By Santa J. Bartholomew M.D. FAAP, FCCM
See Corresponding Journal Article: Iron Deficiency Anemia
A 10 month old baby girl presented to the emergency department with parents stating that she was very sleepy; they were even having a hard time keeping her awake for feedings.
Mom reports that the baby has had several ear infections since she was born. Upon exam, her skin was pale, heart rate 155 bpm, respirations 35 breaths per minute. Mom has also noticed some patchy spots of hair loss, thinking it could be related to a growth spurt or rubbing her head in her sleep.
The baby was born premature and because of complications at birth, cord clamping could not be delayed.
Mom is very proud to have been able to exclusively breastfeed. She has not introduced any table foods at this point because the baby doesn’t seem interested and prefers to nurse.
Mom hasn’t been able to attend all the scheduled well baby checks due to issues with transportation.
Baby currently not on any medications or supplements. Complete blood count (CBC) revealed a hemoglobin of 9.8 g/dl, serum ferritin of 11.5 mcg/L, with the remainder of her blood work within normal limits.
The baby was discharged from the ER with antibiotics for a suspected ear infection and a referral to E.N.T related to the frequency of ear infections.
At the baby’s 12 month well child visit, it was noted that she was not meeting her developmental milestones. A height, weight, and hemoglobin was obtained for routine screening at which time her hemoglobin was 9.0 g/dl.
Iron deficiency anemia treatment immediately started at that time with no improvements to cognition and physical development noted at the next follow up visit.
