PE26.{2,5,16} | Iron Deficiency Anaemia — Summary & Reflection

KEY TAKEAWAYS

Iron deficiency anaemia is the most common nutritional deficiency in Indian children, affecting >67% of under-fives by NFHS-5 data. It progresses through three stages: storage depletion (low ferritin only) → iron-deficient erythropoiesis (low ferritin + low transferrin saturation, Hb still normal) → frank IDA (microcytic hypochromic anaemia, all iron indices abnormal). Diagnostic hallmarks: MCV <80 fL, RDW >18%, serum ferritin <12 µg/L, TIBC elevated, transferrin saturation <15%; peripheral smear shows hypochromic microcytic cells with pencil cells. Treatment: elemental iron 3–6 mg/kg/day between meals for a minimum of 3 months (not stopped when Hb normalises). Expected reticulocyte response at 7–10 days; Hb rise ~1 g/dL/week. Dietary counselling must be specific and feasible: reduce cow's milk, add vitamin C with non-haem iron sources, introduce iron-rich complementary foods by 6 months. Under Anaemia Mukt Bharat (NACP), infants 6–59 months receive 25 mg iron daily for 100 days/year; school children 5–10 years receive 45 mg weekly under WIFS; adolescents receive 60 mg weekly.

REFLECT

Think about Priya's case from the opening scenario. Her anaemia developed over 12 months of a diet that was iron-poor by design — not by neglect, but because her family did not know that cow's milk and rice gruel are inadequate iron sources for a growing infant. How would you structure a 5-minute counselling conversation with her grandmother that is clear, non-judgmental, and actionable? What three specific dietary changes would you prioritise? And if you were working in this PHC regularly, how would you use the NACP infrastructure — anganwadi workers, ASHA, weekly VHND — to create a follow-up system that ensures Priya's iron stores are actually replenished, not just her prescription filled?