What is the iron-deficiency anemia in children？

What is iron-deficiency anemia in children?

Iron-deficiency anemia is a common health problem in children. The most common cause of iron-deficiency anemia in children is not getting enough iron. Iron-deficiency anemia in children does not have enough red blood cells or enough hemoglobin. Hemoglobin is a protein that lets red blood cells carry oxygen to other cells in the body. Iron is needed to form hemoglobin.

What causes iron-deficiency anemia in a child?

Iron-deficiency anemia can be caused by:

Diets in iron-deficiency anemia. A child gets iron from the food in his or her diet. But, only a small amount of the iron in food is actually absorbed by the body.
- Full-term newborns, born to healthy mothers, have iron that they get during the last 3 months of pregnancy.
- Infants of mothers with anemia or other health problems may not have enough iron stored. And infants born early may not get enough iron.
- At 4 to 6 months of age, the iron stored during pregnancy is at a low level. And more iron is used as the infant grows.
- The American Academy of Pediatrics (AAP) advises feeding your baby only breastmilk for the first 6 months. But breastmilk does not have a lot of iron, so infants that are breastfed only, may not have enough iron.
- Older infants and toddlers may not get enough iron from their diets.
Body changes in iron-deficiency anemia. When the body goes through a growth spurt, it needs more iron for making more red blood cells.
Gastrointestinal tract problems in iron-deficiency anemia. Poor absorption of iron is common after some forms of gastrointestinal surgeries. When you eat foods containing iron, most of the iron is absorbed in the upper small intestine. Any abnormalities in the gastrointestinal (GI) tract could alter iron absorption and cause iron-deficiency anemia.
Blood loss in iron-deficiency anemia. Loss of blood can cause a decrease of iron. Sources of blood loss may include gastrointestinal bleeding, menstrual bleeding, or injury.

What are the symptoms of iron-deficiency anemia in children?

1. The pathophysiological process of iron-deficiency anemia includes three stages

(1) Iron-deficiency anemia phase: In this phase, the body's iron reserves are reduced, but the amount of iron used by red blood cells to synthesize hemoglobin is not reduced.

(2) Iron-deficiency anemia in erythropoiesis: In this stage, stored iron is further depleted and the amount of iron required for erythropoiesis is insufficient, but the amount of circulating hemoglobin is not reduced.

(3) Iron-deficiency anemia stage: small cell hypochromic anemia with some non-hematopoietic symptoms.

2. Clinical manifestations of iron-deficiency anemia in children

It can occur at any age, the onset is slow and most of the time of onset cannot be determined, and many children go to the doctor for other diseases before they are found to have this disease. The clinical manifestations vary with the severity of the disease.

(1) General manifestations: gradual pallor of the skin and mucous membranes, especially on the lips, oral mucosa and nail beds. Easy fatigue and weakness, inactivity. Older children may complain of dizziness, dark eyes, and tinnitus.

(2) Extramedullary hematopoiesis: The liver and spleen may be slightly increased due to extramedullary hematopoietic reaction. The younger the age, the longer the disease duration, the more severe the anemia, and the more pronounced the enlargement of the liver and spleen.

3. Non-hematopoietic iron-deficiency anemia symptoms

1) Digestive symptoms: Loss of appetite, a few have xenophagia, such as a preference for mud, wall skin, cinders, etc. Vomiting and diarrhea may occur. Stomatitis, tongue inflammation or atrophy of the tongue papillae may occur. Severe cases may have atrophic gastritis or malabsorption syndrome.

2) Neurological symptoms: manifested as irritability or discomfort, the elderly tend to have poor concentration, memory loss, and lower intelligence than children of the same age.

3) Cardiovascular system symptoms: increased heart rate due to obvious anemia, severe heart enlargement, and even heart failure.

4) Other manifestations: often accompanied by infections due to low cellular immune function. Fingernails and toenails may be reversed due to epithelial abnormalities.

Children are born with iron stored in their bodies, but a steady amount of additional iron is needed to fuel a child's rapid growth and development. Here's a guide to iron needs at different ages:

Age group	Iron-deficiency anemia in children
7 - 12 months	<11 mg
1 - 3 years	<7 mg
4 - 8 years	<10 mg
9 - 13 years	<8 mg
14 - 18 years, girls	<15 mg
14 - 18 years, boys	<11 mg

How is iron-deficiency anemia treated in children?

Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is.

To prevent iron-deficiency anemia:

Beginning at 4 months of age, infants that are only breastfed or partially breastfed should be given a daily iron supplement until they begin eating iron-rich foods.
Infants that are formula-fed do not need iron supplements. The formula has iron added to it. Whole milk should not be given to infants less than 12 months old.
Infants and toddlers from 1 to 3 years old should have foods rich in iron. They include cereal that has iron added, red meats, and vegetables with iron. Fruits with vitamin C are also important. The vitamin C helps the body absorb the iron.

Treating iron-deficiency anemia includes:

Iron supplements. Iron drops or pills are taken over several months to increase iron levels in the blood. Iron supplements can irritate the stomach and discolor bowel movements. They should be taken on an empty stomach or with orange juice to increase absorption. They are much more effective than dietary changes alone. If the child can’t take drops or pills, IV iron may be needed, but this is very unusual.
Iron-rich diet. Eating a diet with iron-rich foods can help treat iron-deficiency anemia. Good sources of iron include:
- Iron-enriched cereals, breads, pasta, and rice
- Meats, such as beef, pork, lamb, liver, and other organ meats
- Poultry, such as chicken, duck, turkey, (especially dark meat), and liver
- Fish, such as shellfish, including clams, mussels, and oysters, sardines, and anchovies
- Leafy greens of the cabbage family, such as broccoli, kale, turnip greens, and collards
- Legumes, such as lima beans and green peas; dry beans and peas, such as pinto beans, black-eyed peas, and canned baked beans
- Yeast-leavened whole-wheat bread and rolls

References

1. Iron-Deficiency Anemia in Children | Cedars-Sinai

2. Iron deficiency in children: Prevention tips for parents - Mayo