If a child's blood test showed deviations from the norm, this always causes anxiety. Most often in childhood, changes in the level of hemoglobin are detected, in particular, its decrease. What does a decrease in hemoglobin affect, what is a dangerous low indicator and how to help a child - these questions are important for any parent.

What hemoglobin in children is considered low?

Hemoglobin is a blood protein found in red blood cells. It contains iron, so due to the lack of iron, the formation of such a protein is disrupted. The main function of this protein is the transport of oxygen throughout the child's body. Hemoglobin gives oxygen to the tissues and takes carbon dioxide from them, which it carries to the lungs.

To assess whether a child’s hemoglobin is normal or underestimated, one should take into account the age of the baby, because such an indicator in a newly born child, at 1 year old, at 2 years old or at 10 years old, will be different. In newborns, the level of this protein is higher, and from the second week of life it gradually decreases. And therefore, the indicator, for example, 110 g / l, for a child of 1 year old will be within the normal range, and for an infant of the first months of life it will turn out to be dangerous anemia.

The following dosages are considered the lower limit of the normal hemoglobin level in children.

Why does hemoglobin decrease in children?

The most common cause of low hemoglobin in childhood is anemia, which is caused by iron deficiency. The well-known pediatrician Komarovsky agrees with this. Iron deficiency in infancy is caused by anemia in the mother, untimely introduction of complementary foods and low physical activity of the crumbs. At an older age, iron deficiency is often associated with the nutrition of the child himself, for example, if he has a vegetarian diet.

The release of Dr. Komarovsky's program on the problem of low hemoglobin in children, see the following video.

In addition to iron deficiency anemia, a decrease in hemoglobin in children can be a sign of:

• hemolytic anemia, in which red blood cells are destroyed;
• anemia, which was provoked by a deficiency of B vitamins (in particular, B12 and B9);
• acute bleeding, for example, with trauma or surgery;
• chronic bleeding, such as frequent nosebleeds or heavy periods in a teenage girl;
• Crohn's disease and other bowel diseases;
• hemophilia and other blood diseases;
• infectious disease;
• helminthic invasion;
• taking certain medications;
• allergies;
• tumors.

Signs of a decrease in hemoglobin

Anemia in childhood is manifested by:

• pale skin;
• lethargy;
• rapid onset of fatigue;
• weakness;
• dizziness;
• monlivosity;
• changes in nails (white dashes and spots appear on them);
• loss of appetite;
• worsening sleep;
• elevated body temperature;
• bad mood;
• circles under the eyes;
• frequent viral infections;
• peeling and dry skin.

If you do not pay attention to such symptoms immediately, the child develops shortness of breath and tachycardia, apathy appears, attention and memory deteriorate, and developmental delay occurs.

What to do?

Having noticed in a child the symptoms that occur with anemia, you need to contact a pediatrician who will send a small patient for a clinical blood test. If low hemoglobin is found in a baby during a routine examination, the child should retake a blood test to rule out a mistake in the laboratory. When the low rate is confirmed, the pediatrician will additionally examine the child to determine the cause of anemia, as well as to select the correct treatment.

Consequences of anemia

If low hemoglobin is not detected on time or the situation is left to chance, this threatens the child with serious health problems. Lack of hemoglobin causes insufficient oxygen supply to all tissues of the child's body, including brain tissue.

The consequences of prolonged hypoxia will be a lag in the development and deterioration of the brain activity of the child, as well as disruption of the internal organs.

Treatment

The approach to treating a child with low hemoglobin should be comprehensive and based on the reason for the decrease in this blood count.

• If a child has iron deficiency anemia, he is shown iron supplements. They should be prescribed by a pediatrician, choosing the appropriate dosage for the age. Do not give your child any iron supplement on their own. Children with iron deficiency are usually prescribed drugs that are taken by mouth. They are represented by drops or syrup, for example, drugs Aktiferrin, Ferrum Lek, Maltofer and Ferronal 35.
• If the cause of low hemoglobin is acute blood loss, the child may be prescribed a blood transfusion. Also, this procedure is recommended for children with severe iron deficiency anemia.
• At the same time, the doctor will advise you to adjust the child's diet by adding foods high in iron to it, which promotes the formation of hemoglobin in the body. These products include meat (from which iron is absorbed much better than from any plant food), legumes, eggs, offal, cereals, pomegranates, berries, nuts and other products.
• Children with anemia are also advised to take long walks in the fresh air., since the access of oxygen stimulates the formation of red blood cells.

Parents should understand that it is impossible to treat anemia only by changing the child's diet, dietary correction will only help to supplement the treatment. Moreover, it should be remembered that iron preparations are completely neutralized by milk. Therefore, they should not be taken together with milk porridge, for example.

The opinion of the famous pediatrician Yevgeny Komarovsky regarding the diet during the treatment of anemia, see here.

Prevention

To prevent a decrease in hemoglobin in childhood, such measures should be taken.

• During the period of gestation, the expectant mother must regularly take blood tests and take complex vitamins. If anemia is detected in a pregnant woman, treatment should be started in a timely manner so that the fetus can accumulate iron before birth in the right amount.
• Breastfeeding is important for a newborn after all, iron is absorbed from human milk better than from any other food, even from a quality mixture enriched with iron. This is due to the presence in breast milk of a special enzyme called lactoferrin. By the way, this enzyme helps the child absorb iron from complementary foods, so it is not recommended to complete breastfeeding during the period of acquaintance with new food.
• Complementary foods for infants should be introduced in a timely manner. The advice of pediatricians to acquaint the baby with new products from the age of 6 months is also due to the fact that the iron stores in the baby’s body run out by this age. When introducing complementary foods, it is important to take into account current recommendations, since the early introduction of cow's milk crumbs into the diet is considered by pediatricians as a risk factor for the development of both anemia and rickets.

