So, iron deficiency anemia has been identified, its causes have been found and, if possible, eliminated. The next stage is the treatment of iron deficiency anemia in children. Just giving medicine is not enough. Let's start with other equally important activities, such as daily routine, walks in the fresh air, and, if necessary, additional daytime sleep. Children with anemia do not feel very well, they experience constant weakness, lethargy, headaches, so for some time you need to free them from too active participation in additional clubs, sports sections, replacing intense physical activity with walking in the fresh air, gymnastics, massage.

Diet for iron deficiency anemia in children is of great importance, since properly selected nutrition in combination with drug treatment quickly leads to improved well-being, normalization of hemoglobin, and elimination of all unpleasant symptoms of anemia. However, one diet, albeit high in iron, unfortunately, cannot completely eliminate its deficiency. Remember - first, pre- and latent iron deficiency occurs, when hemoglobin is still normal, but the iron depot rapidly loses it, and only then the hemoglobin content in the blood drops. When treatment begins and iron enters the child’s body, hemoglobin is first normalized, and only then iron reserves in the depot are replenished. And this cannot be ensured by diet alone, since the absorption of iron from the gastrointestinal tract is limited to only 2-2.5 mg per day. That is, more than two and a half milligrams of iron per day will not be absorbed, even if there is plenty of it in food.

As I already wrote, iron contained in meat products is absorbed best and much worse in plant products. Thus, about 20-22% of the total iron contained in them is absorbed from meat products, 11% from fish, 3% from fruits, beans, corn, and 1% from cereals. By the way, the well-known opinion that in case of anemia you need to eat liver, especially pork, is not entirely true: it is absorbed from the liver much worse than from meat, since it is contained there in the form of ferritin and hemosiderin. It is good to give liver with vegetables, since iron, which is part of ferritin and hemosiderin, improves the absorption of iron from vegetables. And let me remind you that tannin, oxalates, phosphates and phytates found in tea, cheese, eggs, cereals, as well as large amounts of milk, significantly reduce the absorption of iron. In addition, fatty foods and excess carbohydrates impair iron absorption due to inhibition of gastric secretion.

Breast milk is a unique product in terms of iron absorption: 50% of the iron contained is absorbed from it! Therefore, for infants suffering from iron deficiency anemia, it is so important to breastfeed longer. In addition, it is imperative that mother’s food contains sufficient iron.

Children under one year of age who suffer from iron deficiency anemia must be given iron-rich vegetables as their first complementary foods, rather than starting complementary foods with cereals. These are zucchini, cabbage, potatoes, beets. Of course, not all at once, but gradually adding new ones. Next, it’s good to introduce the meat, and give it with vegetable puree. Then cereal complementary foods are introduced, best in the form of industrially produced cereals fortified with iron (buckwheat, for example), fruit puree and juice.

1. Foods moderately rich in iron:

Oatmeal 4.3 mg

Peaches 4.1 mg

Lamb 3.1 mg

Raisins 3 mg

Spinach 3 mg

Beef 2.8 mg

Apricots 2.6 mg

Chicken egg 2.5 mg

Apples 2.5 mg

Pears 2.3 mg

Plum, black currant 2.1 mg

Pork 1.6 mg

Chicken 1.5 mg

Beetroot 1.4 mg

Rice 1.3 mg

Potato 1.2 mg

Cabbage 1.1 mg

Cod 1 mg.

2. Iron-rich foods:

Sunflower halva 33.2 mg

Pork liver 29.7 mg

Rosehip 28 mg

Dried apples 15 mg

Dried pears, prunes 13 mg

Dried apricots, apricots 12 mg

Beef liver 9 mg

Blueberry 8 mg

Buckwheat 6 -7 mg

Peas (shelled) 6 mg

Yolk 5.8 mg

Beef tongue 5 mg

Oatmeal 5 mg

Beans 5 mg.

You see that there are quite a lot of foods rich in iron; the main thing is to include them in the child’s diet every day. This especially applies to meat and fish. It has been revealed that the majority of vegetarians who refuse meat products suffer from iron deficiency anemia if they do not take additional multivitamins and iron supplements. A lack of vitamins in food, which are so abundant in vegetables and fruits, also leads to impaired absorption of iron and anemia, so feed the child and eat the fruits and vegetables themselves, drink juices, rosehip decoction, dried fruit compotes.

Health to you and your kids! And may everything be fine!

