9 month old severely anaemic

[Ah5337]

Hello, my baby was born IUGR and prem (36+2).

At 9 and half months he was found to be severely anaemic through a blood test. He is very delayed in his development (does not roll or sit and always tired and wants to lie and watch everything from a distance). This explains why he has never been interested in playing however has anyone experienced this with their baby? If so how did it affect their brain development ? Will it leave mental or physical impairment. The fact that they never caught it and the doctors have concluded it is iron deficiency anaemia and chronic as it has happened over a long period of time. I am worried it will have caused some sort of damage effecting my son.

OP I don’t think that this can be anything you have done. Perhaps he doesn’t absorb iron well ? Have you had any advice about possible causes.
I don’t know about anaemia in babies but a friend’s teenage dd was severely anaemic and would fall asleep anywhere. She was fine once her levels were brought back to normal. I hope your baby recovers speedily.

Oh I'm so sorry OP. I have no experience but my thoughts were that he will probably catch up as he's just delayed rather than impaired? There's no reason to think it's harmed permanently, I can't think of any biological reason, but I'm not medical. I'd definitely seek out an official apology from them and your HV though, can't believe they didn't test sooner!

Has he had full testing by a paediatrician?
Referral to metabolic disorders clinic?
Genetic testing?

pubmed.ncbi.nlm.nih.gov/21150441/

He needs full assessment and referral to a metabolic specialist

pubmed.ncbi.nlm.nih.gov/29746437/

Hiw are they treating him? Is he under paediatrician or had he been referred?

Thank you all for your responses.

So he has been under paedtriatric care since he was born premature and IUGR.
They failed to pick up on this on the appointments and everytime I brought up concerns regarding his colour.

They have apologised and done testing to see if it is a blood disorder but these came back clear.

They have referred him onto genetic testing however I am not sure this could relate to a genetic disorder? If so are there any that I can check him up against. He doesn't really have any other symptoms apart from delayed development.

He has been put on oral iron and within a week we have seen a difference. He is more alert and playful but not "normal" but I guess that will take time as his iron was considerably low. He has been like this since he was around 5 and a half months. And he is now 9 and a half months so it's a big delayment.

I should also add that he has not started weaning. He has no interest in food and will only take a few sips of water. I am not sure if this again is related to anaemia. He cries everytime I go near him with a spoon. The doctor had said anaemia affects appetite and maybe that's why he never felt like he needed food. I am very worried and anxious. I do try give him something everyday but he is still not interested.

Poor little soul. From experience, anaemia can mess up digestion and appetite so I'd try to let the iron levels go up before worrying so much about the eating - maybe just give him food to play with in a low pressure way. If he eats, bonus, but sounds as if the cause of the anaemia should be the priority.

. It is so hard worrying about a little one. You have done so well to keep pushing them on instincts about your baby. I am sorry that you have been let down for months.

Delayed development plus specific symptoms need more investigation
How is his Weight?
Temporary feeding tube?
Ask for a multi discipline assessment bring in paed , SLT(for feeding) physio OT etc

His weight is perfect if anything over what is expected
He had a feeding tube for 2 weeks when he was first born but he picked up breastfeeding really well.

Again do you have any suggestions as to what genetic disorder it could be?
He does not have any other symptoms apart from delayed development so I am not sure what to look for. He is due to have an mri so I'm hoping to have closure soon as I cannot deal with the anxiety of not knowing what is happening.

Feeding tube at birth
does not roll or sit
and always tired
and wants to lie and watch everything from a distance
never been interested in playing
Having mri ? Why mri?

There are many many syndromes and conditions
If he iron deficient why is that?
If he is absorbing his milk?
If not why not?
If he is putting on weight ok
But still deficiency why is that?
There are lots of questions there so keep asking for answers
Does he have low muscle tone?
Dies he have any strength such as when crying is he strong?
Can he kick and grab things?

Does he understand and play simple cause effect does he laugh or babble?

@Embracelife

Delayed development plus specific symptoms need more investigation How is his Weight? Temporary feeding tube? Ask for a multi discipline assessment bring in paed , SLT(for feeding) physio OT etc

Agree with this. You need full assessment. And get therapy services on board to help with development.

@Ah5337

His weight is perfect if anything over what is expected He had a feeding tube for 2 weeks when he was first born but he picked up breastfeeding really well.

Again do you have any suggestions as to what genetic disorder it could be?
He does not have any other symptoms apart from delayed development so I am not sure what to look for. He is due to have an mri so I'm hoping to have closure soon as I cannot deal with the anxiety of not knowing what is happening.

