A Simple and Cheap Treatment for Infant Anemia

Anemia is a dire problem for infants in the developing world. Slate contributor Dr. Sydney Spiesel talks with Madeleine Brand about a very simple, cheap and effective solution to the illness, caused by iron deficiency.

ALEX CHADWICK, host:

This is DAY TO DAY from NPR News. In many of the world's poorer countries, half of all babies become anemic in their first months of life. That means they don't develop enough red blood cells or the oxygen-carrying pigment hemoglobin. Often the condition is passed on by anemic mothers.

Now, though, a group of doctors in Mexico City has found a simple solution to the problem. Dr. Sydney Spiesel of the Yale Medical School joins us regularly to talk about new medical research. Syd writes for the online magazine Slate, and he spoke with DAY TO DAY's Madeleine Brand about infant anemia.

MADELEINE BRAND reporting:

Why is anemia such a problem in the developing world?

Dr. SYDNEY SPIESEL (Yale Medical School): In the developing world, there is a lot of poor nutrition leading to iron loss. And parasites tend to cause anemia, often because what they're doing is they're stealing some of the patient's blood.

BRAND: So, these doctors in Mexico have come up with a solution. What is it?

Dr. SPIESEL: Well, it's a kind of a funny one. You wouldn't have thought of it. I love it because it's so simple and so straight forward. And - as you'll see in a minute - so cheap. These doctors - who were lead by some people at a hospital in Mexico City under the direction of Camila Chaparro and Kathryn Dewey of the Department of Nutrition of U.C. Davis, University of California, Davis - they got the idea of well, what if we could just increase the amount of blood that a baby had after birth? And the way you do it is to simply delay the time that you clamp the cord. Usually, after babies are born, the umbilical cord is tied off very quickly because everybody's in a hurry. In fact, in this particular study, they found in Mexico City the average amount of time was 17 seconds, previously. So, they would tie cord off and cut the cord and then do their stuff.

And so what they decided to do was just wait a little while and let the blood -which was the baby's blood, which is in the placenta and in the vessels of the placenta - just let it drain back into the baby as the vessels in the cord tighten up. And there's some previous research that actually showed that this might increase the baby's amount of blood by about three to four ounces per kid.

BRAND: And then it would lead to less anemia?

Dr. SPIESEL: That was the subject of the experiment, is that would that lead to less anemia. The answer is, it did.

BRAND: Just like that?

Dr. SPIESEL: Just like that. It was just as simple as waiting two minutes to clamp the cord instead of doing it in those first 15, 17 seconds. The babies at six months had less anemia, they had better iron stores, and it was just like an incredibly simply intervention. Amazingly simply intervention.

BRAND: You mention that doctors usually cut the cord very quickly to save time, but are there health reasons to do it quickly?

Dr. SPIESEL: Well, health reasons are often cited to do it, although, the true studies haven't been done very well. One problem is that one of the concerns that we have is that sometimes babies will have too much blood, and that's a condition called polycythemia. And we do see it in some infants. And when there's too much - when there are too many red cells in a baby's circulation, the blood tends to circulate sluggishly and it's harmful. And I think that that was one of the arguments.

I think the main argument is well, there it is, let's just do it and get it over with. There has been a whole bunch of research on the effect of iron deficiency anemia. And there have been a number of studies that say that kids who are iron deficient at a year - and these are studies both in the United States and other places - just don't do quite as well developmentally. So, this intervention may prevent that.

BRAND: That's opinion from Dr. Sydney Spiesel. He's a practicing pediatrician and a contributor to Slate.com. Thank you, Syd.

Dr. SPIESEL: Thank you.

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