I waltzed into my son's 1-year checkup a few months ago feeling like an old pro. With two kids before him, I had the routine down pat. A few questions here, a stethoscope there and we would be out of there. Well, not exactly.
What parents need
Just when I thought the appointment was almost over, the nurse wielded a needle at him and told me it was time for his "test." Um, what?
I shielded my son from the needle as I pulled him back from her over-eager advances.
"Sorry, but this is a new one for me," I said. "What is this test for?"
"Oh, well, it's standard. We've always done it," she said, looking at me like I may have lost my mind.
With my oldest only 5 and my middle child only 2, I knew it wasn't something that they had "always" done, so she finally explained that the pediatrician was now routinely screening babies' hemoglobin levels around 1 year of age.
The test for hemoglobin comes from new recommendations that were designed to detect iron deficiencies in babies. According to the American Academy of Pediatrics (AAP), "Babies should be screened at 12 months of age for iron deficiency and iron deficiency anemia under new AAP recommendations aimed at preventing long-term neurodevelopmental problems."
One of the leading physicians behind the study that led to the recommendation was Dr. Richard Baker, who concluded that there is a growing body of evidence that suggests that iron deficiency and anemia have long-term effects on behavior and brain development.
What is anemia?
Anemia occurs when the body's levels of the protein known as hemoglobin are low. Hemoglobin is responsible for binding oxygen in the bloodstream and carrying oxygen throughout the body — so without it, the body is not properly oxygenated. The most common cause of anemia is low levels of iron in the blood, because iron is required for the body to make hemoglobin. Anemia can also have other causes and will present in the body as low levels of hemoglobin — which is another reason why the test is so important. It can help alert a child's care provider to problems of anemia and beyond.
Although many baby cereals and foods are now fortified with iron, the AAP reports that more than 9 percent of the U.S. population is iron deficient. And who is at most risk of developing iron deficiency-related anemia? Exclusively breastfed babies, especially after the first 4 months of their lives, since human milk naturally contains very little iron. (This is also why most pediatricians recommend supplementing breastfed babies with vitamin D.)
So, what does the hemoglobin screening test actually entail? It was, much to my surprise, relatively simple. The nurse's aide poked my son's finger with a very small needle and took a blood sample using a cylinder tube. He squirmed and got rather angry at her, but he didn't even cry. It took less than a minute and because I never heard otherwise, I'm guessing the results came back just fine. (Although, now that I think about it, I should probably check on that, huh?)
Why the screening is important
Megan Bishop knows the importance of the hemoglobin screening test. She thought her son just had "puffy" eyelids, but soon, his symptoms worsened. According to Megan, her son was very pale, lethargic, and sleeping most of the day. But the real concern that tipped Megan off that something was very, very wrong was when his nails starting to become indented. Turns out, her son's symptoms were all due to his very severe anemia and iron deficiency. Without the screening test, Megan had no idea just how severe her son's anemia was — but after he was tested, his doctors found that his hemoglobin level was critical at only 4.2 (normal for a 1-year-old ranges from 9.4 to 14).
Megan also cautions parents to watch out for their infants and toddlers drinking too much cow's milk, as that can interfere with iron absorption in the body.