Iron Deficiency Anemia IDA: Decreased Supply, Iron Content Food

4th Pediatric Infectious Diseases Conference

ISSN 0973 - 0958

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APPROACH TO A CHILD WITH IRON DEFICIENCY ANEMIA

Related Topics

Introduction and Etiological Classification of Anemia

Iron Metabolism and Clinical Features

Investigations

Management and Treatment

Side Effects and Prevention

Dr. M. R. Lokeshwar
Visiting Pediatrician - P.D.Hinduja National Hospital, Mumbai
Pediatrician and Hematologist-Oncologist,
Lilavati Hospital, Bandra, Mumbai.

Dr. Nitin Shah
Division of Pediatric Hematology-Oncology,
Dept. of Pediatrics, L.T.M.G.Hospital & L.T.M.Medical Collage,
Sion, Mumbai - 400 022.

DECREASED SUPPLY :

Breast milk, the primary source of infant nutrition is poor in iron, containing 0.28 - 0.73 mg/lit as compared. However, the iron in breast milk has a very high bioavailability (20 - 80%) and hence iron deficiency rarely occurs in exclusively breast fed infants till the age of 4 - 6 months. Breast-feeding does not protect against iron deficiency after the age of 6 months, unless iron containing weaning foods are introduced. During adolescence, false concern about the body figure, food fads, ignorance, particularly in girls lead to iron deficiency.

Table 2 : ETIOLGICAL FACTORS IN IRON DEFICIENCY ANEMIA :

Decreased iron assimilation	Blood loss	Increased physiologic requirement
Iron poor diet & poor bioavailability of Fe in the food	* GI bleeding Hookworm infestation,Peptic ulcer,Diverticulitis,	Prematurity
Iron malabsorption Chronic diarrhea & Malabsorption Syndrome Sprue G. I. Surgery	Milk induced enteropathy Aspirin & other drugs Feto- maternal transfusion Early clamping of cord Bleeding disorders	Period of growth Infancy Adolescence
Pica

Table 3 : IRON CONTENT OF FOOD ARTICLES :

Class of Food	Iron content mg/100 g	Articles rich in iron > 10 mg / 100 g
Cereals	2.5 - 14.0	Bajra, Wild Barley, Kang Ragi, Rice flakes, whole wheat Flour, Kodra (Harik)
Pulses & Legumes	2.7 - 11.0	Bengal gram, Cow gram, Soya bean
Leafy Vegetables	0.9 - 40.0	Amaranth, Beet, Greens,Bengal gram leaves, Coriander, Alu leaves, Pudina, Neem, Radish top, Rajgira leaves, Turnip greens, all types of green bhajis. (Spinach, methi, lettuce, etc.)
Roots & tubers	0.4 - 13.9
Other Vegetables	0.2 - 22.2	Amaranth seeds,Daincha seeds
Nuts & oil seeds	2.5 - 10.0	Garden cress, Gingelly, mustard, Pistachio
Fruits	0.1 - 10.0	Dates, Karwanda, Raisins
Sea food	1.0 - 11.5	Most Indian fish, crab
Meat	2.0 - 18.8	Beef
Milk	0.2 - 0.8
Miscellaneous		Jaggery, Yeast

Table 4: FACTORS AFFECTING THE BIOAVAILABILITY OF THE DIETARY NON-HEME IRON

Enhance	Ascorbic acid, meat, fish, poultry
Inhibit	Tannates (tea, coffee), Bran, Egg Yolk, Calcium Phosphate, EDTA, Antacids, phytates, cholestyramine, clay, starch.

Table 5: PERCENTAGE & AMOUNT OF IRON IN SOME COMMONLY USED IRON TABLETS

Preparation	Iron compound (mg) per tab	Elemental iron (mg) per tab	% of iron given
Ferrous fumarate	200	66	33
Ferrous gluconate	300	36	12
Ferrous sulphate (7H2O)	300	60	20
Ferrous sulphate (anhydrous)	200	74	37

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