Anemia, popularly called anemia, occurs in children during active growth due to changes in the skeletal system. Most often, this disease affects children under two years of age, as well as in adolescence. This disease manifests itself in paleness of the skin and mucous membrane. These manifestations indicate a violation of internal processes associated with an insufficient amount of hemoglobin. Hemoglobin is a blood protein rich in iron, responsible for attaching oxygen particles and transporting it through the circulatory system.

The culprit of the disease is poor nutrition or nutrition lacking the required amount of vitamins. But if anemia is diagnosed, then only special diets will not be effective. In such a situation, you have to take medications with a high iron content, prescribed by your doctor.

Products necessary for a child with anemia

The main, key approach is systematic and proper nutrition. First of all, you should contact a specialist who will help you choose the right list of food products for this disease.

An incorrectly selected diet is the cause of the disease, and changing it is a clear path to a speedy recovery.

Main components to pay attention to:

• vitamin B 12;
• iron;
• chlorophyll.

There are various lists and diets that doctors prescribe for anemia, but not all of them are valid. An integrated approach to the selection of products that promotes the formation of red blood cells is important.

First of all, food should be prepared tasty and arouse appetite, since the caloric content of food for this disease should slightly exceed age norms. A complex of vitamins A, B, C will be an excellent helper in hematopoiesis. But the most important component, which will certainly lead to success, is the chlorophyll contained in greens.

Animals avoid this disease because they eat green plants, because everyone has repeatedly seen how cats or dogs eat green shoots, being predators. This program is laid down by nature, so why doesn’t a person follow this obvious instruction?

Some nutrition rules

Nutrition system for children with anemia:

Rules for feeding children

The first and basic rule from which all others are built is diet. implies that all sorts of “harmful things” like Coca-Cola, chips and other things will be excluded. The diet should last for a long time; a week or a month will not fix anything. It is better if a proper nutrition system accompanies the child throughout his life - this is not only the prevention and treatment of anemia, but also an excellent opportunity to live a little longer and better.

The next rule or principle is the daily routine. Whatever one may say, a healthy lifestyle depends not only on what we eat, but also on when we eat it, how many times a day, when we sleep and how much time we spend on it. Daytime naps are a great option for your baby, but they generally aren't suitable for everyone.

Sleep determines the time when the need for food comes, and therefore breakfast should not be late, just like dinner itself. It is impossible to give precise guidance to parents on organizing the child’s daily routine; everyone knows this aspect, but not everyone attaches special importance to this fact.

And, of course, frequent walks in the fresh air will be useful. Good metabolism in the body and absorption of necessary elements occurs with active rest. The more calories burned, the better, and being active in childhood contributes to better development of all functions and processes in the child’s body.

What not to eat if you have anemia

If so, then you will have to abstain from some foods. First of all, we are talking about food containing large amounts of calcium - it is this substance, when consumed in large quantities, that interferes with the processes of effective absorption of iron.

Doctor's advice: a child's diet should definitely be based on this fact. This is quite simple to implement - for example, it is better to give dairy products separately from iron-containing products, and in specific small portions.

Childhood anemia, among other things, limits the ability to eat fried and fatty foods. This is a prerequisite within the philosophy of proper nutrition. Of course, this does not mean that you need to feed your baby exclusively low-calorie foods - everything should be in moderation and harmonious. It is better not to include dishes with a high content of vinegar or brine in your child’s diet.– this product has a negative effect on the blood condition. Drinks with caffeine, carbonated sweet drinks - these should also not be abused. A balanced diet is the key to success in treating anemia in children.

Video about anemia in children

Anemia caused by a lack of iron in the body is not such a rare disease. A child's condition is largely determined by his diet. So, with a balanced diet, the baby feels great, he is rosy and cheerful. When the balance of substances in the body is disturbed due to poor nutrition, the picture changes dramatically. How to avoid common mistakes in baby food?

Anemia, or colloquially anemia, is a disease that is accompanied by a decrease in the level of red blood cells in the blood. Blood cells play a huge role in maintaining the general condition of the baby, since they are involved in the delivery of oxygen to the main systems of the body. The red color of the cells is due to hemoglobin, which contains iron. Hemoglobin performs the function of retaining oxygen in the blood and providing a transport function for it, delivering it throughout the body.

The consequences of a decrease in blood levels are quite serious: decreased immunity, weakness, decreased activity, lag in weight gain. In this state, the body is unable to adequately resist various infections.

