Over the course of 4 months, the child’s hemoglobin dropped. The child has low hemoglobin in the blood: why and what to do. Why does iron deficiency anemia occur in children?

In a healthy child, the hemoglobin content in the blood should be as follows:

In newborns - 130 g/kg;

In the first three months of life - 95-100 g/kg;

At 1-3 years: 110 g/kg;

In children from 4 to 12 years old - 115 g/kg.

If the blood test showed lower numbers, the doctor will diagnose “low hemoglobin” and... Will he give recommendations for enhanced nutrition? Yes and no at the same time. Low hemoglobin will return to normal only if the true causes of this problem are eliminated.

Why does hemoglobin decrease?

There can be many reasons for a decrease in the level of hemoglobin in a child’s blood. Most often, hemoglobin decreases in children aged two years and during adolescence. The reasons for this are active growth and insufficiently balanced nutrition. In the vast majority of cases, this problem of low hemoglobin is solved by increased nutrition, sometimes with the help of iron-containing drugs. But remember that iron-containing drugs cannot be prescribed independently: a sharp increase in the level of iron in a child’s blood is no less dangerous than its deficiency!

But sometimes, despite the measures taken, it is still not possible to increase the hemoglobin content in the child’s blood. In this case, the doctor prescribes additional studies of the body in order to exclude diseases such as impaired absorption of iron and vitamin B12 in the gastrointestinal tract, chronic atrophic gastritis, chronic enteritis, immune-related diseases, etc.

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How to increase hemoglobin in a child

If all serious causes of the problem of low hemoglobin in the child’s blood are excluded, the doctor will recommend the child approximately the following diet:

1. Animal products rich in iron. Even if your entire family adheres to the principle of strict vegetarianism, exceptions must be made for a child during his period of intensive growth. Yes, there are plenty of plants in nature whose fruits are rich in iron. But this iron, unfortunately, is less absorbed by the body. Therefore, enrich your baby’s menu with liver and red meat. Egg yolks are also necessary for the baby.

The condition of anemia, or anemia, is a fairly common phenomenon in children of all ages. It is characterized by the hemoglobin content in red blood cells being below the required norm, which disrupts the delivery of oxygen to tissues and organs. Every parent should know the dangers of low hemoglobin in a child in order to recognize the symptoms in time and provide the necessary treatment.

Consequences of anemia in children

In most cases, the child’s parents do not go to see a doctor with complaints about low hemoglobin levels, but learn about the pathological condition only after a blood test. The negative impact on all organs and systems is aggravated by asymptomatic anemia. Low hemoglobin in a child under one year of age, the consequences of which are especially dangerous, is especially difficult to tolerate, since during this period internal organs are intensively developing, requiring oxygen and intensive blood supply.

The consequences of low hemoglobin in a child may not appear immediately, and have the following effects on the body:

Possible outcomes

When the correct diagnosis is made and subsequent treatment is carried out in compliance with the necessary nutritional requirements and regimen, in most cases a favorable outcome is observed.

In case of untimely treatment, when the condition enters an advanced stage, or lack thereof, the following outcomes are possible:

1. A decrease in hemoglobin to 100-80 g/l of blood provokes in children constant fatigue, enlarged liver, swelling of the extremities, diseases of the mucous membranes and skin, as well as all types of developmental delays. A sharp drop in the indicator without treatment often leads to hypoxic coma.
2. Untreated anemia in children for a long time, the consequences of which manifest themselves in the body’s unsuccessful attempts to saturate the tissues with oxygen, causing the heart to contract with redoubled force, can cause the most terrible complication is cardiomyopathy and, as a result, heart failure. Further development of dilatation of the left ventricle over time leads to its hypertrophy and death.

How to avoid

Anemia in newborns most often occurs when hemoglobin is low during pregnancy. To prevent this condition, the expectant mother needs to provide proper nutrition and apply special preventive measures. For this purpose, in the last period of pregnancy, iron and vit supplements are taken. E, and for newborns, natural feeding and the necessary introduction of complementary foods are recommended.

The severe consequences of low hemoglobin in a child oblige parents to undergo periodic examinations to identify anemia at the initial stage and timely initiation of treatment. To prevent anemia, children's nutrition must be complete with a sufficient content of essential vitamins, minerals and proteins to ensure the process of hematopoiesis.

