Babies with low iron (that is not fixed by diet) x posted - Mothering Forums
Forum Jump: 
 
Thread Tools
#1 of 12 Old 01-31-2007, 12:41 PM - Thread Starter
 
vanessab23's Avatar
 
Join Date: Nov 2005
Location: Houston
Posts: 1,090
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Any babies out there that were diagnosed with low hemoglobin and hematocrit where diet changes and iron supplements didn't help? I am looking for mamas whose babies were anemic due to other causes (absorption issues like colitis, or bone marrow or cancer )

Our story: at 9 mos DS had a 9.6 and my ped reco'd fer-in-sol. I ignored him and instead made an effort to push more iron rich foods and we both started taking Floradix (I took the regular dose and I gave him a dropperful/day). So, instead of going back to check the iron one month later (at 10 mos), we just went back at 13 mos and to my surprise he is now at HGB 8.8 (less than 10 is LOW) and HCT 28.4 (less than 32 is LOW). So, now my ped is a bit more worried (especially since the HCT is low now, showing abnormally small red blood cells being sent out from the bone marrow where they are made.) Tomorrow we will start the fer-in-sol and in month check the levels again. If it isn't better, he will do more extensive blood tests to rule out major issues, like genetic flaws (like what is tested in the Newborn Screens, which I believe came back normal, but neither the Ped or I have a copy of it ) and GI problems.

What is the difference between Floradix and Fer-in-sol? Aren't they both IRON? If floradix didn't work, will fer-in-sol?

I could start freaking out about this (especially b/c I feel SO guilty that I let it get this bad, and after my ped reco'd drops!) but I would rather get educated.

FWIW, DS seems healthy, normal and energetic and to have what I perceive to be a normal level of whinyness . But I do remember a mama here on MDC at one point said that she saw a HUGE difference in her DC after they started drops.

TIA mamas!

Miles (December 2005) Pascual (March 2009). P's was my beautiful home waterbirth that healed me from my M's birth. natural birth, midwifery, postpartum depression, babywearing, breastfeeding.
vanessab23 is offline  
#2 of 12 Old 01-31-2007, 01:26 PM
 
kellybelly's Avatar
 
Join Date: Jul 2004
Posts: 321
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Anyone in your family have Thalassemia?

http://www.cooleysanemia.org/sections.php?sec=1

My mom, myself, and DD have Thalassemia minor (inherited from the Italian part of our heritage). From the way it has been explained to me, our blood cells are smaller and more fragile, but the body compensates by making more. Because of the way we process hemoglobin and the way it looks like an iron deficiency under the microscope, doctors usually mistake it for iron deficiency anemia. Iron supplements will do nothing to improve our numbers to above what is normal for us. Of course, one could be iron deficent on top of having Thalassemia, and iron would help in that case, but it still won't improve the numbers to be above what is normal for a person with Thalassemia.

Mention this to your doc, they don't usually consider this. And Thalassemia minor is very non-life threatening! I hope they find out the cause for your babe, and that it is something very simple!
kellybelly is offline  
#3 of 12 Old 01-31-2007, 01:59 PM
 
CallMeIshmael's Avatar
 
Join Date: Sep 2004
Location: Deep Gray
Posts: 325
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Yep, been through this with my own daughter when she was that age.

By far the most likely reason you didn't see a boost in hematocrit was that your son simply wasn't getting enough iron, even with the Floradix. Floradix contains 1mg of iron per 1 mL (not sure how big a dropper is). In order to fix an iron deficit, you generally need at least 3mg for each kilogram that your baby weighs. That'd be a whoooooole lot of Floradix.

How much does your son wiegh, and how much Fer-in-Sol is he taking? Fer-in-sol contains 15mg of iron per 0.6mL, making it 25 times more concentrated than Floradix, though it tastes godawful.

Keep up with it for a month, and then recheck -- I bet you'll see a big difference in his crit.
CallMeIshmael is offline  
#4 of 12 Old 01-31-2007, 02:05 PM - Thread Starter
 
vanessab23's Avatar
 
Join Date: Nov 2005
Location: Houston
Posts: 1,090
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
thanks for responding kelly-- no one in our family has it, although I do tend to be slightly anemic (I am a vegetarian). my side is swedish/norwegian and DH's side is mexican. although who knows what skeletons could be in the closet on either side

Our our ped mentioned a couple options (too low dietary intake, absorption issue like colitis, or one of the diseases that the newborn screen tests for-- I thought he said hemoelectrophoresis but when I googled it i got nothing, maybe he was thinking "thalassemia"?) anyway, I am trying to track down the actual NBS results b/c he wants to see what they were. thinking *maybe* the numbers were low-normal before and now they are creeping even lower.

thanks for the advice and the link.....

