Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content +++ Key Features ++ Defined as a hemoglobin more than 2 standard deviations below normal for age and gender Iron stores are sufficient in normal-term infants for the first 4 months of life Iron stores may be reduced in Premature infants Infants with low birth weight Infants with neonatal anemia or in those with perinatal blood loss or subsequent hemorrhage Breast milk is low in iron relative to cow's milk and fortified formulas, and without iron supplementation, iron deficiency may develop in exclusively breast-fed children +++ Clinical Findings ++ Pallor, fatigue, irritability Poor dietary intake of iron (ages 6–24 months) Chronic blood loss (age > 2 years) Microcytic hypochromic anemia History of pica +++ Diagnosis ++ Screening for anemia should be performed at about 12 months of age with determination of hemoglobin concentration and an assessment of risk factors for iron deficiency If the hemoglobin is < 11 mg/dL or there is a high risk for iron deficiency, an iron evaluation should be performed There is no single measurement that documents the iron status; recommended tests include serum ferritin and C-reactive protein or reticulocyte hemoglobin concentration +++ Treatment ++ If a child has hemoglobin of 10–11 mg/dL at the 12-month screening visit Can be closely monitored or Empirically treated with iron supplementation with a recheck of hemoglobin in 1 month If anemia is present, recommended oral dose of elemental iron is 6 mg/kg/d in three divided daily doses Parenteral administration of iron is rarely necessary Iron therapy results in an increased reticulocyte count within 3–5 days, which is maximal between 5 and 7 days Treatment is generally continued for a few additional months to replenish iron stores Your MyAccess profile is currently affiliated with '[InstitutionA]' and is in the process of switching affiliations to '[InstitutionB]'. Please click ‘Continue’ to continue the affiliation switch, otherwise click ‘Cancel’ to cancel signing in. Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Username Error: Please enter User Name Password Error: Please enter Password Forgot Username? Forgot Password? Sign in via OpenAthens Sign in via Shibboleth