A low hemoglobin level in a child is not a simple indicator, but a sign of a dangerous condition, which, in the absence of proper and timely treatment, can have a detrimental effect on a person’s entire future life, and sometimes lead to death. The key to the absence of anemia in a newborn baby is the pregnant woman’s concern for her health, and a properly organized diet and lifestyle ensures that the child will never encounter this pathological condition.

In the early stages of a baby’s life, most young parents are faced with such a disease as low hemoglobin in an infant. This phenomenon is quite common not only among young children, but also among adults. Initial signs of low hemoglobin may already appear. This blood disease has been well studied, it is quite understandable from a medical point of view, the physiology of the child, the causes of its occurrence, symptoms and methods of treatment have been sufficiently studied.

General information about hemoglobin

Low hemoglobin(in medicine - anemia, iron deficiency anemia) is a low content of red blood cells in the blood. The main task of red cells is to transport and distribute oxygen molecules to organs and tissues to obtain energy and ensure the vital functions of the body. A low hemoglobin level will negatively affect the overall development and physical condition of the infant.

Infants under one year of age should not have a hemoglobin level in their blood below 105 g/l. In children in the second year of life, anemia is indicated by the indicator less than 100 g/l.

Causes of hemoglobin loss in the body

There are many reasons for the decrease in red blood cells in the blood of an infant. Factors that may contribute to this include:

• External (surgeries, unbalanced diet, anemia of the pregnant mother);
• Internal (hereditary pathology, immune, infectious diseases);
• Features of intrauterine development.

Intrauterine period of development and formation of the child’s body depends entirely on the health of the mother, organizing her proper nutrition, the presence/absence of bad habits, hereditary diseases, etc. The supply of iron accumulated by a newborn during intrauterine development will be enough for about the first six months. After this time, a decrease in hemoglobin occurs. In the future, normal hemoglobin levels can be maintained through continued breastfeeding and.

When artificially feeding a baby, the level of red blood cells should be maintained using special fortified baby food with the addition of complementary foods (meat, fish, fruits, vegetables, vitamins) in subsequent months, which can correct the hemoglobin level.

It is necessary to take into account the intensive development and growth of the child in the first year of life, when significant changes occur in height and body weight. Accordingly, the consumption in energy production increases, and therefore in the production of red blood cells, which the body may not be able to cope with for various reasons.

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Conditions for normal hemoglobin formation

1. Breastfeeding should continue for as long as possible.
2. The diet of a nursing mother and a bottle-fed infant must be balanced.
3. Normal functioning of the gastrointestinal tract and hematopoietic system.
4. No acquired or hereditary blood diseases.
5. The presence of animal protein in food.

Symptoms of iron deficiency anemia

Symptoms of low hemoglobin in an infant can be divided into primary and secondary.

Unfortunately, parents do not always pay attention to such primary signs as: decreased appetite, constant weakness, increased fatigue, and the general unsatisfactory condition of the child.

The progression of the disease in the future can be expressed in the following external signs:

• pale skin (up to a jaundiced tint);
• unreasonable increase in temperature to 37.5º;
• dark circles under the eyes;
• drowsiness;
• dizziness;
• cardiopalmus;
• dry skin.

Prevention and treatment of iron deficiency anemia

It is necessary to treat anemia in infants, as it will lead to oxygen starvation of the whole body, will depress the functioning of the nervous system, create the preconditions for a lag in general and mental development, and will worsen the general condition of the baby. Iron deficiency anemia can be easily prevented by balancing your child's diet.

When breastfeeding, the baby's need for iron will be fully satisfied until almost 6 months due to the good digestibility of iron in milk (up to 50%), which is significantly higher than in other products. By the end of the first year of life, the child’s diet has been significantly expanded, thus it is possible to adjust the amount of iron entering the body.

High iron content contains buckwheat, apples, beets, meat, liver, apple and pomegranate juices.

However, pomegranate juice must be diluted with water (1:1) to avoid problems with the gastrointestinal tract.

Thus, in order to increase the hemoglobin level in an infant, you need to eat:

1. Lots of fruits: blueberries, apricots, dried apricots, apples, strawberries, pomegranate;
2. Lots of meat: beef, turkey, liver, veal;
3. Any products made from wheat flour;

Treatment with drugs for anemia (low hemoglobin) must be carried out as prescribed by a pediatrician.

