A lowered hemoglobin level in a newborn is a serious cause for concern, since it performs a very important function in the child'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 violation.
What is hemoglobin?
Hemoglobin is a protein containing iron, which is able to bind to oxygen molecules and ensure their transportation to the tissues of the whole body. In humans, it is contained in blood cells - red blood cells.
Hemoglobin is a coloring matter in the blood.
Epidemiology
The prevalence of lowered hemoglobin in infants indicates that this problem is common and may not depend on the standard of living of the family. Often the cause of anemia in infants is hemolysis, 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, it is necessary to know its normative indicators.
The baby's circulatory system 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 of an adult. He has the ability to attach more oxygen than usual, so that the whole body of the child is saturated with oxygen.
As a result of this feature, a newborn hemoglobin should normally contain from 180 to 220 grams per liter. Such an indicator is the norm for the baby in the first month of life. Thus, a value below 180 is considered an indicator of reduced hemoglobin.
Here is what Yevgeny Olegovich Komarovsky says about reduced hemoglobin in infants:
The concept of the norm is very relative and in many respects depends not only on whether the newborn is a child or a one-year-old, but also on how the child was born (naturally or through cesarean section), in what period and with what weight, what diseases the mother was ill during pregnancy. Low hemoglobin is not associated only with iron deficiency. It can also be associated with a lack of certain vitamins, for example, vitamin B12, folic acid, can be determined by the nature of nutrition and lifestyle (low motor 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 using standard methods of treatment, then this is an occasion to consult a specialist - a pediatric hematologist.
Reasons for violation
The main causes of reduced hemoglobin in infants include:
- significant blood loss;
- violation of the absorption of iron on the background of ulcerative colitis and other pathologies;
- increased iron consumption due to chronic diseases or congenital heart disease;
- iron fixation during pathological processes by macrophages.
Repeated blood loss exacerbates the lack of iron, which initially manifests itself as latent, and later obvious 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 iron absorption may be a consequence of resection of the small intestine, most often caused by treatment failure.
Redistribution of iron may occur in the body of a newborn. This sometimes results from a chronic infection or connective tissue disease. When a child is sick with such diseases, iron is not used in the process of erythropoiesis (hematopoiesis), but to fight infections.
Iron deficiency anemia develops most often in newborns who are unsustainable or artificially fed.
In addition, this problem can occur in an infant whose mother during pregnancy did not have proper nutrition and did not form a supply of iron for the baby.
Risk factors
At risk of developing low hemoglobin are:
- premature infants or twins;
- newborns whose mothers did not eat enough during pregnancy;
- babies who are fed goat or cow milk;
- children with provoking diseases;
- babies with congenital malformations;
- babies whose relatives had hemolytic disease.
Symptomatology
Symptoms of reduced 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 completely lacking appetite;
- the child sleeps for a very long time at night and rarely wakes up on his own in order to eat;
- the baby has reduced activity and is weakened;
- drowsy and inhibited;
- the skin turns pale;
- heart palpitations;
- cardiac tones are reduced;
- heart pains appear;
- the borders of the heart expand;
- relative heart valve failure develops;
- there is a systolic murmur over the heart;
- in severe anemia, there are signs of heart failure (pastiness, swelling of the legs).
With prolonged severe anemia, hypoxia of the brain may occur. Endocrine syndrome develops due to a lack of oxygen in the thyroid gland, hair falls out, the skin dries, swelling occurs, and the fontanel is poorly overgrown. When the secretory function of the stomach, pancreas and liver is impaired, the development of dyspeptic syndrome begins, the manifestation of which becomes constipation or diarrhea. Respiratory failure may occur, causing an increase in respiratory rate.
If reduced hemoglobin in the baby occurs due to congenital hemolytic anemia, the main symptom will be yellowness of the skin.
There are hidden and obvious lack of iron. During a latent deficiency of symptoms, it may still not be, however, it will be visible in the analyzes. Since deep deficiency of iron is characteristic of a clear deficiency, then during its development there are clear symptoms and disturbances in the functioning of internal organs.
Possible complications and consequences
The causes and consequences of reduced hemoglobin in infants are closely related. They most often occur due to a prolonged lack of treatment for anemia. Insufficient oxygen can be critical for some baby organs. The first from oxygen starvation, brain cells begin to suffer. This may 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 a newborn can often get sick.
Complications can occur if a congenital or acquired hemolytic disease has become a cause of low hemoglobin levels. In this case, the amount of bilirubin in the baby’s blood is very dangerous for the brain.
Diagnosis
The beginning of the diagnosis of reduced hemoglobin in the baby consists in a visual examination. Pale skin and mucous membranes may be a determining factor for further examinations.
The examination begins with listening to systolic murmur at the apex of the heart. Next, you will need to perform a blood test to determine the amount of iron. If any changes occur, a serum blood test is performed. It is also possible to conduct a bone marrow examination, but it is rarely used, since preliminary studies can confirm or refute the alleged diagnosis.
Testing is very important because it is necessary to determine the severity of the disease. In a blood test, 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.
The baby is diagnosed with the following main criteria:
- a low hemoglobin level was found in the newborn - less than 180 grams per liter;
- the color indicator is reduced and is less than 0.85;
- more than 20% of red blood cells have a diameter of less than 6;
- MCV, MCH, and MCHC are downgraded.
Treatment process
Treatment of reduced hemoglobin in infants and the causes of its development are directly related, because the treatment regimen depends on the reason for the deficiency.
The treatment of anemia involves two goals: to eliminate the cause of its development and to eliminate the deficiency with the help of pathogenetic therapy.
Moms ask themselves: "What to do with reduced hemoglobin in infants?" First of all, they should adjust their diet or change the baby mixture, as well as conduct treatment with iron-containing drugs. However, all this can only be done as directed by a doctor.
Iron-containing drugs can sometimes be poorly tolerated due to the fact that they need individual selection. Poor tolerance can be expressed in the form of belching, taste in the mouth, bloating, diarrhea.
Often, such drugs must be taken orally. 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 the preparations in liquid form.
In case of intestinal malabsorption, doctors may prescribe intravenous iron-containing drugs.
Control the effectiveness of treatment through a blood test. After 10 days from the start of treatment, the first control analysis is carried out, according to the results of which specific appointments are made.
Vitamins with reduced hemoglobin in infants should be given as maintenance therapy.
Preventive actions
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 children whose mother is sick with anemia should take iron-containing drugs for prophylactic purposes, and the dosage should be set by a pediatrician.