In the case of Pearl, also, in spite of the additional iron the hemoglobin fell 15 per cent in one month. The administration of broths in a few cases had no effect on the hemoglobin. Only my general impressions can be given as to the actual cause of the anemia. The incubator seems to predispose, if not actually cause, a loss of hemoglobin. Keeping the incubator very warm increases the loss of hemoglobin.
Indigestion increases the anemia.
The anemia increases as the stay in the incubator is prolonged. The administration of iron can only partially diminish the loss of iron. It is clear, then, to treat this anemia, in addition to the administration of iron, the infant should be removed from the incubator as soon as possible. Premature infants show a remarkable predisposition to the appearance of edema. It occurs especially in connection with anemia, but it may appear in those whose blood shows little diminution in hemoglobin.