How should we follow up a positive screen for anemia in a 1-year old?
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Healthy infants who test positive for anemia on routine screening at 1 year of age are most likely iron-deficient and may be treated empirically with a trial of iron therapy (3-6 mg of elemental iron/kg/d). Documentation of response to iron confirms the diagnosis of iron-deficiency (strength of recommendation [SOR]: B; evidence from randomized controlled trials with some conflicting results; lack of evidence for long-term benefits/harms of screening strategies). In these cases, further testing with a complete blood count, mean corpuscular volume, red cell distribution width (RDW), serum ferritin concentration, as well as hemoglobinopathy screening when appropriate, may be effective in determining the cause of anemia (SOR: C, expert opinion).
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