Determining the state of health of a child using laboratory methods, first of all, a blood test is performed. In this case, one of the most important indicators of such a study is the level of hemoglobin. And therefore, any mother should know what such an indicator is, what it should be in the norm, because of what it can change and what to do in case of deviations from the norm.
What is it
Hemoglobin is a protein that is in the blood of every person. It is found in red blood cells and has a complex structure in which protein molecules are linked to heme (a compound that includes iron).
The main task of hemoglobin in a child's body is to transfer gases - both oxygen from the lungs to all tissues, and carbon dioxide from tissues to the lungs.
How is it determined
To determine the amount of hemoglobin in the blood of children, a clinical blood test is used. The results of such an examination also note the number of blood cells, their ratio with plasma and other parameters. Hemoglobin levels are measured in grams per liter.
For more information on what hemoglobin is and how it is determined, see the video of Dr. Komarovsky's program:
What affects the level of hemoglobin in the blood
The indicator will change depending on:
- Child's age. The maximum level is observed in newborns, but after a few weeks hemoglobin begins to gradually decrease. That is why it is impossible to evaluate the indicator in the child's blood test form without indicating the age. For example, the hemoglobin level of 110 g / l in a child at 2 years old is within the normal range, but for a baby at the age of 3 months, this indicator is a sign of anemia.
- Baby food. Babies receiving breast milk suffer from a decrease in hemoglobin less often than bottle-fed babies. In children over one year old, malnutrition is the most common cause of changes in hemoglobin levels.
- Health conditions. Hemoglobin decreases or increases in various diseases, which helps in their diagnosis.
- Pregnancy and childbirth. The level of hemoglobin is influenced by diseases of the mother during gestation, blood loss during childbirth, especially the ligation of the umbilical cord, term of birth, multiple pregnancy and other factors.
- Genetic factor. If the mother's health is normal, but the hemoglobin level is always slightly below normal, this situation can also be observed in the child.
- Time of the year. The lower frequency and duration of walks in the autumn-winter period leads to a slight decrease in hemoglobin in the child at this time.
Table by age
The following indicators are considered the norm of hemoglobin at different ages:
Hemoglobin in premature babies
The hemoglobin index in a baby who was born prematurely will be lower in the first month of life than in a full-term baby. For such a baby, the lower limit of the norm is called 160 g / l. By 1 month, hemoglobin in a premature baby decreases, as in a toddler born at term, while the lower limit of the norm corresponds to 100 g / l.
Note that babies born prematurely develop anemia more often. This is due to the insufficient maturity of the baby's internal organs. In addition, in the first year of life, such children are often diagnosed with severe forms of anemia that require blood transfusions.
Hemoglobin is above normal
Why is rising
Higher hemoglobin levels are caused by:
- Dehydration, which causes the blood to thicken... This condition is observed with intestinal infections with diarrhea and vomiting, diabetes mellitus, ARVI with fever, extensive burns and other pathologies.
- Chronic respiratory disease, in which respiratory failure develops, and the number of erythrocytes increases compensatory to provide the body with oxygen.
- Chronic heart failure, which in childhood is often caused by congenital heart disease.
- Erythrocytosis... This disease, also called polycythemia, is characterized by increased production of blood cells (mainly red) in the bone marrow.
- Kidney diseasein which an excess of erythropoietin is produced.
Physical activity and living in the mountains are not dangerous reasons for an increase in hemoglobin levels. Also, a slight increase in this indicator is noted with a long stay in a warm and dry room. In adolescents, high hemoglobin can be caused by anabolic steroids (if the adolescent plays sports) or smoking.
For the opinion of Dr. Komarovsky regarding increased hemoglobin, see here:
What are the symptoms to suspect
High hemoglobin in many cases does not show any symptoms, but with such changes in blood, a child may experience lethargy, poor appetite, fatigue, drowsiness, rise in blood pressure, bruising, headaches and other ailments.
What is dangerous
Due to the strong thickening of the blood, blood clots may form, which threatens to disrupt the functioning of the internal organs, as well as the brain. Also, with high hemoglobin in children, spleen pathology may develop, and excess iron may be deposited in internal organs, which also disrupts their work. Such a deposit is especially dangerous for the kidneys of the child.
How to lower
First of all, it should be understood that high hemoglobin is only one of the symptoms of the disease, and the task of parents and doctors should be to find out which disease. In most babies, an increase in hemoglobin is not caused by dangerous reasons, therefore, changing the diet or humidifying the air helps them reduce the indicator.
Your child should be given less iron and replaced them with fish, seafood, white chicken, and legumes. If hemoglobin has increased due to an infectious disease or other pathology, the doctor will prescribe appropriate treatment.
Sometimes it is necessary to resort to the use of medicines that thin the blood, but only a doctor should prescribe such medicines, having chosen the correct dosage.
Hemoglobin below normal
Why falls
The most common reason for a decrease in the amount of hemoglobin in the blood is iron deficiency, which provokes the development of anemia (and therefore it is called iron deficiency).
In newborns a lack of iron is often triggered by anemia in a woman during pregnancy, due to which the child did not receive enough iron and was unable to accumulate its reserves in his blood.
In children over 6 months of age iron deficiency causes late introduction of complementary foods. It is by this age that all the iron stores that the baby has accumulated during intrauterine development end. And if the mother continues to feed the baby only with breast or formula, the baby gradually develops a lack of iron, which leads to anemia.
In school children and adolescents iron deficiency is often caused by an unbalanced diet, for example, if a child is following a vegetarian diet. Fascination of adolescent girls with diets for weight loss also threatens the development of iron deficiency anemia.
Other causes of low hemoglobin include:
- Blood loss - acute (due to surgery or injury) or chronic (for example, frequent nosebleeds).
