ANAEMIA IN NEW BORN

At birth normal values of hemoglobin (central venous) in infants > 34 weeks gestation are 14–20 g/dL with an average value of 17 g/dL.

DEFINITION: Central venous hemoglobin level < 13 g/dL in an infant of > 34 weeks gestation is considered anemia.

PATHOPHYSIOLOGY: Anemia in the newborn infant may be due to any one of the three pathologies: (a) Physiologic anemia of infancy is due to shorter life span of RBCs and less erythropoietin production; (b) Loss of RBCs (Hemorrhagic anemia); (c) Destruction of RBCs (Hemolytic anemia) (p. 554) or (d) Under production of RBCs (Hypoplastic anemia).

CAUSES:

 (1) Hemorrhagic anemia:

1. Obstetric causes:

• (a) Abruptio placenta;
• (b) Placenta previa;
• (c) Traumatic rupture of umbilical cord;
• (d) Obstetric trauma (difficult delivery with visceral or intracranial hemorrhage);
• (e) Twintwin transfusion;
• (f) Delivery of the baby by cesarean section after cutting through the placenta in anterior placenta previa;
• (g) Ruptured vasa previa;
• (h) Excessive fetomaternal bleed;
• (i) Anemia of prematurity;
• (j) Hereditary RBC disorders—hemoglobinopathies.

1. Neonatal causes:

• Caput succedaneum
• Cephalhematoma
• Intracranial hemorrhage
• Visceral hemorrhage (spleen, kidneys and adrenals)
• DIC
• Thrombocytopenia
• Hemorrhage due to deficient vitamin K dependent factors (II, VII, IX and X).

(2) HEMOLYTIC ANEMIA

(3) UNDER PRODUCTION OF RBCS:

• Congenital hypoplastic anemia,
• Leukemia and
• Infections (Rubella, Syphilis).

 DIAGNOSIS:

(1) History:

1. Family history of bleeding and
2. Maternal medications (phenytoin, warfarin),

(2) Clinical examination (jaundice, spleenomegaly, skin bruises) and

(3) Laboratory tests: Complete blood count, RBC indices, blood smear, reticulocyte count, Kleihauer Betke test, coagulation profile, intrinsic RBC defect, TORCH study and ultrasound of abdomen and head.

HOMEOPATHIC TREATMENT:

FERRUM METALICUM - Ferrum met. is one of the top remedies for anemia.  The persons needing Ferrum Met are weak with paleness, and have frequent false flushings appearing at the slightest excitement. Difficulty in breathing, shortness of breath with palpitations in heart are dominantly present in such patients, as is coldness of body. 

ALETRIS FARINOSA -- Aletris Farinosa is the best Homeopathic medicine for children suffering from anemia with extreme weakness and fatigue. There is a marked weariness and tiredness all day in such patients. The energy level seems to be markedly reduced and the body feels powerless

NATRUM MURIATICUM - Natrum muriaticum is one of the best medicines for anemia with weight loss. Natrum Mur acts very efficiently to control weight loss as a result of anemia. The person appears very lean and emaciated with loss of flesh. Natrum Mur is also effective when anemic patients experience palpitations. Natrum Mur has a great ability to control palpitations due to decreased blood. Anemia due to longstanding grief is also best treated with this  remedy Natrum Mur.

 FERRUM PHOS - Ferrum phos is a haemoglobin enhancer. Ferrum Phos is the most frequently used Homeopathic medicine to increase the haemoglobin level. It can be safely used among people of all age groups. Even during anemia in pregnancy, Ferrum Phos is a safe Homeopathic remedy though the dosage is to be properly handled by the physician during pregnancy. The skin appears pale in persons needing Ferrum Phos and they also experience palpitation of heart and weakness. The pulse rate is quickened. Vertigo and headache also appear as symptoms. Ferrum Phos is also the best remedy for controlling sweat in anemic patients especially at night.

PICRIC ACID - Picric acid is an effective remedy for pernicious anemia. Picric Acid have extreme weakness and prostration. Very marked weakness is present with a tired feeling all day. There is also an aversion to do any kind of work.

PHOSPHORUS - Phosphorus is another effective remedy for pernicious anemia Longstanding diarrhoea with weakness is also experienced. An increased desire for cold drinks and ice creams is often noticed in Phosphorus patients. Phosphorus is also prescribed for anemia due to kidney diseases .

ARSENIC ALBUM - Arsenic alb is another effective remedy for anemia following malaria. Arsenic Album is prescribed when there is a marked weakness that gets worse at night. The person seems exhausted with much weakness. Even a slight exertion seems to worsen the weakness

PULSATILLA NIG. - Pulsatilla is an excellent remedy for anemia of those patients who were heavily and irrelevantly drugged by medications and tonics or due to accidental stoppage of menses. Thirstlessness is another guiding symptom of this remedy.