One of the indicators of the completely normal functioning of a child’s body is the level of hemoglobin (a special protein associated with iron that fills red blood cells). A decrease in hemoglobin in the baby’s body leads to the development of sideropenia and these are different stages of oxygen and energy deficiency of cells due to problems with the transfer of oxygen to them. It is hemoglobin that has the properties of binding oxygen molecules, bringing them into tissues, and carbon dioxide, removing them from cells to the lungs and releasing them out of the body. There are plenty of reasons for a decrease in hemoglobin, and it is a mistake to think that this is associated only with diet and a lack of iron in it. What are the roles of this mineral and hemoglobin, why is its reduction dangerous and what to do?

Iron for a child: why and how much is needed?

If we talk about vital minerals that are constantly needed for the full development of a child, then iron will be one of the leading microelements. The total content of this ion does not exceed 3 grams, but its role is so great that the deficiency immediately affects the metabolic processes of the entire body. Iron is a component of enzymes and proteins that perform vital body functions such as transporting oxygen and protecting against infections in the mucous membranes and tissues of the body ( nonspecific immunity ). In addition, due to its presence, motor functions are also carried out. The body synthesizes a special protein - globin , consisting of 4 glomeruli connected by bridges and iron ions ( heme ). Only in this form does it take on the appearance of hemoglobin and can transport oxygen molecules from the pulmonary system to the tissues, and carbon dioxide from the tissues to the lungs.

But the functions of the iron ion are not limited to hemoglobin; it is part of muscle protein myoglobin , which only in combination with heme can maintain the tone of muscle fibers, their excitability and contractility. Therefore, with anemia and iron deficiency, muscle weakness and rapid fatigue often occur.. But that’s not all: iron forms the basis of ferritin, lactoglobulin, lactoferrin and many enzymes, storage proteins (hemosiderin). To summarize all that has been said, the role of iron ions in the body can be described as:

• Carrying out the functions of tissue respiration and oxidation with the formation of energy
• Performing immunostimulating functions due to the synthesis of proteins with protective functions
• Metabolism regulator
• Participant in the processes of building and renewing body tissue.

In this regard, the intake and expenditure of iron in the body must be strictly controlled, dietary iron must be enough to cover all needs, and its increased losses must be immediately compensated.

Sources of iron

A child's body, depending on age, should receive at least 8-15 mg of iron per day, which comes from the intestines (with food, water, supplements or medications).

note

Iron reserves are initially formed in a child from the mother in utero, in the last months of gestation, but then they are actively spent on the needs of their own body, so there are few reserves. If the mother did not eat well during pregnancy or suffered from iron deficiency or iron deficiency, reserves will be initially reduced.

After birth, the baby accumulates iron, which is actively absorbed from the intestines and used to build both hemoglobin and other proteins. If we talk about dietary iron, it is absorbed into the plasma in the form of ions, combining with special carrier proteins, and is sent to the bone marrow to build new red blood cells. Part of it goes to the liver, where with its participation the rest of the body’s proteins are built.

Iron is a common mineral in nature, it is quite abundant in various foods, but the amount of the ion in different types of food varies, as well as the degree of its absorption due to the fact that iron can have different valence. So, if we talk about the types of mineral, it stands out:

• Heme iron , which is built into the hemoglobin of animal tissues or muscle proteins, it is abundant in meat products and the offal category.
• Iron in ionized form , having a di- or trivalent ion. Such iron is usually contained in plant foods; it is absorbed with difficulty, and the trivalent ion can only be absorbed if there is also an ion that converts the valence from three to two. Legumes are the richest in iron, but for good absorption of the mineral they must be consumed with fresh fruits.

Animal foods allow you to absorb up to 25% of iron from them, while from plant foods this is a maximum of 6-8%, which is important if you want to switch to vegetarianism with your child.

The absorption of iron and its absorption depends on many conditions. If there is phytin in food (a protein from cereals), the absorption of iron is inhibited; it binds in the intestines and cannot be absorbed. Dairy products make absorption difficult due to calcium, which competes with iron in terms of absorption. Absorption occurs worse with a deficiency of folate, vitamin C and.

Iron deficiency and its effect on hemoglobin

With iron deficiency, first of all, hematopoiesis suffers, or rather the synthesis of hemoglobin for new red blood cells. Some of the iron comes from the spleen, where old cells are destroyed, but it is not enough to cover all needs due to iron losses that occur daily. Children most often suffer from iron deficiency, which leads to decreased hemoglobin synthesis and anemia. Nutritional problems contribute to the development of low hemoglobin, especially if instead of breast milk or a complete IV formula, the child is fed cow's milk, kefir or semolina.

