Why does a breastfed infant persistently have iron deficiency?

Question

Hello doctor,

My daughter has been dealing with iron deficiency since the age of two months. For the past eight months, she has been taking a Poly-vi-sol iron supplement and consuming an iron-rich diet for six months. Despite these efforts, her iron deficiency persists.

Her pediatrician believes that her continued breast milk consumption, which is now at around 16 ounces per day at one year of age, is a contributing factor. Recent lab results confirm ongoing iron deficiency, and the pediatrician has recommended an additional 2 mL of Novaferrum per day on top of the Poly-vi-sol with iron she already takes.

A few months ago, a hematologist diagnosed her with anemia of chronic disease, but ferritin levels were not repeated at her latest evaluation. Her ferritin levels, which have previously been high, have recently entered the normal range. Unfortunately, her current ferritin levels were not checked. Her hemoglobin stands at 9.5 g/dL, hematocrit at 28.4%, iron saturation at 13%, iron at 37 mcg/dL, platelets at 492,000 k/cumm, RDW at 16.6%, and MCV at 75 fL.

Kindly help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I can understand your concern.

Please keep in mind a few things. If your child takes iron at the same time as calcium, then iron does not get absorbed, so make sure you do not give iron along with milk. There should be a time period of two to three hours between both. The second thing is that taking vitamin C increases iron absorption, so you can try giving her iron with some citrus fruit that would increase the absorption of iron.

Make sure she does not have any kind of malabsorption and get it checked by a gastroenterologist. Get her dewormed and give her medicine to remove worms from the intestine. Remove the cause of iron deficiency if there is anything else, such as a poor diet, any inflammation, or any drug. Give me a follow-up after you do these measures.

I hope this helps you.

Thank you.