Anemia in a child 4 years of treatment. Anemia in children: symptoms, causes and treatment

In pediatric practice, a condition is quite common, which is characterized by a decrease in the level of hemoglobin and red blood cells in the blood of an infant - anemia. Anemia can occur in any infant, regardless of weight, height, age, and other indicators. The reasons for its occurrence also vary. Why is anemia dangerous and how to overcome it?

Most often, the following factors lead to the development of anemia in infants:

• insufficient amount in the body of a future and / or nursing mother;
• lack of folic acid and;
• problems with the placenta during pregnancy (structural anomalies, circulatory disorders, etc.);
• Rhesus conflict during pregnancy;
• intrauterine infections;
• prematurity;
• the presence in the child of diseases of the gastrointestinal tract, in which the absorption of iron is impaired;
• artificial feeding and some others.

Under the above conditions, the production of red blood cells may slow down or stop, hemoglobin becomes insufficient for the normal functioning of the body.

There are several types of anemia in children of the first year of life:

• physiological anemia of newborns and / or premature infants. This is the most common type of disease;
• alimentary anemia, the development of which is due to an unbalanced diet;
• anemia as a complication of severe infection;
• Yaksh-Gayem anemia.

Anemia of any kind is divided into several degrees:

• light;
• average;
• heavy.

Symptoms

Anemia most often develops slowly, so its signs can be noticed only after some time. First of all, they include a decrease in appetite, pallor of the skin, low muscle tone. The child gets tired faster, sleeps poorly and is more often naughty. The liver may be slightly enlarged, the stool is clay-like in consistency. The immune system also suffers, as a result of which the child may often get colds.

Unlike other types of the disease, Yaksh-Gayem anemia is characterized by a sharp and rapid deterioration in the child's well-being. The pallor of the skin is clearly expressed, the liver and lymph nodes are significantly enlarged, the body temperature rises periodically. In some cases, the baby may suffer from shortness of breath.

If you notice one or more of these signs in your infant, then contact your pediatrician for a referral for a blood test to rule out or confirm the presence of anemia, as well as determine its type and severity.

Hemoglobin: norms

Depending on the age of the child, the lower limit of the hemoglobin norm is in the following values:

• 130 g / l - from birth to 3 months;
• 100-110 g / l - from three months to a year;
• 110 g / l - from one to three years;
• 115 g / l - from 4 to 12 years;
• 120 g/l. - from 12 years old.

Although for a child of the first three years of life, a hemoglobin index of 110 g / l is within the normal range, this condition is considered pre-emic by pediatricians.

Anemia treatment

As the name suggests, it is easier to compensate for a mild degree of anemia. Most often, it appears due to poor nutrition and poor lifestyle (lack of sleep, fatigue, rare walks in the fresh air, etc.). In such cases, a nursing mother is recommended to eat regularly, increase the proportion in her diet, walk more often with her baby, and take vitamins. If complementary foods are already being introduced to the child, then it is necessary to focus on iron-containing foods, introducing mashed liver, egg yolk, and vegetables into the diet of crumbs.

In cases of moderate and severe anemia, it is first necessary to identify and eliminate its cause, i.e. complete diagnosis and treatment. In addition, doctors will recommend that a nursing mother and baby take special preparations of iron, enzymes, homeopathic remedies, and vitamin complexes. As in milder cases, walking in the open air is a prerequisite for curing anemia.

Regardless of what causes anemia and how it progresses, don't stop breastfeeding! Breast milk provides the baby not only with nutrients and immune protection, but also with iron in an easily digestible form, which is exactly what a baby needs.

Diet

What foods in the diet of a nursing mother will help eliminate a mild degree of anemia in crumbs?

