Iron Deficiency Anaemia

Question 1

What is the most common cause of anaemia in children?

Answer 1

-iron deficiency is the most common cause of anaemia in children

IT IS ALSO THE MOST COMMON NUTRITIONAL DEFFICIENCY WORLDWIDE

Question 2

What will the haemantinics of a patient with IDA look like?

Explain Iron deficiency anaemia to a parent.

Answer 2

Microcytic, hypochromic

The blood is filled with RBC which carry the oxygen round the body. The body needs iron to form RBC. lack of iron means less RBC produced (leading to tiredness, headaches, dizziness). Extremely common condition

Question 3

What are the three main causes of IDA?

Answer 3

-Poor intake (bad diet, fussy kids, 1yr old required 8mg/day)
-Poor absorption (coeliac
Blood loss (Meckel’s diverticulum, haemolytic disease newborn)

Question 4

How do breast milk, formula and cow’s milk compare as iron sources?

Answer 4

• Breast milk has low levels but absorption is good and so it is a GOOD SOURCE
• Formula milk is supplemented so it is a GOOD SOURCE
• Cow’s milk is a POOR SOURCE (baby cant absorb iron)

Question 5

Once a child has been weaned what is the leading source of iron in their food?

Answer 5

Breakfast cereals - these are usually supplemented with iron

Question 6

What are some common causes for a child with IDA? (3)

Answer 6

• Delay in weaning the child (beyond 6 month) - rate of growth cannot be supported by milk alone
• Diet insufficient in iron rich foods - this is usually the case in children who still consume a lot of Cow’s milk
• Poor intake of fruit and veg - not only do some of these contain iron but absorption of iron is markedly increased when ingested with bit C (found in fruit and veg)

Question 7

What are some good dietary sources of iron?

Answer 7

Dark leafy vegetables (kale, broccoli, spinach)
Pulses and beans 
Wholemeal products 
Fortified cereals
Dried fruit 
Nuts and seeds 
Oily fish  
Red meats
Liver and kidney

Question 8

What are some commonly seen clinical features of IDA?

remember to ask in history:

Answer 8

• Easy tiring and fatigue
• Pale - pallor of the palmar crease and of the tongue

HISTORY OF TIREDNESS

• Always ask about hx of blood loss
• Do they ever try and eat inappropriate foods (rubber, soil, sand)

Question 9

What investigations should be done in IDA?

Answer 9

• FBC (low MCV and MCH) and low Hb

- Serum ferritin

Question 10

How do you managed IDA?

How long should IDA be treated for?

Answer 10

• For the vast majority it will be DIETARY ADVICE as well as possible supplementation with oral iron (SYTRON)
• Should be treated until iron is within normal limits and then for 3 months after to replenish iron stores