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Anemia, (Age >7months AND <17 months), Due for anemia screening Clinician Summary Screening for iron deficiency anemia using hemoglobin or
hematocrit is recommended for: Pregnant women. High-risk infants. There
is insufficient evidence to recommend for or against routine screening for
iron deficiency anemia in other asymptomatic persons, but recommendations
against screening may be made on other grounds. Encouraging parents to
breastfeed their infants and to include iron-enriched foods in the diet of
infants and young children is recommended. There is currently insufficient
evidence to recommend for or against the routine use of iron supplements for
healthy infants or pregnant women. CDC Recommendations: Infants Ages Newborn to 12
Months and Children Ages 1 to 5 Years Health professionals should assess all
infants and young children for risk of anemia. Those at high risk or those
with known risk factors need to be screened for iron-deficiency anemia with a
standard laboratory test. Universal Screening for Infants and Children at High Risk: At ages 9 to 12
months, 6 months later (at 15 to 18 months), and annually from ages 2 to 5
years, screen those at high risk for iron-deficiency anemia, including:
Infants and children in families with low incomes
Infants and children who are eligible for WIC
Infants and children who are migrants or recently arrived refugees Selective Screening for Infants and Children with Known Risk
Factors: In
populations of infants and young children not at high risk, screen only those
who have known risk factors for iron-deficiency anemia: Before
age 6 months, screen preterm infants and low birth weight infants who are fed
infant formula not fortified with iron. At ages 9 to 12 months, and 6 months later (at ages 15 to 18
months), screen the following:
Infants born preterm or with low birth weight
Infants fed non-iron-fortified infant formula for more than 2 months
Infants fed cows milk before 12 months of age
Breastfed infants who do not receive adequate iron from supplemental foods
after 6 months of age
Children who consume more than 24 oz of cows, goats, or soymilk per day
after 12 months of age Children with special health care needs who use medications
that interfere with iron absorption (e.g., antacids, calcium, phosphorus, magnesium), or those with
chronic infection and inflammation, restrictive diets, or extensive blood
loss At ages 2 to 5 years,
annually screen the following: Children who consume a diet low in iron Children with limited access to food because of poverty or
neglect
Children with special health care needs Children Ages 5 to 12 Years
and Adolescent Males Ages 12 to 18 Years Screen only those with known risk factors, such as low iron
intake, special health care needs, or a history of iron-deficiency anemia. Adolescent Females Ages 12 to 18 Years and Nonpregnant Women of Childbearing
Age Screen annually those with known risk factors, such as
extensive menstrual or other blood loss, low iron intake, or a history of
iron-deficiency anemia. Screen every 5 to 10 years during routine health examinations. Pregnant Adolescents and Women Screen for anemia at the first prenatal care visit. Males 18 Years and Older No routine screening is recommended. Iron deficiency or anemia
detected during routine examinations should be fully evaluated.
·
age > 7
months and < 17 months; and ·
no hemoglobin
or hematocrit performed between 7 and 18 months of age References 1. Centers
for Disease Control and Prevention. 1998, April 3. Recommendations to prevent
and control iron deficiency in the 2. 3. 4.
Web
Links 1. http://www.cdc.gov/mmwr/preview/mmwrhtml/00051880.htm 3. http://www.ahcpr.gov/clinic/uspstf/uspsiron.htm
Implementation
Notes
Disclaimer These rules
and/or reminders were created using national, state and local guidelines, and
group consensus regarding best practices. These guidelines, and their
interpretation by clinicians at Partners Healthcare System, may not represent
the standard of care across all regions or settings, and are not intended to
be adopted or applied without independent assessment of their suitability for
a particular setting. Moreover, guidelines change over time (for example, the
age range for children who should receive influenza vaccinations was recently
extended to 59 months). The rules and/or reminders may need the addition or
modification of certain items to ensure that they remain consistent with
current guidelines. Therefore, the rules and/or reminders included here are
intended only as examples or guides for the development of similar rules
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