• In the diet of preschool and school children, there should be enough foods rich in proteins, iron and B vitamins. Such foods are chicken, beef, liver, apples, persimmons, blueberries, buckwheat, nuts, turkey, dried apricots and others. It is also important to provide the child with sufficient physical activity and daily exposure to fresh air.
• To timely identify the risk of anemia, the child should regularly take a clinical blood test. It is best to do this survey once a year.

Such a complex protein as hemoglobin, consisting of two components gemma and globin, is the basis of red blood cells. Its functional significance for the human body is great - after all, it is he who is involved in the transport of oxygen molecules from the lungs to the tissues, and also removes carbon dioxide and helps regulate the acid-base state (ACS).

In the blood, the protein is presented in two variations: as oxyhemoglobin (in combination with oxygen), and as reduced hemoglobin (giving oxygen molecules to tissues). If the former is found mainly in the arterial blood, giving it a bright scarlet color, then the reduced protein is present in the venous blood, which makes its color darker.

Naturally, hemoglobin plays a huge role in the life of the body and is an important indicator of its normal functioning. That is why, starting from birth, a blood test is taken from a person, where such an indicator as the quantitative determination of this protein is mandatory. Pediatricians around the world rightly pay great attention to ensuring that hemoglobin in the child's blood remains normal, since its decrease is fraught with unpleasant consequences.

Causes of low hemoglobin in a child

Depending on the age of the child, the reasons for the decrease in the vital protein may be different.

As for newborn babies, due to blood loss, increased destruction, or a general violation of the production of red blood cells, anemia may occur in a child:

The baby can lose a significant amount of blood during childbirth, this happens when premature placental abruption or rupture of the umbilical cord begins.

A low level of hemoglobin can also be in the case of increased breakdown of red blood cells, while the bone marrow cannot cope with the production of new proteins, due to its underdevelopment. Similar phenomena are often observed in premature babies aged 1-2 months.

Some diseases can also lead to increased breakdown of hemoglobin, such as hemolytic disease of the newborn. At the same time, antibodies that he received from his mother act in the body of the child. It is they who destroy the erythrocytes of the fetus.

Such a hereditary disease as spherocytosis is the cause in infants. Hemoglobin quickly breaks down due to the irregular, spherical shape of red blood cells.

The reason for the rapid destruction of red blood cells can also be an intrauterine infection received by a child, for example, rubella, herpes simplex or syphilis.

Even with initially normal hemoglobin levels, if there is insufficient dietary iron intake, hemoglobin levels may decline as early as 6 months of age, as the reserves received from the mother by this time are depleted.

As for children of preschool and school age, they have other reasons for reducing the level of hemoglobin in the blood:

Most often at an older age, the main cause is malnutrition of the child. But it is worth understanding that it is not enough just to feed your child with foods rich in iron content. It will be absorbed only if certain vitamins and minerals (copper and manganese) are present in the body. As studies conducted by WHO have shown, this process is greatly facilitated by ascorbic acid. If it is present in the body, the assimilation of both organic (contained in products) iron and in the form of drugs occurs very quickly and almost in full.

If a child has a deficiency of folic acid and vitamin B12, the production of red blood cells is disrupted, and as a result, anemia will not take long. Often this is due to the fact that the baby receives few vegetables during the period of active growth, or they are cooked for too long.

The reason for the decrease in the level of hemoglobin, which is so necessary for the body, can also be various bleeding, both obvious and passing in a latent form. As for the former, for girls who are in the puberty phase, these are most often begun. If the discharge is abundant, then in most cases the hemoglobin level decreases. But with the right approach to nutrition, no additional funds are required. Also, with errors in the menu, it can develop, due to even small but regular blood losses, the treasured protein becomes smaller, and doctors can diagnose anemia. Naturally, due to various kinds of injuries and injuries, bleeding can occur, which will inevitably lower the level of hemoglobin. As for hidden bleeding, in children they can be observed with gastrointestinal disease.

Another reason leading to the problem described above can be an unhealthy lifestyle, namely: if a child spends little time on the street, does not move, does not play sports, then it is natural that his metabolism is disturbed. This will inevitably lead to the fact that the level of iron in the blood will be low. But it is worth considering that, on the contrary, increased physical activity can lead to such a reaction of the body, when the child is engaged in excessive physical labor or too heavy a sport.

Taking certain medicines in childhood, especially without medical supervision, can lead to anemia.

Most often, those children suffer from anemia, whose mothers during pregnancy did not take care to cure their iron deficiency anemia. Naturally, this is also transmitted to the baby, since its already small reserves are quickly depleted. The cause of early anemia, in addition to the above, can also be frequent colds of the mother during childbearing, or if the pregnancy is multiple. At the same time, at birth, all indicators of the crumbs are most often normal, but by the 3rd month, a blood test will reveal a low level of hemoglobin.

