What is hemoglobin
Hemoglobin is a four-subunit molecule. Each subunit contains iron-containing pigment (heme) and protein (globin). Each gram of hemoglobin is capable of carrying 1.34 ml of oxygen.
In medical practice, the determination of the level of hemoglobin in the blood is used to determine anemia (insufficient amount of iron in the blood), its severity and the selection of therapy. The analysis is performed on collected blood and is expressed as the amount of hemoglobin in grams per liter of whole blood. The normal values of this test may slightly differ from the standard values (approximately by 5-50 g / l) and each individual doctor will be treated differently.
Hemoglobin rate in children (up to a year)
The hemoglobin level is normal in children under one year varies greatly depending on age and gender. In newborn babies, hemoglobin concentration is higher than in one-year-old children. Premature babies are lower than those born on time. Girls are taller than boys. However, for each period of child development, the average hemoglobin rate is determined.
So the normal hemoglobin values accepted by the majority of pediatric therapists are:
• at the time of birth - from 135 to 240 g / l (rounded 165 g / l);
• at the age of 7 days - from 150 to 200 g / l;
• in 3 weeks - from 110 to 150 g / l (rounded 139 g / l);
• in 4-8 weeks - from 100 to 160 g / l (rounded 112 g / l);
• in 2-6 months - from 95 to 140 g / l (rounded out 126 g / l);
• in 6-24 months - from 105 to 135 g / l (rounded 120 g / l).
If the baby’s hemoglobin is lowered
The low value of hemoglobin in the blood of a child most often indicates that the baby does not receive the required amount of iron for its development. That is, simply put, has a lack of quality nutrition. The decrease in the concentration of hemoglobin in the blood provokes a poor supply of blood with oxygen, leading to malfunction of the body.
Iron plays a special role in muscle function, energy production, brain development. Consequently, if the child has a long time iron deficiency, this can cause developmental inhibition and behavioral problems.
Causes of low hemoglobin in children
As mentioned above, malnutrition (either quantity or quality of milk or mixtures) can be the cause of a decrease in the level of hemoglobin in a child. If the child receives a sufficient amount of nutrition, and the hemoglobin is nevertheless lowered, then some other factors play a role. Hemoglobin in newborns can be reduced in cases of:
• rapid death of red blood cells;
• large blood sampling for laboratory tests;
• blood loss at birth;
• weak production of red blood cells in the bone marrow.
The lack of red blood cells in the blood provokes the development of anemia and a high level of bilirubin - hyperbilirubinemia. Causes of the condition can be:
• hemolytic disease in a child;
• hereditary red blood cell anomaly;
• hereditary spherocytosis, with pathology, red blood cells have the form of small spheres;
• lack of enzyme (glucose-6-phosphate dehydrogenase);
• use of a sulfa and drugs containing aniline dyes by a pregnant woman;
• infectious diseases, such as parasitic toxoplasmosis, rubella, viral cytomegalovirus infection, herpes simplex, syphilis;
• bacterial infections of the newborn acquired during or after childbirth.
Blood loss can also cause anemia. Blood loss can occur in different ways. For example, when blood is lost through the placenta, the organ that attaches the fetus to the uterus and provides nutrition to the fetus. If too much blood gets into the placenta during birth. When the placenta is separated from the uterus before delivery.
Symptoms and diagnosis of low hemoglobin levels in children
Most babies with mild or moderate anemia do not have any noticeable symptom of pathology. Mild anemia may manifest as slowness, lethargy, and poor appetite of the newborn, but may also be asymptomatic.
Some newborns who have lost a significant amount of blood during childbirth may be in a state of shock, appear pale, have a rapid pulse and low blood pressure.
When anemia is a consequence of the rapid destruction of blood cells in an infant, an increased production of bilirubin is observed. The skin and the whites of the eyes become yellow - according to the results of a physical examination and a blood test a diagnosis is made - children's jaundice.