Miles (December 2005) Pascual (March 2009). P's was my beautiful home waterbirth that healed me from my M's birth. natural birth, midwifery, postpartum depression, babywearing, breastfeeding.
vanessab23 is offline  
#5 of 12 Old 01-31-2007, 02:09 PM - Thread Starter
 
vanessab23's Avatar
 
Join Date: Nov 2005
Location: Houston
Posts: 1,090
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
Originally Posted by CallMeIshmael View Post
Yep, been through this with my own daughter when she was that age.

By far the most likely reason you didn't see a boost in her hematocrit was that your son simply wasn't getting enough iron, even with the Floradix. Floradix contains 1mg of iron per 1 mL (not sure how big a dropper is). In order to fix an iron deficit, you generally need at least 3mg for each kilogram that your baby weighs. That'd be a whoooooole lot of Floradix.

How much does your son wiegh, and how much Fer-in-Sol is he taking? Fer-in-sol contains 15mg of iron per 0.6mL, making it 25 times more concentrated than Floradix, though it tastes godawful.

Keep up with it for a month, and then recheck -- I bet you'll see a big difference in his crit.
Yea, I just looked at the bottle of floradix-- it has 10mg (and his half-dropperful was probably one twentieth of that!), whereas the fer-in-sol has 15mg per dropperful. Ped didn't tell me any "instructions" so I just have what the bottle said (0.6mL which is 15mg)

I tasted, and we both did one of those shakes you do after taking a shot of tequila

he weighs 21lbs and 4ozs....

Miles (December 2005) Pascual (March 2009). P's was my beautiful home waterbirth that healed me from my M's birth. natural birth, midwifery, postpartum depression, babywearing, breastfeeding.
vanessab23 is offline  
#6 of 12 Old 01-31-2007, 03:23 PM
 
CallMeIshmael's Avatar
 
Join Date: Sep 2004
Location: Deep Gray
Posts: 325
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
So he's about 10kg, give or take. That means he needs at least 30mg a day which = 1.2mL = two droppersfull. Yuck. But I'd definitely try to get it into him -- when you're at the point that your hematocrit is dropping (as opposed to holding its own)and your red blood cells are shrinking, you've pretty much bottomed out your iron stores.

There's a product called Niferex that is available by prescription and is supposed to taste better -- haven't sampled it myself, though.

As for the thalassemia -- that's certainly a possibility too, but iron deficiency is way way way way more common in this age group. I wouldn't even begin to think about colitis or bone marrow issues at this point. The newborn screen should test for thal (though every state is different). The test is called "hemoglobin electropheresis" -- it just looks for any type of abnormal hemoglobin (so would also pick up sickle cell etc.)

Just so you know, my daughter was anemic at her 12mo check -- so we started giving her some multivites and tried to boost up her diet. As it turned out, the iron supp had a pretty piddly amount of iron in it-- enough to help her maintain the status quo, but not enough to help her build back her stores. At her 15 month, she was lower still. I too had begun to wonder whether she had some weird other cause of anemia -- until I calculated out how much iron she was actually getting. We did one month of Fer-in-Sol and it totally fixed things.

Best of luck!

Oh, and don't feel bad. 28 isn't that low (the lowest I've seen for iron deficiency anemia is 8 -- and that child was walking around!)
CallMeIshmael is offline  
#7 of 12 Old 01-31-2007, 11:49 PM - Thread Starter
 
vanessab23's Avatar
 
Join Date: Nov 2005
Location: Houston
Posts: 1,090
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Oh, okay I will give him another dose of the fer-in-sol before bed. And I'll confirm that doasge with the ped when I call tomorrow to make the next appt.

I forgot to mention also that if the iron levels are not up by one month he also wants to do a occult blood stool test.