A pediatrician can detect anemia in a child. He can also determine the baby’s predisposition to this disease. When the previously described symptoms appear, the doctor prescribes a blood test that shows the level of hemoglobin. If the analysis results deviate from the norm, immediate action should be taken. At the same time, the best way out of this situation would be to prevent the development of the disease and carry out competent preventive work related to proper nutrition of the child.

Prevention of anemia

A balanced diet must be introduced immediately after the start of complementary feeding. During the first six months of life, the baby receives all the necessary substances from the mother from breast milk or an adapted formula.

The most iron-rich foods are meat and offal. However, you cannot start complementary feeding with such products. Therefore, in order for the child to be provided with iron, it is necessary to introduce vegetables. The leaders in iron content and products allowed at the beginning are:

1. green pea;
2. spinach.

After vegetables have been successfully introduced into the baby’s diet, you can expand it with the help of cereals. So, those with the highest content of iron include buckwheat and oatmeal. In order for the porridge to be healthy, and for the iron contained in it to be absorbed by the child, the dish must be prepared correctly. Under no circumstances should you cook porridge in milk or pour milk into boiled cereals. Calcium, which enriches milk, makes it difficult to absorb iron. Moreover, in case of anemia, calcium is completely excluded from the baby’s diet. In addition, milk is a fatty product and requires the body to work harder to process it, and its inclusion in a child’s diet is allowed after 12 months. In addition to milk, calcium is found in all lactic acid products, which also need to be treated with caution.

In addition, you must continue to give your child formula containing breast milk until he reaches 1 year of age.

Thus, anemia is not a death sentence, but it cannot be ignored either. At the first symptoms of the disease The child needs to immediately go to the doctor and get tested, and it is best to prevent the development of the disease by adhering to certain nutritional rules.

The best sources of iron for children over 1 year of age include red meat, beans, iron-fortified grains, and dark green leafy vegetables such as spinach. Good sources are also chicken, raisins, tuna and other types of fish. Iron from animal sources such as beef and chicken, is easier to absorb than iron from plant sources.

The role of vitamin C

Vitamin C increases the absorption of iron from foods by up to three times. Therefore, in case of anemia, give your child foods rich in vitamin C and iron at the same time. Foods such as citrus fruits, tomatoes, potatoes, broccoli, strawberries and others rich in vitamin C, as well as foods rich in iron, will help your child increase the amount of iron he gets at each meal.

3 steps to correct anemia in a child

Step 1: If the iron deficiency is minor, then you can correct it with an anemia diet, as described above. Those. introduce foods rich in this element, and for better absorption, add foods containing vitamin C to your diet. This diet should be followed from 2 to 4 weeks, then get tested for hemoglobin or ferritin. If your iron levels have not increased, then you should move on to step 2.

Step 2: If your iron levels are low, your doctor may
prescribe medications containing this element to your child. A child may be prescribed a drug in the form of drops if he is under 3 years old and in the form of tablets if he is older. The dosage is determined by the doctor. During the first three weeks of treatment, hemoglobin increases at a rate 0.15-0.25 grams per day, therefore, if the child has low hemoglobin, then you will need about three weeks to reach normal levels. To replenish your body's iron stores, it is best to continue taking iron supplements for at least two months after your hemoglobin status returns to normal.

Step 3: If the child’s hemoglobin does not increase by one gram after two to four weeks treatment, your doctor may either prescribe an increased dosage of an iron supplement or perform additional blood tests to determine whether the anemia has causes other than iron deficiency.

Is iron deficiency anemia dangerous?

Not in the short term. A few months of anemia in infancy has no long-term health consequences. However, research has shown that children who are anemic for several years may have problems with intelligence and learning later in childhood. Those. Iron deficiency anemia in infancy leads to irreparable cognitive damage. Therefore, it is important to monitor for signs of anemia in all children after 6 months.

Don't be afraid and add me to

If a child is diagnosed with anemia, then his diet should, first of all, be radically changed towards increasing foods containing iron, since it is this microelement that helps to increase hemoglobin in the blood. And he, in turn, delivers oxygen to all the tissues and organs of the baby, supporting their normal functioning and ensuring the vital functions of the whole organism.

In addition, we must remember that for better absorption of iron, it is necessary to include foods containing copper in the children's diet. It is necessary for hemoglobin to bind more tightly to blood cells: this increases the efficiency of its “work”.

The third component that promotes good absorption of iron is vitamin C. It helps it stay in the body and not come out along with breakdown products.

