The iron-deficiency anaemia of late infancy

Abstract

Since attention was drawn by the work of Mackay' to the great frequency of anaemia during infancy, many investigators have studied the problem. As part of the large-scale investigation into the iron-deficiency aniaemias of the poor classes, which has been carried out in Aberdeen 2 3 haemoglobin estimations by the Haldane method have been made in 789 infants of all ages up to twenty-three months. A chart showing the course of the haemoglobin level according to age in 629 infants has already been published3. Since that time haemoglobin estimations of 160 infants between the ages of nine and twenty-three months have been made, and in figure 1 the results obtained in the complete series of 789 infants are presented. The figure at each point on the curve represents the number of infants available for calculation of the average haemoglobin level for each age. It is seen that a very marked fall in haemoglobin level occurs during the first two months of life, namely, from a level of 145 per cent. at birth to 77 6 per cent. at two months. This fall is due to rapid reduction by haemolysis of the polycythaemic state present in the foetus as compensation for the low oxygen tension in the placental circulation. Following the slight rise in average haemoglobin level during the fourth month, the curve falls gradually until the eighth month. Thereafter there is a marked change, the haemoglobin level falling from 78 5 per cent. at the eighth month to 69 6 per cent. for the ages, eleventh month and twelfth to seventeenth months. From this point onwards the curve shows a rise which continues throughout childhood' and which is probably due to the increasing iron content of the diet during this period.