Patient's question:
Baby's problem description: At 6 months, the baby was told by the hospital that they had iron deficiency anemia. How can it be supplemented with food? Thank you for the answer.Doctor's answer:
Hello: The principle is to supplement iron and remove the cause.1. Iron Therapy
Iron therapy is a highly effective drug for treating iron-deficiency anemia. There are many types of iron preparations, with oral inorganic salts being the most economical, convenient, and effective method. Divalent iron is more easily absorbed than trivalent iron, so it is more commonly used. Common preparations include ferrous sulfate (20% iron content) and ferrous fumarate (30% iron content).
For infants, to facilitate administration, it is often prepared as a 2.5% ferrous sulfate mixed solution (2.5g ferrous sulfate, 2.9ml dilute hydrochloric acid, 12.5g glucose, 100ml chloroform water). The dosage should be calculated based on the iron content. According to experiments, a daily dose of 4.5–6 mg/kg, divided into three doses, is ideal (equivalent to 0.03g/kg/day of ferrous sulfate; 0.02g/kg/day of ferrous fumarate; 1.2ml/kg/day of 2.5% ferrous sulfate mixed solution). This amount can achieve the maximum absorption rate. Exceeding this dose will reduce absorption and increase irritation to the gastric mucosa. A high dosage may lead to poisoning. It is best to take the medication between meals to reduce irritation to the gastric mucosa and enhance absorption. Avoid taking it with large amounts of milk, as milk contains high levels of phosphorus, which can affect iron absorption.
Vitamin C can reduce trivalent iron to divalent iron, making it more soluble and easier to absorb. It also helps maintain iron in a soluble state in the small intestine, even when the pH increases. For example, adding 60mg of vitamin C to rice can increase iron absorption threefold. Therefore, it is recommended to take vitamin C concurrently with iron supplements. However, if vitamin C is taken 4 hours before iron supplements, this effect does not occur.
For a small number of children with severe reactions, gentler alternatives like ferrous glucoate can be used, or the above iron preparations can be reduced to half the dose. Once symptoms such as nausea, vomiting, diarrhea, or stomach discomfort subside, the dose can be gradually increased to the standard level. For children who cannot tolerate oral iron supplements and have severe diarrhea with significant anemia, iron injections may be considered.
Common iron injection preparations include:
- Dextran iron, 50mg of iron per ml, administered via intramuscular injection.
- Iron dextran, 20mg of iron per ml, administered via intravenous injection.
Local pain and urticaria may occur with intramuscular iron injections, and symptoms such as fever, joint pain, headache, or localized lymph node enlargement may also be observed. Intravenous iron injections may also cause thrombophlebitis. The therapeutic effect of iron injections is not faster than oral administration, so they should be used with caution.