Amniocentesis results

His Hb is lower than normal, but in normal range for a thal minor. The fever would affect a ferritin test, but there is no reason for one at his age. The longer than typical fever isn't unusual in reports from thal minors. My only concern is the indicators that iron deficiency might also be a possibility, but at this transitional age, I don't know if that can be determined. His MCV and MCH are lower than what might be expected with just thal minor, but as I said, it may just be the age. As a precaution, I suggested the iron rich diet. His tests at 10 months will be more accurate.

Thanks a lot Andy!

Would you think the iron deficiency (if present) is due to thal minor or his diet ? He was on exclusive breastmilk for almost 6 months. We started his solids with the Gerber bottles (peas, carrot, etc) and Oatmeal cereal around end of 6th month.

My wife was regular on her prenatal vitamins during pregnancy but not so regular during breastfeeding. Could that reduce iron in the breastmilk, possibly ?

No worries then. Breastfed babies have lower iron levels and there is nothing wrong with that.

Hi Andy,

We are going to try giving him lots of home cooked vegetables (spinach, beans etc) to help his iron. Our doctor suggested waiting till 9 months before starting chicken. But some of my friends started chicken soup for their 7-month old infants.

For my reference, what HB level would be considered unsafe for this age infants ? As I mentioned in this same thread, my 7month son's numbers are:

  Hgb - 9.2  (the doctor said the normal is 9.4-13 for infants of this age)
  Hct  - 28.4
  MCV - 56.8
  MCH - 18.4
  MCHC - 32.4
  RDW  - 21.2

Is unsafe usually depends on HB and activity levels ?

I'm a bit concerned that my son's immunity against viruses is low. Would an iron deficiency affect immunity levels ?

Thanks!

Unsafe Hb level is below 7. Unhealthy is below 8.5-9, depending on the patient. As a parent, always look for signs of prolonged lethargy, but most minors are able to have fairly normal lives, even if an afternoon nap may be a requirement, even as adults.

Hi Andy,

We got blood work results for my 9 month old son. Could you please take a look at the results below :

--
CBC:
  RBC :  5.2  (3.9-5.5)
  Hb  :  10.0 (11.3-14.1)
  Hematocrit :  31.5 (31 - 41)
  MCV :  60.5 (70-86)
  MCH :  19.3 (23-31)
  RDW:  23.5 (11-15)

Electrophorosis:
  Hb A : 86.1  (>92%)
  Hb A2 : 4.8  (<8.0)
  Hb F  : 9.1  (<2.7)

Interpretation: Consistent with beta thal trait in an infant. Rule out iron deficiency. Suggest repeat in 3-6 months if clinically indicated.
--

I think this confirms that he is thal minor, right ? Also, anything to worry on iron deficiency ? The pediatrician is not concerned. But I want to make sure.

Thanks!
Sumit

Certainly looks like thal minor. Nothing to indicate iron deficiency at this time. For peace of mind, repeat the test in 6 months.

Hi Andy, it is now close to 6 months. Should we get iron checked along with CBC ? Or just CBC is good enough like last time. Thanks a lot.

At this time, I would suggest a CBC, a hemoglobin electrophoresis and an iron panel. The child is old enough now where the electrophoresis results will no longer reflect any fetal hemoglobin from birth.