Surprisingly, the myths about artificial feeding and, as a result, the development of anemia are really myths. If a child receives a full-fledged adapted milk formula in the proportions necessary for his age and weight, as well as a well-introduced first complementary food, then he will not face iron deficiency. But there are exceptions here, it is not too early to transfer to a mixture, since a very young organism is sometimes not able to break down cow protein, on the basis of which mixtures are made.

As for some symptoms, children under one year old may show the following symptoms:

The skin becomes dry, even small cracks may appear, especially noticeable in the corners of the mouth. Hair and nails grow poorly, fall out and break.

The baby is lethargic, gets tired quickly, lags behind in development, due to changes in the muscles, does not begin to raise his head in time, roll over to one side and crawl.

The mucous membrane of the mouth dries up, it may appear, and appetite is often reduced, the stool is disturbed. Moreover, both and can be observed.

Mental retardation is also observed, especially if anemia remains undetected. This is due to the fact that oxygen is not “supplied” to the brain in the proper level, it experiences corresponding starvation and cannot fully function.

The immunity of a baby up to six months of age depends on the antibodies received from the mother. Naturally, it will be reduced in those children whose hemoglobin is not at the proper level. Such babies from an early age are prone to frequent diseases of the upper respiratory tract, suffer from and.

The rate of hemoglobin per year

The limits of the norm of an important protein for life can vary depending on the age of the child. The indicator that is adequate for a newborn baby will be too high for a one-year-old baby. That is why parents should be guided by the numbers indicating the normal values ​​​​of the child's hemoglobin.

In the first 3 days of life, hemoglobin values ​​can range from 145 to 225 g/l, and by the month they are already much lower from 115 to 175 g/l. Further, starting from two months of age and ending with a year, this figure varies between 110 and 145 g / l.

Knowing these numbers and donating blood regularly, as prescribed by a doctor, you can monitor the normal level of hemoglobin and prevent the development of a disease such as iron deficiency anemia. This disease is very insidious and may not give itself away, while weakening the defenses of the baby's body. Experts note that anemia is a fairly common disease that many children face. However, do not despair, because with timely diagnosis and adequate treatment, it disappears without a trace.

How to increase hemoglobin in infants?

Ways to increase hemoglobin in infants will directly depend on the cause that caused this condition.

If protein deficiency occurs due to blood loss during childbirth, then an immediate transfusion is required. With excessive destruction of red blood cells, an exchange transfusion is required. The child's own blood is gradually and slowly replaced with a donor's. Thanks to a similar procedure, damaged bilirubin and red blood cells, as well as maternal antibodies, are removed from the baby's body. When direct treatment of anemia is required, appropriate iron preparations are prescribed, with the development of serious symptoms of the disease, a blood transfusion is performed.

Nursing mothers need to adjust their diet to include those foods that are rich in iron. After all, in infancy, children mainly eat only mother's milk. With the introduction of complementary foods, it will be easier to raise the level of hemoglobin, since the child will be able to directly receive iron from food without "sharing" with the mother.

As for preventive measures, they begin at the stage when the child is in the womb. A pregnant woman should register in a timely manner, donate blood and treat anemia, if any. Infants, on the other hand, are shown adequate feeding, prevention of rickets and dystrophy. Measures should be taken in time to treat possible intestinal and infectious diseases, and, of course, do not forget about regular blood tests. This is especially true for children at risk.

Depending on the severity of anemia, you can raise the child's hemoglobin in the following ways:

If the indicators fell below 110 g / l, but did not go beyond 100, then the baby's nutrition should be adjusted and thus try to increase the hemoglobin level. For this, it is very important to eat not just meat products, but in combination with vegetables. So the percentage of iron absorbed in the intestine increases significantly. But about such drinks as milk, tea and coffee should be forgotten. Often pediatricians prescribe ascorbic acid. A dentist should be consulted to rule out gingivitis, as a child may lose blood when brushing their teeth. After adjusting the nutrition, a second blood test is performed, and if no improvement is observed, then appropriate drugs are prescribed.

If the indicators have reached the limit of 100 g / l, but not lower than 90, then preparations containing iron should be taken. Their choice should be taken very carefully, so in order to avoid many complications and improve absorption, preference should be given to the 3-valent iron contained in the tablets. Most often, the duration of the course is a month, after which a control blood sample is taken, if an increase in hemoglobin is observed, then the drugs are taken for another 60 days. All treatment must be carried out under the supervision of a physician.

If the indicators have reached the level of 60 - 90 g / l, then one should proceed from the general condition of the child. Depending on it, either iron solutions are taken by mouth or intramuscular injections are prescribed. Blood counts are monitored every 10 days, self-medication is unacceptable.

When hemoglobin falls below the mark of 60 g / l, an emergency transfusion of erythrocyte mass is prescribed, since such conditions are a direct threat to life, first of all, the brain suffers.

It should be remembered that all treatment is carried out under the supervision of a doctor, hospitalization is required only in the last case, with severe anemia. At the same time, it is important for parents to remember that a balanced diet, combined with regular examinations, is the best prevention of iron deficiency anemia.

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One of the indicators of the quite normal functioning of the child's body is the level of hemoglobin (a special protein in connection with iron that fills red blood cells). A decrease in hemoglobin in the baby's body leads to the development of sideropenia and, these are different stages of oxygen and energy deficiency of cells due to problems with the transfer of oxygen to them. It is hemoglobin that has the properties to bind oxygen molecules, bringing them to the tissues, and carbon dioxide, taking them out of the cells to the lungs and releasing them out of the body. There are plenty of reasons for a decrease in hemoglobin, and it is a mistake to think that this is due only to nutrition and a lack of iron in it. What are the roles of this mineral and hemoglobin, what is the danger of its decrease and what to do?