First of all, these are pork and beef liver, chicken egg yolk, veal kidneys, sesame seeds, seaweed, oysters, legumes, chickpeas (chickpeas), buckwheat, nuts. But, adjusting her menu, a nursing mother should not forget that, in addition to iron, potential allergens can also get into breast milk. For this reason, carefully introduce foods such as beans, peas, nuts, and some others into the diet.

vitamins

Iron deficiency in young children is usually not isolated and is often accompanied by a lack of a number of vitamins and minerals. For this reason, a nursing mother (and sometimes a child) is required to take vitamin therapy. It is almost impossible to get all the necessary substances from only products, while the right one will satisfy all the body's needs for vitamins and minerals.

Preparations

To date, pharmacies offer a wide range of iron preparations from various manufacturers. Most of them are perfectly combined with breastfeeding, but, despite this, you should not buy such products without consulting a doctor. When prescribing an iron preparation, the doctor proceeds from the individual person's need for this element.

Treatment effectiveness

How effective the treatment is can be judged after 12-14 days from the start of therapy by an increase in the number of reticulocytes. Normalization of hemoglobin levels is observed after 6-9 weeks of treatment, however, iron supplements should continue for another 2-4 months.

Anemia is quite common in infants. Depending on its type and severity, various methods of treatment are used: from correcting the diet of a nursing mother to taking special iron preparations in combination with other medicines.

Is anemia dangerous in a baby and how to avoid it

Anemia (anemia) in a child- this is a group of clinical and hematological syndromes, a common symptom for which is a decrease in the concentration of hemoglobin in the blood. A decrease in hemoglobin most often occurs with a simultaneous decrease in the number of erythrocytes (or the total volume of erythrocytes).

Anemia is not considered a separate disease, it is a temporary state of health of the baby. But it must be treated very carefully. Omissions by parents and pediatricians to adjust the level of hemoglobin lead to delays in the development of the child, dysfunction of internal organs, and decreased activity.

What is anemia (anemia)?

Anemia- this is an unnatural health condition, which is characterized by a lack of hemoglobin and red cells - erythrocytes in the blood. Sometimes there is a deficiency of only one of the above components.

red blood cells- these are blood cells that are responsible for the delivery of oxygen, hemoglobin, for tissue nutrition. They are involved in the synthesis of new cells, help blood coagulation. The level of hemoglobin decreases if red blood cells cannot cope with its transportation.

During the period of natural feeding, children most often receive the required amount of iron with mother's milk. After the termination of breastfeeding, parents can make an unbalanced menu for feeding the baby. Then the child's body suffers from a lack of red blood cells, hemoglobin is delivered to the tissues in a smaller amount. This is how anemia (anemia) develops.

Iron deficiency anemia is most commonly diagnosed in babies from 1 to 1, but there are several other types of the disease. This is hemolytic form- lack of production of red blood cells by the body; posthemorrhagic- occurs after a large blood loss; megaloblastic- characterized by a lack of folic acid, cyanocobalamin.

Separately, there are some genetic forms of anemia: sickle cell anemia, microspherocytosis and others. Hereditary forms are related to gene mutations, changes in the shape of red cells.

Videos anemia in children

Causes of anemia (anemia) in children

Anemia is diagnosed in babies under 3 years old very often - in 40 children out of 100. The causes of the pathological condition may be the following factors:

• Unfavorable intrauterine period of fetal development.

An unborn child does not accumulate the required amount of hemoglobin due to its deficiency in the mother’s blood, infections she has had, and placental abruption.

• Prematurity.
• Diseases of the blood.
• genetic predisposition.
• Insufficient intake of iron-containing foods.

The child does not like to eat or does not have in his diet meat, eggs, fish, spinach, legumes, pomegranates, plums, apples, cereals, bran in the required amount.

The rate of iron intake for children from 1 year to - 10 mg per day.

• Regular bleeding.

These are nosebleeds, postoperative period, hemophilia.

• Iron metabolism disorders.

Meet with, celiac disease, cystic fibrosis.

• Chronic diseases, past infections.

Mycosis, tuberculosis, pyelonephritis and others.

