Iron-deficiency Anemia: Prevention and Management (Pediatric Nursing)

00:01 The American Academy of Pediatrics, the World Health Organization and other well-known pediatric organizations have proposed many recommendations for the prevention of iron deficiency anemia which is the most common nutritional deficiency in the world.

00:15 These recommendations include enrichmeent of foods with iron, giving iron-rich formulas when breast milk is insufficient, avoiding cow's milk in the first year of life, giving infants iron prophylaxis and screening infants in the first 9 to 12 months of life for this anaemia to see if supplementation is indicated, and preventing premature delivery because remember these infants are building up their stores from their mother in-utero and when they're born too soon, their stores are not adequate.

00:45 The main principles in the treatment of iron deficiency anemia include making the diagnosis, investigating and eliminating the condition.

00:53 so how do we replace the iron? Well we can do this in a few ways.

00:57 The first through foods.

00:58 Non-heme iron is found in plant based foods such as nuts, fruits and vegetable.

01:04 Foods with non-heme iron are still an important part of a nutritious well-balanced diet but the iron containing these foods will not be absorbed completely.

01:12 You only absorb between 2 and 10% of the non-heme iron that you consume.

01:17 Another option is heme iron and that's found in meats and meat products and the absorption is higher.

01:23 You can also replace iron orally and this is through ferrous sulfate.

01:28 It has high bioavailability.

01:30 The problem is it can cause GI upset, it can also cause constipation, nausea and vomiting.

01:36 And I always tell my patients that if they get a really upset stomach when they're taking their iron supplement, sometimes they just stop taking it and we can come up with other options to augment their iron intake.

01:46 In addition, it can cause black discoloration of the stool so I am always careful to warn my patients of this.

01:52 You want to take this one hour before or 2 hours after meals and this is a problem because it's better tolerated if you take it with food but it decreases the absorption.

02:01 And you always want to remind patients that vitamin C is going to increase their absorption so maybe they take it with a little bit of orange juice.

02:08 Parenteral options are also there, you can do intramuscular or IV infusions and these are usually in settings of malabsorption like celiac or inflammatory bowel disease where orals are not an option.

02:21 What are complications? Well patients can have impaired physical growth and compromise cognitive development.

02:28 Some patients will also develop impaired learning capacity.

02:31 There is reduced muscle function because of the decreased oxygen to the tissues.

02:35 There's also decreased physical activity and a lower work productivity.

02:40 The patient's gonna have a lower immunity and an increased risk for infectious disease.