Most babies usually have a weak form of anemia and do not require any treatment. Newborns who have lost a large amount of blood are treated with therapy based on the intravenous administration of fluids followed by a blood transfusion.
A very severe form of anemia, caused by hemolytic disease, requires, along with blood transfusion, the use of preparations reducing bilirubin levels, as well as increasing the concentration of red blood cells. Transfusion is performed by gradually replacing the blood of the newborn with donor blood.
What is hemolytic disease in newborns?
Hemolytic disease - erythroblastosis is a condition in which red blood cells break down or are destroyed faster than normal ones. In severe forms, pathology can cause infant death.
Hemolytic disease can develop in Rh-positive children born to Rh-negative mothers. In an infant, red blood cells are destroyed by anti-rhesus, which were produced by the mother and transferred to the infant through the mother's placenta before delivery.
If the fetus has Rh-positive red blood cells, the mother’s antibodies will attempt to destroy the red blood cells of the fetus, and cause anemia of varying degrees of severity. Severe forms of anemia caused by hemolytic disease are treated as usual types of anemia.
Jaundice is treated in infants by exposure to bright light - phototherapy or replaced with a blood transfusion on the donor. Very high levels of bilirubin can cause brain cell damage - nuclear jaundice. If this condition is not diagnosed promptly and treatment is not started, the consequences can be dire.
In infants, not only low hemoglobin is found, but also high, which is also not the norm.
Elevated hemoglobin in a child (erythrocytosis), what does this mean?
Pathology is the opposite of anemia and is characterized by an increased concentration of red blood cells in the blood.
Elevated hemoglobin levels in a child’s blood can occur when:
• chromosomal abnormalities are present (with chromosome 13, 18 and 21), which cause an increased production of red cells in the blood;
• extra red blood cells were introduced due to blood transfusion;
• the baby was born at a high altitude or in conditions where there is a lack of oxygen;
• the baby was born after 42 weeks of pregnancy;
• twins were born separating the placenta;
• a child is born to a mother with diabetes;
• the pregnant woman smoked, took alcohol and narcotic drugs.
Why is hemoglobin elevation in children worrisome?
The increased concentration of red blood particles in the blood thickens the blood and makes it difficult to deliver to the organs and tissues. Children may experience shortness of breath, rapid heartbeat, lethargy, and poor appetite. A large number of blood cells begins to destroy bilirubin. Against this background, seizures may occur.
The main symptoms with elevated hemoglobin in children
Many children with mildly elevated hemoglobin levels do not have any visible symptoms. But in some cases (especially if the child’s hemoglobin is greatly elevated), the child can be noticed:
• deep red-purple color of the lips, shells around the eyes;
• poor appetite;
• lethargy;
• rapid breathing, respiratory failure;
• low blood sugar.
Symptoms of pathology may be similar to other medical problems, therefore they always require proper diagnosis and timely treatment. Pathology is determined by laboratory blood tests. If the analysis shows a child has a high hematocrit (hemoglobin level), then the disease is present.
In each individual case, the specific treatment is prescribed by the attending physician on the basis of the obtained tests and:
• age of the child, general condition and history of the disease;
• severity of illness;
• the body’s response to specific drugs, procedures and measures taken;
• parental opinion.
The classic treatment of elevated hemoglobin levels in children may include:
• remove a certain amount of blood from the child’s body
• replacement of the withdrawn blood with special medicinal liquids (allows to reduce the concentration of red blood cells);
• partial exchange transfusion.
The listed procedures can be performed only by a qualified doctor in a hospital hospital through a vein, artery, rarely umbilical blood vessels.
As ancillary measures to resolve the problem, it may be recommended:
• excessive drinking (allows you to thin the blood and reduce hemoglobin levels);
• refusal of food containing iron (including for a nursing mother);
• introduction to the diet of a nursing mother of fish, a large amount of seafood, plant products that reduce the level of hemoglobin in the blood;
• rejection of red meat, liver, offal (both for the child and the nursing mother).