Iron for a child: why and how much is needed?

If we talk about vital minerals that are constantly needed for the full development of the child, then iron will be one of the leading trace elements. The total content of this ion does not exceed 3 grams, but its role is so great that the deficiency immediately affects the metabolic processes of the whole body. Iron is part of the enzymes and proteins that perform the vital functions of the body, such as carrying oxygen and protecting against infections in the mucous membranes and tissues of the body ( nonspecific immunity ). In addition, due to its presence, motor functions are also carried out. The body synthesizes a special protein - globin , consisting of 4 glomeruli connected by bridges and iron ions ( gema ). Only in this form does it take on the form of hemoglobin and can transport oxygen molecules from the pulmonary system to tissues, and carbon dioxide from tissues to the lungs.

But the functions of the iron ion are not limited to hemoglobin, it is part of the muscle protein. myoglobin , which only in combination with heme can maintain the tone of muscle fibers, their excitability and contractility. Therefore, with anemia and iron deficiency, muscle weakness and rapid fatigue often occur.. But that's not all: iron is the basis of ferritin, lactoglobulin, lactoferrin and many enzymes, storage proteins (hemosiderin). In summary, the role of iron ions in the body can be described as:

• Carrying out the functions of tissue respiration and oxidation with the formation of energy
• Performing immunostimulatory functions due to the synthesis of proteins with protective functions
• Metabolic regulator
• Participant in the processes of building and updating body tissues.

In this regard, the intake and consumption of iron in the body should be clearly controlled, dietary iron should be enough to cover all needs, and its increased losses should be immediately compensated.

Sources of iron

Per day, the child's body, depending on age, should receive at least 8-15 mg of iron, which comes from the intestines (with food, water, supplements or drugs).

note

Iron reserves are initially formed in the child from the mother in utero, in the last months of gestation, but then they are actively spent on the needs of their own body, so there are not many of them. If the mother was malnourished during pregnancy or suffered from or lack of iron, the reserves will be initially reduced.

After birth, the baby accumulates iron, which is actively absorbed from the intestines and goes to build both hemoglobin and other proteins. If we talk about dietary iron, it is absorbed into the plasma in the form of ions, connecting with special carrier proteins, and sent to the bone marrow to build new red blood cells. Part of it goes to the liver, where the rest of the body's proteins are built with its participation.

Iron is a common mineral in nature, it is quite abundant in various foods, but the amount of the ion in different types of food varies, as well as the degree of absorption due to the fact that iron can have different valencies. So, if we talk about the types of minerals, then it stands out:

• Heme iron , which is built into the hemoglobin of animal tissues or muscle proteins, it is abundant in meat products and offal categories.
• Iron in ionized form having a divalent or trivalent ion. Such iron is usually contained in plant foods, it is absorbed with difficulty, and a trivalent ion can be assimilated only if there is also an iron that transfers valence from three to two. Legumes are the richest in iron, but for good absorption of the mineral, they must be consumed with fresh fruits.

Animal foods allow you to absorb up to 25% of iron from them, while from plant foods this is a maximum of 6-8%, which is important if you want to switch to vegetarianism with your child.

The absorption of iron and its assimilation depends on many conditions. In the presence of phytin (a protein of cereal crops) in food, the absorption of iron is inhibited, it binds in the intestine and cannot be absorbed. Difficult absorption of dairy products due to calcium competing with iron in terms of absorption. Absorption is worse with a deficiency of folate, vitamin C and.

Iron deficiency and its effect on hemoglobin

With iron deficiency, first of all, hematopoiesis suffers, or rather the synthesis of hemoglobin for new red blood cells. Part of the iron comes from the spleen, where obsolete old cells are destroyed, but it is not enough to cover all the needs due to iron losses that occur daily. Children most often suffer from iron deficiency, which leads to a decrease in hemoglobin synthesis and anemia. Feeding problems contribute to the development of low hemoglobin, especially if instead of breast milk or a complete mixture for IV, the child is fed cow's milk, kefir or semolina.

Problems with hemoglobin lead to problems such as:

• Digestive disorders in the form of enzymatic defects and inflammatory processes in the intestinal wall, a violation of the microbial balance of the intestine.
• Allergic disorders with inflammation of the intestinal wall and impaired absorption of iron.

A decrease in hemoglobin below certain standards leads to the formation of anemia, which affects metabolic processes, reduces the body's immune defenses and leads to trophic disorders. As a result, problems with physical development develop - growth and weight gain, as well as mental development, fatigue, moodiness, sleep disturbances and cognitive functions are formed.

Hemoglobin norms in children

The amount of hemoglobin in the blood of a child depends on his age, state of health and degree of activity. Children have a maximum level during the neonatal period, on the 4th day of life, and then it decreases due to the destruction of fetal hemoglobin, which was necessary in utero for good nutrition. Gradually, fetal hemoglobin is replaced by its adult form. In the first months of life, up to 1.5% of fetal hemoglobin of the total volume is permissible, and in general the amount is about 110-120 g / l, gradually changing by age and sex. By the period of adolescence in boys, the norms will be up to 120-145g / l, in girls 110-140g / l. After this age, the norms are the same as among adults. The decrease in hemoglobin in the female body is due to the hormonal and physiological characteristics of the body.

