Low hemoglobin in 1-year old

[tribord]

At my son's 1-year well-check about 2 weeks ago the ped did a toe-stick and his hemoglobin was 9.4.  The nurse said it needs to be 10.4 and told me to do Poly-vi-sol with iron.  I said I'd do Floravital instead and I described it and she seemed OK with that and said they'd retest at 15-month well-check.  I believe this is the first time his hemoglobin has been checked.

After doing some thinking and research I feel like I am missing something.  I don't know why he is low on iron.

Full-term, avg weight at birth. He is huge now (like 90-95% for height and weight) but DH and I are big/tall, too.  He started solids at about 6.5 months.  We started with sweet potato, avocado, egg yolk, and added meat fairly soon.  No iron-fortified baby cereal, though.  He doesn't eat a huge amount of solids but he has some scrambled eggs in the morning and meat every day.  Very minimal dairy.  Around 9 months I started giving him 1-2mg of Floravital maybe once a week or so b/c he refused to eat liver but he really disliked it so I didn't do it often. He still nurses a ton through the night, and maybe 3 or 4 times during the day.  His lead levels were <3.6 which the nurse said is the lowest the lab measures.

He was jaudiced as a newborn for a long time, but I was told it was breastmilk jaundice and not to be concerned.  His bili levels were tested once at that point and were in the normal range.  DS does have dark circles under his eyes, but so does DD (who's hemoglobin levels have always been OK) and I always have, too (and my "iron" has always been fine according).  He was getting over a cold that day, which the nurse and ped were aware of. 

So, I've been doing the Floravital, which he *hates*  and I can maybe get only 2-3 mg a day into him (which is just 2-3mg of iron) since he spits out a lot of what goes in... I believe the nurse said he should be getting 10mg/day in supplements.  I've been pushing more meat (esp beef) which seems to work OK but he takes after me and will unfortunately not eat liver.  I know it is supposed to be well-tolerated but lately he's been having these little green mucousy poops and I assume it's related to the Floravital.

I am thinking of calling back and asking for a blood draw because I am reading online that a toe stick for hemoglobin doesn't provide a full picture, and I guess I'd also like to see if the supplementation I'm doing has made a difference.  Does anyone have any suggestions for what I should say to the ped that I'm looking for in this test(ferritin, etc.) and how I should phrase it to her?  We just switched to her about 5 months ago so I want to take the right approach with her and not insinuate that I don't think she knows what she's doing.  Ped is open to holistic/natural options but as I mentioned above first rec. from the nurse was the poly-vi-sol and she'd never heard of Floravital.

Also, what levels should I be trying to get DS to, ex. isn't 10.4 hemoglobin still kind of not ideal?

And thoughts for steps I should be taking at home?

thank you

[1love4ever]

Keep in mind that meat is not the only source of iron.  I would first try to include other sources.  I like spinach or kale, I chop it up small and mix it with home made organic applesauce and add a little organic cinnamon to cover the taste.  I also grate a carrot or 4 in there, depending on how much spinach I use.  There are also raw nuts/seeds, I find that organic raw sunflower seeds are cheap, and easy to smash up to mix into other things such as applesauce(although raw pumpkin seeds have higher iron!).  And there are peas and beans.  Here is some info on iron, I love this site for nutritional info  http://www.whfoods.com/genpage.php?tname=nutrient&dbid=70 

You could also use ground sesame seeds and mix in with other foods, they are just as high in iron as pumpkin seeds.  I am getting this info from the in depth nutritional profiles for each food provided on the site I mentioned above.  You could mix the floravital with other foods instead of trying to give it to him plain.  How are your iron levels?  Maybe if you increased your iron he would get a little more through your breast milk.

I think that a blood level of 10.4 is just fine, which is why it is considered acceptable. 

And absolutely if you think you would like another test done, or a different type of test than the first, please ask for it!  Just say you are concerned and want to be sure the test is as accurate as possible.

[Chloe'sMama]

DD2 had hers checked at 9 months, 10 months and 12 months.  Each time they were significantly different.  I think at 9 months it was 12.3 at 10 months it was 9.8 (or something similar) and at 12 months it was 11.1.  The doc says that the technique has so much to do with the level.  I may request another toe stick to see the level  before doing a blood draw as they are pretty horrible.  Doc said there was no way her levels could change that drastically so quickly.

Anyways, just wanted to share my story.  Good luck.