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Dr. Harsha Prasad L

Consultant - Pediatric Hemato Oncology

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Dr. Harsha Prasad L

Consultant - Pediatric Hemato Oncology

Manipal Hospitals, Mangaluru

Anemia and Nutrition In children

Posted On: Aug 05, 2020

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Anemia and nutrition in children

Why is Anaemia So Prevalent?

Anemia is a global public health problem, affecting both developed and developing countries. It is estimated that around 50% of anaemia cases are due to nutritional deficiencies such as iron vitamin B12 or folic acid. Anaemia (including iron deficiency anaemia) is more common in girls than in boys. 

How is Anaemia Caused?

Iron is needed for many important processes inside the body. It is especially important for making haemoglobin – the protein in your blood that carries oxygen. If there is not enough iron, the body can’t make enough haemoglobin to meet its needs. Then the red blood cells become abnormally small and can’t carry enough oxygen to your organs and tissues. This leads to the symptoms of anaemia. Babies, teenagers, and women who have heavy periods are more likely to get iron deficiency anaemia. The recommended intake of iron increases when girls reach puberty, due to increased losses from menstruation and this puts girls of this age at greater risk of having low iron intakes and status. Iron is absorbed from food and drink by the bowel. It’s carried in the blood to the bone marrow, where blood cells are produced. Here, iron is combined with proteins to make haemoglobin. Any iron that doesn’t get used up is stored in the bone marrow and other organs, such as the liver. If the body has a sudden demand for extra iron, one may develop iron deficiency anaemia. This can happen, for example, during a growth spurt (which is most common during the teenage years) and the body makes more red blood cells to support your developing bones, muscles and tissues.

The cause for nutritional anaemia could be due to delayed weaning, blood loss, poor diet,  excessive cow milk intake, poor absorption, a period of life when iron requirements are especially high (growth spurt), heavy blood loss as a result of menstruation, infections and worm infestations.  Anaemia is particularly common in girls who have tried to lose weight and among vegetarians. 

If the child feels tired quickly, looks pale, has breathlessness, feels his heart thumping( palpitation), eats mud or ice or paint, has brittle nails, and is irritable then consult the doctor and get the blood tests done. If anemia is left untreated it can lead to problems with the lungs and heart. If the blood tests show low levels of haemoglobin with small, pale, red cells, one may have iron deficiency anaemia. This can be confirmed if one also has low levels of ferritin in the blood.

Treatment for Anaemia 

Treatment involves replacing iron in the body and treating a particular condition if it is causing the iron deficiency. Taking iron syrup in younger children and tablets in teenagers is the best way to make up for the shortage of iron. Iron tablets can cause side effects, such as feeling sick, heartburn, constipation, and diarrhoea. By taking tablets after meals and drinking enough fluids, one can reduce these side effects. If one cannot take iron tablets, or if they don’t work, an iron infusion through a drip into a vein can be given. Iron infusions can cause side effects, such as headache or joint pains and, occasionally, allergic reactions. If anemia is severe causing heart failure then the child will require a blood transfusion. 

The risk of developing Iron deficiency anaemia can be reduced by weaning at the appropriate time in infants, eating a healthy, balanced diet that contains plenty of iron-rich foods (red meat, green vegetables, dried fruit, chickpeas, lentils, and fortified foods such as breakfast cereals).  For most children, this will provide enough iron without the need to take supplements.

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