• Food, diathesis.

Iron loss occurs through the epidermis.

• The negative impact of the environment.
• Increased body weight.

Symptoms of anemia (anemia) in children

Signs of anemia children can be divided into several groups. If you observe at least 3-4 of them in your baby, be sure to consult a doctor and take the KLA for the level of hemoglobin, erythrocytes.

Treatment of anemia (anemia) in children

For the treatment of childhood anemia for parents and pediatricians You need to pay attention to the nutrition and daily routine of the baby. Drawing up a balanced menu for the crumbs helps to solve the problem of hemoglobin deficiency in 80% of cases without drug treatment. Add buckwheat porridge, fruits, vegetables, herbs, meat dishes, seafood to the children's menu. Watch the level of caloric content of food, feed the baby at least five times a day.

Important! If fish and meat are consumed along with vegetables, then iron is absorbed better. The same applies to S.

If possible, do not take the child to. Anemic children get tired quickly, cannot play much, run. They need extra rest, sleep, walks.

Taking medication is necessary for moderate and severe anemia. Pediatricians prescribe multivitamins and ferrous sulfate. Preparations should be given after meals, washed down with juices, water. The effect of therapy may not come quickly. Normalization of KLA parameters occurs 2-3 months after the start of treatment.

Children enjoy drinking syrups, for example, Ferum Lek. Iron-containing medicines are available in the form of tablets, dragees. This is Ferroplex. In the form of drops - "Hemofer".

Babies with diseases of the intestines, gastrointestinal tract are prescribed intravenous injections. They are well absorbed, give a faster positive effect than tablets and syrups, but, of course, are poorly tolerated psychologically by babies.

It is important for parents to understand that to stop taking medication immediately after the normalization of the content of red blood cells, hemoglobin in the blood -it is forbidden! The child needs to "store" them. Continue to give medication for at least 1 month after a positive blood test, otherwise the level of iron will again fall to critical levels.

Massages, exercise therapy are used as a method of improving the overall somatic health of a child with any degree of anemia.

Blood transfusion is used in extreme cases. Indications for its implementation are high blood loss, sepsis, a threat to the life of the baby. Before blood transfusion, you need to test for the compatibility of a small patient and a donor, determine the group, the Rh factor of the child's blood.

Therapy of anemia is necessarily carried out in a complex and under the supervision of a physician. UAC must be taken regularly, at least 2 times a month.

Prevention of anemia (anemia) in children

Regular medical examinations and examinations by a pediatrician help to avoid an advanced form of anemia in children. Parents of babies with a genetic predisposition to anemia should be especially careful.

Nursing mothers need to carefully plan their diet and complementary foods. Eat buckwheat, meat, legumes if the child does not; greens, bran, fish, radish, cabbage, spinach, beets.

After, analyze the baby's menu. Teach him to eat right - food rich in iron.

Hours of walking, regular exercise (at least 15 minutes a day) prevent anemic syndrome from childhood.

Compliance with preventive measures helps to reduce the risk of severe anemia in children to a minimum. Do not disregard even the slightest deviation from the norm in blood tests, take action without delay, but always after consulting a doctor.

Attention! The use of any medicines and dietary supplements, as well as the use of any medical methods, is possible only with the permission of a doctor.

Anemia (or anemia) is a condition that is characterized by a decrease in the level of hemoglobin, as well as red blood cells in the blood in children.

Why anemia develops in children - all the reasons in the table

Table number 1. Causes of anemia in children.

How to identify anemia in children: symptoms, diagnostic methods

Table number 2. Symptoms of anemia in babies under one year old and in older children

Anemia in infants is a disease that is often diagnosed in children of the first year of life. It is accompanied by a decrease in the level of hemoglobin in the blood, iron, red blood cells. The most common type of disease in children is iron deficiency anemia. It is characterized not only by a decrease in the number of red blood cells, but also by a change in their appearance: the shape of the cells changes from round to oval, the shell becomes pink. It is possible to reliably diagnose anemia in a child only in laboratory conditions.

