Wie wird Anämie bei Kindern diagnostiziert?

Wie wird Anämie bei Kindern diagnostiziert?

Iron deficiency anemia can be caused by a variety of factors, such as:

– Low-iron diet: A child gets iron from food, but only a small amount is actually absorbed by the body. Full-term newborns, born to healthy mothers, store iron in the last three months of pregnancy. However, babies of mothers with anemia or other health problems may not accumulate enough iron, and premature babies have particularly low iron stores.
– Changes in the body: During periods of rapid growth, the body needs more iron to produce new red blood cells. Babies between the ages of 4 and 6 months begin to use up the iron stores accumulated during pregnancy, so there is a risk of deficiency during this period.
– Digestive system problems: Iron malabsorption can occur after certain digestive system surgeries or due to diseases that affect bowel function. Most of the iron is absorbed in the upper part of the small intestine, and any disturbance in this process can lead to anemia.

The most common symptoms of anemia in children include:

– Pale skin,
– Irritability and nervousness,
– Tiredness or lack of energy,
– Increased heart rate,
– Pain or swelling of the tongue,
– Enlarged spleen,
– Desire to eat unusual things such as dirt or ice.

The American Academy of Pediatrics (AAP) recommends screening for anemia with a hemoglobin test for all infants as young as 12 months of age. The test should also include a risk assessment, which involves asking questions about nutritional problems, stunted growth, and other specific health needs. If your haemoglobin level is low, further blood tests are performed, such as:

– Hemoglobin and hematocrit levels: This is a basic screening test that measures the amount of hemoglobin and red blood cells in your blood.
– Complete blood count (CBC): This is a more detailed test that checks the number of red and white blood cells, platelets, and young red blood cells (reticulocytes). The complete blood count also includes hemoglobin and hematocrit and detailed information about red blood cells.
– Peripheral blood smear: A small sample of blood is analyzed under a microscope to assess the shape and appearance of the blood cells.
– Iron level tests: special tests measure the amount of iron in the child’s body.

Early detection and appropriate treatment of iron deficiency can prevent more serious health complications.

Ferritin: What do we consider normal?

Research conducted in pediatric sleep clinics is increasingly focusing on measuring serum ferritin levels in children with sleep disorders such as restless leg syndrome (RLS), periodic limb movements during sleep (PLMD) or in children reporting restless sleep. However, the question still arises: what level of ferritin in children can be considered “normal”?

One study, authored by Dr. Rosen and colleagues, looked at the effects of iron supplementation in children with RLS and ferritin levels below 50 ng/mL, which was defined as a biochemical indicator of iron deficiency. The results showed that supplementation increased ferritin levels and reduced the severity of RLS symptoms, but there was no direct correlation between changes in ferritin levels and clinical improvement.

Ferritin levels in children

Studies from pediatric sleep clinics show that ferritin is routinely measured as an indicator of iron stores in children with RLS, PLMD, and restless sleep. Researchers also study children who do not meet the criteria for RLS or PLMD but have reported symptoms of restless sleep and the daytime consequences of the disorder. One unpublished study collected data on ferritin levels in children who underwent sleep studies (excluding children with sleep apnea). The results show that the average serum ferritin levels were:
– 24.7 ng/mL (for children aged 1-5 years),
– 31.4 ng/mL (for children aged 6-11 years),
– 35.0 ng/mL (for children aged 12-19 years).

These values are very close to the ferritin levels reported in the general population of children in the United States, suggesting that if levels below 50 ng/mL were considered iron deficiency, most children would qualify for this category.

Ferritin and clinical symptoms

Although most studies suggest that children with RLS, PLMD, and restless sleep may experience improvement after iron supplementation, serum ferritin levels do not always directly correlate with symptom improvement. One possible explanation is that serum ferritin does not accurately reflect the iron stores in the brain, which may be crucial for the development of these disorders. Studies in adults with RLS found that differences in cerebrospinal fluid ferritin levels were significant, while serum ferritin levels remained similar in those with and without RLS.

Healthy sleep is the basis of your toddler’s well-being, so it is worth reaching for our Sleepee blankets and kissen, which will provide softness and comfort every night. For babies, carrycot sheets will also be an ideal solution, designed for a peaceful and safe sleep from the first moments of life.

Understanding ferritin levels

An important aspect in the interpretation of ferritin level results is the way they are communicated to parents. Describing ferritin levels between 20-30 ng/mL as “low” or indicating “iron deficiency” can lead to unnecessary concerns about the child’s health. Instead, it is suggested to refer to such values as “suboptimal” in the context of sleep disorders, without indicating full iron deficiency.

Emilia Adamczyk