“Iron” products: essential for anemia

Now let’s figure out which foods should be included in the diet of children with anemia, and which ones are not recommended for very young children, even though they contain a lot of iron.

A record amount of easily digestible iron is found in red meat: beef, veal, lamb, as well as in beef, veal and pork liver. There is slightly less iron in chicken meat; there is quite a lot of it in turkey meat. These are ideal foods for the diet of children suffering from anemia. After all, their nutritional value is determined by the presence, in addition to iron, of animal proteins necessary for the formation of hemoglobin. In addition, these types of meat contain fats, mineral salts, vitamins, and various extractive substances that facilitate the absorption of food prepared from them.

Liver, unlike meat, contains not only iron, but also copper, which is necessary for the synthesis of hemoglobin. In addition, like meat, it contains complete protein and biologically active phospholipids. Since liver is a delicate product, it can be introduced into the diet of babies from one year of age.

Among the cereals that contain iron, buckwheat, barley, millet and oatmeal are considered. But iron from them is not absorbed as well as from red meat and liver. It is least absorbed from oats. The fact is that special substances present in oatmeal prevent iron from being absorbed into the blood.

But iron and copper, which are present in lentils and beans, are perfectly absorbed by the body. However, one must keep in mind that it is not recommended to give homemade legume dishes to children under two or three years of age, as they are difficult for the baby’s delicate digestive tract. These products are introduced into the diet with caution as the baby grows older, when his gastrointestinal tract is relatively mature. And by the age of five, you can safely offer your child boiled lentils and beans in combination with his usual stewed vegetables or make soups using them.

To prevent anemia in a child, dried fruits are also useful: prunes, dried apricots and raisins. For children's dishes, they are soaked, ground, and added to casseroles and porridges.

Products for treating anemia in children: support group

Iron from foods is absorbed much better if you serve vegetables that contain vitamin C with liver or meat. These are various types of cabbage, especially broccoli, stewed or boiled, as well as salads from fresh vegetables with the addition of bell peppers, green apples, cranberries and currants.

Just remember to follow the age-specific recommendations of nutritionists. For a one-year-old baby, offer vegetables stewed and then pureed, green apples in the form of puree, mousse, baked, and after two years, offer finely chopped fresh white cabbage in combination with grated apple.

Of the foods containing copper, the most famous are squid, veal liver, walnuts, and pumpkin seeds. True, we must remember that seafood can only be included in a child’s diet from the age of four. Walnuts and pumpkin seeds can be given from the age of three, but at first in thoroughly crushed form. By the way, walnuts contain a lot of not only copper, but also iron.

Healthy diet for anemia in a child

To prepare meat dishes, choose chicken or turkey breast, beef without bones, tendons or films. For babies in the second year of life, make steamed cutlets or meatballs, meat soufflé. After two years, include small pieces of boiled meat and liver in the diet, because the baby needs to learn to chew solid food.

Starting from the second year, give your baby buckwheat with mashed liver puree or red meat pate. These are classic dishes containing a lot of iron. To prevent anemia, they should be included in the children's diet once every 10 days, and if the baby has already been diagnosed with this, then more often.

For example, children with stage 1 anemia are given foods containing iron and copper twice every 10 days. Babies who have all the signs of the second stage of anemia suffer more from fatigue and weakness, so the amount of such products is increased to four times every 10 days.

Third degree anemia greatly weakens the body, and the task of doctors is to increase the level of hemoglobin in the blood as quickly as possible. Therefore, dishes containing iron and copper are introduced into the diet of such children every day. In addition, a child with the third degree of anemia must undergo a course of medication, since increased nutrition with iron-containing foods alone will not be enough in this case.

But in any case, parents should remember that diet therapy for anemia should be long-term, and only with careful adherence can success be achieved in the treatment of this disease.

Note to mom

When creating a healthy diet for children with anemia, a problem often arises: the baby categorically does not like the mandatory foods, and he refuses them. For example, sometimes such a danger “lurks” in liver dishes. After all, she has a special taste that may not suit little whims. To cope with this, nutritionists recommend resorting to simple tricks.

• Add liver to minced meat or fish. The fact is that the taste of beef, turkey or fish is more pronounced than the taste of liver, so its presence in the cutlet is practically not felt.
• For children over the age of three, grated or finely chopped liver can be added to salads, omelettes, porridges, and casseroles.
• When preparing potato or vegetable zrazas, use finely chopped liver for the filling. Also add liver, minced in a meat grinder, to recipes for potato, zucchini or pumpkin pancakes.
• Along with homemade meat dishes, use canned liver intended for feeding babies. Add this baby food to a variety of homemade dishes, such as soups. Such canned food has high nutritional value, is easily digestible and improves the taste of dishes.