If there are problems with iron intake, hemoglobin synthesis and loss of iron, blood, various anomalies in the structure and functioning of red blood cells, anemia is formed. But this is not only iron deficiency anemia, which is most talked about in childhood.

Consequences of anemia in children

A decrease in hemoglobin may not make itself felt for a long time until the numbers reach significant deviations. Manifestations of a decrease in hemoglobin and the resulting anemia may have non-specific symptoms that parents may mistake for other problems until it is received. So, children can be pale, with dark circles or blue under the eyes, they are lethargic and get tired quickly, complain of weakness and malaise. Against the background of loads, both (sharply rapid contraction of the heart), and are not uncommon. Children have dry skin, flaky lips, pale mucous membranes of the mouth and bad nails and hair. They grow worse, eat poorly and sleep anxiously, constantly get sick.

Hemoglobin deficiency leads to hypoxia of tissues and organs. This is especially critical for those organs that consume a large amount of oxygen and energy - the brain, kidneys, liver and heart. With oxygen deficiency, the process of oxidation with the formation of energy is inactive, the cells experience energy hunger, which leads to problems in the synthesis of certain substances. In general, cellular and tissue metabolism suffers. This leads to a decrease in muscle tone and activity, impaired contractility of the heart, the excretory function of the kidneys, and the synthetic function of the liver suffer. The nervous system hardly tolerates hypoxia, since its metabolic processes are oxygen-dependent. This threatens to slow down mental development and reduce concentration.

Causes of low hemoglobin in children

The most common cause of low levels is iron deficiency, and such anemias account for up to 70% of all hemoglobin problems. We have already discussed the mechanisms in detail above, but it is worth remembering that low hemoglobin is not always exactly iron deficiency anemia. There are a number of other reasons and factors affecting its concentration. These include:

Identification and principles of treatment of anemia

It is not difficult to identify a hemoglobin deficiency; it determines it. It can also partially indicate the reasons for the shape, type and size of erythrocytes, the number of special (immature) forms of erythrocytes in the blood - reticulocytes. But the exact reasons can be revealed by determining the level of iron and its compounds in the serum, and in some situations, by analyzing the bone marrow punctate. Additional tests and instrumental studies are also needed to assess the severity of anemia, the focus of blood loss in case of suspected bleeding, etc.

The principles of treatment are developed by the doctor, after determining the type of anemia and its severity. The basis is:

• Rational nutrition with the intake of a sufficient amount of iron, as well as microelements (stranded, magnesium or manganese), supplementation of vitamin C and rutin, group B - especially folates and cyanocobalamin. The diet necessarily contains animal proteins and offal, vegetarianism for anemia, especially in young children, is prohibited.
• routine activities, frequent exposure to fresh air, load according to the degree of fatigue.
• treatment of digestive disorders and all disorders caused by anemia during the treatment of the underlying disease.
• with iron deficiency as the cause of anemia, taking drugs according to age in therapeutic dosages, then switching to prophylactic ones for a long period.
• prevention of colds, infections, due to hardening, elimination of disorders of the nervous system, maintaining a healthy lifestyle.

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Alena Paretskaya, pediatrician, medical commentator

Low hemoglobin in infants during breastfeeding and artificial feeding - causes and consequences

Low hemoglobin levels in infants can occur with both breastfeeding and bottle-feeding. But this disease is insidious - and it is dangerous because it is asymptomatic for a long time, but at the same time all the tissues of the body do not receive enough oxygen, which is necessary to ensure all metabolic processes in the body and for the normal development of the child, both physical and mental.

Anemia in a child under one year old- a very widespread disease that in the early stages does not have specific obvious signs, but leads to a deterioration in the functions of all body tissues. Under the general medical term “anemia”, different in etiology and nature of the course of the disease are combined, in which there is a decrease in the level of hemoglobin and erythrocytes in the blood, which leads to an insufficient supply of oxygen to tissues. Therefore, during a preventive examination, the doctor prescribes a clinical blood test to the child. The norm of hemoglobin changes with age, which is due to the characteristics of a growing organism.

After reading this article, you will know:

What is hemoglobin?

Hemoglobin consists of a protein molecule and an iron atom and is located inside erythrocytes - red blood cells. The function of this protein is the ability to attach oxygen or carbon dioxide to itself and transport them to various organs. It is the erythrocytes that deliver oxygen from the lungs to the tissues and vice versa, taking carbon dioxide from the tissues, transfer it to the alveoli. Reduced hemoglobin in a child leads to insufficient oxygen circulation in the body. This means that all tissues do not receive it in sufficient quantities. And oxygen is necessary for the origin of all oxidative processes in the cell. Therefore, all organs cannot perform their functions properly. Low hemoglobin in a child under one year old can affect the baby's susceptibility to seasonal diseases, as resistance to infections decreases, his activity, curiosity.

What is the norm of hemoglobin?

The norm of hemoglobin in the blood in children is indicated as the minimum and maximum allowable values, a deviation to either side indicates a violation of blood formation in the body due to a lack or excess of iron.

1-3 days 145 – 225 g/l

1 week 135 - 215 g/l

2 weeks 125 – 205 g/l

1 month 100 – 180 g/l

2 months 90 – 140 g/l

3-6 months 95 – 135 g/l

0.5-2 years 105 - 135 g/l

2-6 years 115 - 135 g / l.

If the hemoglobin level is higher than normal, is it good or bad?