Causes of anemia in newborns

In a young child (up to three months), the causes of anemia may be as follows.

Improper diet during pregnancy

Unbalanced nutrition of the mother during childbearing, iron deficiency in her diet. In the last stages of pregnancy, many women experience a sharp drop in hemoglobin levels, so it is necessary to pay attention to this in time and include iron-containing foods and appropriate medications in the diet. Do not forget, a low level of hemoglobin in the mother can cause intrauterine oxygen starvation in the baby.

Infection

Infectious diseases transmitted by the mother of the child during pregnancy. Infections block the normal supply of iron to the fetus and cause iron deficiency.

prematurity

Prematurity. About 90% of premature babies have a history of anemia. It occurs because the weakened body of a newborn born prematurely cannot independently produce the required number of viable red blood cells.

Improper nutrition while breastfeeding

In older children (up to a year), the reasons associated with the malnutrition of the mother and the child during breastfeeding are added to the above. Iron-deficiency anemia often occurs in children who are fed adapted formulas. Full breastfeeding of a child up to a year avoids this problem. Anemia can occur in breastfed children if the mother does not receive a complete balanced diet, her diet is limited in iron-rich foods, or she abuses alcohol and tobacco. For young children diagnosed with anemia, there are special milk formulas with an increased dose of iron.

Rhesus conflict

A serious reason for the occurrence of this disease in young children is the Rh conflict in mother and child. In this case, hemolytic anemia develops. After the birth of a baby in such situations, the membrane sheath of erythrocytes is broken in him and hemoglobin begins to quickly break down. Hemolytic anemia can also be caused by intrauterine infection of the infant with herpes viruses, rubella, toxoplasmosis. A woman in labor at risk should be under special control in the antenatal clinic throughout the pregnancy.

blood loss

The causes of anemia in infants in the first year of life can also be associated with serious maternal blood loss during pregnancy and childbirth, untimely ligation of the umbilical cord, abnormalities in the structure of the umbilical cord or placenta. Hemolytic anemia can be inherited. In this case, the fault is a special gene that provokes a change in the shape of red blood cells. This form of the disease can be externally manifested by a deformation of the shape of the child's skull, a high position of the sky, a special shape of the nose.

signs of anemia

What symptoms will reliably confirm the presence of this disease in a child of the first year of life? Anemia can only be diagnosed by a complete blood count. Primary signs of the disease in young children:

• poor weight gain, dystrophy
• low blood pressure
• frequent respiratory infections
• drowsiness and lethargy in the child
• problems with the gastrointestinal tract
• poor appetite
• pale skin tone
• fatigue, prolonged sleep
• stomatitis, cracks in the corners of the lips
• dry skin, causeless peeling of the skin
• paleness and unnatural appearance of the eye membranes

These symptoms in infants should alert parents. If anemia is suspected, the pediatrician writes out a referral for a blood test from a finger. As a result of this study, the level of hemoglobin will be determined, which in newborn babies is about 200 units, up to 6 months in a healthy child - 100 g / l, in children up to a year and older - it should be 140 g / l.

The degree of complexity of the disease

Anemia in a newborn baby and a child up to a year old can be diagnosed according to the following scheme:

1. disease of the first degree - the level of hemoglobin is higher than 90 g / l
2. second degree - an indicator in the range from 70 to 90 units
3. third degree - hemoglobin at a level of up to 70 g / l

Identification of the degree of anemia largely determines the scheme for the subsequent treatment of young children.

Treatment

Treatment of anemia in newborns can be carried out at home (if the first or second degree of the disease is diagnosed) or in a hospital (third degree).

A mild form of anemia is not dangerous for a newborn. It can be effectively treated with iron-rich foods. With such a diagnosis, special adapted mixtures are offered to artificial people, mothers of babies who are fully breastfed need to enrich their diet with buckwheat porridge, beef liver, pomegranate juice (in the absence of allergies in infants), green apples.

