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Hemoglobin and hematocrit values: What is normal?
Volume 82 Number 3
Letters to the Editor
543
Table I. Average weight gain during nursery stay (grams per day)
Number No complications Phase 1 Phase 2 Mean
oo1 oo 1,000
zoo 800
900
1
4
2
2
4
5
7
3
9.7 30.0 19.8
11.5
22.3
15.6 27.1 21.3
10.8 26.1 18.8
10.9 28.2 19.5
11.8 32.3 22.0
20.6 32.5 26.5
15.6 33.0 24.3
16.9
Complications Phase 1 Phase 2 Mean
oool 1,200 ,oo[ 1,300 oo[ ,oo1,400
I,I00
1,500
1
2
3
2
2
2
2
9.3 13.8 11.6
10.4 25.9 18.1
14.0 39.3 26.6
7.5 21.5 14.5
21.9 38.5 30.2
19.6 38.4 29.0
21.2 31.0 26.1
Table II. Time to regain birth weight
Less than 2 wk.
2 to 4 wk.
More than 4 wk.
Uncomplicated
7 (average birth weight 1,282 Gin.)
23
6 (average birth weight 1,161 Gin.)
Complicated
3 (average birth weight 1,460 Gin.)
17
2 (average birth weight 1,219 Gin.)
Delivery
Birth weight (Gin.)
ards of the technique can be controlled, our results are encouraging enough to justify continuation of a controlled, clinical investigation. Pending these results, traditional methods for feeding premature infants should be continued.
John M. Driscoll~ Jr., M.D. William C. Heird, M.D. John N. Schullinger, M.D. Robert D. Gongaware, M.D. Robert W. Winters, M.D. Departments of Pediatrics and Surgery Columbia University College of Physicians & Surgeons The Babies Hospital Columbia-Presbyterian Medical Center New York, N. Y. 10032
Hemoglobin and hematocrit values: What is normal? To the Editor: In the October, 1972, issue of the JOVRNAL, Brown and associates 1 demonstrated a significant incidence of iron deficiency anemia in black adolescents, and Hunter and Smith 2 analyzed
iron deficiency anemia in early childhood. I would like to inquire on what basis are these children considered anemic? It is certainly true that they fall significantly below the mean for their age for hemoglobin and hematocrit values and, in some instances, in percentage of transferrin saturation. But the significant question is whether mean levels of hemoglobin and optimal levels ~of hemoglobin can be equated. Can the investigators demonstrate that their patients with hemoglobin values in the 10 to 11 range have any clinical symptomatology or that functioning is impaired? The often-made assumption that what is normal in our society is good and what is abnormal is bad is not necessarily valid. I am not being critical of their reports so much as I am asking for further study before we begin a national drive to have everyone conform to an arbitrary standard.
Stephen Kau[man, M.D., F.A.A.P. 6200 Geary Blvd. San Francisco, Call[. 94121 REFERENCES
1. Brown, K., Lubin, B., Smith, R., and Oski, F.: Prevalence of anemia among preadolescent and young adolescent urban black Americans, J. P~oIATm 81: 714, 1972. 2. Hunter, R. E., and Smith, N. J.: Hemoglobin and hematocrit values in iron deficiency in infancy, J. PEDIATI~. 81: 710, 1972.
Reply To the Editor: Dr. Kaufman actually raises two separate questions in his letter. The first is: "Are children or adolescents whose hemoglobin values are below those of other well-nourished subjects of the same age anemic?" The other is: "Is a slight reduction in hemoglobin level of any consequence?"
Letters to the Editor
543
Table I. Average weight gain during nursery stay (grams per day)
Number No complications Phase 1 Phase 2 Mean
oo1 oo 1,000
zoo 800
900
1
4
2
2
4
5
7
3
9.7 30.0 19.8
11.5
22.3
15.6 27.1 21.3
10.8 26.1 18.8
10.9 28.2 19.5
11.8 32.3 22.0
20.6 32.5 26.5
15.6 33.0 24.3
16.9
Complications Phase 1 Phase 2 Mean
oool 1,200 ,oo[ 1,300 oo[ ,oo1,400
I,I00
1,500
1
2
3
2
2
2
2
9.3 13.8 11.6
10.4 25.9 18.1
14.0 39.3 26.6
7.5 21.5 14.5
21.9 38.5 30.2
19.6 38.4 29.0
21.2 31.0 26.1
Table II. Time to regain birth weight
Less than 2 wk.
2 to 4 wk.
More than 4 wk.
Uncomplicated
7 (average birth weight 1,282 Gin.)
23
6 (average birth weight 1,161 Gin.)
Complicated
3 (average birth weight 1,460 Gin.)
17
2 (average birth weight 1,219 Gin.)
Delivery
Birth weight (Gin.)
ards of the technique can be controlled, our results are encouraging enough to justify continuation of a controlled, clinical investigation. Pending these results, traditional methods for feeding premature infants should be continued.
John M. Driscoll~ Jr., M.D. William C. Heird, M.D. John N. Schullinger, M.D. Robert D. Gongaware, M.D. Robert W. Winters, M.D. Departments of Pediatrics and Surgery Columbia University College of Physicians & Surgeons The Babies Hospital Columbia-Presbyterian Medical Center New York, N. Y. 10032
Hemoglobin and hematocrit values: What is normal? To the Editor: In the October, 1972, issue of the JOVRNAL, Brown and associates 1 demonstrated a significant incidence of iron deficiency anemia in black adolescents, and Hunter and Smith 2 analyzed
iron deficiency anemia in early childhood. I would like to inquire on what basis are these children considered anemic? It is certainly true that they fall significantly below the mean for their age for hemoglobin and hematocrit values and, in some instances, in percentage of transferrin saturation. But the significant question is whether mean levels of hemoglobin and optimal levels ~of hemoglobin can be equated. Can the investigators demonstrate that their patients with hemoglobin values in the 10 to 11 range have any clinical symptomatology or that functioning is impaired? The often-made assumption that what is normal in our society is good and what is abnormal is bad is not necessarily valid. I am not being critical of their reports so much as I am asking for further study before we begin a national drive to have everyone conform to an arbitrary standard.
Stephen Kau[man, M.D., F.A.A.P. 6200 Geary Blvd. San Francisco, Call[. 94121 REFERENCES
1. Brown, K., Lubin, B., Smith, R., and Oski, F.: Prevalence of anemia among preadolescent and young adolescent urban black Americans, J. P~oIATm 81: 714, 1972. 2. Hunter, R. E., and Smith, N. J.: Hemoglobin and hematocrit values in iron deficiency in infancy, J. PEDIATI~. 81: 710, 1972.
Reply To the Editor: Dr. Kaufman actually raises two separate questions in his letter. The first is: "Are children or adolescents whose hemoglobin values are below those of other well-nourished subjects of the same age anemic?" The other is: "Is a slight reduction in hemoglobin level of any consequence?"