Many children who live in orphanages are not provided with a balanced diet. The amount of the offerings is insufficient and the constituent nutrients are limited. Sometimes formulas are diluted lessening the concentration of nutrients. Vitamin D and iron are consistently missing from the diet of children living in orphanages abroad. These are vital nutrients for an actively growing infant, toddler, and school age child.
When vitamin D is missing rickets is the result. When iron is missing, the child becomes iron deficient and finally anemic. The long-term effect of anemia can be diminished cognitive ability. Diagnosis of anemia is easy. When blood is drawn at the time of the child's initial medical examination in the United States, a complete blood count is obtained. This allows a physician to evaluate the child's hemoglobin which is the protein which contains the iron. When the hemoglobin is less than what we expect for a child of that age, we consider the diagnosis of anemia. There are other features of the blood count which can help us to understand whether a child actually has iron deficiency anemia or whether the child has a genetically distinct hemoglobin molecule.
Some children who are anemic have genetic anemias which do not require iron supplementation. The hemoglobin is low because it is genetically determined. In China there are hemoglobins that are normal to the Chinese. In Africa, there are hemoglobins which are normal for Africans. An example of this is sickle cell anemia. Those individuals of African descent who have sickle cell trait are protected from malaria and so the trait has value and is sustained in the population. If two parents have the trait, then some of the children may actually develop the full blown sickle cell disease which is a serious disease and must be treated by physicians.
Chinese children can have thalassemia trait (beta, alpha) which is a mild anemia without consequence medically. If two parents have the trait, then the child can develop a thalassemia which like Sickle Cell Disease has serious health consequences. Children with thalassemia trait can also have iron deficiency, but this can easily be treated with iron supplements for a short interval. Sometimes, physicians who are not familiar with thalassemia trait in Chinese children treat these children for extended periods of time when it is not necessary. Iron can be obtained from iron rich foods like leafy green vegetables, meats, and beans. Iron supplements can be given to a baby from a dropper and it can be disguised in the child's daily diet.
|This page last updated September 17, 2003 7:30 PM EST|