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1. IRON DEFICIENCY ANAEMIA IN
NEWBORN (ЖЕЛЕЗОДЕФИЦИТНАЯ
АНЕМИЯ)
Atharva patil
Group -1428

2. Introduction
◦ Iron is a nutrient that your child needs to grow and develop properly. But some kids don't have
enough iron. This also is called an iron deficiency.
◦ Iron helps move oxygen from the lungs to the rest of the body. It also helps muscles store and
use oxygen. If your child's diet lacks iron, you child might develop an iron deficiency. The
condition is a common problem in children. It can range from mild to serious. Without
treatment, it can affect a child's growth and development. Sometimes, being low on iron can
leave the body without enough healthy red blood cells, which carry oxygen.
There may be insufficient intake of food needed or discrepancy between intake and loss of iron
(transport).The deficiency may vary depending on child to child.
example, a one-year-old infant loses about 0.2 mg of iron/day, calculated on the basis of body
surface area, from values measured in adults. The amount needed for growth averages roughly 0.6
mg.• Consequently, about 75% of the 0.8 mg of absorbed iron needed per day during this period,
is for growth.

3. Who's at risk of iron deficiency?
◦ Infants at highest risk of iron deficiency include those
who:Are born prematurely or have a low birth
weight.Drink cow's milk or goat's milk before age
1.Aren't given other foods that contain iron after age 6
months.
◦ Drink formula that isn't fortified with iron
◦ Children at highest risk of iron deficiency include those
who:Are ages 1 to 5 and drink more than 24 ounces
(710 milliliters) of cow's milk, goat's milk or soy milk a
day.Have certain health conditions, such as chronic
infections or restricted diets.Have been exposed to
lead.Don't eat enough iron-rich foods.
◦ irritability or pica (in iron deficiency), jaundice (in
hemolysis), shortness of breath, or palpitations
◦ . Physical examination may show jaundice, tachypnea,
tachycardia, and heart failure,

4. CLASSIFICATION OF ANEMIA
◦ CLASSIFICATION DUE TO HAEMOGLOBIN
CONTENT IN RBC.NORMALLY HAEMOGLOBIN
CONTENT IN ERYTHROCYTE IS 0,8-1,05. THIS
INDEX IS NAMED COLOR INDEX (CI)
HYPERCHROMIC-CI>1,05 (B12 AND PHOLATE-
DEFICIENCY)HYPOCHROMIC-CI<0,8 (IRON
DEFICIENCY)NORMOCHROMIC-CI IS NORMAL
(INHERITED HAEMOLYTIC ANAEMIAS)
◦ CLASSIFICATION BASED ON THE DEGREE OF
REGENERATION. NORMALLY RETICULOCYTES
CONSTITUTE 0.5 TO 1.5% OF THE
RBC.REGENERATIVE-NORMAL RETICULOCYTES
COUNT (MOST OF
ANEMIAS)HYPOREGENERATIVE-
RETICULOCYTES <0.5 (CHRONIC
POSTHEMORRHAGIC)NON-REGENERATIVE
ANEMIA-RETICULOCYTES ARE ABSENT (BONE
MARROW APLASIA)HYPERREGENERATIVE
RETICULOCYTES >1,5 (INHERITED HEMOLYTIC
ANEMIAS)

5. ◦ Anisocytosis describes red blood cells that
are of different sizes. Normal red blood cells
are generally the same size. Having red blood
cells of unequal sizes may be a sign of
anemia, a condition that can cause
symptoms like fatigue and shortness of
breath

6. ◦ [Poikilocytosis means that there are red blood
cells of varying shapes in blood smear.It refers to
an increase in abnormal red blood cells of any
shape that makes up 10% or more of the total
population. Poikilocytes can be flat, elongated,
teardrop-shaped, crescent-shaped, sickle-shaped,
or can have pointy or thorn-like projections, or
may have other abnormal features.

