Decreased hemoglobin in a newborn is a serious cause for concern, as it performs a very important function in the baby's body. An insufficient amount of oxygen can negatively affect the development of cells in the brain and internal organs. That is why it is important to know about the manifestations and possible causes of the development of this disorder.
What is hemoglobin?
Hemoglobin is a protein containing iron, which is able to bind to oxygen molecules and ensure their transportation to tissues throughout the body. In humans, it is contained in blood cells - erythrocytes.
Hemoglobin is the coloring matter of the blood.
Epidemiology
The prevalence of low hemoglobin in infants indicates that the problem is ubiquitous and may not depend on the family's standard of living. Often the cause of anemia in infants ishemolysis, which reduces the supply of hemoglobin in the blood. In second place, you can put the lack of iron in the baby, inherited from his mother. On the third - blood loss.
Norms of hemoglobin in a newborn
In order to analyze the level of hemoglobin in a child, you need to know its normative indicators.
The circulatory system of the baby during its development in the womb is limited to the functioning of only a large circle of blood circulation. As a result, there is a need for more efficient work of blood cells. That is why the hemoglobin in an unborn child is different from the hemoglobin in an adult. It has the ability to attach more oxygen than usual, so that the entire body of the child is saturated with oxygen.
As a result of this feature, a newborn's hemoglobin should normally contain from 180 to 220 grams per liter. This indicator is the norm for a baby in the first month of life. Thus, a value below 180 is considered an indicator of low hemoglobin.
Here's what Evgeny Olegovich Komarovsky says about low hemoglobin in babies:
The concept of the norm is very relative and largely depends not only on whether a newborn is a child or a one-year-old, but also on how the child was born (naturally or by caesarean section), at what time and with what weight, what mother was ill during pregnancy. Low hemoglobin is not associated only with iron deficiency. It may also be related to the lack of certainvitamins, for example, vitamin B12, folic acid, can be determined by the nature of the diet and lifestyle (small physical activity of the child) - all these are factors that fundamentally affect the level of hemoglobin. In the end, some variants of congenital anemia are possible. In general, if a child has low hemoglobin, which does not rise with the help of standard methods of treatment, then this is an occasion to contact a specialist - a pediatric hematologist.
Reason for violation
The main causes of low hemoglobin in infants include:
- significant blood loss;
- impaired iron absorption against the background of non-specific ulcerative colitis and other pathologies;
- increased iron consumption due to chronic diseases or congenital heart disease;
- fixation of iron during pathological processes by macrophages.
Repeated blood loss exacerbates iron deficiency, which initially manifests itself as latent, and later overt anemia. Often, blood loss in newborns occurs in the digestive canal. The reason for this may be the development of diaphragmatic hernia, ulcerative colitis, hemorrhagic disease, cerebral hemorrhage.
Impaired absorption of iron may be a consequence of resection of the small intestine, the cause of which is most often the ineffectiveness of treatment.
In the body of a newborn, a redistribution of iron can occur. It sometimes results from chronic infection or connective tissue disease. When a child is sick with such diseases, iron is not used inthe process of erythropoiesis (hematopoiesis), and to fight infections.
Iron deficiency anemia develops most often in newborns who are irrationally or artificially fed.
In addition, this problem can occur in a baby whose mother during pregnancy did not have proper nutrition and did not form a supply of iron for the baby.
Risk factors
At risk for developing low hemoglobin are:
- premature or twin babies;
- newborns whose mothers were undernourished during pregnancy;
- babies fed goat or cow milk;
- children with triggering illnesses;
- babies with birth defects;
- babies whose relatives had hemolytic disease.
Symptomatics
Symptoms of low hemoglobin in infants depend on the level of iron deficiency. The greater the deficit, the more expressive will be the picture of the disease and the condition of the child.
