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Clerkship Ready: Pediatrics

Before You See a Child With Possible Iron Deficiency

18 Jan 2024

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Iron deficiency is the most common nutritional deficiency that occurs in children in United States. Iron plays a vital role in cellular function in all organ systems. Today, we will be reviewing what you need to know before you first see a patient with possible iron deficiency. We will discuss why iron is so important, when and why iron deficiency occurs, screening, diagnosis, and treatment for iron deficiency. Importance of Iron  Iron and Hemoglobin  Iron and Neurodevelopment Iron and the Immune System What happens in iron deficiency Reasons that children are at high risk for iron deficiency  Rapid Growth .  Insufficient dietary intake and limited absorption  Increased losses  Peaks of Incidence Other risk factors for iron deficiency. Preterm infants  Children who suffer from neuro-motor disorders as they often have nutritional deficiency related to swallowing impairment G.I. diseases that cause malabsorption,  Diseases predisposing them to bleeding. Lead toxicity.  Screening for IDA History: Asking about prematurity, low birth weight, exclusive breastfeeding beyond 4 months of age, weaning to whole milk without addition of iron rich foods, feeding problems, and any past medical conditions.  Exposure to lead (i.e. age/ condition of home, recent renovations, a parent who has occupational exposure, concerns about drinking water).  Any possible symptoms of anemia, such as fatigue, breath holding spells, pica Physical exam: pallor.  Lab testing. Treatment for iron deficiency  Oral iron: daily dose of 3 to 6 mg per kilogram of elemental iron divided into three doses is adequate. Give iron supplements with juice - increases iron absorption through the action of ascorbic acid! Juices that are high in ascorbic acid include orange and apple juice. Supplements should be continued for a minimum of three months to reestablish iron stores. After completion of treatment, reassessment of iron status  In addition to iron supplementation, the other aspect...

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