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Hematocrit or hemoglobin screening

To diagnose iron deficiency anemia, your doctor may run tests to look for:

  • Hemoglobin also noted as Hgb or Hb. It is what makes your blood red. This protein is rich in iron and bonds with oxygen. A sufficient hemoglobin level must be maintained so that body tissue can get enough oxygen.
  • Hematocrit also called Hct. It is the volume of red blood cells compared to the total blood volume, which is made up of red blood cells and plasma.

Who is at risk

Infants and toddlers with the following are at highest risk for iron deficiency anemia:

  • History of prematurity or low birth weight
  • Lead exposure
  • Weaning to cow’s milk and or formulas with low-iron or no iron before 12 months
  • Exclusive breastfeeding beyond 4 months of age without supplemental iron
  • Children of low socioeconomic status or with special health needs, feeding problems, or poor growth and development and inadequate nutrition

Symptoms

These are the most common symptoms:

  • Increased heart rate
  • Breathlessness, or trouble catching a breath
  • Lack of energy, or tiring easily
  • Dizziness, or vertigo, especially when standing
  • Headache
  • Irritability
  • Irregular menstrual cycles
  • Absent or delayed menstruation
  • Sore or swollen tongue
  • Jaundice, or yellowing of skin, eyes, and mouth
  • Enlarged spleen or liver
  • Slow or delayed growth and development
  • Poor wound and tissue healing

What you can do

  • Breastfeed your child for at least a year. If that isn’t an option, use formula with added iron. Don’t give cow’s milk until he or she is at least a year old.
  • Be sure your child eats iron-rich foods such as meat, iron-fortified cereals or beans.

Preventive service at no cost

Children at 12 months

Perform blood test to evaluate hematocrit or hemoglobin levels.

Children at 4 months and again at each well child visit from 15 months through 21 years

Assess risk for anemia and perform blood test if assessment is positive.


Why screening is important

Your child may have no symptoms of anemia, but once discovered, anemia is often a symptom of another disease. Iron deficiency anemia may cause developmental delays and behavioral disturbances in children.

What the screening is

To get a blood sample, a healthcare provider will insert a needle into a vein, usually in the child's arm or hand. A tourniquet may be wrapped around the child's arm to help the healthcare provider find a vein. Blood is drawn up into a syringe or a test tube. In some cases, blood can be taken using a needle prick.

Blood tests may cause a little discomfort while the needle is inserted. It may cause some bruising or swelling. After the blood is removed, the healthcare provider will remove the tourniquet, put pressure on the area, and put on a bandage.

Treatment

Your child’s pediatrician may recommend a change in diet. Iron supplements may be recommended. The doctor will also treat the underlying cause of iron deficiency, if necessary.

Additional tips

Vitamin C in citrus juices, like orange juice, helps your body to better absorb dietary iron.

Resources