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Subject:
From:
"Maryelle G. Vonlanthen" <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Thu, 29 Jun 1995 11:12:36 -0500
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In response to your concern about the validity of hemoglobin check at 1 year.

1.  Hb at 1 year is only a screening test for anemia.  10.5gm/dl  and
above is what is considered nl in our textbooks.  They do comment on the
fact that iron in better absorbed from breastmilk than cow's milk and that
BF babies need less dietary iron.

2.  A low hemoglobin at 1 year does not necessarily mean that the child
is Iron deficient. Other conditions such as lead poisoning can cause
anemia as well and further testing is usually needed to make final diagnosis
Iron deficiency is not necesarily nutritional.  Chronic gi bleeding per
example can lead to anemia even with adequate intake.

3.  Babies most at risk for anemia  6 months and older  and sometimes at
earlier age are babies born with low iron stores. I think in particular
of premature, small for gestational age, babies who had a bleeding
problem at birth and therefore started off with a lower count.  Small
babies at birth, in addition to having low iron stores tend to grow
faster to catch up with normally grown newborns and therefore may need
more iron.
These are your at risk category for nutritional anemia, in these children
supplements may be appropriate at an earlier time.
To answer your comment about how the children look, your typical "milk
baby" develops and acts normally.  They actually look pudgy and somewhat
pale but otherwise they are very well adapted to the low levels of iron
and continue to have normal activity. The classic example is the bottle
fed baby 12-18 months drinking tons of milk  in bottle and eating very
little food.

Good luck
Maryelle

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