Thursday, October 19, 2006
Iron deficiency anemia in children explained
By Dr. Anthony Policastro

Iron deficiency anemia is a commonly used term. Whenever someone has a low blood count, iron deficiency anemia is the first thing he/she hears. That is because it is the most common form of anemia. What people do not always understand is where iron deficiency comes from. There are many causes. Before birth iron is transferred across the placenta from the mother. This happens throughout pregnancy. However, much of it occurs in the last few weeks of pregnancy. Thus a premature infant does not get as much iron as a full term infant. This lack of iron to start with makes premature infants prone to iron deficiency. Full term infants have high blood counts. This is because there is not a lot of oxygen delivered before birth. After birth, they start breathing on their own. They do not need as much oxygen. Most infants are born with blood counts of about 60. Over the first 8 weeks of life the count drops to about 30. While the blood cells are breaking down, the body stores the iron from the lost blood cells. At the age of 8 weeks, they begin using that iron to build new blood cells. The amount of iron they have put aside is about half of what they started with. That means that they will have enough iron until they double their birth weight. That occurs at about 5 months of age. Until that point, infants do not get iron deficient. However, we put them all on an iron-fortified formula. That allows them to have the needed iron when they run out of their stored iron. The exact date is different for each child. Therefore, we start them all on iron-fortified formula at birth. Once children start taking solid foods, they get iron from the foods. They usually do not need much iron from formula at this point. You might wonder then why we give iron-fortified formula for a full year. The answer is simple. There is no iron in whole milk. Some children will prefer to drink whole milk instead of eating food. In the days before iron-fortified formula, children would drink 2 - 3 quarts of milk per day. That gave them their fill of calories. They got no iron. That made them iron deficient. Now if they drink more than the recommended 16 to 24 ounces of formula after 6 - 8 months of age, they are at least taking in iron from the formula. When I was in my pediatric residency, we saw iron deficiency anemia in one-year olds all the time. Now due to the iron-fortified formula, we see a lot less of it.

Breast milk
This might lead to the question about breast milk. Breast milk does not have a lot of iron it. However, the type of iron that it has is highly absorbed. In addition, it is unlikely to see infants drinking 2 to 3 quarts of breast milk per day. Mothers do not supply that much milk. For these two reasons, breast fed infants do not often get iron deficiency anemia. Once children start eating foods and cut down on milk intake, we rarely see iron deficiency anemia. It usually does not occur until someone loses blood. In males, blood loss is unusual. When it does occur, it is abnormal. Females will lose blood once they start having periods. Usually, the amounts are small enough that they do not develop iron deficiency anemia. However, women who have heavy periods can lose enough blood to develop anemia. Women who have long periods can lose enough blood to develop anemia. Women who have other menstrual irregularities can lose enough blood to develop anemia. The bottom line to all of this is that a well-balanced diet usually will prevent iron deficiency. That is true starting in infancy. That is true in older children. That is true in adults.

Dr. Anthony Policastro is medical director at Nanticoke Memorial Hospital.

Division of Public Health influenza vaccination
Delaware's Division of Public Health announces its influenza vaccination schedule for Delawareans without a healthcare provider or whose insurance does not cover flu shots. While many DPH adult clinics accept walk in clients, DPH will vaccinate children by appointment only on scheduled days. Medicare Part B and donations are accepted.

Sussex County adult clinics
Oct. 24, Tuesday, Greenwood Fire Hall, 13 Governors Ave., Greenwood, 9 a.m.-1 p.m. Walk In.
Oct. 26, Thursday, Greenwood Fire Hall, 13 Governors Ave., Greenwood, 4 - 7 p.m. Walk In
Nov. 14, Tuesday, Laurel Fire Hall, 205 West 10th St., Laurel, 4-7 p.m. Walk In
Nov. 16, Thursday, Laurel Fire Hall, 205 West 10th St., Laurel, 9 a.m.-1 p.m. Walk In
Nov. 28, Tuesday Blades Fire Hall, 200 East 5th St., Blades, 4-7 p.m. Walk In
Dec. 7, Thursday, Blades Fire Hall, 200 East 5th St., Blades, 9 a.m.-1 p.m. Walk In

Flu shots for children under 18
Children under the age of 18 will be seen by appointment only at the DPH Clinics and State Service Centers. Parents or guardians interested in making appointments for flu shots should call one of these DPH clinics. Sussex County, Georgetown State Service Center, 856-5213 Sussex County, Shipley State Service Center, 628-2006 For more about flu clinic locations and dates, go to

Nanticoke announces Leadership honorees
Nanticoke Health Services recently announced the recipients of the 2nd Annual Nanticoke Tributes for Healthcare Leadership. The awards will be presented at a dinner and reception on Nov. 2 at the Baywood Greens. The Founders Award will be presented to Karl Brown, Sr. for his role in the establishment of Nanticoke Memorial Hospital in 1952. This award will be presented posthumously to his family. The Charles C. Allen, Jr. Philanthropy Award is being awarded to The Auxiliary of Nanticoke Health Services. The Nanticoke Tributes will also recognize the two new inductees into the Nanticoke Physicians Hall of Fame. This year, Judith Tobin, MD and John Lynch, MD will be presented with the Hall of Fame Award. The dinner will be from 6 to 9 p.m. at Baywood Greens in Long Neck. Mitzi Perdue will be the guest speaker. Tickets are $75 and may be purchased by calling 629-6611, ext. 2404.

