رضيع عمره ١٢ شهراً يشرب حليب بقر أكثر من لتر يومياً ويأكل قليلاً، وهو شاحب. الهيموغلوبين ٨٫٤ مع كريات صغيرة. ما النصيحة؟

A 12-month-old drinks over a litre of cow’s milk daily, eats little and is pale. Hb 8.4 g/dL with small red cells. What is the advice?

1. An immediate transfusion at home
2. Increase milk to correct the deficit quickly
3. Limit milk, add iron-rich foods and an iron supplement
4. Stop solids and rely on milk

Answer: C) Limit milk, add iron-rich foods and an iron supplement. Excess cow’s milk reduces food intake and causes occult GI blood loss, leading to iron deficiency. Limit milk to about 500 mL and give iron with iron-rich foods and vitamin C.