Treatment of the second stage of anemia involves the use of medications to raise hemoglobin levels. Such syrups must be given between feedings, since milk blocks the absorption of iron by the body.

Treatment of complex forms of anemia in newborns is carried out in a hospital. Compositions with iron in this case are administered to the child intravenously, the dosage is determined based on the patient's condition.

Iron deficiency anemia can cause oxygen starvation, exhaustion, and dystrophy in a baby. The disease can provoke a delay in physical and mental development, so it is important to start competent treatment on time.

Hemolytic anemia is much more difficult to treat. With such a diagnosis, blood transfusion, removal of the spleen is possible. Hemolytic anemia requires special monitoring of the patient in stationary conditions and an individual complex for its recovery.

Disease prevention

Treatment of anemia includes preventive measures. These include:

• a varied and healthy diet (vegetables, meat, egg yolk, fish, seasonal berries, rosehip broth)
• good sleep
• walks in the open air
• the absence of smokers in the environment of the child
• regular examination by a doctor with a blood test for hemoglobin levels

For the maturation of red blood cells in the body, folic acid is especially needed. It is found in spinach, asparagus, beans, liver, egg yolk, and cheese. Folic acid with its deficiency can enter the body in the form of tablets. The lack of this substance in children manifests itself in the form of poor weight gain, poor development of reflexes, developmental delays.

Folic acid is prescribed to pregnant women in the early stages so that the neural tube of the fetus develops normally. If there are symptoms of anemia in children, folic acid is prescribed from an early age along with iron supplements.

Komarovsky about anemia

Komarovsky claims that iron deficiency anemia in infants is perfectly treated with the help of physical activity. The more the child moves, more often he goes for walks in the fresh air, the higher his hemoglobin will be.

Meat products, which must be present on the menu of all family members, can also raise its level. Mom needs to try to keep breastfeeding, because. breast milk is the most balanced and healthy food for a baby up to a year.

Komarovsky warns that any iron-containing children's syrups can cause constipation in infants, so it is necessary to strictly adhere to the dosage and monitor the frequency of defecation in an infant.

Anemia is a disease that can develop mildly without symptoms, so it is important to diagnose it at an early stage. It threatens the child with developmental delay, reduced immunity. With a competent approach to treatment, compliance with a special diet, regular stay of the baby in the air, the disease will not go into a difficult stage.

Anemia- this is a pathological condition of the body in which the number of erythrocytes - red blood cells - decreases in the blood and the concentration of hemoglobin decreases - a substance that carries oxygen from the lungs to all tissues of the body.

Of all the anemias, the most common is iron deficiency anemia (IDA), which accounts for approximately 80% of all anemias. According to the World Health Organization (WHO), more than 500 thousand people in the world suffer from IDA. The prevalence of IDA in children in Russia and developed European countries is: about 50% - in young children; more than 20% - in older children.

Normal blood counts in children depend on age and differ from those in adults.

The number of red blood cells should be at least 4.5 - 4.1 million / l,
the hemoglobin level in children under 5 years old is at least 110, and over 5 years old - at least 120 g / l.

The daily need of the child's body for iron is 0.5-1.2 mg per day. In young children, due to the rapid growth and development, there is an increased need for iron. During this period of life, iron stores are rapidly depleted due to its increased consumption from the depot: in premature babies by the 3rd month, in full-term babies by the 5th-6th month of life. To ensure the normal development of the child, the daily diet of a newborn should contain 1.5 mg of iron, and for a child of 1-3 years old - at least 10 mg.

Iron deficiency in children leads to an increase in infectious diseases of the respiratory and gastrointestinal tract. Iron is necessary for the normal functioning of the brain structures; if it is insufficient, the neuropsychic development of the child is disturbed. It has been established that in children who had iron deficiency anemia in infancy, at the age of 3–4 years, disturbances in the transmission of nerve impulses from the centers of the brain to the organs of hearing and vision are determined due to impaired myelination and, as a result, impaired nerve conduction.