7. ◦ VASA-OCCLUSIVE CRISIS
◦ OCCURS WHEN THE MICROCIRCULATION IS OBSTRUCTED BY SICKLED RED BLOOD CELLS
RESULTING IN ISCHEMIC INJURY.• THE MAJOR COMPLAINT IS PAIN, USUALLY AFFECTING
BONES SUCH AS FEMUR, TIBIA AND LOWER VERTEBRAE.• ALTERNATIVELY, VASO-OCCLUSION
MAY PRESENT AS DACTYLITIS, HAND AND FOOT SYNDROME (PAINFULAND SWOLLEN HANDS
AND/OR FEET), OR AN ACUTE ABDOMEN.• THE SPLEEN MAY UNDERGO AUTO-INFARCTION
AND IS OFTEN NOT PALPABLE BEYOND 6 YR OF AGE.• INVOLVEMENT OF THE KIDNEY RESULTS
IN PAPILLARY NECROSIS LEADING TO INABILITY TO CONCENTRATE URINE (ISOSTHENURIA).

8. ◦ Prenatal period the presence of IDA or latent iron deficiency in the mother during time of
pregnancy: antenatal complicated course of pregnancy, violation of uteroplacental circulation,
fetomaterial and fetoplacental bleeding, fetal transfusion syndrome in multiple pregnancies
◦ Intrapartum fetoplacental transfusion, premature or late ligation of the umbilical cord,
intranatal bleeding due to traumatic obstetric aids or abnormalities in the development of the
the placenta or umbilical cord.
◦ Postnatal period Factors that cause insufficient Intake of iron into the body alimentaryy
(artificial and mixed feeding with unadapted mixtures, untimely introduction of
complementary foods, unbalanced nutrition with a predominance of plant foods, lack of
proteins, etc.);- violation of intestinal absorption of iron malabsorption syndrome (celiac
disease, cystic fibrosis, lactase deficiency, exudative enteropathy), recurrent acute intestinal
infections, gastric resection.
◦ Disruption of iron transport:hypotransferrinemia,atransferrinemia.
◦ Endocrine diseases:- hypothyroidism. Ovarian dysfunction.

10. ◦ Iron Deficiency in Children-.Infants who experience iron deficiency during the first 6-12 mo of life
are likely to experience persistent effects of the deficiency that alter functioning in adulthood. A
lack of sufficient iron intake may significantly delay the development of the central nervous
system as a result of alterations in morphology, neurochemistry, and bioenergetics. Depending on
the stage of development at the time of iron deficiency, there may be an opportunity to reverse
adverse effects, but the success of repletion efforts appear to be time dependent. Publications in
the past several years describe the emerging picture of the consequences of iron deficiency in
both human and animal studies. The mechanisms iron accumulation in the brain and perhaps
redistribution are being understood. The data in human infants are consistent with altered
myelination of white matter, changes in monoamine metabolism in striatum, and functioning of
the hippocampus. Rodent studies also show effects of iron deficiency during gestation and
lactation that persist into adulthood despite restoration of iron status at weaning. These studies
indicate that gestation and early lactation are likely critical periods when iron deficiency will result
in long-lasting damage.
◦ biological dimension suspected of being altered by iron deficiency is neurochemistry and
specifically the monoaminergic pathways (12-14). In both animal models and cell culture
experiments, there are reproducible findings that dopamine and norepinephrine metabolism are
altered by iron deficiency. Iron deficiency appears to alter the synthesis and catabolism of the
monoamines, and early repletion of iron status after gestational iron deficiency only overcomes
the lasting effects (15.16). The evidence for alterations in dopamine or norepinephrine in humans
is limited.

11. Behavior changes due to
anemia
◦ study had a focus on social-emotional behavior . As
with the motor control studies, there was again a
strong linear relation between severity of iron
deficiency and behaviors of infants at 9 mo of age.
The iron-deficient infants had less engagement with
the interviewer than iron-sufficient infants, were
more shy, and showed less positive affect. These
results are highly consistent with other studies that
have examined emotionality and behaviors in iron-
deficient infants ). These data are also consistent
with a study in South Africa in which maternal iron
status was also evaluated and in which there was the
observation that mother-child interactions were
altered by iron deficiency.

12. ◦ Laboratory Tests: - Complete Blood Count (CBC): A CBC test measures various components of
the blood, including hemoglobin levels, hematocrit (percentage of red blood cells in the blood),
and mean corpuscular volume (MCV). Low hemoglobin and hematocrit levels, along with small
red blood cells (low MCV), may indicate iron deficiency anemia. - Serum Ferritin: Ferritin is a
protein that stores iron in the body. Low levels of serum ferritin can indicate depleted iron stores
and suggest iron deficiency anemia. - Iron Studies: Additional tests such as serum iron, total
iron-binding capacity (TIBC), and transferrin saturation can provide more information about iron
levels and transport in the body.