Problems with hemoglobin lead to problems such as:

• Digestive disorders in the form of enzymatic defects and inflammatory processes in the intestinal wall, disruption of the intestinal microbial balance.
• Allergic disorders with inflammation of the intestinal wall and impaired absorption of iron.

A decrease in hemoglobin below certain standards leads to the formation of anemia, which affects metabolic processes, reduces the body's immune defense and leads to trophic disorders. As a result, problems develop with physical development - growth and weight gain, as well as mental development, rapid fatigue, moodiness, sleep disturbances and cognitive functions.

Hemoglobin norms in children

The amount of hemoglobin in a child’s blood depends on his age, health status and level of activity. Children have the maximum level during the newborn period, on the 4th day of life, and then it decreases due to the destruction of fetal hemoglobin, which was necessary in utero for adequate nutrition. Gradually, fetal hemoglobin is replaced by its adult form. In the first months of life, up to 1.5% of fetal hemoglobin from the total volume is permissible, and in general the amount is about 110-120 g/l, gradually changing by age and gender. By adolescence, the norm for boys will be up to 120-145 g/l, for girls 110-140 g/l. After this age, the norms are the same as among adults. The decrease in hemoglobin in the female body is due to hormonal and physiological characteristics of the body.

If there are problems with the supply of iron, hemoglobin synthesis and losses of iron, blood, various anomalies in the structure and functioning of red blood cells, anemia is formed. But this is far from just iron deficiency anemia, which is most talked about in childhood.

Consequences of anemia in children

A decrease in hemoglobin may not make itself felt for a long time until the numbers reach significant deviations. Manifestations of a decrease in hemoglobin and the anemia caused by this may have nonspecific symptoms, which parents may mistake for other problems until they are diagnosed. Thus, children may be pale, with dark circles or blue under the eyes, they are lethargic and get tired quickly, complain of weakness and malaise. Against the background of stress, both (sharply rapid contraction of the heart) and . Children have dry skin, flaky lips, pale mucous membranes of the mouth and bad nails and hair. They grow worse, eat poorly and sleep anxiously, and are constantly sick.

Hemoglobin deficiency leads to hypoxia of tissues and organs. This is especially critical for those organs that consume large amounts of oxygen and energy - the brain, kidneys, liver and heart. With oxygen deficiency, the oxidation process with the formation of energy is inactive, cells experience energy starvation, which leads to problems in the synthesis of certain substances. In general, cellular and tissue metabolism suffers. This leads to a decrease in muscle tone and activity, impaired cardiac contractility, the excretory function of the kidneys and the synthetic function of the liver suffer. Hypoxia is difficult for the nervous system to tolerate, since its metabolic processes are oxygen-dependent. This threatens to slow mental development and reduce concentration.

Causes of low hemoglobin in children

The most common cause of low levels is iron deficiency, and such anemia accounts for up to 70% of all hemoglobin problems. We have already discussed the mechanisms in detail above, but it is worth remembering that low hemoglobin is not always precisely iron deficiency anemia. There are a number of other reasons and factors influencing its concentration. These include:

Identification and principles of treatment of anemia

It is not difficult to identify hemoglobin deficiency; it is determined by. He can also partially indicate the reasons for the shape, type and size of red blood cells, the amount of special (immature) forms of red blood cells in the blood - reticulocytes. But the exact reasons can be revealed by determining the level of iron and its compounds in the serum, as well as, in some situations, by analyzing bone marrow puncture. Additional tests and instrumental studies are also needed to assess the severity of anemia, the source of blood loss if bleeding is suspected, etc.

The principles of treatment are developed by the doctor after determining the type of anemia and its severity. The basis is:

• A balanced diet with a sufficient supply of iron, as well as microelements (melt, magnesium or manganese), supplementation with vitamin C and rutin, group B - especially folate and cyanocobalamin. The diet must contain animal proteins and by-products; vegetarianism for anemia, especially in young children, is prohibited.
• routine activities, frequent stay in the fresh air, load according to the degree of fatigue.
• treatment of digestive disorders and all disorders caused by anemia during treatment of the underlying disease.
• in case of iron deficiency as the cause of anemia, taking drugs according to age in therapeutic dosages, then switching to preventive ones for a long period.
• prevention of colds and infections through hardening, elimination of nervous system disorders, maintaining a healthy lifestyle.

Alena Paretskaya, pediatrician, medical columnist

Unfortunately, low hemoglobin levels are a fairly common disease in children. This is a factor that has an extremely negative impact on their psychomotor and intellectual development. In this regard, parents need to know what possible signs of this disease in children they need to pay attention to.