The norm of the hemoglobin level in a child depends on age indicators, as a rule, the norm of hemoglobin in children under one year old decreases monthly from birth to 3 months, then, having stabilized, it increases slightly, as the needs of the growing body of the baby also increase. But the level of hemoglobin above the proper level is not a good indicator, but, as a rule, indicates the presence of diseases of the internal organs, in which the body begins to produce an increased number of red blood cells to provide the diseased organ with oxygen. So the level of hemoglobin rises with a disease of the respiratory system. In some cases, an increase in hemoglobin can be observed during the recovery period after an infectious disease, during the heat with insufficient drinking regimen for the baby.

An increase in red blood cells leads to thickening of the blood and disruption of its circulation, which also negatively affects the health of the baby.

Anemias are divided into:

• According to the mechanism of occurrence

• iron deficiency anemia - with insufficient intake of iron from food. In this case, the child's bone marrow is not able to produce a sufficient number of red blood cells.
• Dyshemopoietic anemia - anemia associated with impaired blood formation in the red bone marrow.
• Posthemorrhagic anemia - associated with acute or chronic blood loss.
• Hemolytic anemia - occur against the background of increased destruction of red blood cells under the influence of toxins or a lack of enzymes. Such anemias are quite rare, they can be caused by autoimmune diseases, hemolytic jaundice of newborns, taking drugs containing toxins, and with some viral diseases.
• B12 and folate deficiency anemia.

The most common anemia in children, as well as in women during pregnancy, is iron deficiency anemia.

• According to the stages of the disease

In its development, anemia goes through three main stages:

1. Prelatent iron deficiency. At this stage, the microelement reserves contained in the tissues are reduced. In the composition of the peripheral blood, the level of iron remains within the normal range. In the tissues, its content is reduced, and it is not absorbed from the incoming products due to a decrease in the activity of intestinal enzymes.
2. Latent (hidden) iron deficiency. The amount of deposited reserves of this substance and its content in blood serum are reduced.
3. The last stage of iron deficiency. There is a significant decrease in the level of the microelement per unit volume of blood, as well as a decrease in the number of red blood cells. In fact, this condition is called iron deficiency anemia.

• By degreegravity

In accordance with the level of hemoglobin in the blood, there are three degrees of severity of anemia:

1. The first, or mild: the amount of hemoglobin is below normal, but above 90 g / l.
2. The second is medium: the hemoglobin level is kept in the range from 90 to 70 g / l.
3. The third is severe: the amount of hemoglobin falls below 70 g / l.

Low hemoglobin in children causes and consequences

Causes of low hemoglobin in children under one year old due to iron deficiency:

• Unbalanced nutrition. Mother's milk is able to provide the needs of the child's body for iron up to 6 months, therefore, after the baby is six months old, it becomes necessary to introduce complementary foods. Low hemoglobin in a child aged 1 year may be due to a deficiency of vitamins and iron-containing foods in the baby's diet.
• Early weaning. Breast milk contains a small amount of iron, but it contains the protein lactoferrin, which promotes the absorption of the small amount of iron found in milk. Early weaning, artificial feeding with unadapted mixtures, cow or goat milk often cause low hemoglobin in a child under the age of 6 months.
• Diseases of the gastrointestinal tract, leading to a decrease in iron absorption. In violation of absorption in the intestine, the amount of iron absorbed by the body, as well as vitamins, decreases sharply, which is observed with gastritis, enterocolitis, intestinal infections, malabsorption syndrome, celiac disease, lactase deficiency, rickets, cystic fibrosis.
• Heredity. For some people, the number of red blood cells, bordering on a deficit, is the norm, with little or no effect on health. So, with the normal development and growth of the baby, his activity and general health indicators, reduced hemoglobin in children indicates a hereditary physiological feature of the body and is not a cause for concern.

Factors that cause anemia in an infant

In this case, low hemoglobin in an infant may be due to the influence of a number of factors:

• prematurity. The accumulation of iron in the body of the fetus occurs from 28 to 32 weeks of pregnancy. With premature birth, the baby is born with an insufficient supply of iron;
• hemolytic jaundice of newborns, in which the mother's antibodies destroy the baby's red blood cells. This happens when there is a difference between the Rh factors or the blood group of the mother and the newborn. Hemolytic jaundice of newborns is treated with an exchange transfusion for a baby;
• in the presence of anemia in the mother during pregnancy;
• deficiency of folic acid, copper, vitamin B12;
• bleeding in the mother during childbearing;
• malnutrition of the expectant mother, leading to insufficient accumulation of iron in the baby's body;
• anomalies in the development of the placenta or umbilical cord;
• violation of placental blood flow - fetoplacental insufficiency;
• birth trauma;
• early or late ligation of the umbilical cord;
• lead poisoning;
• chronic inflammatory processes;
• feeding a child with cow or goat milk, feeding with unadapted milk mixtures;
• late introduction of complementary foods or a lack of products containing hemic iron in the baby's diet after the introduction of complementary foods - iron reserves accumulated during intrauterine development in a full-term baby last up to 6 months. After 6 months, meat (beef, veal, rabbit, turkey, chicken), liver, egg yolk, fish must be present in the child's diet; Those. at the age of 6 months and 2 weeks (2 weeks after the introduction of complementary foods), meat and liver must be added to complementary foods;
• in children with exudative diathesis, food allergies, neurodermatitis, a lot of iron is lost through damaged skin, and therefore they are at risk for developing anemia.

