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Blood test: in what cases is it prescribed by pediatricians?

Blood test: in what cases is it prescribed by pediatricians?

The baby receives its very first blood test while still in the hospital. Newborn babies are taken on the 4th, and in premature babies (or those who received blood or plasma transfusions) on the 7th day of life.

If the child is at home earlier or if he was born outside a medical institution, blood must be donated at the children’s clinic in the place of residence. The terms are chosen so that the hormonal changes that occur in the body in the first days of life do not affect the result.

This screening of newborns (a study that is carried out to all crumbs, without exception) makes it possible to exclude the earliest terms of the five most serious and common hereditary diseases: phenylketonuria, galactosemia (congenital metabolic disorders), hypothyroidism (reduced thyroid function), cystic fibrosis (systemic hereditary disease , adrenogenital syndrome (dysfunction of the adrenal cortex). These diseases, although rare, but very dangerous, are the better treatable, the earlier they are identified.

A few drops of blood taken from the heel of a newborn (it is much more difficult to take it from a finger) are applied to a special test strip and sent to a laboratory. After 10 days, the answer from the laboratory goes to the children’s clinic in the place of residence.

The mark on the analysis must be put in the exchange card.

In addition, the baby in the hospital can take blood for research if the mother has a negative Rh factor. If the baby’s blood is Rh-positive, it will also be taken from the umbilical cord to determine the level of bilirubin – a substance that is formed when disposing of damaged or damaged red blood cells.

Increasing its level indicates a massive death of red blood cells, which creates a serious threat to the health of the child.

Additional blood tests are also carried out if the newborn has other problems. Depending on the situation, blood may be taken from him for general or biochemical analysis, as well as for the determination of antibodies to infections, etc.

In the future, the child will have to pass a general clinical blood test. According to its results, it is judged on its quantitative and qualitative composition, which allows to learn about the state of the organism as a whole: whether there is an infection, inflammation, how serious the child is and whether the treatment is effective.

According to the plan, this analysis is taken at 3 months, at 9 months, at 1 year and then once every year. The age of 3 months was not chosen by chance: it is during this period that iron deficiency anemia may develop due to a lack of iron in the body, which reduces the level of hemoglobin and red blood cells.

Often this condition is detected only on the basis of the results of this analysis. Also, from the age of 3 months, the baby begins a routine vaccination, and, before making preventive vaccinations, you need to make sure that the baby is healthy and his blood counts are within the normal range.

If the vaccine schedule is shifted, another blood test will have to be performed immediately prior to vaccination.

Outside the schedule, the doctor may prescribe a general blood test if an infectious disease is suspected (for example, pneumonia, acute bronchitis, pyelonephritis). The results of the study help to assess the severity of the condition and decide on the appointment of antibiotics.

The doctor pays attention to:

  • hemoglobin level – when it decreases, the tissues receive less oxygen (this happens after blood loss, with anemia and some hereditary diseases);
  • the number of red blood cells (erythrocytes): less red blood cells – less hemoglobin;
  • the number of white blood cells (leukocytes) – increases with infections, decreases with cancer and autoimmune diseases;
  • leukocyte formula (each type of leukocyte is counted);
  • the number of platelets (platelets) – an indicator below the norm may indicate an immunological disease or severe inflammation;
  • the number of eosinophils – increase can talk about allergies, the presence of parasites (including worms);
  • number of neutrophils – an increase indicates a purulent inflammatory process;
  • erythrocyte sedimentation rate (ESR) – increase indicates an inflammatory or other pathological process.

But the case is not limited to a general clinical blood test. In what cases may require additional research?

1. If a metabolic disorder (for example, diabetes mellitus), liver function, anemia, or jaundice is suspected, a biochemical blood test is performed. Using this study, determine:

  • protein metabolism (total protein, albumin, creatinine, protein fractions);
  • carbohydrate metabolism (glucose);
  • lipid metabolism (lipoproteins, cholesterol, triglycerides);
  • pigment exchange (bilirubin);
  • iron exchange;
  • enzymes (ALT, AST, amylase);
  • electrolytes (calcium, potassium, sodium, magnesium, phosphorus);
  • specific proteins (C-reactive protein, rheumatoid factor).