Signs of iron deficiency:
- poor or no appetite at all;
- child sleeps very long at night and rarely wakes up on his own to eat;
- the baby has reduced activity and is weakened;
- drowsy and sluggish;
- skin turns pale;
- heartbeat quickens;
- decreased strength of heart tones;
- heart pains appear;
- borders expandheart;
- develops relative valvular insufficiency;
- appears systolic murmur over the heart;
- with severe anemia, there are signs of heart failure (pastosity, swelling of the legs).
With prolonged severe anemia, cerebral hypoxia may occur. An endocrine syndrome develops due to a lack of oxygen in the thyroid gland, hair falls out, the skin dries, swelling occurs, and the fontanel does not grow well. When the secretory function of the stomach, pancreas and liver is disturbed, the development of dyspeptic syndrome begins, the manifestation of which is constipation or diarrhea. Respiratory failure may occur, causing an increase in respiratory rate.
If low hemoglobin in an infant is due to congenital hemolytic anemia, then the main symptom will be yellowness of the skin.
Distinguish between hidden and obvious lack of iron. During a latent deficiency, there may not yet be symptoms, but it will be visible in the analyzes. Since a pronounced deficiency is characterized by a deep iron deficiency, during its development there are clear symptoms and disturbances in the functioning of internal organs.
Possible complications and consequences
The causes and consequences of low hemoglobin in infants are closely related. They most often occur due to prolonged lack of treatment for anemia. Insufficient amount of oxygen can become critical for some organs of the baby. Cells are the first to suffer from oxygen starvationbrain. This can be one of the reasons for the subsequent poor development of the baby. Low hemoglobin leads to a decrease in immunity, as a result of which the newborn can often get sick.
Complications can occur if the cause of low hemoglobin levels is congenital or acquired hemolytic disease. In this case, the amount of bilirubin in the baby's blood increases, which is very dangerous for the brain.
Diagnosis
The beginning of the diagnosis of low hemoglobin in infants is a visual examination. Pale skin and mucous membranes may be a determining factor for further examinations.
Examination begins with listening to a systolic murmur at the apex of the heart. Next, you will need to do a blood test to determine the amount of iron. If there are any changes, a serum blood test is performed. It is also possible to conduct a study of the bone marrow, but it is rarely resorted to, since preliminary studies can confirm or refute a presumptive diagnosis.
Testing is very important because it is necessary to determine the severity of the disease. When examining blood, special attention is paid to the number of red blood cells and the color index. A decrease in their level indicates the development of iron deficiency.
Baby is diagnosed according to the following main criteria:
- a newborn has a low hemoglobin level - less than 180 grams perliter;
- color index reduced to less than 0.85;
- more than 20% of red blood cells have a diameter less than 6;
- MCV, MCH and MCHC downgraded.
Treatment process
Treatment of low hemoglobin in infants and the causes of its development are directly related, since the treatment regimen depends on the reason for the deficiency.
The treatment of anemia involves achieving two goals: to eliminate the cause of its development and to eliminate the deficiency with the help of pathogenetic therapy.
Moms are wondering: "What to do with low hemoglobin in infants?". First of all, they should adjust their diet or change the mixture for the baby, as well as treat with iron-containing drugs. However, all this can be done only as directed by a doctor.
Iron-containing preparations can sometimes be poorly tolerated due to the fact that they need to be individually selected. Poor tolerance can be expressed in the form of belching, taste in the mouth, bloating, diarrhea.
These drugs often need to be taken by mouth. Together with them, the intake of ascorbic acid is prescribed, since it contributes to better absorption of iron. In addition, the form of the drug also affects the absorption of iron - iron is better absorbed from preparations in liquid form.
In case of intestinal malabsorption, doctors may prescribe intravenous iron supplements.
Monitor the effectiveness of treatment through a blood test. After 10 days from the start of treatment, the first controlanalysis resulting in specific appointments.
Vitamins for low hemoglobin in infants should be given as maintenance therapy.
Prevention measures
Prevention of low hemoglobin in a child is the treatment of diseases that can reduce its level to critical levels. Women during pregnancy and lactation also need to take vitamins containing iron. Premature babies and babies whose mothers are anemic should take iron supplements as a preventive measure, and the dosage should be set by the pediatrician.