Consequences of low hemoglobin in infants:

• growth retardation and poor physical development;
• violation of mental and psychomotor development. Children are especially sensitive to iron deficiency during the period of introduction of complementary foods (from 6 to 24 months) - this period accounts for the last phase of a breakthrough in the development of the brain, when cognitive abilities and motor skills develop;
• increased susceptibility to infectious diseases.

Symptoms of low hemoglobin in infants

If most of the diseases immediately, as soon as the child falls ill, manifest themselves, then anemia can be in the child for years, develop gradually and not have bright, catchy signs. But there are signs that appear in a child with a low level of hemoglobin:

• pallor of the skin;
• dry and flaky skin;
• dull and brittle nails and hair, poor growth and hair loss;
• cracks on the palms, feet;
• angular stomatitis - slit-like cracks in the corners of the mouth;
• a child with low hemoglobin gets tired quickly, he is lethargic, drowsy, whiny;
• there is fatigue and shortness of breath during sucking and physical activity;
• the child may begin to eat non-edible things (for example, earth, sand, clay);
• frequent occurrence of aphthous stomatitis, glossitis;
• hypotrophy may be noted;
• regression of psychophysical development, that is, the loss of already acquired skills, for example, a child who has already rolled over may stop doing it;
• fainting may occur, blood pressure decreases, a heart murmur appears;
• there may be frequent regurgitation, sometimes even vomiting after feeding, flatulence, stool disorders, both in the form of diarrhea and constipation;
• appetite decreases;
• there is an increase in the liver and spleen;
• the child begins to get sick with respiratory infectious diseases more often.

Treatment of anemia in an infant

Treatment should be prescribed based on the cause and mechanism of anemia.

Iron preparations are necessary and effective only for iron deficiency anemia. It should also be noted that diet therapy that includes a large amount of foods rich in hemic iron is only effective in maintaining an already existing hemoglobin level and in preventing the onset of anemia, but is not effective as a treatment for an already existing anemia. And for the treatment of iron deficiency anemia, only the use of iron preparations is necessary.

Anemia is treated in children under one year old with drugs in the form of solutions dosed in drops (Aktiferrin, Hemofer, etc.), they are produced in special vials equipped with a dropper. The dosage is 3 mg per day per 1 kg of body weight.

Features of treatment with iron preparations

If, after taking iron supplements, the child's stool turns black and becomes more frequent and liquid, this is normal and should not be frightened. The black color of the feces is associated with the presence of a large amount of iron in the intestinal contents. This color of the stool will persist until the drug is discontinued. Loose stools, loss of appetite, vomiting may be associated with the irritating effect of iron on the mucous membrane of the gastrointestinal tract.

To reduce these symptoms, it is recommended to start taking the drug gradually, for example, if the child was prescribed medicine 5 drops - 2 times a day: on the first day you need to give 1 drop 2 times a day, on the second 2, and so gradually reach the desired dose.

If at the same time the drug is still difficult to tolerate, causes vomiting, then you can give the medicine to the child during meals - this will greatly facilitate its tolerance.

The earliest change in the blood in response to iron treatment will be an increase in the number of reticulocytes, which appear 10-14 days after the start of treatment. And an increase in the number of red blood cells and hemoglobin is noted no earlier than three weeks after the start of treatment. Therefore, a second blood test for the child is prescribed a month after the start of treatment.

Treatment with iron preparations is stopped no earlier than a month after the normalization of hemoglobin levels, since “iron stores” must still form in the body.

If hemoglobin does not normalize during treatment or the child has moderate or severe anemia, the child will need to consult a hematologist.

Nutrition for infants with anemia

Norms of iron intake in children depending on age:

• 7 months to 1 year 11 mg
• 1 to 3 years 7 mg
• 4 to 8 years 10 mg
• Boys 9 to 13 years old 8 mg
• Girls 9 to 13 years old 8 mg
• Boys 14 to 18 years old 11 mg
• Girls 14 to 18 years old 15 mg

It may seem that it is not difficult to provide a child with iron. So, in 100 g of buckwheat it is 8 mg, and in 100 g of beans - in general 72 mg. However, iron is poorly absorbed, so only about 10% of the trace element from food comes into the body's disposal. At the same time, iron in products is divided into heme and non-heme.

Heme is absorbed by about 25%. It is found in meat, liver, fish.

Non-heme is only 8-10% absorbed. It is found in all other types of food. Its absorption is highly dependent on what other food has entered the body.

Promote the absorption of non-heme iron:

• vitamin C;
• fructose;
• heme iron.

Interfere with the absorption of non-heme iron:

• tannins contained in tea;
• cheese, cottage cheese, milk and other foods rich in calcium;
• whole grain products.

They and those foods that contain non-heme iron are best diluted at different meals.

To completely cure anemia and normalize hemoglobin levels, children are prescribed special nutrition. The diet should include products containing the substances necessary for hematopoiesis: vitamins C, PP, group B (in particular, B12 and B9). It is also necessary to take care of the sufficient content of protein in food: include meat, fish, eggs in the diet. In any case, it should be remembered that the ideal product for a child under 1 year old is mother's milk. If, for certain reasons, natural feeding becomes impossible or insufficient, the baby should be fed with adapted mixtures with a high content of iron and vitamins. It is not recommended to give cow's milk to babies under one year old. As complementary foods, it is better to use oatmeal, applesauce, from 6 months - meat and liver must be included in the diet.

