Prevention of Nutritional Anemias Flashcards
Risk factors for Iron Deficiency?
Children living at or below the poverty level
Black and Hispanic children
Risk factors for Iron deficiency Anemia?
Childhood obesity
History of prematurity
Low-birth-weight
Immigrant groups
How much of the daily iron need should come from diet in infants and children?
30%
The normal term infant is replete of iron the first how many months?
5-6 mo
What condiditons can lead to iron deficient anemia in infants?
5
- Prematurity:
- Fetal-maternal hemorrhage
- Twin-twin transfusion syndrome
- Other perinatal hemorrhagic events
- Insufficient dietary intake
What factors in prematurity lead to iron deficeint anemia?
3
- smaller total blood volume at birth
- increased loss through phlebotomy
- gastrointestinal absorption 4. despite decreased ferritin concentrations
Dietary factors leading to IDA?
4
- insufficient iron intake
- Poor iron absorption
- Early introduction to cows milk
- Meds: aspirin and NSAIDS
What type of malabsorption states lead to IDA?
4
Celiac disease
Crohn’s disease
Giardiasis
Resection of the proximal small intestine
Why does ealry introduction of cow’s milk lead to IDA?
2
- Occult blood loss secondary to cow’s milk intolerance
2. Whole cow’s milk increases intestinal blood loss in infants
If an infant is breast fed when should they recieve iron supplementation?
What if they are on formula?
at 4 months/premature start at 1 month
Formula fed use iron rich formula
When should we avoid feeding ababy cows milk?
until 12 months
No more than 20 oz a day until 5 yrs
What kind of anemia is IDA?
Microcytic, hypochromic,
What is the most common presentation for a child/infant with IDA?
Most common presentation is asymptomatic, well nourished child w/ mild microcytic, hypochromic anemia
What can IDA cause in infants?
3
- impaired psychomotor and/or
- mental development/
- cognitive impairment
What is the most important screening test for detecting IDA?
careful dietary history
What are the dietray risk factors that could cause IDA?
For infants:
For preschool aged kids:
- Infants: use of low iron formula, cow’s milk, goat’s milk or soy milk before 1 yr of age
- Pre-school age children: milk intake > 24 oz a day, fewer then 3 servings daily of iron rich foods (iron fortified cereal/meats)
When should risk assessment for iron deficiency be done in infants and children according to the AAP?
4, 18, and 24 months of age, and annually thereafter
What blood test is reccommended at 12 mo of age by the AAP?
What is an abnormal level for Hg?
Ferritan can be measured but why is it not an accurate idea of iron levels?
A hemoglobin or hematocrit is recommended at 12 months of age
Hg
In what conditions do you have a microcytic anemia?
3
thalasemmia, anemia of chronic disease, iron deficiency