Causes of iron deficiency in children

The reasons are very varied. The main cause of anemia in newborns is the presence of iron deficiency anemia in the mother during pregnancy. In addition, the reasons may be:

• insufficient intake of iron from food. At the same time, newborns who are bottle-fed with unadapted milk mixtures, cow and goat milk suffer the most.
• increased body need for iron;
• iron loss in excess of physiological;
• diseases of the gastrointestinal tract, syndrome of impaired intestinal absorption;
• anatomical congenital anomalies (Meckel's diverticulum, intestinal polyposis);
• the use of foods that inhibit the absorption of iron;
• blood loss (posthemorrhagic anemia);
• taking certain medications, such as non-steroidal anti-inflammatory drugs, salicylates, coumarins, glucocorticosteroids.

Which children are most at risk of developing iron deficiency anemia?

• premature babies;
• children from multiple pregnancy;
• large, fast-growing children;
• children born to mothers suffering from iron deficiency anemia;
• children with manifestations of exudative-catarrhal diathesis;
• children with unstable stools;
• frequently ill children;
• children who are early transferred to artificial feeding, especially if it is carried out incorrectly.

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What are the signs of iron deficiency anemia?

Iron deficiency anemia is manifested by general symptoms. One of the main and visible signs is the pallor of the skin, mucous membranes, conjunctiva of the eyes. Attention is drawn to general lethargy, capriciousness, tearfulness, slight excitability of children, a decrease in the general tone of the body, sweating, lack or decrease in appetite, superficial sleep, regurgitation, vomiting after feeding, decreased visual acuity. Changes in the muscular system are revealed: the child hardly overcomes physical activity, weakness, fatigue are noted. In children of the first year of life, regression of motor skills may be observed.

In the second half of life and in children older than a year, there are signs of epithelial tissue damage - dry skin, roughness, angular stomatitis, painful cracks in the corners of the mouth, glossitis or atrophy of the oral mucosa, brittleness and dullness of hair, their loss, dullness and brittleness of nails, tooth decay (caries), lag in physical and psychomotor development.

Depending on the severity of the disease, symptoms of damage to organs and systems are revealed: cardiovascular - in the form of functional heart murmur, tachycardia; nervous system - in the form of headaches, dizziness, fainting, orthostatic collapses. Perhaps an increase in the size of the liver, spleen. On the part of the gastrointestinal tract, there is difficulty in swallowing, bloating, diarrhea, constipation, taste perversion - the desire to eat clay, earth.

When these symptoms appear, it is necessary to do a blood test to determine the level of hemoglobin, red blood cells and a color index. If the indicators are normal, but the child has clinical signs of iron deficiency, it is necessary to determine the level of serum iron. When its level drops below 14.5 µmol/l, the doctor diagnoses latent iron deficiency and prescribes treatment.

Treatment of iron deficiency anemia

Treatment of anemia should be comprehensive and based on four principles: normalization of the regimen and nutrition of the child; possible correction of the cause of iron deficiency; the appointment of iron preparations; concomitant therapy.

In breastfed infants, iron requirements cannot be met by milk alone. Calculations have shown that in order to fill the daily need for iron, a child should drink up to 15 liters of milk per day! In breast milk - 0.3 mg / l of iron. And in cow's milk it is 5 times lower. Therefore, children from 5 months should be introduced into the diet of vegetables, and from 8 months mashed meat.

Formula-fed infants should not be given iron-fortified formulas. Unabsorbed iron can cause an increase in the vital activity of the opportunistic intestinal microflora and contribute to the development of dysbacteriosis.