Parents of young children quite often face the problem of a decrease in the level of hemoglobin in their baby, on the pages of Internet forums you can find posts full of anxiety: low hemoglobin in a child of 1 year old, what to do, how to treat? What measures can be taken, and what drugs should be given to the baby to prevent the development of anemia?

What is hemoglobin for?

A low level of hemoglobin is a characteristic symptom of a lack of iron in the body of a child, because the hemoglobin contained in red blood cells ensures the transport of oxygen from the lungs to the tissues. Hemoglobin, in turn, is an iron-containing protein that performs its transport function precisely thanks to iron.

In terms of composition, hemoglobin is divided into two parts:

• heme - a substance that carries an iron atom and belongs to the group of pigments (thanks to it, the blood has a red color);
• globin is a special blood protein.

Iron, combining with oxygen, enriches hemoglobin, and it transfers O2 atoms to human cells. Then there is an exchange - the blood gives off oxygen, in return taking carbon dioxide. In the lungs, CO2 is separated from the blood and excreted during respiration, and the whole cycle repeats itself.

When this element in the body is not enough, the concentration of hemoglobin also falls. Unfortunately, many children are susceptible to this pathology, regardless of age, but more often the problem is fixed in babies whose mothers themselves suffered anemia during the gestation process. Among these children, there is a high percentage of small patients with anemia, especially in the age group up to a year, this is due to the fact that the mother's body, which is poor in iron, could not give the child enough reserves of this substance.

Only born children have a high hemoglobin index, during the first few days after birth, it gradually decreases, returning to normal, and sometimes falling slightly below that. The latter does not always speak of pathology - the fact is that the child's own hematopoietic system begins to work, which gradually “starts up” at full capacity, and soon hemoglobin returns to normal.

For young children, there are certain indicators of the norm for the content of hemoglobin. So, babies in the first year of life should have 110 grams of hemoglobin per liter of blood, and in the age group from one to three - at the level of 120 grams per liter.

If hemoglobin is low, in a child a year this may indicate the course of some kind of pathological process in the child's body that requires diagnosis and treatment.

Causes and symptoms of decline

Many doctors recommend paying attention to the diet of a child who has anemia. Inadequate, malnutrition, in which there are not enough trace elements and essential vitamins, as well as a lack of fresh air, are highly likely to provoke anemia even in strong and healthy children.

There are also some congenital pathologies accompanied by anemia:

• hemophilia;
• Rendu-Weber-Osler disease;
• Crohn's disease;
• collagenoses;
• malabsorption disorders;
• vasculitis.

But these diseases are quite rare, and are more often inherited by children from parents whose family already had people with such pathologies.

In general, the causes of anemia in babies can be divided into two main categories:

• pathological causes (iron deficiency against the background of any diseases);
• physiological (level fluctuations associated with the process of growth and development of the child's body).

There is another reason that occupies an intermediate place - this is anemia in children whose mothers themselves suffered from iron deficiency.

If a child has developed anemia, it manifests itself gradually, in two stages:

1. The initial stage may not at first manifest itself as some kind of ailment or discomfort for the baby. But he begins to get tired faster and often act up, sleeps more and is reluctant to communicate with his parents. The appetite of such a child falls, the mucous membranes and skin become pale. At this stage, reduced hemoglobin is at the level of 80-100 grams per liter;
2. late stage. Rapid fatigue of the baby persists, dizziness is added to it. The child's heartbeat is quickened (this is how the body tries to compensate for the lack of oxygen), his behavior becomes lethargic, most of the time he is in a state of apathy.

How to treat?

If the baby begins to experience even minor symptoms of anemia, you should immediately contact your pediatrician with them.

The doctor will order a blood test for hemoglobin in the child, and if the result shows a low level, he will give a referral to a hematologist - a specialist in blood problems. Further, depending on the stage of the disease, the specialist will choose a treatment strategy: either on an outpatient basis or in a hospital.

In outpatient treatment, the doctor prescribes various iron preparations to the child (Totem, Fenyuls, Sorbifer and others). Also, the child is corrected nutrition in the direction of increasing the diet of foods rich in iron, vitamins and other trace elements. It is also recommended to walk with the child in the fresh air as often as possible, especially if it is summer in the yard - air, heat and sunlight have a beneficial effect on the hematopoietic function of a growing organism.

In addition to prescribing medications, the child's body is examined for pathologies that can cause anemia. If any are found, appropriate treatment is prescribed. If the case is severe, the child is admitted to the hospital.

If anemia is not treated, it can cause serious consequences:

• atrophy of internal organs and their functional disorders;
• problems with the growth of the baby, its development;
• in advanced cases - the development of hypoxic coma and the death of the child.

Therefore, it is extremely important to monitor the state of children's health and consult a doctor in a timely manner if problems arise.

In addition, the prevention of anemia is also important:

• if a woman with anemia becomes pregnant, she should take vitamin complexes and iron preparations during the gestation period to prevent a decrease in hemoglobin;
• during breastfeeding, a woman should eat a full and balanced diet, introducing iron-rich foods into the diet;
• when a child begins to be given complementary foods, the same rule should be observed - give foods with sufficient iron content;
• conducting regular checks of the child's blood for hemoglobin, taking preventive courses of iron-containing medicines at least once a quarter. One year is a very important period in the life of a little person, and control and early detection of problems are very important here;

Of great importance is the identification and treatment of the disease that could cause anemia, the elimination of blood loss, if any.