Expert opinion

Marina Kopytko, chief physician of the Weight Factor clinic, nutritionist, Ph.D. honey. sciences

According to medical statistics, anemia in children occurs in approximately 40% of cases in the age group from birth to three years and in 30% from three to seven years.

Pale skin, fatigue, lethargy, headaches - all these symptoms can be signs of anemia.

Fortunately, in most cases this disease can be cured by adjusting the children's menu in a certain way. But we must make a reservation right away that not all types of anemia can be defeated in this way. For example, the third stage is treated with medications (although it is extremely rare). Diet alone will also not help in case of large blood loss due to injuries or in the event that the child has suffered some kind of serious illness that has greatly weakened his body.

It is especially dangerous for a child not to receive the required amount of iron during the period of growth and development, when internal organs, skeletal bones, and the brain are formed. If the body is poorly supplied with oxygen, then its normal development may fail, and in the future this will provoke the emergence of a number of chronic diseases.

Iron deficiency anemia is a pathological condition caused by iron deficiency in a child’s body (absolute or relative). This is one of the most common childhood diseases: in young children it is registered in 40-50% of cases, in adolescents – in 20-30% of cases. Iron deficiency anemia accounts for almost 80% of the total number of anemias.

It is a very important microelement for the body: it is used in the synthesis of enzymes and proteins that take part in metabolic processes.

One of the important blood proteins that contains iron is (Hb). It is Hb, combining with oxygen, that ensures its delivery to various tissues. With a lack of iron and hemoglobin, hypoxia (oxygen starvation) develops in all organs and systems. Lack of oxygen is especially unfavorable for the brain.

Iron is found in myoglobin, catalase, cytochrome, peroxidase and other enzymes and proteins. The body's iron reserves are created in the form of hemosiderin and ferritin.

At the stage of intrauterine development, iron enters the fetus through the placenta from the mother's body. This process, which creates a reserve of iron in the fetal body, becomes most intense during pregnancy 28-32 weeks.

At birth, the neonatal iron reserve (depot) is 300-400 mg in a full-term infant, and only 100-200 mg in a premature infant.

Iron from this reserve is used for the synthesis of hemoglobin and enzymes, participates in regenerative processes, and compensates for physiological losses in urine, sweat, and feces.

Intensive growth and development of a child increases the need for iron. This is why iron reserves are depleted quite quickly: in a full-term baby by 5-6 months, and in a premature baby by 3 months.

Absorption of iron from food occurs in the intestine (in the duodenum and jejunum). Only 5% of the iron consumed daily is absorbed from foods. Its digestibility depends on the state of the digestive tract. The main source of iron is meat products.

Causes of iron deficiency anemia

On the left is normal blood, on the right is blood with anemia (schematic representation).

For normal growth and development, a newborn needs an intake of iron in the body in the amount of 1.5 mg per day, and a baby aged 1-3 years needs at least 10 mg. Physiological losses are equal to 0.1-0.3 mg per day in young children, up to 0.5-1.0 mg in adolescents.

If the consumption and loss of iron is higher than its supply and absorption, iron deficiency occurs, which leads to iron deficiency anemia.

Causes of iron deficiency anemia in children:

• immature hematopoietic system;
• malnutrition;
• some infectious diseases;
• hormonal imbalance in adolescence.

Anemia can be caused by bleeding when:

• injuries;
• surgical interventions;
• oncological diseases;
• ulcerative colitis;
• diaphragmatic hernia;
• diverticulitis;
• heavy menstruation in a teenage girl.

Anemia can also develop after treatment with certain medications: salicylates, non-steroidal anti-inflammatory drugs, glucocorticosteroids.

Bad habits in adolescents (drinking alcohol-containing drinks, drugs, smoking), insufficient sleep, vitamin deficiencies, and eating foods that reduce iron absorption contribute to the occurrence of anemia.

Causes of anemia in infants

For the development of iron deficiency anemia in an early age of a child, antenatal and postnatal causes are important.

Antenatal factors do not make it possible to form a sufficient iron reserve in the fetus, and anemia occurs already in infancy. It may be associated with the course of pregnancy:

• anemia in the expectant mother;
• toxicosis;
• infections in a pregnant woman;
• fetoplacental insufficiency;
• threat of abortion;
• multiple pregnancy;
• placental abruption;
• untimely (early or late) ligation of the umbilical cord.