13. ◦ 1. Rapid growth spurts: Infants and young children go through rapid growth spurts that can increase their iron requirements. If their
diet does not provide enough iron to support this growth, they may become deficient.
◦ 2. Exclusive breastfeeding: Breast milk is low in iron compared to formula. While breast milk is the best source of nutrition for infants,
it may not provide enough iron for some babies, especially after the first 4-6 months when their iron stores start to deplete
◦ 3. Intestinal parasites: Parasitic infections in the intestines can cause blood loss and decrease the absorption of nutrients, including
iron
◦ 4. Chronic infections: Some chronic infections or diseases can lead to inflammation that affects iron absorption and utilization in the
body. Hypoxia drumstick fingers with spoon shaped achylia
◦ 5. Blood loss: In rare cases, infants and children may experience blood loss due to conditions like gastrointestinal bleeding, chronic
illness, or trauma, leading to iron deficiency.
◦ 6. Dietary factors: A diet low in iron-rich foods or high in foods that inhibit iron absorption (such as calcium- rich foods) can
contribute to iron deficiency.
◦ 7. Celiac disease or other digestive disorders: Conditions that affect the absorption of nutrients in the intestines, such as celiac
disease or inflammatory bowel disease, can lead to iron deficiency. begins after the introduction of gluten-containing products into
the diet - from the second half of life): - lactase deficiency (begins from the first days, after drinking breast milk);
◦ 8. Haemolytic anemia. Jaundice

14. Cell shape change in iron deficiency
anemia

16. Sickle cell anemia
◦ SICKLE CELL DISEASE (SCD) IS AN INHERITED DISEASE CAUSED BY A SINGLE-GENE MUTATION
AFFECTING THE B-GLOBIN GENE (HBB) ON CHROMOSOME 11• SICKLE CELL ANEMIA IS AN
AUTOSOMAL RECESSIVE DISEASE THAT RESULTS FROM THE SUBSTITUTION OF VALINE FOR
GLUTAMIC ACID AT POSITION 6 OF THE BETA-GLOBIN GENE.• SICKLE CELL ANEMIA (HBSS),
HOMOZYGOUS HBSS, OCCURS WHEN BOTH B-GLOBIN ALLELES HAVE THE SICKLE CELL MUTATION
(BS).

18. Recommendations
◦ Iron-Rich Foods: Introducing iron-rich foods into the infant's diet can also help boost iron levels. Foods such
as fortified cereals, pureed meats, beans, lentils, and dark green leafy vegetables are good sources of iron.
Consult with a pediatrician or a nutritionist to create a balanced diet that includes iron-rich foods appropriate
for the infant's age.
◦ Vitamin C: Vitamin C can enhance the absorption of iron from plant-based sources. Including foods rich in
vitamin C, such as citrus fruits, strawberries, and bell peppers, in the infant's diet can help optimize iron
absorption.
◦ Avoiding Iron Inhibitors: Certain substances can inhibit the absorption of iron. Avoid giving cow’s milk to
infants under 12 months of age, as it contains calcium and casein, which can interfere with iron absorption.
Tea and coffee should also be avoided, as they contain compounds that can inhibit iron absorption
◦ Regularr Monitoring: Regular follow-up appointments with a healthcare provider are essential to monitor the
infant’s iron levels and response to treatment. Blood tests may be conducted periodically to assess iron status
and adjust treatment if needed.A

19. Treatment
◦ • For therapeutic purposes, an adequate and safe
hematological response to oral iron intake can be
achieved in 4-6 weeks with 3-6 mg/kg of
elemental iron
◦ • After 4 weeks, check for a response consisting of
a hemoglobin increase of 1 g/dl, a hematocrit
increase of 3 percent, or a value within the normal
range. If there is a response, continue iron drops
(or iron-fortified formula) for 2 more months and
then discontinue supplemental iron drops.If there
is no response, check compliance with
supplemental iron regimen, determine serum
ferritin concentration, or both. A serum ferritin
concentration of >15 µg/liter suggests that the
anemia is not due to iron deficiency.
◦ • In a prophylactic program-1-2 mg/kg