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Question
A 30 day old newborn ,had rh incompatibility ,rh + ,mother rh-having Hb 8 gm,normocytic normochromic anemia.Given iron drops instead of blood transfusion.After 15 days ,Hb level increased only half gm. Why no response with iron? What should be line of treatment.Continue iron drops or give blood?

Answer
Do a DCT and see if it is still positive. Sometimes, Coombs test may remain positive for couple of months. In that case anemia may persist. Since the hemoglobin is not falling one should not worry. Also physiological anemia of newborn may be seen at 6-8 weeks of life. Thus there may not be a rise in hemoglobin at that time. Blood transfusion is not required unless the baby is in failure.
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