More often, anemia develops in children born with high birth weight, premature babies, with constitutional anomalies, and in twins. These children are at high risk for developing this pathology.

Postnatal factors contributing to the development of anemia are:

• using unadapted milk formulas or feeding formula-fed infants with cow's and goat's milk;
• malnutrition of the child;
• deterioration of intestinal absorption of iron.

The best food for babies is. Despite the fact that the iron content in it is low, it is easily absorbed, as it is in the form of lactoferrin. This substance is necessary for the antibacterial effect of immunoglobulin A to manifest.

How does iron deficiency anemia develop?

First, prelatent iron deficiency develops, in which the hemoglobin level is still normal, but the iron content in the tissues is already decreasing, enzymatic activity in the intestines is deteriorating, as a result of which the absorption of iron from food decreases.

The second stage of iron deficiency is its latent deficiency (that is, hidden). At the same time, iron reserves in the body are significantly reduced, and its level in the blood serum decreases.

At the stage of clinical manifestations, in addition to obvious symptoms, laboratory parameters change: not only hemoglobin decreases, but also the number of red blood cells.

Iron deficiency and reduced hemoglobin levels lead to hypoxia of tissues and organs, which disrupts their normal function. Decreased immune defense leads to gastrointestinal infections, which further impairs iron absorption, exacerbating iron deficiency.

The functions of various structures in the brain are disrupted, causing a lag in the neuropsychic development of the child. There are disruptions in the transmission of impulses from the brain centers to the auditory and visual organs (visual and hearing acuity worsens).

Symptoms

The manifestations of iron deficiency anemia are very diverse. In young patients, signs of one of the disease syndromes may predominate: epithelial, astheno-vegetative, dyspeptic, immunodeficiency, cardiovascular.

1. Signs of epithelial syndrome are dryness, flaking, and hyperkeratosis of the skin. Anemia is manifested by increased fragility and hair loss, striations and brittleness of nails.

The oral mucosa is significantly affected in the form of cracks, inflammation of the lips (cheilitis), inflammation of the tongue (glossitis), stomatitis, caries. During examination, attention is drawn to the pallor of the visible mucous membranes and skin. The more severe the anemia, the more pronounced the pallor.

1. Astheno-vegetative signs of iron deficiency anemia are associated with cerebral hypoxia. The child often experiences headaches, decreased muscle tone, restless shallow sleep, and severe emotional instability (tearfulness, whims, frequently changing mood, apathy, or mild excitability).

Symptoms of vegetative-vascular dystonia often occur: fluctuations in blood pressure, a sharp decrease in it when changing body position (up to fainting), frequent dizziness. Visual acuity may decrease. The child lags behind not only in physical, but also in intellectual development.

Often, a baby loses existing motor skills. Characterized by rapid fatigue. Enuresis (urinary incontinence) may occur due to a weak sphincter in the bladder.

1. Dyspeptic syndrome is characterized by: decreased appetite (sometimes to the point of anorexia), regurgitation, impaired swallowing, and bloating. Some children experience diarrhea, while others experience constipation. A perversion of taste appears (the child eats soil, chalk, etc.) and sense of smell (there is a desire to inhale the smell of varnish, gasoline, paints).

Intestinal bleeding is possible. The size of the spleen and liver increases. The enzymatic function of the gastrointestinal tract suffers, which further aggravates anemia due to impaired iron absorption.

1. With severe iron deficiency anemia, pronounced cardiovascular changes appear: the pulse and respiration rates accelerate, and blood pressure decreases. Dystrophic changes occur in the heart muscle, and heart murmurs appear.

1. For immunodeficiency syndrome with anemia, a characteristic manifestation is prolonged unreasonable fever up to 37.5 0 C, frequently occurring diseases (intestinal infections, respiratory diseases). Infections are difficult to tolerate and are characterized by a protracted course.

Diagnostics

You can suspect anemia in a child based on clinical symptoms. To confirm the diagnosis, clinical and biochemical blood tests are used.

Laboratory criteria for diagnosing anemia:

• decrease in Hb below 110 g/l;
• color index (iron saturation of red blood cells) below 0.86;
• serum iron less than 14 µmol/l;
• increased iron-binding capacity of blood serum (above 63);
• serum ferritin less than 12 mcg/l;
• microcytosis (reduction in size) and poikilocytosis of erythrocytes (change in shape - the appearance of oval, sickle-shaped, pear-shaped elements instead of round ones).

