This refers to anaemia occurring after the first week and often much later. It is due to a number of factors which include:
- Deficiency of haematinics.
- Blood loss associated with repeated investigation.
- Intracranial haemorrhage.
- Erythropoietin deficiency.
Feeding chart for preterm and low birth weight babies: Amount of milk to give every 3 hours (ml)
| Birth weight | Age in days | |||||||
|---|---|---|---|---|---|---|---|---|
| (KG) | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 or more |
| 1.0–1.4 | 8 | 10 | 15 | 20 | 25 | 30 | 30 | 35 |
| 1.5–1.9 | 10 | 15 | 20 | 25 | 30 | 40 | 45 | 50 |
| 2.0–2.4 | 15 | 20 | 30 | 35 | 40 | 50 | 55 | 65 |
| 2.5–2.9 | 20 | 25 | 35 | 40 | 50 | 60 | 70 | 75 |
| 3.0–3.4 | 20 | 30 | 40 | 50 | 60 | 70 | 70 | 75 |
| 3.5–3.9 | 25 | 35 | 45 | 60 | 70 | 80 | 80 | 80 |
Note: Introduce feeds as soon as possible; preferably no later than 24 hrs after birth. Monitor weight at least 3 times a week. Weight gain after the first week is 15g/ kg/day.
Management
- Treat with iron and folic acid.
- Transfuse if:
- Symptomatic: Poor weight gain, recurrent apnoea, congestive cardiac failure, or
- Hb < 8g
Prevention
Limit blood loss; give prophylactic iron starting from 4 to 6 weeks of age.