One other question-- if he just has "normal" infant anemia, would the bone marrow still be pumping out immature RBCs? (I'm trying to google, but it's just so confusing: )

Miles (December 2005) Pascual (March 2009). P's was my beautiful home waterbirth that healed me from my M's birth. natural birth, midwifery, postpartum depression, babywearing, breastfeeding.
vanessab23 is offline  
#8 of 12 Old 02-01-2007, 03:59 PM
 
CallMeIshmael's Avatar
 
Join Date: Sep 2004
Location: Deep Gray
Posts: 325
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Yes, it is confusing.

By "immature red blood cells" do you mean reticulocytes? In general, when you're iron-depleted, you have a lot of trouble making new red blood cells. Your reticulocyte count will be lower than normal, though not nil. If you have anemia from blood loss, your reticulocyte count is higher than normal -- unless you have iron deficiency as well! And to add to the confusion, you always have to correct the reticulocyte count for the degree of anemia.

BTW, if you need a reference for the 3mg/kg iron dose to show your ped, here's one (way at the bottom, under "Medication". As you can see, 3mg/kg is actually on the low end. http://www.emedicine.com/med/topic1188.htm

If you want to talk in more detail and don't feel comfortable posting too much info here, feel free to PM me...
CallMeIshmael is offline  
#9 of 12 Old 02-01-2007, 08:30 PM - Thread Starter
 
vanessab23's Avatar
 
Join Date: Nov 2005
Location: Houston
Posts: 1,090
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
thanks callmeishmael,
i confirmed with the ped today (well, his nurse anyway) that Miles does need a dropperful TWICE/day...which means 0.6 + 0.6 mL per day or thereabouts.

we will see how he does.

I think I mean reticulocytes, but honestly the appt was VERY rushed and eventhough I wrote stuff down I didn't get it all

Miles (December 2005) Pascual (March 2009). P's was my beautiful home waterbirth that healed me from my M's birth. natural birth, midwifery, postpartum depression, babywearing, breastfeeding.
vanessab23 is offline  
#10 of 12 Old 02-01-2007, 08:46 PM
 
CallMeIshmael's Avatar
 
Join Date: Sep 2004
Location: Deep Gray
Posts: 325
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Okey-doke. Good luck with the Fer-in-Sol. Nasty stuff, but it does the trick.

Was there a concern about the immature red blood cells?
CallMeIshmael is offline  
#11 of 12 Old 02-02-2007, 12:05 AM - Thread Starter
 
vanessab23's Avatar
 
Join Date: Nov 2005
Location: Houston
Posts: 1,090
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
yes, he was concerned about the low hemoglobin, hematocrit AND the immature (small) red blood cells. I don't remember if there were a lot or a little...: but he wants to investigate.

Miles (December 2005) Pascual (March 2009). P's was my beautiful home waterbirth that healed me from my M's birth. natural birth, midwifery, postpartum depression, babywearing, breastfeeding.
vanessab23 is offline  
#12 of 12 Old 02-02-2007, 12:37 AM
 
CallMeIshmael's Avatar
 
Join Date: Sep 2004
Location: Deep Gray
Posts: 325
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
OK.

Low hemoglobin and low hematocrit pretty much go together, so no surprises there.

Small red blood cells are not immature, exactly, though I can see how your ped might call them that. Small red blood cells are a marker of a few things: iron def anemia (by far the most common reason) or a rare inherited hemoglobin problem like thalassemia or spherocytosis.

I actually think that the small blood cells are very reassuring -- they totally go along with the notion that iron deficiency is what's causing the problem.
CallMeIshmael is offline  
Reply

Quick Reply
Message:
Options

Register Now

In order to be able to post messages on the Mothering Forums forums, you must first register.
Please enter your desired user name, your email address and other required details in the form below.
User Name:
If you do not want to register, fill this field only and the name will be used as user name for your post.
Password
Please enter a password for your user account. Note that passwords are case-sensitive.
Password:
Confirm Password:
Email Address
Please enter a valid email address for yourself.
Email Address:

Log-in

Human Verification

In order to verify that you are a human and not a spam bot, please enter the answer into the following box below based on the instructions contained in the graphic.



User Tag List

Thread Tools
Show Printable Version Show Printable Version
Email this Page Email this Page


Forum Jump: 

Posting Rules  
You may post new threads
You may post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off
Trackbacks are On
Pingbacks are On
Refbacks are Off