Nanticoke offering flu shots
Nanticoke Memorial Hospital will be offering flu shots to the public on Thursday, Oct. 26 (3-7 p.m.) and Friday, Oct. 27 (9 a.m.-1 p.m.) located at the Nanticoke Mears Health Campus (across from Seaford Post Office). The cost of the vaccination will be $10. The vaccine is not recommended for anyone under 18. The influenza vaccine is recommended for elderly and high-risk individuals. Healthy working adults may also benefit from the influenza vaccine. Large outbreaks of influenza usually do not occur before December in the U.S.A. and reach a peak between late December and early March and many continue into the spring. For additional information contact Nanticoke Memorial Hospital at 629-6611, ext. 2505. No appointment or pre-registration is required.

Family-to-Family Course
The National Alliance on Mental Illness in Delaware (NAMI-DE) is sponsoring a Family-to-Family Education Course. This is a free, 12-week educational program for families of persons diagnosed with serious mental illness. If you have a family member who suffers from schizophrenia, bipolar disorder, obsessive-compulsive disorder, panic disorder or other serious mental illness, you may benefit from this course. The fall class for Sussex County will be on Mondays, starting Oct. 23, at 6:30 p.m., at St. John's United Methodist Church, Seaford. Find out more about the Family-to-Family Education Program and how it can help you. Call (888) 427-2643.

'Kick the habit' seminar
Do you want to be healthier? Improve your life and live longer? If the habit of smoking keeps you from feeling better and enjoying life more, don't be discouragedyou can quit! Delaware Technical & Community College, Owens Campus, Georgetown is offering a Stop Smoking seminar on Tuesday, Oct. 24, 7-9:30 p.m. in the theater of the Arts & Science Center. Anne Connor, DCH, will explain how hypnosis can free you from the cigarette habit without withdrawal, anxiety, or weight gain  even if your other attempts to quit have failed. The American Medical Association recognizes hypnosis as a safe, quick, and effective way to end the smoking habit. You'll be awake, relaxed, and in control the entire time. A free cassette tape helps reinforce what you learn in the seminar. The seminar fee is $39. For more information or to register, contact Corporate and Community Programs at 854-6966.

Balance training series
Medicine philosophies from the East and the West will be highlighted in "Balance Training: East Meets West" on the ninth presentation of the annual Distinguished Lecture Series presented by Delaware Technical & Community College in Georgetown. This continuing education seminar, scheduled for Saturday, Oct. 28, 7:30 a.m.-2:30 p.m., is co-sponsored by the Physical Therapist Assistant Department and the Division of Corporate and Community Programs. The seminar will incorporate the philosophies of eastern and western medicine to improve postural control and balance in patients with basic balance impairments. The complex motor control systems involved in static and dynamic balance will be addressed during the presentation. Western balance techniques will be merged with eastern balance exercises based on tai chi and yoga. Health care providers, specifically those in the fields of nursing, occupational therapy and physical therapy, will benefit from the seminar and be able to earn required credits for continuing education. Nationally-known speaker Trudy S. Goldstein, PT, is the presenter. With more than 25 years of clinical and supervisory experience in physical therapy, she is the author of two best-selling books and the producer of two videos. Currently the director of QUEST Seminars and a therapy consultant in Massachusetts, Goldstein is a second degree black belt instructor who teaches tai chi to adults. General public fee for the one-day seminar is $125; student fee is $45; both fees include refreshments and lunch. A detailed brochure is available upon request by calling Delaware Tech at 302-856-5400, ext. 3190. To register, call 302-855-1617.

Mental Health screening
Have you been feeling consistently moody or sad? Can't relax or concentrate? Been alternating between highs and lows? Have you been troubled by unexplained aches and pains? Are you unable to eat or sleep? If so, you may be suffering from depression or a mental health disorder. Daybreak Counseling Services is offering free mental health screenings for a range of common emotional situations that often go undiagnosed and misunderstood. If you haven't been feeling like yourself lately, a screening can help you figure out what is wrong. Screenings for depression, bipolar disorder, generalized anxiety disorder, and post-traumatic stress disorder will be held at St. John's United Methodist Church , Pine and Poplar Streets, Seaford, from 10 a.m. until 2 p.m. on Saturday, Oct. 21. "We are pleased to be able to offer depression screening to the community as part of this year's event for Mental Health Awareness. Many people are not able to attend a screening event due to work, school or family commitments. This screening program offers people on a Saturday the opportunity for a free screening and confidential referral if necessary," says Constance Hastings, Daybreak counselor and staff counselor for St. John's Church. Attendees will have the opportunity to complete a written self-assessment and talk one-on-one with a mental health professional.

2006 Memory Basket
The LifeCare at Lofland Park Memory Walk Team is now selling the Longaberger Pen Pal Memory Basket. The basket is trimmed in purple around the top with ribbon tacks and has a special engraved tag. The cost is $48 which also includes the basket protector. All proceeds benefit the Alzheimer's Association Delaware Valley Chapter. For more information contact Tawnya at 628-3000 ext., 8452; or

Blast Out Cancer
The 3rd annual Blast Out Cancer Sporting Clay Shoot at Owens Station Sporting Clay Range, Hunters Cove Road, Greenwood, will be held Oct. 22. Registration 9 a.m.-1 p.m., cost $75 (lunch included). Prizes will be awarded - sponsorships available. Proceeds benefit the American Cancer Society's Relay For Life. For tickets or information contact Kenny Hopkins 945-3410; Mary Catherine Hopkins, 875-7308; or Ellen Hall, 422-6219.