they should be unnecessary, except in rare instances. Your child should avoid crowds and other sources of infection as much as possible.
MEDICATION
Your doctor may prescribe iron supplements. Have your child follow these instructions for best absorption:
Take iron on an empty stomach (at least 1/2 hour before meals). If it upsets your stomach, take it with a small amount of food (except milk).
If you take other medications, wait at least 2 hours after taking iron before taking them. Antacids and tetracyclines especially interfere with iron absorption.
Because liquid iron supplements may discolor the teeth, drink any liquid iron preparation through a straw. Iron supplements may also cause black bowel movements, diarrhea, or constipation.
Instructions for parents:
Continue iron supplements 2 to 3 months after blood tests are normal.
Too much iron is dangerous. A bottle of iron tablets can poison a child. Keep iron supplements out of the reach of young children.
ACTIVITY
No restrictions.
DIET & FLUIDS
Limit your child's milk intake to 1 pint a day (do not limit milk for infants whose diet is solely milk). Milk interferes with iron absorption.
Encourage your child to eat protein- and iron-containing foods, including meat, beans, and leafy green vegetables.
Increase dietary fiber to prevent constipation.
Try to provide favorite foods and keep your child company while eating.
OK TO GO TO SCHOOL?
When signs of the condition have decreased, appetite returns, and alertness, strength, and feeling of well-being will allow.
Have your child pace activities and rest until anemia is cured.
CALL YOUR DOCTOR IF
Your child has symptoms of anemia.
Nausea, vomiting, severe diarrhea, or constipation occur during treatment.
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From Complete Guide to Pediatric Symptoms, Illness & Medications by H. Winter Griffith, M.D. Copyright by Putnam Publishing
Group. Electronic rights by Medical Data Exchange.
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