Hi Everybody:
    A mother called me with some questions about anemia that I need some help
with. This mother has 3 1/2 month old twins that have been and are exclusively
breastfed; they are thriving and have nearly doubled their birth weights. Last
week, the twins were sick with a bug. She took them to the pediatrician who
tested their blood. The girl has a Hgb of 8 and the boy has a Hgb of 10. The
pediatrician wants to recheck the values later this week, and treat if the
"anemia"is sustained. He says that their Hgbs may be low because they were
sick. The mother wants to know if they would need treatment, as she realizes
that the iron in her milk is nearly fully absorbed and that supplemental iron
interferes with this mechanism. This mother also wants to know what the side
effects of any supplemental iron would be, and how would she know if the iron
supplement was working. What would you recommend?
     My questions are about reference standards....are there any standard
references for iron levels in the newborn, one month old, two month old, three
month old, etc. etc? And would anemic babies grow and thrive and be happy? Dr.
Jack, are you listening? Thanks in advance for your thoughts.  Warmly, Nikki
Lee