Hey you guys, in this lesson we are going to talk about Iron-deficiency Anemia. Anemia is when the body either doesn’t have enough red blood cells or it doesn’t have enough hemoglobin. Remember, hemoglobin is that part of the red blood cell that is responsible for carrying oxygen. So if the body doesn’t have enough of it, the red blood cells won’t be able to carry the amount of oxygen needed and this results in hypoxia. There are 4 different types of anemia, Pernicious, Aplastic, Sickle Cell and Iron Deficiency Anemia. Pernicious and Aplastic Anemia are covered in the adult hem/onc course and sickle cell is covered in another peds lesson. This lesson is focusing on Iron Deficiency Anemia. So a few quick facts to start – First, it accounts for 60% of all anemias, making it the most common. Iron is a essential for the production of new red blood cells and hemoglobin – so if you don’t have iron, your body can’t make these! For your assessment with iron deficiency anemia you would expect to find pallor, fatigue, increased heart rate and breathlessness. Kids may also try to eat things that are non-edible, like dirt or ice because their bodies know they are missing that nutrient. This is called Pica. With iron deficiency anemia the causes are usually one of the following 3 things. 1) not enough intake of iron 2) inability absorb the iron they do take in and 3) blood loss. So it’s important to ask patients about their diet and any potential blood loss. Okay so for the first 4-6 months of life babies have enough iron stores in their body from when they were in utero. Remember RBC’s live for about 120 days. So 120 days after birth the RBC’s they have from mom will start to die and the baby has to start making them on their own. If they dont have iron they cant do this. Iron deficiency anemia used to be a huge problem for babies, but now that all infant formulas are fortified with iron its less of a problem. So really, the greater risk is for babies that are exclusively breastfed. These babies should be given a supplement until they can start eating more iron rich foods or are started on iron fortified baby cereals. Toddlers and preschoolers are at risk for iron deficiency because they are likely to be picky eaters and may not be getting enough iron rich foods. Another potential problem is when toddlers and preschoolers are given too much milk to drink. Milk is filling and will likely decrease their appetite for iron rich foods and it can block the absorption of iron. Sometimes you’ll hear these kids referred to as milk babies. They are the very pale 2-3 year old kids that you see walking around with their bottles full of milk. It’s an honest mistake really because parents of picky eaters just naturally think that milk is pretty healthy so at least they are having that, not realizing that it could actually be blocking the absorption of iron in the body. So, parents may need advise on how to get their kids to eat more and in the meantime they may need a supplement. Adolescents, particularly adolescent females, are at risk for iron deficiency anemia because of rapid growth, poor eating habits and the onset of menses. Dietary changes and supplements may be appropriate for these patients as well. Management is very simple and straightforward. The first option is to increase dietary intake. This means eating foods like red meats, oily fish, beans, dark green veggies, and dried fruits. Clearly, these are not all the most kid friendly foods so the second option for treatment is to give an iron supplement. Parents need to know the following things about iron supplements: it should always be given between meals, giving with something high in vitamin c like orange juice will help with absorption and it may cause their stools to turn black. Your priority nursing concepts for a pediatric patient with iron deficiency anemia are nutrition, oxygenation and health promotion. So, lets recap! Symptoms of anemia are pallor, lethargy and possibly pica. Our primary method of treating iron deficiency anemia is to increase intake, either through diet or with a supplement. Remember each age group has slightly different risks for developing iron deficiency anemia. Keep these in mind as you are talking to families and thinking of your nursing care plans! “That’s it for our lesson on iron deficiency anemia. Make sure you check out all the resources attached to this lesson. Now, go out and be your best self today. Happy Nursing!”
Iron-deficiency anemia is the most common type of anemia, a condition that happens when your body does not make enough healthy red blood cells or the blood cells do not work correctly. Iron-deficiency anemia happens when you don’t have enough iron in your body. Your body needs iron to make hemoglobin, the part of the red blood cell that carries oxygen through your blood to all parts of your body.
Iron-deficiency anemia affects more women than men. The risk of iron-deficiency anemia is highest for women who:
Infants, small children, and teens are also at high risk for iron-deficiency anemia. Learn how much iron children need at different ages.
