The early anaemia of Premature infants: The haemoglobin level of immature babies in the first half-year of life and the effect during the first three months of blood injections and iron therapy.

An anaemic baby is more susceptible to infection than the normal infant3' and this, is an important factor in the mortality rate of infants of subnormal birth weight. Lichtenstein6, from his extensive work with premature babies, concluded that these infants regularly become anaemic in the first months of life although they are not anaemic at birth. The average haemoglobin level of thirty-six premature infants examined by him in the third month of life was about 40 per cent. (ranging between about 30 per cent. and 50 per cent.). He found that healthy full-term babies only exceptionally showed a drop to below 60 per cent. Many others have reached similar conclusions, though usually the number of their cases has been smaller; for example, Kunckel4 found in twenty-one premature babies, whose birth weight averaged four pounds, a drop to an average figure of 46 per cent. It has been generally accepted that premature babies at this age drop to much lower levels than full-term babies although they all start extra-uterine life with high haemoglobin levels. The author's observations on premature babies brought to the Queen's Hospital for Children for advice on feeding or management did not contradict these views. It should be borne in mind that the normal full-time infant always shows a considerable drop in haemoglobin level after birth, the lowest level being reached at about two to three months of age. This is followed by a rise in the second three months of life and then, if, as so often happens, a sufficiency of iron is not available, a renewed fall.