Erythrocytes and Hemoglobin of the Blood in Infancy and in Childhood

Abstract

The term nutritional anemia designates a type of anemia especially prevalent among infants of 1 and 2 years, currently thought to be due mainly to lack of iron, which, derived either from stores in the body or from food, is needed for building hemoglobin. The severe form of the disease is seen most frequently among infants who have too long been given an exclusive milk diet, but it is seen also among infants who have been offered a seemingly well balanced diet. In most instances the anemia tends to improve spontaneously, as a rule coincidentally with the increasing acceptance of a well balanced diet, but even in infants who recover spontaneously (i. e., without iron medication) the period of transitory anemia is a critical one, in which the hazards of intercurrent infection and general nutritional disturbances are increased. The evidence produced by recent investigations 1 that there is a higher morbidity among anemic infants than among nonanemic infants emphasizes as a major pediatric problem the need for increased prevention of the condi¬ tion as well as for better aids to its early diagnosis and cure.Several extensive investigations of the hemoglobin content of the blood of normal infants, the results of which have been published during the past few years, have emphasized the fact that nutritional anemia is more prevalent than is generally recognized. Mackayla examined 4,811 samples of blood from infants of the poorer classes of London and reported that at 12 months of age 42 per cent of the breast-fed infants and 70 per cent of the artificially fed infants were definitely anemic. At Madison, Wis., Elvehjem, Peterson and Mendenhall2 reported the results of a determination of the hemoglobin content of 2,000 samples of blood from 740 children ranging in age from birth to 5 years. Approximately 38 per cent of the children at 1 year of age had less than 11 Gm. of hemoglobin per hundred cubic centimeters o: blood, and approximately 10 per cent had less than 10 Gm. The range of values between 10 and 11 Gm. constitutes a borderline zone for clinically recognizable anemia in infants of that age group. Most pedia¬ tricians recognize anemia in infants whose hemoglobin content is less than 10 Gm., but among infants who have between 10 and 11 Gm. anemia often goes unrecognized or is considered clinically insignificant. The hemoglobin level of the blood considered alone is, however, a less exact criterion of anemia in such infants than the alteration of the size and the hemoglobin content of the red cells, to which attention is mainly directed in this paper.The size and the coloration (i. e., hemoglobin content) of the red blood cells have been used as the basis for a classification of the anemias by a number of investigators. In a recent paper by Haden 3 such a classification is concisely summarized under a terminology which is employed by a number of writers at the present time, describing the red cells by terms designating normal, low or high values for their size and coloration, as follows: (1) normocytic, normochromic...

The problem of iron deficiency anemia in preschool Negro children.

“…The prevalence cited in other reports has varied between these two extremes.6'9'10"14'15 It is generally accepted that the prevalence is considerably higher in Negro children" and in low income groups of all races. 16 One important fact has emerged from recent studies: diet, even Several recommendations seem warranted, based on the present information on the high prevalence of iron deficiency anemia that is found in the well-baby clinics of large cities: (1) routine laboratory testing should be performed by six months of age and again at 12 months of age-on those who do not receive prophylactic iron medication; (2) injections of iron by the intramuscular route should be considered for certain unusual cases; and (3) some form of prophylactic iron medication, preferably in the form of formulas fortified with iron to the level of 12 mg per quart, should be made available in the first nine months of life.…”

Anemia in Preschool Children in the United States of America[9]

“…This is especially true when screening certain ethnic groups. For example, in 100 1 We are indebted to M. PAGANO for these analyses.…”

“…To the best of our knowledge, this represents the first wide-spread survey to determine the Anemia, predominately nutritional anemia secondary incidence of anemia in nonhospitalized, preschool to dietary iron deficiency, is very common during the children from a specific segment of the American pofirst two years of life in the United States [1,7]. How-pulation.…”

History of Pediatric Hematology Oncology

“…A.H. Washburn in Denver and G.M. Guest in Cincinnati performed studies of the blood values of normal infants and children (16,17). With definition of normal value, it became easier to identify specific hematologic diseases.…”