The stage of iron deficiency anemia is determined by Hb level:

• mild degree with Hb from 110 to 91 g/l;
• moderate – Hb level is 90-71 g/l;
• in severe cases, Hb decreases below 70 g/l;
• super-severe anemia: serum Hb levels below 50 g/l.

Additional research may be required to determine the causes of anemia:

Laboratory:

• analysis of bone marrow puncture obtained during sternal puncture (decreased number of sideroblasts is determined);
• feces for occult blood;
• feces on helminth eggs;
• analysis of stool for dysbacteriosis.

Hardware Research:

• fibrogastroduodenoscopy;
• irrigoscopy (x-ray examination of the large intestine);
• colonoscopy.

Treatment

Treatment of iron deficiency anemia will be successful if the cause of the disease is identified and eliminated or corrected. In case of anemia due to acute significant blood loss, there may be indications for transfusion of donor blood or its components (erythrocyte mass).

The treatment package includes:

• rational nutrition of the child;
• daily routine in accordance with age (sufficient sleep, walks in the air, avoidance of stress, limitation of physical activity);
• use of iron-containing drugs;
• symptomatic treatment.

Diet therapy is an indispensable component of complex therapy for anemia. The child needs to be provided with adequate nutrition.

The optimal nutrition for a baby is breast milk. It not only contains iron, but also promotes the absorption of iron from other foods if the child is already receiving them according to his age.

Active metabolic processes in the baby's body lead to the fact that the antenatal iron supply is depleted during the first six months of life. This is why it is so important that the child receives iron from complementary foods.

Complementary feeding for infants with anemia is introduced 3-4 weeks earlier. It is not recommended to include semolina and oatmeal porridge in a baby’s diet. Preference is given to buckwheat, barley, and millet porridges. is introduced as early as 6 months. For bottle-fed babies, the doctor will select an adapted milk formula fortified with iron.

For digestive disorders, herbs can be used (in the absence of allergies). Their anti-inflammatory effect will improve the secretion of digestive juices and the body's absorption of minerals and vitamins. Decoctions of rose hips, dill, stinging nettle, mint, elecampane, blueberries, red clover, etc. can be used. Their use should be agreed with the pediatrician.

Iron-rich foods should be included in the diet of children suffering from anemia in older age.

These products include:

• beef and veal (especially beef tongue and veal kidneys);
• pork liver;
• fish;
• (cabbage, oysters);
• wheat bran;
• chicken yolk;
• cereals;
• beans;
• buckwheat;
• (walnuts, forest, pistachios);
• apples and peaches, etc.

Certain substances in foods and medications can reduce iron absorption.

Such substances include:

1. Oxalates: their high content is found in chocolate, black tea, cocoa, beets, spinach, peanuts, almonds, sesame seeds, lemon zest, soybeans, sunflower seeds, buckwheat, pistachios, etc.
2. Phosphates: sausages, processed cheese, and canned milk are the richest in them.
3. Tannins contained in tea.
4. Preservative ethylenediaminetetraacetic acid.
5. Antacids (used for high acidity of gastric juice).
6. Tetracyclines (a group of antibiotics).

Increases iron absorption:

• acids (ascorbic, citric, malic);
• medications Cysteine, Nicotinamide;
• fructose.

An important component of complex treatment of anemia is the use of iron-containing drugs to eliminate its deficiency. Monocomponent preparations or a combination of iron with other substances - proteins, vitamins - are used.

The choice of drugs is quite large:

• Ferroplex;
• Hemofer;
• Ferrous fumarate;
• Maltofer;
• Ferrum lek;
• Aktiferrin;
• Totema;
• Tardiferon;
• Ferronate;
• Maltofer foul et al.

First, the drug is prescribed to be taken by mouth (for babies in the form of syrup, drops, suspension). More effective is the oral administration of nonionic iron compounds: protein (Ferlatum) and polymaltose hydroxide (Maltofer) complexes, which do not interact with food and rarely cause side effects.

The dosage of iron supplements for any method of administration is calculated by the doctor individually for each child. The dose of the drug can be increased gradually (from ¼ or ½ of the required dose to the optimal one). Iron supplements should be given orally to the child 1-2 hours before feeding. You can take the medicine with water or juice.