You should pay attention not to the total content of iron in the products, but to the form in which it is contained. Food iron is divided into heme (combined with protein) and non-heme (in the form of iron salts). Heme iron, which is found in meat products, is best absorbed. Plant foods, although rich in iron, are significantly inferior to meat in terms of digestibility. Of plant products, citrus fruits, black currants, rose hips, peaches, dried apricots, legumes, parsley root, spinach, dill are preferable. The role of apples and pomegranates as a source of iron is clearly exaggerated.

In the diet of older children with iron deficiency anemia, meat products should not be combined with dairy and flour dishes. They contain phytin, which prevents the absorption of iron. Citrus fruits contribute to the strengthening of iron absorption, so it is useful to drink, for example, orange juice with a meal.

Plant fibers, bran, fats, salts of oxalic and phosphoric acid inhibit the absorption of iron. You should not drink tea with meat dishes, as the tannin contained in tea also inhibits the absorption of iron.

Treatment of iron deficiency conditions should be carried out with iron preparations. For young children, it is better to use liquid forms of drugs (hemofer, aktiferrin), for older children - encapsulated forms or tablets (conferon, ferroplex, tardiferon retard, ferro-gradumet). It is advisable for adolescents to prescribe prolonged iron preparations (tardiferon, ferro-gradumet), which are slowly absorbed and well tolerated. In any case, the drug and dose should be determined by the doctor. Modern preparations, as a rule, are combined and contain, in addition to iron, components that improve its absorption and tolerability, for example, ascorbic acid.

Iron preparations in the form of injections do not have a significant advantage over tablet forms, but they can give a number of undesirable effects: allergic reactions, deposition of excess iron in tissues, infiltrates when administered intramuscularly.

It must be remembered that in young children, iron deficiency is never isolated and is often combined with a deficiency of vitamins C, B12, B6, PP, A, E, folic acid, zinc, copper, etc. This is due to the fact that nutritional deficiency and impaired intestinal absorption, leading to iron deficiency, also affects the saturation of these micronutrients. Therefore, it is necessary to include multivitamin preparations in the complex therapy of IDA.

Contraindications to the appointment of iron preparations are:

• lack of laboratory confirmation of iron deficiency;
• sideroahrestic anemia;
• hemolytic anemia;
• hemosiderosis and hemochromatosis;
• infection caused by gram-negative flora (enterobacteria, Pseudomonas aeruginosa, Klebsiella).

Rules for taking iron supplements

There are general rules for taking iron supplements:

It is better to take iron before meals, with poor tolerance - during meals or 1-1.5 hours after meals

Treatment should be started with small doses and, if well tolerated, reach the dose prescribed by the doctor within a week.

Take iron along with drugs that improve its absorption - ascorbic acid 0.1 g each or drink citrus juice

To prevent dyspeptic manifestations, pancreatin is used (after eating), in children with intestinal dysbacteriosis - drugs that normalize the microflora (Vitaflor, Bificol, etc.)

Criteria for correct treatment:

Clinical improvement - reduction of muscle weakness after 5-6 days

Increased levels of reticulocytes (young red blood cells) after 8-12 days

Increase in hemoglobin level 3-3.5 weeks after the start of treatment

Normalization of hemoglobin levels after an average of 1.5 months

Treatment with iron preparations should be carried out under the supervision of a physician, in sufficient doses and for a long time (at least 3 months), even after normalization of hemoglobin levels, in order to replenish iron stores in the depot.

Prophylactic administration of iron preparations is indicated for children at risk for the development of IDA:

• premature babies (from 2 months of age);
• children from multiple pregnancy, complicated pregnancies and childbirth;
• large children with high rates of weight gain and growth;
• children with constitutional anomalies;
• children suffering from atopic diseases;
• those who are artificially fed with non-adapted mixtures;
• with chronic diseases;
• after blood loss and surgical interventions;
• with malabsorption syndrome.

Literature used
1. Your child's health. The latest reference book./Under rivers. V.A. Alexandrova. Izv-vo Eksmo, 2003