Signs of low hemoglobin in a child

Often, low hemoglobin in a child is detected only during a routine laboratory examination, this is explained by the fact that very often the symptoms characteristic of low hemoglobin are either absent altogether or they are quite nonspecific. A child, for example, may get tired quickly, be moody, irritable or drowsy. The skin may be pale and dry. The mucous membranes may also be pale (special attention should be paid to them, for example, to the oral mucosa). Problems with stool may arise (a tendency to both diarrhea and constipation is typical). Many children may not have any of these symptoms, but even their presence rarely leads parents to think about low hemoglobin.

Low hemoglobin for young children is extremely dangerous due to its irreversible consequences. Intellectual, psychomotor and psychoemotional development is inhibited, even if the child is sooner or later prescribed treatment.

There is no doubt that no parent wishes anything bad for their child, but it is not difficult to prevent anemia in a child. It is quite enough to monitor the hemoglobin level at least from time to time, because It is very important to identify its decline at an early stage. In addition, it is necessary to try to eliminate or reduce the influence of factors that reduce hemoglobin, and if they are present, take iron supplements for preventive purposes.

Causes and prevention of decreased hemoglobin in a child

According to statistics, 50% of pregnant women suffer from anemia, and low hemoglobin in young children has a direct connection with its low level in their mothers during pregnancy. Therefore, even during pregnancy, with low hemoglobin, it is necessary to take iron-containing drugs in order to provide the unborn baby with a sufficient amount of iron, which accumulates during intrauterine development and is gradually consumed by the child’s body after birth. Premature babies and children from multiple pregnancies have a particularly high risk of developing anemia.

There are factors that slow down the process of absorption of iron by the body and the formation of hemoglobin, and, accordingly, increase the need for iron in the body. Such factors are allergic reactions, helminthic infestations, acute and chronic diseases, bleeding, as well as frequent use of medications and, of course, insufficient and irrational nutrition.

To maintain normal hemoglobin levels in a child’s blood, it is extremely important that his diet contains sufficient amounts of protein foods and foods containing iron, manganese and copper. Iron is a component of hemoglobin in the blood, and manganese and copper ensure the synthesis of hemoglobin. Manganese is a trace element that plays a huge role in the process of hematopoiesis, but it is important to consider that its maximum effectiveness can only be ensured in combination with other components involved in hematopoiesis. These are primarily copper and iron. The role of copper is to ensure the transport of iron to the bone marrow for normal hematopoiesis and the conversion of inorganic iron supplied with food into the human body into its organic forms - this process is necessary for successful hematopoiesis.

The highest iron content is in beef and pork liver or heart, bran, wholemeal flour, legumes, nuts, and egg yolks. There is a lot of manganese in green leafy vegetables, beets, nuts, cereals, and wholemeal flour. There is a large amount of copper in seafood, green vegetables, legumes and, again, in nuts and wholemeal flour.

Undoubtedly, a balanced diet may be quite sufficient to maintain normal hemoglobin levels in a healthy child. The problem is that not many children eat rationally, and there are not so many absolutely healthy children, but with food alone it is almost impossible to raise an already diagnosed iron deficiency to the required level. In this case, just prescribing a course of treatment with drugs containing iron is the only effective method of increasing hemoglobin levels.

Diagnosis of low hemoglobin levels in a child

The norms for hemoglobin levels depend on the age of the child: in children from 6 months. up to 6 years of age, the hemoglobin level should be no less than 110 g/l, in children after 6 years of age - no less than 120 g/l. Determining your hemoglobin level is not difficult; all you need to do is take a finger prick blood test.

In addition, to make sure that the cause of low hemoglobin in a child is iron deficiency, it is recommended to do a blood test to check iron levels. This test can also diagnose hidden iron deficiency, at a time when hemoglobin levels have not yet fallen below normal. In this case, taking iron supplements will help avoid a decrease in hemoglobin in the child’s blood. At the same time, we should not forget that it is still necessary to monitor this indicator (1-2 times a month).

Today, the choice of iron-containing drugs intended for use by children is quite large. One of them is Totema. Totema is a modern, effective complex preparation, which includes iron, manganese and copper. Totema is a safe drug and can be taken by children over 1 month of age. Available in the form of ampoules with a drinking solution. The contents of the ampoule must be dissolved in water. Dosage of the drug: per 1 kg of child’s weight - 5 - 10 mg. It is enough to take 1 time per day. Typically, the duration of treatment is from 3 to 6 months.