- Anemia caused by a lack of folic acid and vitamin B12.
- Hemolytic anemia, in which red blood cells are destroyed.
- Other blood diseases.
- Diseases of the gastrointestinal tract.
- Infectious diseases.
- Taking certain medications.
- Autoimmune pathologies.
- Malignant tumors.
We recommend watching the recording of the webinar for parents as part of the seminar of the social project "MD Klass" It examines in detail the problems of anemia in children, its causes and consequences.
How does low hemoglobin manifest?
You can assume anemia in a child by the appearance of:
- Fatigue.
- Decreased appetite.
- Weakness and loss of strength.
- Dizziness.
- Pale skin tone.
- Sleep disorders.
- Dry skin and peeling.
- White spots and dashes on the nails.
- Circles under the eyes.
- Irritability and moodiness.
- Increased heart rate.
- Increased body temperature.
What is dangerous
In a child with anemia, the general condition worsens, his body becomes weakened, and the organs receive less oxygen, which is especially bad for the brain tissues. In addition, a lack of hemoglobin threatens the child with a decrease in immunity and frequent illnesses. If such a problem is not eliminated in time, there is a risk of delayed physical and intellectual development.
At what indicator is anemia diagnosed?
According to the WHO recommendations, the boundary hemoglobin parameters at which anemia in a child is not diagnosed are:
A mild degree of anemia is diagnosed with the following indicators:
If a child under 5 years old has hemoglobin in the range from 70 to 99 g / l, and in a child over 5 years old - from 80 to 109 g / l, this indicates moderate anemia. Acute anemia is characterized by a drop in hemoglobin levels below 70 g / l in children under five years old and below 80 g / l in children over 5 years old.
Komarovsky on low hemoglobin
A well-known physician notes that the most common reason for a decrease in hemoglobin in a child's blood is iron deficiency. Komarovsky emphasizes that he has many times encountered in his practice situations when, at the age of 5-6 months, an infant is diagnosed with anemia caused by a lack of iron.
And therefore, a popular doctor advises at this age to check every baby without fail, especially if during pregnancy the future mother's hemoglobin was low. In addition to a general blood test, Komarovsky recommends determining ferritin in order to know if the child has iron reserves or they are already running out.
With regard to treatment, a popular pediatrician assures that feeding a child with iron-rich foods, if anemia has already developed, cannot correct the situation. Komarovsky emphasizes that such children should take iron supplements, choosing the appropriate remedy together with the attending physician. Fortification of the diet with iron from food can only be an addition to the treatment with such drugs.
See the record of Evgeny Komarovsky's program on low hemoglobin in a child below:
What to do when descending
After making sure that the child really has anemia, it is important to find out its cause, since this will determine the medical tactics. If iron deficiency anemia is confirmed, the child will be prescribed iron supplements in the form of syrup or drops, for example, Maltofer or Aktiferrin. Such drugs are prescribed for a long period - not less than 1-2 months.
If a child under one year old has a hemoglobin decrease of less than 85 g / l, this condition is considered critical by doctors and requires a blood transfusion. For children over a year old, transfusion is performed when hemoglobin drops to 70 g / l and below.
Prevention of low hemoglobin
- Have a blood test regularly during gestation, in order to detect a decrease in hemoglobin in time and eliminate it. Also, a pregnant woman should take multivitamins as directed by a doctor.
- Don't give up breastfeeding, because iron is absorbed better from mother's milk than from the highest quality mixtures.
- During breastfeeding, the mother should control her diet, enriching it with products, from which it will receive proteins, iron and all vitamins necessary for blood formation.
- Introduce complementary foods in a timely manner, because by the age of 6 months, the child already lacks the iron accumulated in his body, as well as the mineral supplied with breast milk.
- Don't wean your baby as soon as he began to introduce complementary foods. Lactoferrin from human milk will help your infant absorb iron from new foods.
- Do not add cow's milk to complementary foods for children under 1 year old, and some pediatricians advise to postpone such a product until 1.5-3 years of age. Its consumption by an infant is a risk factor for the development of anemia as well as rickets.
- Children under two years old should not be given black tea.because it contains substances that bind iron.
- Walk with your child in the fresh air dailyas walking stimulates the formation of new blood cells.
- Take your child to the pediatrician regularly and take all routine tests in order to identify in time any violations in the general condition and blood of the baby.
Foods to help keep hemoglobin normal
- Veal, beef, lean pork, chicken, turkey and other meats, as well as offal.
- Beans, peas, lentils, and other legumes.
- Buckwheat, barley, oatmeal and other cereals, as well as wheat dishes.
- Apples, persimmons, figs, pears and other fruits.
- Greens and various vegetables.
- Almonds, pistachios and other nuts.
- Dried apricots, prunes and other dried fruits.
How often to check hemoglobin
The examination of a healthy child is recommended to be carried out once a year. If the baby has a chronic illness, then after registration, such a child will regularly undergo examination, including donating blood.
If parents are overly worried about the child, they will always be alerted to any changes in his condition, for example, very pale skin. However, it is not worth taking tests without a doctor's referral. If you suspect anemia in your baby, you should first contact your pediatrician. There are situations when a pale child with normal hemoglobin, so the doctor will take into account other symptoms, and then determine whether an unscheduled blood test is needed.
When conducting an analysis, the following nuances should be taken into account:
- If you take blood from a child while lying down, the hemoglobin concentration will be lower.
- After eating, the amount of hemoglobin may decrease. Also, a slight decrease (by 5-10%) is observed in the evening.
- If you apply excessive pressure when drawing blood from a finger, intercellular fluid will enter the blood sample, so the result will be lower due to dilution.
- If blood is taken from a vein, and the tourniquet has been applied for too long, the result will be increased due to vascular stasis.