Iron-deficiency anemia often develops slowly. In the beginning, you may not have any symptoms, or they may be mild. As it gets worse, you may notice one or more of these symptoms:3
If you think you may have iron-deficiency anemia, talk to your doctor or nurse.
Women can have low iron levels for several reasons:
Talk to your doctor if you think you might have iron-deficiency anemia. Your doctor may:
If you have iron-deficiency anemia, your doctor may want to do other tests to find out what is causing it.
Maybe. Talk to your doctor about getting tested as part of your regular health exam if you have heavy menstrual periods or a health problem such as Crohn's disease or celiac disease.
Treatment for iron-deficiency anemia depends on the cause:
If you have severe bleeding or symptoms of chest pain or shortness of breath, your doctor may recommend iron or red blood cell transfusions. Transfusions are for severe iron deficiencies only and are much less common.
Your doctor may recommend iron pills to help build up your iron levels. Do not take these pills without talking to your doctor or nurse first. Taking iron pills can cause side effects, including an upset stomach, constipation, and diarrhea. If taken as a liquid, iron supplements may stain your teeth. You can reduce side effects from iron pills by taking these steps:
If left untreated, iron-deficiency anemia can cause serious health problems. Having too little oxygen in the body can damage organs. With anemia, the heart must work harder to make up for the lack of red blood cells or hemoglobin. This extra work can harm the heart. Iron-deficiency anemia can also cause problems during pregnancy.
You can help prevent iron-deficiency anemia with the following steps:
The chart below lists how much iron you need every day. The recommended amounts are listed in milligrams (mg). See a list of good sources of iron.
Source: Adapted from Institute of Medicine, Food and Nutrition Board6 *Vegetarians need more iron from food than people who eat meat do. This is because the body can absorb iron from meat better than from plant-based foods.
Food sources of iron include:
Find more sources of iron.
Yes. During pregnancy, your body needs more iron to support your growing baby. In fact, pregnant women need almost twice as much iron as women who are not pregnant do. Not getting enough iron during pregnancy raises your risk for premature birth or a low-birth-weight baby (less than 5 ½ pounds). Premature birth is the most common cause of infant death. Both premature birth and low birth weight raise your baby's risk for health and developmental problems at birth and during childhood. If you're pregnant, talk to your doctor about these steps:
No, you do not need more iron during breastfeeding. In fact, you need less iron than before you were pregnant. The amount of iron women need during breastfeeding is 10 milligrams per day for young mothers 14 to 18 and 9 milligrams per day for breastfeeding women older than 18. You need less iron while breastfeeding because you likely will not lose a lot through your menstrual cycle. Many breastfeeding women do not have a period or may have only a light period. Also, if you got enough iron during pregnancy (27 milligrams a day), your breastmilk will supply enough iron for your baby.
It might. If you still get your period and take menopausal hormone therapy, you may need more iron than women who are postmenopausal and do not take menopausal hormone therapy. Talk to your doctor or nurse.
It could. Hormonal birth control, such as the pill, the patch, the shot, or the hormonal intrauterine device (IUD), is often used to treat women with heavy menstrual periods. Lighter menstrual periods may reduce your risk for iron-deficiency anemia. Also, the non-hormonal, copper IUD (Paragard) may make your menstrual flow heavier. This raises your risk for iron-deficiency anemia. Talk to your doctor or nurse about your risk for anemia and whether hormonal birth control may help.
You can help make sure you get enough iron by choosing foods that contain iron more often. Vegetarians need more iron from food than people who eat meat. This is because the body can absorb iron from meat better than from plant-based foods. Vegetarian sources of iron include:8
Talk to your doctor or nurse about whether you get enough iron. Most people get enough iron from food.
Yes, your body can get too much iron. Extra iron can damage the liver, heart, and pancreas. Try to get no more than 45 milligrams of iron a day, unless your doctor prescribes more. Some people get too much iron because of a condition called hemochromatosis that runs in families. Learn more about hemochromatosis, who is at risk, and how it is treated. You can also get too much iron from iron pills (if you also get iron from food) or from repeated blood transfusions.
The Office on Women's Health is grateful for the medical review by:
All material contained on these pages are free of copyright restrictions and maybe copied, reproduced, or duplicated without permission of the Office on Women’s Health in the U.S. Department of Health and Human Services. Citation of the source is appreciated. Page last updated: February 22, 2021 |