After 1-2 weeks, the effect of using iron supplements should be noticeable - the appearance of reticulocytes and an increase in hemoglobin levels. It is normal to increase Hb by 10 g/l in 1 week. Before starting the course, serum iron is determined and its level is monitored during treatment.

The course of therapy to eliminate iron deficiency, as a rule, lasts up to one and a half months in children, after which they switch to a maintenance course (2-3 months). It is necessary to replenish iron depots.

If Hb levels have not returned to normal within a month, it is necessary to establish the reason for the ineffectiveness of treatment.

It could be:

• unidentified or ongoing blood loss;
• insufficient dosage of iron supplement;
• concomitant deficiency of vitamin B 12;
• unidentified or untreated pathology (helminthiasis, inflammatory process in the gastrointestinal tract, neoplasm, etc.).

If the medication is poorly tolerated (nausea, vomiting or bowel dysfunction), children are given iron supplements by injection. Injectable drugs are also used to quickly achieve an effect in cases of severe anemia, gastrointestinal pathology (ulcerative colitis, etc.), impaired iron absorption, and no effect from oral iron intake after 2 weeks.

Iron deficiency occurs in combination with a lack of vitamins, so the treatment of anemia includes the use of vitamin and mineral complexes. Homeopathic medicines are often used, but they must be prescribed by a pediatric homeopath.

At the same time, treatment of the underlying disease is carried out - symptomatic or pathogenetic.

For severe anemia, rhEPO (recombinant human erythropoietin) preparations – epoetins a and b – are used. This treatment makes it possible to do without blood transfusions (blood transfusions) with their high probability of complications. Epoetins are administered subcutaneously. In the Russian Federation, Eprex and Epokran are more often used.

Contraindications for prescribing iron supplements are:

1. Sideroachrestic anemia is an iron-saturated anemia (low iron content in red blood cells is associated with its non-use in the synthesis of hemoglobin by the bone marrow).
2. - a disease with an unknown cause (possibly of autoimmune origin), in which, as a result of vascular damage, red blood cells leave the vessels, and hemosiderin is deposited and accumulates in the skin.
3. Hemochromatosis is a disease associated with impaired intestinal absorption of iron and the accumulation of iron-containing pigments in the internal organs with the development of fibrosis.
4. Iron deficiency has not been confirmed by laboratory data.
5. Hemolytic anemia, caused by the destruction of red blood cells.

This is why correct diagnosis of the child’s condition before starting treatment is so important.

Forecast

Timely detection of anemia, elimination of the cause that caused it, and proper treatment of the child make it possible to achieve recovery and normal results in peripheral blood tests. Uncorrected iron deficiency is a path to retardation in physical and intellectual development, and a tendency to somatic and infectious diseases.

Prevention

Prevention of anemia should be carried out at the stage of intrauterine development and during the process of monitoring the child after birth.

Antenatal prevention includes the following measures:

• a pregnant woman's adherence to a daily routine (sufficient rest, daily exposure to air);
• a preventive course of iron-containing medications and vitamin complexes for women at risk;
• timely diagnosis and treatment of anemia in pregnant women.

Postnatal prevention (after birth) includes:

• breastfeeding the baby for;
• timely introduction of complementary foods and the correct selection of products for it;
• use of adapted milk formulas for artificial feeding;
• proper child care;
• regular monitoring by a pediatrician of the baby’s development;
• timely prevention of malnutrition and rickets.

Sufficient exposure to air, balanced nutrition, massage, gymnastics, hardening procedures and a clear daily routine are necessary for a child of any age. These measures will help ensure the necessary balance of iron in the child’s body and prevent the development of anemia.

Children at risk need preventive courses of iron supplements.

Such courses are conducted:

• twins;
• premature babies;
• children with constitutional abnormalities;
• with malabsorption syndrome;
• during puberty and rapid growth;
• girls in adolescence with heavy menstruation;
• after blood loss for any reason;
• after surgery.

Premature children from 2 months of age (up to 2 years) are prescribed iron supplements for preventive purposes. Rh-EPO may be used to prevent anemia.

Summary for parents

Iron deficiency anemia is a common disease in children of all ages. Preventive measures carried out starting from the prenatal period of the child’s development and (if indicated) in all subsequent years will help avoid the development of anemia. Only regular medical observation with control blood tests makes it possible to diagnose the disease at the initial stage. Timely treatment of anemia helps prevent complications.

School of Dr. Komarovsky, issue topic “Low hemoglobin”: