Iron Deficiency Recommendations/Prevention/Screening Flashcards
Definition of Anemia?
Hgb that is 2 SDs below mean Hgb concentration for normal population of same gender/Age
Anemia is defined as a Hgb concentration of less than ___ g/dL for both male and female children age 1-3 yo.
11.0
What is the storage form of iron?
Serum Ferritin
When does a term newborn baby receive most of their iron in utero?
Third Trimester
What is the estimated daily iron requirement for preterm infants?
2-4 mg/kg/day PO
What is the estimated daily iron intake for term infants age 0-6 months who are exclusively breastfed?
0.27 mg/day
What is the recommended dietary allowance of iron for term infants age 7-12 months?
11 mg/day
What is the recommended dietary allowance of iron for term toddlers aged 1-3 years?
7 mg/day
What mineral does IDA increase intestinal absorption of?
Lead
How does IDA affect chelation therapy in patients with concomitant lead poisoning?
IDA decreases effectiveness of chelators
- giving supplemental iron helps increase effectiveness of chelators
What effect does supplemental iron affect patients with IDA and concomitant lead poisoning when chelation therapy is not occuring?
it will increase blood lead concentrations and decrease basal lead excretion
What three lab findings provide the most information about iron status?
- Serum ferritin concentration
- reticulocyte hemoglobin concentration (CHr)
- Transferrin Receptor 1 (TfR1) concentration
1 microgram/L of transferritin accounts for what amount of available storage iron?
8-10 mg
What is the suggested cutoff value of SF in pediatric patients? What must be checked when checking SF to rule out inflammation?
Cutoff: 10 micrograms/L
- check CRP = inc. CRP means inflammation (SR is acute phase reactant)
What lab value is the strongest predictor of Iron Deficiency in children?
Reticulocyte Hgb Concentration (CHr)
To establish a diagnosis of IDA, what three tests must be obtained?
- Hgb < 11.0 g/dL
AND
- SF + CRP levels
OR
- CHr concentration
Using iron supplementation to diagnose IDA, what amount of iron increase in 1 month signifies likely IDA?
1 g/dL increase over 1 month
A breastfeeding preterm infant (< 37 weeks gestation) should receive what amount of iron supplementation and when?
2 mg/kg/day
starting at 1 month and lasting through 12 months of age
What is the AAPs recommendation on exclusive breastfeeding length?
Why do they recommend this, in the context of IDA?
minimum of 4 months but preferably 6 months
- low iron values in breastmilk, increased risk of IDA by 9 months of age if exclusively breastfed past 6 months
Exclusively breastfed term infants should receive how much iron supplementation and for how long?
1 mg/kg/day starting at 4 months until appropriate iron-containing foods have been introduced
What is the iron requirement for toddlers (1-3 yo)?
7 mg/day
What affect does Vitamin C (ascorbic acid) have on iron absorption?
INCREASES iron absorption
When should universal screening for anemia take place in children?
at 1 year of age
How long do term, healthy infants iron stores typically last for?
4 months
How much iron is typically found in formula?
10-12 mg/L
Toddlers not receiving appropriate iron intake can take what form of iron supplement?
LIQUID –> chewable tablets not recommended till >3 years old