It could be any genetic condition. It could be none. Or it could be a genetic condition that they cannot yet define, otherwise known as a SWAN. but without full assessments you can't begin to look. Try not to focus on the iron deficiency being the 'cause'. It could be a symptom of something that needs more investigation.

It may be nothing sinister, OP.
Full term babies are born with sufficient iron stores for the first six months, but as yours was premature, he may have simply been deficient to start with.
Plus, there is very little iron in breast milk. Breast fed babies often need an additional source from six months onwards - either from solid food, or iron supplements.
Formula milk is fortified with iron, so doesn't have this problem.

Not hugely prem
IUGR and prem (36+2)

Iugr could imply an underlying condition
Not hugely prem, almost full term
Ask for full microarray to start
Is he near sitting or not at all? Look at neuromuscular is it muscles or low tone?
What about communication and play?
Get full paed review

@Embracelife

Feeding tube at birth does not roll or sit and always tired and wants to lie and watch everything from a distance never been interested in playing Having mri ? Why mri?

There are many many syndromes and conditions
If he iron deficient why is that?
If he is absorbing his milk?
If not why not?
If he is putting on weight ok
But still deficiency why is that?
There are lots of questions there so keep asking for answers
Does he have low muscle tone?
Dies he have any strength such as when crying is he strong?
Can he kick and grab things?

He is already under a paedtrician since he was born small. They have been keeping an eye on him but have now requested an mri due to his delayed development.

They are unsure whether it is due to him being severely anaemic or not.

He did have low muscle tone when born but they said its low side of normal. So he can sit and roll he just doesn't want to.

He does not have much stregnth when crying he has always had a weak cry. But I'm assuming that's because he is severely anaemic?

He can kick and since being on iron supplement this past week he had started to reach more for toys.

He rarely laughs only when my daughter talks to him. He has babbled but again rarely.

He just wants to be held so he can watch from a distance and has just started trying to play with toys himself by trying to reach and play.

He doesn't go to anyone much only a selected few.
He has good strength in his legs - he can stand for a good period however he has no strength in his upper body (arms shoulders). This is because he hates tummy time so I'm unsure how to make him build his strength.

The therapists have all said he needs time and they cannot do anything just now until he starts building his strength and moving himself.

He doesnt communicate or "play" as such. He seems like he has the mentality of a 5/6 month baby. Again I'm not sure if this is becauseof the anaemia where he was just too tired to concentrate or play and therefore caused a delay.

Speak to physio for ideas.
So long as he being followed up
It is a c ase of watching to see what issues there are
Get as much input as you can
Refer to SLT physio OT
Use makaton signs with him

Turn on tummy. every time you change him even30 seconds

OP what are his haemoglobin & serum iron & ferritin levels? Have they ruled out other kinds of anaemia? What was his full blood count like?

His blood count was down at 41 (it should be in the 100s) so they said this is considered severely low. His ferritin levels were also very low but they never told me amounts. They concluded it was iron deficiency anaemia as they checked all other disorders and types and they were all fine. His bone marrow was fine, his spleen, kidney, liver function was normal. He is able to produce his own blood cells. So they done all the tests necessary.

I just want to add, I know I mentioned he doesn't roll or sit but he has done it many times in the past he just chooses not to. He has the strength to do everything he just doesn't want to. I feel like that's also with everything else such as playing, he will play but he would rather prefer to just sit and watch others. The physio has checked all his muscles and said he is completely fine he just needs time to be able to practise it all more. But the problem I have is he never wants to.. which is very unusual for a baby.

He watches his TV programmes and understands his name. He laughs when my older daughter calls him (rare) but he is still able to do these things.

He chooses to not do tummy time and not sit because he prefers to be held by me at all times.

My nearly two year old is iron deficient - his ferritin and iron levels were half what they should be but they weren’t concerned because his haemaglobin (so?) looked okay and was functioning normally. He also didn’t have any symptoms, he doesn’t fall asleep everywhere, doesn’t seem tired all the time only sometimes, sleeps through at night well but misses his nap when he feels like it. His development is also fine.

The only reason I’m saying all this is because if any of the above wasn’t the case I’d be pushing for more tests (if there are any!) and support. But he’s only been on his supplement for a little while so give it time to see how he responds. We have to go and have a blood test after a solid three months of iron supplements as then if his iron is still low it will be conclusive that he’s not absorbing it properly and they’ll do further investigation.

As far as I understand it it takes time to get into their systems properly.

Also meant to add my DS eats everything put in front of him and is still iron deficient so it’s definitely not something you’re doing or not doing OP! I was told it’s very common for young children and babies to be low on iron.