2. When there are concerns that your baby has a serious infectious or viral disease, doctors refer you for a serological blood test. It helps to determine if there are antibodies in a blood to a certain type of bacteria or viruses, including rubella, measles, mumps, hepatitis (A, B, C, D, E), HIV, toxoplasmosis, chlamydia, mycoplasmosis, herpes, etc. .

When antibodies are detected, an appropriate diagnosis is made.

3. If you suspect diseases of the endocrine system and the pancreas, blood sugar testing is performed and the fasting blood glucose level is determined, which is expressed in millimoles per liter (mmol / l). If at repeated blood donation the indices differ from the norm, the diagnosis is confirmed.

4. If the child is to have an operation, blood will be taken from him to determine its group and Rh factor, as well as the level of its clotting. The last analysis allows to identify abnormalities – insufficient or excessive ability of blood to clot.

If a baby has allergic reactions, atopic dermatitis or a doctor suspects asthma, a blood test is taken for a common immunoglobulin E, and if necessary for a specific immunoglobulin E. The first analysis makes it possible to understand whether there is a general allergic reaction and what is its degree (“low”, “medium”, “high”) on certain foods, pollen, types of dust, mites, etc .; the second is to test the sensitivity to specific allergens (for example, at one time to 20-100 foods) and to identify the true culprits of trouble.

The study may be prescribed only by an allergist.

What it looks like

For general analysis and blood sugar testing, blood is taken from a finger (usually a nameless one). A finger is wiped with an alcohol solution, then with a sterile disposable scarifier — a thin plate with which a wound of a few millimeters is applied is punctured. The first drop of blood is blotted with a cotton swab, and then smears are applied and blood is collected in a special glass pipette.

After taking blood to the wound, it is necessary to apply a cotton wool dipped in alcohol solution for a few minutes, or to glue it with a sterile adhesive plaster.

For biochemical and serological studies, determination of the blood group and its Rh factor, clotting, and if allergies are suspected, blood is taken from the vein using a needle. After the procedure, you need to bend the arm in the elbow and hold it for 10–15 minutes in such a position that a hematoma does not form at the puncture site.

The babies take blood from a vein located not only in the elbow, but also on the head or on the back of the hand.

Blood tests are recommended to take in the morning – as a rule, time is set aside in clinics from 8 to 10-11 hours. Samples made on an empty stomach give a more accurate result (after the last meal there should be at least 8 hours), and it is better not to eat fat for dinner. Before donating blood for viral hepatitis, exclude brightly colored (yellow, red, orange) vegetables and fruits from the diet for a day or two.

You can drink as usual, but only plain water.

For infants, compliance with these conditions is optional. Still, it is better to try to donate blood between feedings.

If in time this does not work at all, it is better to feed the baby before taking blood than to make him nervous and cry once more.

  1. If the child is taking medications, consult your doctor if you need (and how long before the study) to stop taking them.
  2. Do not donate blood immediately after ultrasound, physiotherapy, x-rays, massage.
  3. Before taking blood, fingers do not need to be rubbed, as this may lead to changes in some indicators — for example, an increase in leukocyte levels or a change in the ratio of liquid and dense parts of blood (these parameters are evaluated in a general clinical blood test).

Having received a blank with the results, the parents, seeing that the indicators differ from the norm, start to panic, and it is in vain. The doctor prescribes a study for himself and medical specialists to better understand the state of health of the child.

And only a doctor can professionally and correctly interpret the results. Indicators in adults and children are very different, and in a newborn, a half year old child and a two year old child they will be completely different, therefore, it’s only the doctor who can figure out what’s what.

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