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August 21, 2019


ThedaCare Pediatrician Recommends Regular Screenings Starting at 12 Months

August 21, 2019


ThedaCare Pediatrician Recommends Regular Screenings Starting at 12 Months

DARBOY, Wis. – If your child or your teenager is feeling sluggish, there could be many reasons behind the change. One possibility may be iron deficiency.

“Iron deficiency occurs when there isn’t enough iron in the body to maintain normal function,” explained Dr. Abby Smolcich, a pediatrician with ThedaCare Physicians Pediatrics-Darboy. “Without proper treatment of iron deficiency, iron deficiency anemia can occur, which is a decline in hemoglobin.”

Iron deficiency requires a hemoglobin test to pinpoint, and manifests differently in younger and older children, Dr. Smolcich said.

“Teenagers who are iron deficient will often report vague symptoms like fatigue which can be from multiple causes,” she said. “Some teens may report shortness of breath or an inability to keep up with teammates. Younger kids are often asymptomatic. Parents may notice they don’t play as much or look pale.”

Less often, kids with severe anemia may exhibit symptoms such as pica, a disorder in which they may crave non-food items such as ice, dirt or paper.

“If the process goes on for long enough, there can be neurodevelopmental outcomes, which could possibly lead to behavioral issues,” she said. “Sometimes kids are at higher risk for infections and febrile seizures.”

If left untreated, iron deficiency can cause hemoglobin levels to drop to a point where kids can experience detrimental health effects including heart failure and poor feeding. Some have required blood transfusions to help resolve the issue.

While iron deficiency can be caused by a number of factors, in younger children the most common cause is drinking too much cow’s milk.

“The intestines can become inflamed and you can have microscopic bleeding which can be enough to decrease the amount of hemoglobin in the body,” Dr. Smolcich said. “Milk is good for you; it has calcium which helps keep your bones strong. People don’t realize too much can actually cause problems.”

The recommendation is for kids to between 16 and 20 ounces of cow’s milk per day.

Other dietary issues that can sometimes lead to iron deficiency include a lack of nutritional balance, particularly for carb-heavy diets without green vegetables or red meats.

Older girls can experience iron deficiency because of blood loss due to heavy periods. If there is a concern surrounding heavy menstrual cycles, it is important to speak with a gynecologist to address potential underlying issues. Dietary issues in older kids can also cause iron deficiency.

Less common cause of iron deficiency anemia include blood loss, chronic inflammation, problems with absorption of iron, or problems with the red blood cells themselves, she said.

The American Academy of Pediatrics recommends hemoglobin screening at a child’s 12-month checkup. Additional testing can determine the shape and size of red blood cells and determine how much iron is stored in the body.

Iron deficiency is treated through supplements, monitoring iron levels through lab work and offering dietary counseling. Often milk consumption must decrease and intake of iron-rich foods such as red meats and leafy green vegetables must increase.

“The important thing is making sure you’re always bringing your child in for each well-child visit, especially in the first one to two years of life,” Dr. Smolcich said. “Those visits give us the opportunity to discuss any concerns with families.”  

About ThedaCare

For more than 110 years, ThedaCare® has been committed to finding a better way to deliver serious and complex healthcare to patients throughout Northeast and Central Wisconsin. The organization serves a community of more than 600,000 residents and employs more than 6,700 healthcare professionals throughout the regions. ThedaCare has seven hospitals located in Appleton, Neenah, Berlin, Waupaca, Shawano, New London and Wild Rose as well as 31 clinics in nine counties. ThedaCare is the first in Wisconsin to be a Mayo Clinic Care Network Member, giving our specialists the ability to consult with Mayo Clinic experts on a patient’s care. ThedaCare is a non-profit healthcare organization with a level II trauma center, comprehensive cancer treatment, stroke and cardiac programs as well as a foundation dedicated to community service.

For more information, visit or follow ThedaCare on Facebook and Twitter.

Media should call Cassandra Wallace, Public Relations Specialist at 920.442.0328 or the ThedaCare Regional Medical Center-Neenah switchboard at 920.729.3100 and ask for the marketing person on call.