Anemia Screening
Anemia is a condition where there are less red blood cells than normal or there is less normally functioning hemoglobin than normal in the red blood cells. Hemoglobin is the molecule that carries oxygen to all parts of the body; the hemoglobin molecule requires an atom of iron to function. The most common cause of anemia is too little iron in the diet. The most common symptom of anemia in adults is fatigue. However, children are not little adults; their brains are growing and developing. Anemia during the first few years of life can actually result in decreased brain development. It also appears that iron deficiency itself, apart from anemia, may result in decreased brain development.
Current guidelines recommend screening all children at 12 months of age for anemia by measuring the hemoglobin level. If it is abnormal, the child takes additional iron in the diet and the level is rechecked. If the child is still anemic, then further tests are necessary.
Measuring hemoglobin is actually not a very good test for anemia; it is not as accurate as other tests, and it is a late indicator of iron deficiency. Nevertheless, it is a quick, readily available, and inexpensive test. Other, more accurate tests, are more difficult and expensive to perform.
We also screen high risk patients at other ages as well as adolescent females.
In order to screen all our patients, we do this test in our office. It is almost always covered by insurance plans, though sometimes part of the cost is listed as patient responsibility; however, it is only a few dollars.
References
Baker RD, Greer FR; American Academy of Pediatrics Committee on Nutrition. Diagnosis and prevention of iron deficiency and iron-deficiency anemia in infants and young children (0–3 years of age). Pediatrics. 2010;126(5):1040–1050
Hagan JF, Shaw JS, Duncan PM, eds. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, 4th ed. Elk Grove Village, IL: American Academy of Pediatrics, 2017. Bright Futures website